Case study:

14 July 2010

Dementia flow chart from the Modernisation Initiative End of Life Care Programme

Key points

The Modernisation Initiative End of Life Care Programme has produced an easy to read flow chart aimed at helping health and social care professionals plan the future health care of people with dementia.

It outlines all the steps needed to prepare for an advance care planning discussion with the person who may lack capacity.

The content has been developed by an expert group that includes users, palliative care and elderly care consultants, nurses and social care teams.

The flow chart offers advice on how to establish whether someone has mental capacity and suggests what steps to take if they do. Where it is clear they do not have capacity and no advance decisions have been made, the chart outlines the process of appointing a decision-maker to help make decisions in the person’s best interests.

The authors point out that every health and social care professional needs to be aware of the steps to follow in assessing mental capacity and the various factors to consider when holding a best interest meeting. Just because a person lacks capacity does not mean that decisions about their future care cannot be made.

The guidance, which can be held in a team resource file and used for training, is a supplement to Concise Guidance to Good Practice Number 12, Advance Care Planning National Guidelines, Royal College of Physicians 2009.

The Modernisation Initiative End of Life Care Programme is committed to improving services in Lambeth and Southwark so more people have a ‘good death’. It is a partnership between local people, acute and primary health and social care, voluntary and independent sector organisations.