It is important to emphasise to the family that the team are trying to find out what George’s wishes are. The team agree that George does not have capacity to participate in decision making. He has had an Adults with Incapacity Certificate completed for all his care since early in his admission. When considering a best interests decision for George the team ask themselves a number of questions:
- Can we intervene to ensure George is supported to be involved in decision making?
The team need to consider- George cannot communicate and doe not respond to visual cues, therefore determining the best ways to support his communication is essential. However George is not attending to visual stimuli or responding to basic commands in any consistent way.
- Is there an advance directive or advance care plan in place relevant to this situation?
The team need to consider- although an advance care plan is not legally binding, it could give insight into George’s wishes prior to this severe stroke. George had not formally recorded his wishes prior to his stroke
- Does his family know of any strongly held views George has held about tube feeding?
The team need to consider- conversations with families can help to reveal any preferences held by George without feeling they must make a decision themselves.
- What are the feasible options?
The Team need to consider- the relative benefits and burdens of the options need to be considered.
The Adults with Incapacity (Scotland) ACT 2000 Guide to assessing capacity [PDF, 163KB)] provides information on communication and assessing capacity for social work and health care staff.
Page last reviewed: 15 Nov 2021
