What is informed consent in Aged Care?

What is informed consent?

Informed consent is the term used to explain a person’s decision, given voluntarily, to agree to a healthcare treatment, procedure or other intervention that is made. This decision is made following the provision of accurate and relevant information about the necessary healthcare needed. Good clinical practice involves ensuring that informed consent is validly obtained and appropriately timed.

Consent is not only agreeing to a treatment or intervention, but it should also be given in an informed way, with consideration given to all available options.

Why is informed consent important?

Consent is a key issue of quality and safety in aged care and is referenced directly in the Aged Care Quality Standards, under Standard 1. Consumer dignity and choice. Estia Health has processes in place to support receipt and subsequent recording of informed consent for treatment for residents. This includes for the use of restrictive practices. These processes are also referenced under Standard 8. Organisational governance and should be supported under Standard 7. Human resources.

Informed consent involves the person being able to:

• Understand the reason for the proposed medication/intervention
• Understand the available options (including not taking or using the medicine or intervention)
• Understand the risks and benefits of those options
• Come to a considered decision
• Communicate the decision

That decision is then recorded.

Consent for any treatment or intervention should always be given by the person themselves unless they lack the capacity to do so. Without the information that relates to their medical condition and treatment, a person can't make a fully informed choice and give valid consent for their medical treatment.

What are the different types of examples of informed consent?

While informed consent may sound obvious, there are three different types of consent, and it can really matter depending on the medical treatment or surgery you are agreeing to.

Implied Consent

You would provide implied consent for low-level treatment or procedures through a healthcare professional. For example, drawing blood for testing, providing urine or stool samples, or taking medication from your doctor. Implied consent means you have followed and cooperated with instructions given to you by your Doctor or Registered Nurse.

Verbal Consent

This type of consent is for treatment that does not have a lot of risk. You have provided your agreement to treatment verbally to the relevant people.

Written Consent

Providing written consent is only for more complex or riskier treatment. For example, you need to understand all the complications or risks that may arise from a vaccination. In the current case, the Government is making sure older Australians have an understanding around accepting COVID-19 vaccinations.

What happens if you don’t give informed consent?

There are some instances where medical professionals cannot get informed consent from you before medical treatment. With residents who are living with dementia, it may also not be possible to receive informed consent.

This is where an Advanced Care Directive (ACD) can become really important during these situations. In your ACD, you can stipulate procedures you may not want to receive. For example, if you have a do not resuscitate request if you live in a aged care residence.

It is vital that your Enduring Power of Attorney or medical decision maker, as well as your family, is aware of your wishes around medical treatment when you are unable to make the decisions yourself. So, if there is an emergency your family can make the correct decisions or arrangements on your behalf.

When you organise your ACD or estate plan, these decisions should all be made before you become ill or before there is an accident, otherwise, someone else may make decisions about your care or medical treatments that may go against your wishes.

At Estia Health, we ask all of our residents to have an Enduring Power of Attorney and Advanced Care Directive organised when they first enter our homes. If the resident is unwell, or no longer has the capacity to create such a document, then it might be necessary to apply to the guardianship board or tribunal in the resident’s state or territory, to appoint a guardian and/or administrator to make decisions on their behalf. Sometimes, where a person is unwell due to mental illness, injury or disability there might also be options to involve the State Trustee to assist in managing the resident’s affairs.

How to make the most informed decision

When your doctor or medical professional suggests certain treatments or procedures for illnesses, asking a lot of questions is the best way for you to fully understand what will be required with this treatment.

This could include:

• How does this treatment work?
• Will it cost a lot of money?
• How common is this procedure?
• Will I be recovering for long afterwards?
• What benefit will I have after this treatment?
• Is there anything else I should know when deciding?

 

It is also a great opportunity to raise any concerns you have with the treatment as well as reasons why you may not want the specific treatment and alternative options to take its place. For example, people of some faiths may not agree to a blood transfusion and would want to find alternative treatment for the health issue they are experiencing.

It can be a good idea to talk to your family and friends as well, they can provide helpful insight that may assist you in making your decision or you may decide to get a second opinion from another health professional.

For further information regarding Consent for medication in aged care, visit the Aged Care Quality and Safety Comission Fact Sheet.