Long Term Care

Consent & Capacity

Client Centred Care involves advocacy and respecting residents' autonomy and participation in decision making.

Consent

Permission must be asked and obtained before giving care or providing treatment.

Capacity

The ability of the resident to understand and appreciate what could happen if they choose to accept or refuse the care or treatment that is being suggested.

Ontario Law tells us that resident's in Long Term Care, who are capable of making their own decisions, must make their own decisions. If the resident is not capable, determined by a regulated health care professional at the time of the decision, then the Power of Attorney for Personal Care (POAPC) or the Substitute Decision Maker (SDM) may make the decision that is in line with the resident's wishes.

Resident's may be capable of some decisions but not capable of others. Capacity is not all or nothing.

Only the SDM or POAPC can make decisions or receive information regarding an incapable resident in LTC.

A POA cannot be made after a resident has been deemed incapable.

If there is no POA for Property and the resident is deemed in capable, then the OPGT will take over.

If there is no POA for Personal Care and the resident is deemed in capable, the LTC home will follow the hierarchy that Ontario Law has intended:

• Guardian
• Power of Attorney for Personal Care (POA)
• Representative appointed by the Consent and Capacity Board (CCB)
• Spouse (same sex or opposite sex, married, common-law at least one year or couple with a child) or partner
• Your child (if over 16 years of age) if more than one all rank equally
• Your parent with right of access only, Custodial parents rank ahead of noncustodial parents
• Your brother or sister – if more than one all ranks equally
• Any other relative by blood, marriage or adoption
• The Office of the Public Guardian and Trustee (as a last resort)

Ethics Program

The John Noble Home is governed and guided by ethical principles and standards for business and professional behavior. They guide us in how we will conduct ourselves and how we act with each other related to our mission, vision and values. We have ethical governance that fosters fair, transparent equitable and accountable approach to policy making improving overall performance.

Ethical Principles That Guide Our Decision Making

• Respect for Autonomy
• Beneficence
• Non-Maleficence
• Justice
• Professional Integrity
• Privacy/Confidentiality

The John Noble Home has an ethics committee that is interdisciplinary, representative and responsive to the needs of the John Noble Home .This committee is responsive to ethical dimensions that balance competing values, wishes and preferences.

All John Noble Home healthcare professionals are guided by the standards and codes of their own self-regulating colleges and professional associations, as well as by additional provisions in provincial legislation (e.g., Ethics Practice Standard College of Nurses of Ontario, Social Work and Social Service Work Act, Regulated Health Professions Act).