Niko used to be a security guard working nightshifts at nightclubs and bars; after suffering a severe stroke however, he now requires full time care and supervision in a care home. Niko requires invasive surgery to fix a shunt in his brain to help alleviate pressure and reduce the likelihood of future strokes. Initially the decision maker (DM) spoke to Niko about this decision around midday after a meeting at the care home; the DM suspected Niko lacked the capacity to make this decision as he presented as lethargic, withdrawn and disengaged. However, the care home staff informed the DM that he is much more alert in the evenings as this was his routine for most of his working career. Upon returning out of hours, the DM was able to communicate more easily with Niko who was then able to make an informed decision.
Meeting with the individual at a time when they are more alert (including out of ‘office hours’), or by using aids that help them understand or communicate, is taking practicable steps to help the person make a decision.
Case study examples taken from practice and linked to information in the toolkit to give practical examples of different aspects of the Act.