The Assisted Decision-Making (Capacity) Act (ADM) (2015) came into law in Ireland on the 26th of April 2023, and marked an important moment for the decision-making rights of all people living in Ireland. Almost a year on from its initial implementation, join us as we talk a look at the Assisted Decision-Making (Capacity) Act in 2024, and what impact it has had for people living in Ireland with an intellectual disability, mental illness, acquired brain injury or age-related conditions affecting capacity, such as dementia.

The Purpose of The Assisted Decision-Making (Capacity) Act (2015)

Despite the fact that The Assisted Decision Making (Capacity) Act (2022) came into full effect in April of 2023, the legislation itself had long been outlined for full implementation. The ADM Act sets out to protect the rights of those people who may be vulnerable when it comes to their capacity regards decision-making, including those with an intellectual disability, mental illness or acquired brain injury or some people with age-related conditions affecting capacity, such as dementia.

Capacity, in this instance, refers to the ability of an individual to understand “when a decision is being made and the nature and consequences of the decision in the context of the available choices.” An individual is always presumed to have capacity, and under this new legislation, an individual’s decision-making capacity is assessed based on the decision in question being made at a given time.

This is crucially important, as it means that those individuals maintain their capacity to make decisions in general, rather than having their decision-making ability be accounted for once and for all, and subsequently assumed when it comes to making other decisions, thereby eliminating the risk of people’s autonomy and decision-making rights being assumed (and with that, potentially manipulated or taken advantage of) by another party. You can access further information about Capacity and The Assisted Decision Making (Capacity) Act by visiting the Citizen’s Information website.

The Significance of The Assisted Decision Making (Capacity) Act (2015) for People Living with Capacity-Limitations

The ADM Act ensures that people receive an appropriate level of assistance in making decisions, and will not have decisions made for them unfairly and without the necessary level of assistance from trusted and reliable parties that they have selected, thereby enabling people living with an intellectual disability, mental illness, acquired brain injury or age-related condition that affects capacity, to have their entitled and fair say in any and all decisions made involving their lives.

This new legislation ensures that people within Care settings in Ireland will feel a greater sense of both freedom and independence in contrast to how their lives were lived in the past, both of which are 2 essential quality of life elements that people can feel as though they have lost, or possess to a much lesser degree, following their entry into Social Care services.

In the past, the “Ward of Court” system was used within Ireland when reviewing cases relating to the life and wellbeing of individuals who were deemed to be of “unsound mind, which made it so that court authorities were left to make decisions for the individual that were deemed to be in their “best interests”. This system, having been established in 1871 under the Lunacy Regulation (Ireland) Act, was definitively outdated, and placed tremendous restrictions on all facets of the individuals’ lives, including rendering them legally unable to make decisions about their everyday lives. 

Given the restrictive nature of Ireland’s past legislative treatment and representation of those with capacity-related difficulties, the ADM Act is of particular significance to both Health and Social Care settings and services within Ireland, and has been long campaigned for to come into full legislation. It is estimated that, as of April 2023, there are as many as 220,000 people living in Ireland who have difficulties relating to capacity. This number represents a sizable percentage of the total Irish population, at approximately 4% of the total population as per the most recent census of April 2022.

The Decision Support Service and The Assisted Decision-Making (Capacity) Act (2015)

Alongside the entering into legislation of the ADM Act in April 2023, the Decision Support Service (DSS) was also launched. The stated purpose of the DSS is  “to promote the rights and interests of people who may need support with decision-making.”

Within the first 100 days of the DSS being available, over 1300 applications had been initiated. Additionally, over 6000 queries had been handled by the DSS’s information service team within the first 100 days of the service’s launch. The sheer volume of applications and requests for information made within the first 100 days of the Decision Support Service clearly reflects the need that exists for such a service today, as well as the fact that this type of resource has clearly been needed within Ireland for a long time prior to becoming a reality.

There is Still More Work to be Done…

Whilst the introduction of the ADM Act into Irish law is undoubtedly a massive leap forwards in terms of both the representation and rights of people living in Ireland who are vulnerable with regard to their decision-making capacity, there remains work to be done within this area.

According to Sage Advocacy, who serve as an advocacy service for older people within Ireland, the new legislation and associated rights “in some cases are being resisted by health and social care professionals and legal practitioners”. Also highlighted by the group were issues relating to place of care and control relating to finances and assets, with some people continuing to attempt to assume total control over all decisions, rather than approaching things on a case-by-case basis as is central to the fresh legislation. Another issue relating to the ADM Act since its legislative introduction is the general lack of awareness around it amongst the general public, with as little as only ⅓ of Irish adults knowing of its existence, or having heard anything about it at all.

How iplanit can aid Decision-Making

As previously mentioned, The ADM Act makes it so that any decisions that are being made are evaluated on an individual, case-by-case basis, thereby avoiding generic, one-size-fits-all decisions being made with regard to the person supported, and their respective decision-making abilities, ensuring that people supported are not unfairly denied the opportunity to be at the very least considered for a given experience or opportunity.

Through the use of iplanit, staff users possess the ability to easily and efficiently capture and record all the necessary details of decisions that are made in relation to a supported person’s life as part of their overall care planning and management.

Members of the user’s so-called “Circle of Support”, typically comprised of friends and family members, can be granted access (upon the service user’s approval) to elements of the supported individual’s care plan within iplanit. This in turn can help to keep individuals nominated as decision-making assistants by the person receiving care in the know and up-to-date with the details of their care, which helps them to make appropriate, informed decisions with regard to the supported person’s life and care planning.

iplanit enables the user to select relevant categories based on the type of decision that is being made – such as financial or housing, as well as also allowing the user to highlight the decision-making “capability” of the person supported, as per HSE and HIQA guidelines etc. This feature of iplanit ensures that decisions will be made with all necessary considerations each and every time, ultimately helping the people that you support to live better, more enabled lives.

If you would like to learn more about how iplanit can help your organisation to keep track of and record the decisions of the people that you support, get in touch with our Client Director for Ireland, Clive Evans (cevans@aspirico.com) by email, or connect with Clive over on LinkedIn.

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