To what extent does the Mental Capacity Act 2005 meet the psychosocial needs of people living with dementia, from an ethic of care perspective

Abstract

People with dementia (PWD) are misunderstood to lack capacity and are therefore denied autonomy. The Mental Capacity Act (MCA, 2005) was designed to empower and protect this group, by facilitating their active participation within the decision-making process. However, an ethics of care perspective suggests it falls short. This study focused on reviewing data in the extant literature on the Act, people with dementia, and service user involvement; using the ethics of care theory as an interpretive grid. It focused on ten journal articles, comprising of empirical qualitative studies, legal reviews and commentaries. Broadly, the MCA 2005 represents an improvement in meeting the psychosocial needs of PWD, but is hampered by problems in practice. There were five themes: (1) Communicative challenges can hamper decision-making; (2) Lack of recognition of interdependence; (3)Lack of adequate service user consultation; (4) Bias towards preservation of life; and (5) Paternalism limits the autonomy of vulnerable people. Recommendations on overcoming these in professionals and family members were made, in line with ethics of care theory. It was suggested that society's misunderstanding of dementia needs to be addressed in order to help the MCA 2005 better meet the psychosocial needs of PWD.