1. Mental Capacity Act 2005 The Mental Capacity Act 2005 provides a legal framework to empower and protect people aged 16 and over who lack, or may lack, capacity to make certain decisions for themselves because of illness, a learning disability, or mental health problems. Guidance to the MCA, Department of Health 2007

2. The act was fully implemented in October 2007 and applies in England and Wales. The main purpose of the act is to clarify and reform the common law provisions for people lacking decision-making capacity. It is supplemented by new statutory schemes for advanced decision making and court-based resolution of disputes or difficulties. The act covers property and financial affairs, together with decisions regarding healthcare treatment and more everyday decisions, such as personal care.

3. What is mental capacity? If someone is unable to make a decision for themselves at the necessary time because of an impairment of the mind, then that person can be said to lack the mental capacity to make that decision.

4. According to the MCA, a person is defined as being unable to make decisions for themselves if they are not able to undertake at least one of the following: - understand information given to them - retain that information long enough to be able to make a decision - weigh up the information available to make a decision - communicate their decision by any possible means, including talking, using sign language, or even through simple muscle movements such as blinking an eye or squeezing a hand.

5. The five main principles of the act 1)A presumption of capacity - Every adult has the right to make their own decisions and must be assumed to have capacity to do so unless it is proved otherwise. That capacity is presumed to be ongoing until there is evidence to the contrary. 2 ) The right for individuals to be supported to make their own decisions - All reasonable help and support should be provided to assist people to make their own decisions and to communicate those decisions where necessary, before it can be assumed that they have lost capacity.

6. 4) If someone lacks capacity, anything done on their behalf must be done in their best interests. The act provides a checklist of factors that all decision makers must work though in deciding what is in the best interests of the incapacitated person. 3) It should not be assumed that someone lacks capacity simply because their decisions might seem unwise or eccentric.

7. 5) If someone lacks capacity, before making a decision on their behalf, all alternatives must be considered and the option chosen should be the least restrictive of their basic rights and freedoms. When considering a person's views and wishes it is important that they are given weight, and are carried out, unless the effects would be detrimental to that person.

8. Planning for the future Enduring power of attorney and lasting powers of attorney The Mental Capacity Act 2005 created a new type of power of attorney known as a lasting power of attorney (LPA). LPAs replaced enduring power of attorney (EPA) in 2007, when the Mental Capacity Act came into force. Any EPA remains valid whether or not it has been registered at the Court of Protection, provided that both the donor of the power and the attorney/s signed the document prior to 1 October 2007.

9. There are two types of LPA: - A property and affairs LPA gives the attorney(s) the power to make decisions about financial and property matters, such as selling a house or managing a bank account. - A personal welfare LPA gives the attorney(s) the power to make decisions about health and personal welfare, such as day-to-day care, medical treatment, or where the person should live.

10. Advance decisions An advance decision allows someone to specify particular types of treatment that they do not want should they lack the mental capacity to decide this for themselves in the future. This may include refusal of life-sustaining treatment. Advance decisions are legally binding and, as long as they meet certain conditions, they must be followed by health professionals.