Question

An 82-year-old woman with moderate Alzheimer disease is admitted with a displaced intracapsular neck of femur fracture after a fall. She is in pain despite analgesia and says she wants to go home and refuses surgery. On assessment she cannot retain or weigh information about the risks of refusing surgery and cannot explain a consistent choice. There is no advance decision or lasting power of attorney. Her son feels surgery is in her best interests. What is the most appropriate course of action?

Accepted Answer

Proceed with surgery based on a best interests decision under the Mental Capacity Act, involving her son in the discussion

Answer

Respect her refusal and arrange discharge home with community support

Answer

Ask her son to sign a consent form on her behalf

Answer

Delay surgery until she regains capacity, regardless of the hip fracture

Answer

Apply to the Court of Protection before making any decision

Practice question