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Assisted Decision Making

Assisted Decision-Making Act 2015

The Assisted Decision-Making Act recognises that, as far as possible, all adults have the right to play an active role in decisions that affect them.

The Act supports people who require assistance to make decisions and the people interacting with them.

The Decision Support Service (DSS)

The Decision Support Service is a statutory public service which aims to provide information and guidance about the new support framework and to register and supervise decision support arrangements.

The Decision Support Service can help people with an intellectual disability, mental illness, dementia or acquired brain injury by connecting them with services to support their decision-making. These services can help with decisions relating to personal welfare, property and other affairs.

How can I access the Decision Support Service?

You can access the Decision support service online by visiting www.decisionsupportservice.ie

What is a decision supporter?

A decision supporter is someone who can assist the decision-making process. Your specific needs determine the level of decision support you require. There are three levels of support:

A Decision-making assistant may be able to support you in making decisions.
You can make decisions jointly with a Co-decision-maker registered to assist you.
Or the court can appoint a representative to make certain decisions on your behalf.

What is a capacity assessment?

A capacity assessment looks at a person’s ability to decide for themselves. Patients undergo a functional test to determine if they:

Understand information relating to the decision
Can remember the information long enough to make a choice
Are capable of processing the information to make a decision
Can communicate their decision in their own way

Can a family carer apply to be a decision supporter?

The person who requires support decides whether or not to arrange for:

A Decision-making assistance agreement
A Co-decision-making agreement
An Enduring power of attorney
An Advance healthcare director
A family carer cannot make a decision support arrangement for the person or on their behalf.

If someone believes that a person cannot make certain decisions for themselves, they can ask the court to make a declaration about the person’s capacity to make a decision-making representation order. Then, the court will decide whether to appoint a decision-making representative for the person.

What is an advance healthcare directive?

If a person wishes to plan ahead, they can make an advance healthcare directive. This lets them set out their wishes regarding treatment decisions in case they cannot make them in the future.

Under the new law, a person can appoint someone they know and trust as their designated healthcare representative to ensure their wishes are respected. The designated healthcare representative may give or refuse consent to treatment as set out in the advance healthcare directive.

Advance healthcare directives can be cancelled at any time if the relevant person has the capacity to do so.

Enduring Power of Attorney

If a person has already made an Ensuring Power of Attorney (EPA) under the Powers of Attorney Act 1966, then they can keep that arrangement, which will continue to be valid.

If a person wishes to make an EPA following the commencement of the 2015 Act, this arrangement will come under the supervision of the DSS.

For more information: Visit www.decisionsupportservices.ie or talk to a member of our Medical Social Work Team.

When will I get an appointment?

Open or “Dear Doctor” referrals are assigned to the shortest waiting list and receive the earliest possible appointment.

If you are referred to a specific Consultant, then your waiting period is determined by that Consultant’s waiting list. Consultants with multiple specialties may have longer waiting lists.

Factors influencing waiting times for surgery

As an elective surgical centre, surgical procedures are planned in advance and rarely cancelled. Several factors can determine your date for surgery. These include:

Surgical Procedure

Delays in obtaining specialist equipment (e.g. prosthesis) and securing specialist services (e.g. spinal cord monitoring) can prolong the waiting period.

Complex Procedures and Underlying Health Conditions

Patients undergoing complex surgical procedures and those with underlying medical conditions often require postoperative care in the Higher Dependency Unit (HDU). HDU beds at the Hospital are limited. Where possible, the medical team will anticipate the need for a HDU bed. If a HDU bed is not available, you may experience a delay.

COVID-19

If you test positive for COVID-19, we will defer your surgery for seven weeks from the testing date to ensure your safety and well-being. However, if you continue to experience symptoms after seven weeks, please get in touch with the Hospital for advice.

Medical Records

We often request medical records from your GP, another Consultant or Hospital. This information is relevant to your treatment; we cannot proceed to surgery without it. Unfortunately, delays in obtaining files can increase waiting times.

Surgical Risk

The Preoperative Assessment Clinic (PAC) assesses your suitability for surgery. If you have an infection, underlying health condition or high Body Mass Index (BMI), you may not be suitable for surgery at this time. In this event, PAC will defer surgery, recommending health improvements, investigations or procedures to reduce your surgical risk.

Surgical Dates

Your safety is our priority. Once medical information gathering is complete and your surgical risk, peri-operative requirements, and postoperative care have been thoroughly assessed, you will receive a date for surgery.