Challenges and expectations of the Mental Capacity Act 2005: an interview‐based study of community‐based specialist nurses working in dementia care

Abstract

This study aimed to explore experiences of specialist community nurses providing information about the Mental Capacity Act and supporting people with dementia and carers. The role of specialist community nurses and case managers, such as Admiral Nurses, suggests that providing information about the recent Mental Capacity Act (2005) in England and Wales would be appreciated by people with dementia and carers and would assist in assessment and support. In-depth qualitative methodology was adopted to explore experiences and opinions of Admiral Nurses using the Mental Capacity Act. A volunteer sample of 15 Admiral Nurses were interviewed in 2008 about their experiences of explaining the legal framework to carers and people with dementia and expectations of the Act. Thematic analysis identified textual consistencies in the interviews. Most participants reported positively about the Mental Capacity Act and considered it beneficial when working with people with dementia and carers. Specific themes included knowledge acquisition and training, alongside limited confidence with implementation; practice experiences in the community and the empowering nature of the Mental Capacity Act; practice expectations and challenges with implementation. The Mental Capacity Act has potential for supporting the safeguarding and empowerment role of community nurses. However, not all participants felt confident using it and speculated this would improve with greater familiarity and use, which should be facilitated by refresher training and supervision. The article concludes that nurses providing support to carers and of people with dementia may need greater familiarity about legal provisions. This may assist them in providing general information, making timely referrals to sources of specialist legal advice, and in using the Act to reduce anxiety, conflict and disputes.