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Care Planning in Residential Care (view source)
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The forms also generally make no attempt to place the person’s expression of wishes in the context of their current health condition, or to discuss the risks and benefits of treatment. Instead, they simply request that people express their future wishes about, for example, whether they want to be hospitalized and receive antibiotics, without grounding the application of that wish in likely hospitalizations relating to the patient’s present health condition. It has been pointed out that these level-of-care forms in particular seem to be used frequently as consents although they are being portrayed as advance directives. They are completed without the information required for a valid informed consent. | The forms also generally make no attempt to place the person’s expression of wishes in the context of their current health condition, or to discuss the risks and benefits of treatment. Instead, they simply request that people express their future wishes about, for example, whether they want to be hospitalized and receive antibiotics, without grounding the application of that wish in likely hospitalizations relating to the patient’s present health condition. It has been pointed out that these level-of-care forms in particular seem to be used frequently as consents although they are being portrayed as advance directives. They are completed without the information required for a valid informed consent. | ||
==References== | |||
#The Residents Bill of Rights notes under “Commitment to care” that “An adult person in care has the right to a care plan developed: (a) specifically for him or her, and (b) on the basis of his or her unique abilities, physical, social and emotional needs, and cultural and spiritual preferences.” | |||
#S. 81(3) of the RCR note that the care plan needs to address ten areas : medication, “behavioural intervention”; use of restraints; oral health care; nutrition (including therapeutic diets); recreation and leisure; fall prevention; “elopement risk”; any condition or requirement associated with the resident’s admission to the community care facility under the Mental Health Act. | |||
#HCCCFA defines "representative" in this manner means a person authorized by a representation agreement to make or help in making decisions on behalf of another and includes an alternate representative. This would seem to limit the support for anyone who does not have a representative under the Representation Agreement Act. However as noted, | |||
#Nothing in this regulation confers on the person any greater authority to make health or personal care decisions than the person has under those Acts or an agreement under the Representation Agreement Act. | |||
#The Residents Bill of Rights notes under “Commitment to care” that “An adult person in care has the right to a care plan developed: (a) specifically for him or her, and (b) on the basis of his or her unique abilities, physical, social and emotional needs, and cultural and spiritual preferences.” | |||
#Antipsychotic drug review, pg. 18. | |||
#Some of these examples are from the Antipsychotic drug review. | |||
#Ombuds, Best of Care, Part 1. | |||
#ACE: Decisionmaking, | |||
#ACE : Decision Making. | |||
#Ministry of Health. (July 18, 2012) Advance care planning - frequently asked questions. Online: http://www2.gov.bc.ca/assets/gov/topic/2038E757D68E49D5DC8C3CD0061E8E1B/pdf/faqadvancecareplanning.pdf (Last accessed: May 1, 2014). | |||
#AGA, s. 3 (1) | |||
#Health Care (Consent) and Care Facility (Admission) Act, s. 19.91. | |||
#Wahl, J., Dykeman, M.J., & Gray, B. (January 2014). Health Care Consent And Advance Care Planning In Ontario- Legal Capacity, Decision‐Making and Guardianship. Commissioned by the Law Commission of Ontario, p. 203 and 205. Online: http://www.lco-cdo.org/capacity-guardianship-commissioned-paper-ace-ddo.pdf [“ACE_ LCO”] (Last accessed: May 1, 2014). | |||
#HCCCFA, s. 19.91. | |||
#ACE_ LCO, p. 205. | |||
#While advance directive can be directly relied on by physicians in British Columbia, they have to ascertain whether the advance directive applies in the situation, and if the advance directive is part of a representation agreement, the representative may be the interpreter. | |||
#Fraser Health. Medical Orders for Scope of Treatment (MOST) and Advance Care Planning (ACP). [Date Approved: June 13, 2012.] | |||
#Malpas, P.J. (May, 2011). Advance directives and older people: Ethical challenges in the promotion of advance directives in New Zealand. Journal of Medical Ethics: Journal of the Institute of Medical Ethics. 37(5). pp. 285-289. | |||
{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}} | {{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}} | ||
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}} | {{Legal Issues in Residential Care: An Advocate's Manual Navbox}} | ||