The National Institute for Health and Care Excellence (NICE) has released a guideline covering decision-making in adults, over 16 years of age, who may lack capacity. The aim to support people to exercise their own decision-making where they have the capacity, and to keep people who lack such capacity at the centre of decision-making. All fine and dandy.
Decision-making and mental capacity. NICE Guideline [NG108]. London: National Institute for Health and Care Excellence (NICE), October 2018.
There is an associated online NICE Pathways version.
Involvement of Patients With Dementia in Decisions to Initiate Pharmacological Treatments?
A recent study of actual practice in memory clinics found that patients are initially the “nominated” decision-makers when advised to start medication for dementia, but that over 80% of patients tend to be reluctant to comply (usually through passive resistance) and yet their medications tend to be prescribed regardless.
Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).
Dooley, J. Bass, N. [and] Livingston, G. [et al] (2018). Involving patients with dementia in decisions to initiate treatment: effect on patient acceptance, satisfaction and medication prescription. British Journal of Psychiatry. October 1st 2018: 1-5. [Epub ahead of print].