Webinar: Understanding Capacity and Decision Making
Dementia Australia webinars are free videos where subject experts discuss topics relating to dementia for a general audience.
In this webinar Margaret Crothers, Manager of Advocacy and Regional Services at Seniors Rights Service, discusses capacity and supported decision making, what advocates do, and how they can assist you.
Margaret is joined by Halil Ozbeyazli, Aged Care Advocate at Seniors Rights Service, sharing scenarios that illustrate the work of an aged care advocate in helping older peoples’ voices be heard.
You will learn about:
- capacity and what supported decision making means
- advocacy and the role of an advocate
- how advocates can help you be heard.
Transcript
[Beginning of recorded material]
[Title card: Dementia Australia]
[Title card: Understanding Capacity and Decision Making]
Margaret: Welcome, everyone! Welcome to our webinar on Understanding Capacity and Decision making. My name's Margaret Crothers, and I'm the manager of Advocacy and Regional Services at Seniors Rights Service, and with me is Halil Ozbetazli, who is an Aged Care Advocate at Seniors Rights Service. And we are here to present this information to you today. Let's begin by acknowledging the traditional custodians of the land on which we all live, and pay our respects to the Elders past, present, and emerging. So, let's get underway.
I suppose the best way to start is to think about capacity, because that's our first question, isn't it? Understanding capacity. If we look at it, there's no real single definition of capacity. It's not just that simple, it's not just that black and white. It really depends on the decisions that are being made. So, I think we'll just work from this simple overview. You are capable of making decisions if, number one, you understand the facts and choices involved. Number two, you understand how the choices affect you. And finally, that you can tell someone what your choice is. And this is an important thing. If you are able to communicate your choices, then of course you have the ability to provide that information and you have that ability to make that decision. Supported decision making is very simply just helping another person make choices. So that's another part of our talk today, understanding capacity and understanding supported decision making.
The other person helping you make choices doesn't have to be an enduring guardian or power of attorney. Sometimes, there are legal restrictions and you will have to have an enduring guardian or a power of attorney sign some documents, but it can, in general, just be a representative, just someone that you choose. For example, if you are entering an Aged Care home and you can't sign the contract or the agreement, you can ask a representative to sign it for you. So when we're talking about supported decision making, we are just simply talking about someone who is helping you to make those choices.
So how does it work? Well, very simply, that person who is helping you to make those decisions is going to be by your side. They're going to be listening to you, they're going to be listening to what's important to you, and they're going to be listening to what you want. And then probably the most important role that they have is helping others understand what you want. I'm going to ask my colleague, Halil, who is a very experienced aged care advocate to give an example and some case studies of the various points that I'm going to be talking about. So, Halil is going to share with us a case that he dealt with, with a gentleman called Max. Thank you Halil.
[Background: Senior Rights Service 1800 424 079]
Halil: My name is Halil Ozbetazli, aged care advocate at Senior's Rights Service. Max was a client with early onset dementia and lived in an aged care home. As Max had difficulty communicating, his sister would often speak for him and make decisions for him, but not all of the sister's decisions were in line with Max's wishes. In particular, Max wanted to go on bus trips and have pocket money to spend on treats when he went out on the trips, but his sister would not allow this because of safety concerns.
The aged care manager contacted the advocacy service and suggested Max could benefit from the support of an independent advocate. Our advocate visited Max at the Aged Care Home, and asked Max if he would like the advocate support during a round table conversation between Max, Max's sister, and the aged care manager, which Max said he did. Our advocate attended and supported Max during the meeting, to enable him to make decisions about things that were important to him by asking Max yes/no questions. By framing questions in terms of a yes or no. With the support of our advocate, Max was able to communicate his wishes to the aged care manager and to his sister, including that he wanted to go on bus trips. And in the end, Max got to go on the bus trips with a special safety clamp fitting for his wheelchair. And he also got pocket money for his treats, so it was an overall positive outcome.
Margaret: Thanks, Halil, that was great. Let's look at enduring Power of Attorney and Enduring Guardian. Some people are very concerned about these roles because they think, “Oh dear, I don't want to give any of those powers because they're going to take over my life.” Let me assure you, an enduring guardian and a power of attorney shouldn't be taking control over you. The functions that they have are very limited. They just can't make willy-nilly decisions. There has to be a balance. They have to work in your best interests. They have to consider your wishes. They have to think about the things that you may enjoy.
In New South Wales, an Enduring Guardian and Power of Attorney are two different functions. It is different in other states, so it's very important that you understand that the differences. Halil and I work in New South Wales, and so, for us, we have to understand the powers of both of these guardianship and attorney ships. But basically, guardian makes decisions about health, and medical, and accommodation, and a power of attorney makes financial decisions. But the important thing that I want you to understand today is that, while you can make your own choices known, only you can make those decisions, you should be consulted. And if you can't make those decisions, then the guardian or attorney can step in.
There will be times when you've decided that you don't want to make the decisions yourself. And for example, the power of attorney with your finances. You may have a very large portfolio of shares and stocks that you, you're sick of playing the stock exchange with, and you're going to hand that over to someone. Or you just might simply be tired of paying all the bills, and you can't keep track of them. You can ask the power of attorney to do that for you. And of course, when you lose the ability to make your own choices known, then that's what the enduring guardian and the enduring power of attorney can do on your behalf. But remember, they shouldn't take over control, and when they make decisions, it should be a balanced decision based on your wishes and your interests.
Which then brings us to advocacy, which is the third part of our talk today. What is advocacy? Halil and I work for the Senior's Rights Service, which is part of the Older Person's Advocacy Network. And it's a network of services similar to ourselves, which covers the whole country, the whole of Australia.
There's a service like ours in each state, and I encourage you to use the resources that are linked to this webinar to find out which OPAN services in your state or territory. Basically, though, an advocate supports you. We're coming back to this supported decision making again, aren't we? And they support you by listening, by helping you to understand the issues that you may be concerned about, and then by assisting you, if you want us to, to sort that issue out or speak on your behalf.
Advocacy fits in with supported decision making. And once again, I'm going to get asked Halil to give a case study, an example of how an advocate can support you, and the role that an advocate does play.
Halil: Robert was a resident of an aged care home who was living with dementia. Robert contacted Senior's Rights Service because he was quite distressed about an incident that occurred involving another resident entering his room at night and switching on the light, which was quite stressful to him. An advocate spoke with Robert about the incident and provided support over the phone. With Robert's permission, the advocate got in touch with the manager of the aged care home and had a chat about what happened. The manager explained that the other resident, who also lived with dementia, accidentally entered Robert's room as he mistook it for his own room.
The manager also said that the care staff were working to ensure that that does not happen again, and were committed to making sure Robert's comfort and wellbeing are respected. The advocate explained this to Robert who was, in the end, quite thankful for being listened to, and was appreciative of the support being offered by the aged care home, and to make sure that that type of incident does not happen again.
Margaret: Thanks again, Halil. A really important part of being an advocate is to get the best for you. The best outcome, and the best for you in understanding what the issues are. One of the things that we do rely on heavily and all advocacy services use this is that the Charter of Aged Care Rights. There are 14 rights and many of them involve choice, decision making, involving you as a person in that decision making, keeping you informed, and keeping you in the centre of any decisions that are made while you have the ability to contribute and make those decisions. So, an advocate really does talk to you about being heard. It's important that you understand the role of an advocate. Not only do they support your rights, but they help you to be heard, very similar to supportive decision making. And Halil's going to give us another good example of how that is utilized, and how advocates work with people in aged care.
Halil: Petunia was a resident in an aged care home and had some memory loss. Petunia contacted us concerned that her clothes were stolen from her room, and felt that her repeated requests for the return of her clothes were being ignored. With Petunia’s permission, an advocate got in touch with the aged care home and spoke to the facility manager, who explained that the care staff had simply taken Petunia’s clothes to the laundry for washing, and that once they were finished washing, they would be returned to Petunia’s room.
Our advocate explained this to Petunia that the clothes were not stolen, but merely being washed, but acknowledged Petunia’s concerns and frustrations. In the end, Petunia was thankful for the advocate's support in helping to resolve the issue, and agree that she would reach out for assistance again in the future if needed.
Margaret: An advocate can also help you to educate those around you. An advocate can assist you by supporting your rights, and informing those who you are working with to understand your rights. Advocates go into aged care facilities, they talk to aged care staff, they talk to seniors’ groups all around the country. And basically, part of their education is ensuring that your voice is heard and that you are listened to, and that people understand that that is part of your right as an aged care recipient. Halil's going to give another case where this was very important to Thomas in his journey in aged care.
Halil: Thomas was a client we helped with his home care package. On one occasion, Thomas and his daughter were having a face-to-face discussion with a home care provider. During the conversation, the home care provider was only speaking to Thomas's daughter and not to Thomas. And this upset Thomas as he was perfectly capable of communicating and making his own decisions, and it left Thomas feeling as though he was not treated with dignity and respect. With the help of an advocate, Thomas' right to be treated with dignity and respect, and the right to be listened to were pressed, so that during future meetings, Thomas was actively involved in deciding about his home care which was an overall positive outcome that was favourable to Thomas.
Margaret: Thanks, Halil. Finally, I want you to know that there are three important things that we're getting across to you today. You are supported. There are services and people here who can support you, and you can ask to have that support. There are advocate services right around the country who can provide that service if you are an aged care recipient.
There are other advocacy services as well. And if you've got someone there to help you or you can do it yourself, it's a good idea to Google all sorts of different advocacy services because they are out there for you. And of course, an advocate's role is to help you, to educate those around you, that you do have the right to be consulted, and that's the most important thing – the right to be consulted, the right to be listened to, and the right to have a voice. It’s very important that you know that.
And finally, as part of the webinar, we have supplied different resources and that there'll be links to those resources. The Ready to Listen program is one that OPAN has put together, and it is really talking more about residential aged care or aged care services where that related to incidents and assaults in aged care, where often, the older person was just ignored, their voice wasn't listened to, they weren't even consulted. And this ‘Ready to Listen’ project is all about ensuring that the older person, doesn't matter what their capacity is, has the right to have a say and to explain what may have happened.
The supported decision making is just an overview, it's a document, it's an overview of what we've been talking about today, a lot more detail, of course, and it's worth a read. There is a link to the OPAN Advocacy services so you can find the advocacy service in your state. And finally, a copy of the Aged Care Charter of Rights. It's really important that you do know your rights, and of course, the most important right which is, or from our point of view, the right to have an advocate and have someone to speak for you, and that's what we're about today. So, thank you for listening.
[Title card: Together we can reshape the impact of dementia]
[Title card: Dementia Australia. 1800 100 500. Dementia.org.au]
[END of recorded material]
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