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Toby

Elderly man with dementia refusing care package - assess mental capacity

8 posts in this topic

Hello All,

 

Did anyone pass this station?

 

It was one of the linked stations for September 11.

 

I did not pass the capacity assessment bit with patient but got A in discussion with daughter.

 

I would be grateful if anyone would throw light on the best way of approaching this station.

 

 

Thanks

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Hello All,

 

Did anyone pass this station?

 

It was one of the linked stations for September 11.

 

I did not pass the capacity assessment bit with patient but got A in discussion with daughter.

 

I would be grateful if anyone would throw light on the best way of approaching this station.

 

 

Thanks

Same here

Crapped A and cracked B

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Hello All,

 

Did anyone pass this station?

 

It was one of the linked stations for September 11.

 

I did not pass the capacity assessment bit with patient but got A in discussion with daughter.

 

I would be grateful if anyone would throw light on the best way of approaching this station.

 

 

Thanks

Same here

Crapped A and cracked B

 

 

I passed this station with a B and the next one with an A. will post the details of the 1st station later.

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Hello All,

 

Did anyone pass this station?

 

It was one of the linked stations for September 11.

 

I did not pass the capacity assessment bit with patient but got A in discussion with daughter.

 

I would be grateful if anyone would throw light on the best way of approaching this station.

 

 

Thanks

Same here

Crapped A and cracked B

 

 

I passed this station with a B and the next one with an A. will post the details of the 1st station later.

 

Thanks Pria

please do

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Yeah,please do post Prian. This station was my worst nightmare  on the 11th

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I passed this station. The moment I entered the station and started explaining my purpose, the patient said he was not in hospital. I checked his orientation, and let him know that he was in the hospital and that I have come to discuss his discharge plans. When I again started to ask him about his current situation, he immediately forgot where he was and denied any problems existed. The whole station, I was trying to give information but he didn't let me. Literally didn't let me give any information at all and he repeated the same things over and over again. Imagine, something like that happening for 10 mins. It felt stupid to do a capacity test, when his memory impairment was so severe. I just finished the station saying that I was concerned about his memory and would come back to him after speaking to the team. Also told him that, I would like to arrange a meeting with her daughter, himself and the team to see how we can best manage this situation. I don't remember the exact details of what I did, as all my structure to approach the station was messed up because he didn't allow me to do anything else.

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I passed this station. The moment I entered the station and started explaining my purpose, the patient said he was not in hospital. I checked his orientation, and let him know that he was in the hospital and that I have come to discuss his discharge plans. When I again started to ask him about his current situation, he immediately forgot where he was and denied any problems existed. The whole station, I was trying to give information but he didn't let me. Literally didn't let me give any information at all and he repeated the same things over and over again. Imagine, something like that happening for 10 mins. It felt stupid to do a capacity test, when his memory impairment was so severe. I just finished the station saying that I was concerned about his memory and would come back to him after speaking to the team. Also told him that, I would like to arrange a meeting with her daughter, himself and the team to see how we can best manage this situation. I don't remember the exact details of what I did, as all my structure to approach the station was messed up because he didn't allow me to do anything else.

 

I did pretty much the same and found myself repeating again and again to him. And he repeatedly told me that hi is in a hotel!!

 

Ok, to start with, I explained to him that I am psychiatrist and here to talk about the care package proposed by his doctors. I also said that I am sorry that he had a difficult time by having a heart attack. He did not remember anything and said that he is in a hotel . I asked, did anyone talk to him about the care package, he said NO. I explained to him what it involved, benefits and risks, and checked his understanding, as expected he asked what did you say? who you are? - This make clear that he cannot understand and retain.

Then I persisted that the care package helps to support him; what does he think, he said he can manage on his own. Then asked about what are the benefits and disadvantages of not having them, he did not remember what I explained earlier. At this point, I started doing registration, repetition and recall and orientation to TPP, which he failed.

Then after one more attempt of briefly explaining him the care package and saying who I am, I asked what is his decision on care package, he said I don't want any support.

I ended up by saying Mr. X, it appears that you have trouble remembering things and that is affecting your decision. I am concerned about your decision at the moment. I will come back later to talk to you about this, is that ok?

He said Ok and the bell rang

 

I have to mention here, although I passed this station, in the areas of concerns, it was marked, poor structure and communication, so we have to improve the structure further!!

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I passed this station. The moment I entered the station and started explaining my purpose, the patient said he was not in hospital. I checked his orientation, and let him know that he was in the hospital and that I have come to discuss his discharge plans. When I again started to ask him about his current situation, he immediately forgot where he was and denied any problems existed. The whole station, I was trying to give information but he didn't let me. Literally didn't let me give any information at all and he repeated the same things over and over again. Imagine, something like that happening for 10 mins. It felt stupid to do a capacity test, when his memory impairment was so severe. I just finished the station saying that I was concerned about his memory and would come back to him after speaking to the team. Also told him that, I would like to arrange a meeting with her daughter, himself and the team to see how we can best manage this situation. I don't remember the exact details of what I did, as all my structure to approach the station was messed up because he didn't allow me to do anything else.

I did pretty much the same and found myself repeating again and again to him. And he repeatedly told me that hi is in a hotel!!

Ok, to start with, I explained to him that I am psychiatrist and here to talk about the care package proposed by his doctors. I also said that I am sorry that he had a difficult time by having a heart attack. He did not remember anything and said that he is in a hotel . I asked, did anyone talk to him about the care package, he said NO. I explained to him what it involved, benefits and risks, and checked his understanding, as expected he asked what did you say? who you are? - This make clear that he cannot understand and retain.

Then I persisted that the care package helps to support him; what does he think, he said he can manage on his own. Then asked about what are the benefits and disadvantages of not having them, he did not remember what I explained earlier. At this point, I started doing registration, repetition and recall and orientation to TPP, which he failed.

Then after one more attempt of briefly explaining him the care package and saying who I am, I asked what is his decision on care package, he said I don't want any support.

I ended up by saying Mr. X, it appears that you have trouble remembering things and that is affecting your decision. I am concerned about your decision at the moment. I will come back later to talk to you about this, is that ok?

He said Ok and the bell rang

I have to mention here, although I passed this station, in the areas of concerns, it was marked, poor structure and communication, so we have to improve the structure further!!

I did exactly the same but His Excellency Dr. A. M. failed me in this station. Hats off to him.

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