Case study 21.3

Does Joan have capacity to be making the unwise decisions concerning her dietary management?

On many aspects of her life Joan will demonstrate capacity. It is arguable that the features of her addition to food will mean that she does not have capacity concerning her diet.

How does Joan’s learning disability make this case different?

There will be issues of effective communication, and how best to respond to her compulsive eating.

Should Joan be moved into an environment with restricted access to food?

Ideally this should be done with her on the basis of her own consideration of her deteriorating health. A Best Interest meeting may decide that Joan’s behaviour is unsafe and she needs to be in a safe environment.

What can you, as the student working with the practice nurse do to support Joan’s wishes?

Be honest with Joan, demonstrate effective communication. Joan will not easily respond to typical health promotion and education concerning diet.

Which members of the multi-disciplinary team do you think would be useful contacts in this case.

Psychiatrist, social worker, diabetic nurse specialist, community learning disability nurse.