Adults with learning disabilities and Alzheimer’s are having Do Not Attempt Resuscitation (DNR) notices placed on them without their guardians being told, according to the findings of an investigation published today.

Legal guardians of people who lack the capacity to make their own decisions with DNRs had only been consulted in a third of cases sampled by the Mental Welfare Commission for Scotland.

The watchdog said the situation for the remaining two thirds of individuals with DNRs was an area of ‘real concern’ and warned of ‘significant upset to family members’.

In one case a form had been completed while a person referred to in the report as ‘A’ was a resident in a nursing home despite a lack of discussion with their welfare guardians.

Concerns had previously been raised that older people were having DNRs “slipped into their discharge notes” as they left hospital – without their families having input.

Revised guidance was issued by the Scottish government in a bid to allay concerns.

But the watchdog found that guardians had definitely been consulted for only 33% of people who lack capacity and had DNRs.

For another 42% it was not clear whether they had been involved and in the remaining 25% of cases relatives had not been consulted.

Guardianship orders are used to safeguard those who lack the capacity to make their own decisions.

Nearly 16,000 people in Scotland have an order in place, with learning disabilities and Alzheimers or dementia the most common reasons.

A total of 3,199 guardianship orders were granted in the year 2019-20, a seven per cent rise on the previous year.

Speaking about the report, Mental Welfare Commission chief executive Julie Paterson said: "Guardianship orders are designed to protect some of the most vulnerable people in our society”.

“In previous years we have said that we believe the law needs to be modernised and streamlined to ensure care can be provided when it is needed, and to better protect the rights of people with dementia and learning disabilities.”

A Scottish Government spokesperson said: “All people being cared for by our NHS deserve to be treated with dignity and respect at all times – regardless of their age or medical circumstances.

“We want adults with impaired capacity to get the best possible support to maximise their decision making ability.

“That is why we are reviewing practice in relation to care, particularly focusing on changes to guardianship processes to improve people’s experience.

“There is a need for reform of the Adults with Incapacity Act and we have instigated the independent review of mental health and incapacity law. Ongoing work to reform this area will be informed by the results of this review,” they added.

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