Elder abuse and Mental Capacity

1. Elder abuse and Mental Capacity Kritika Samsi, Jill Manthorpe Social Care Workforce Research Unit King’s College London EviDEM Programme of Research – Mental Capacity Act         EviDEM www.evidem.org.uk

2. Outline • Why this topic – concern about people with dementia and elder abuse • Mental Capacity Act 2005 (England & Wales) and its relevance • Not time to discuss possible legal changes – but watch this space • Helpful material on SCIE website – film and prose

3. Context of discussion • Elder abuse recognised by policy (No Secrets)& highlighted by pressure groups (e.g. Action on Elder Abuse) • Significant questions • What constitutes abuse? Or poor practice? • People with dementia may be at particular risk, maybe less likely to complain, maybe less likely to be heard, may be less likely to have access to justice but risk factors are complex • Feelings of powerlessness

4. “Ill-treatment” & “wilful neglect” • Mental Capacity Act 2005 section 44 defines “ill-treatment” and “wilful neglect” • Criminalises neglect and abuse occurring in a relationship of trust • Can include professionals and family carers • The offender indulges in behaviour believing the person lacks capacity • Serious departures from required standards of treatment that they were aware they were under duty to perform • If reported and prosecuted, penalty for criminal offences may be fine and/or a prison sentence for up to five years

5. What’s new? • Applies to professionals, plus family and friends • Can be reported by someone other than the abused individual • Criminal conviction of “ill-treatment” or “wilful neglect” can prevent re-employment in the health & care sectors, thus possibly protecting vulnerable adults in the long term

6. Two young women filmed their sickening abuse of old people to entertain their friends Two former care home workers tormented their victims, both suffering from severe dementia, (by) pinching them, pulling and contorting their faces, pushing a mobile phone at one woman’s face and putting their fingers in the mouth of another. The abuse was filmed by one of the women, with both laughing at their distressed victims, one of whom called for them to stop… They each pleaded guilty to two charges of wilful neglect. Lacey was sentenced to a 12-month community order and 200 hours’ unpaid work. Hetherington was handed a 12-month community order and 150 hours of unpaid work. http://www.iwcp.co.uk/news/care-workers-filmed-attacks-on-elderly-24800.aspx

7. 12.09.09: Care home nurse conviction for neglect under Mental Capacity Act makes legal history Ms Ramona Dublas, aged 41, was found guilty of taking a photo on a mobile phone of a 92-year-old semi-naked woman after being convicted of ill-treatment and wilful neglect …the picture showed the elderly dementia sufferer being held up by her wrists and naked from the waist up.. She was sentenced to nine months' imprisonment, suspended for a year, 200 hours community service and banned from working with children and vulnerable adults in the future. http://cms.met.police.uk/news/convictions/nurse_conviction_makes_legal_history

8. Other sections of MCA • ‘Getting your house in order’ • Making a Lasting Power of Attorney • Minimising hazards • Link up support or care plan with safeguarding plan • Office of Public Guardian • Advance care planning • Independent Mental Capacity Act • What might the barriers be to planning? • When does information stop and advocacy start? • Importance of local expertise around MCA & safeguarding

9. Disclaimer This report/article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-060-1005). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.