title: Effect of socioeconomic deprivation and the appointment of Welfare Attorneys.
abstract: Most patients in intensive care unit (ICU) lack decision-making ability. The Adults with Incapacity (Scotland) Act 2000 allows someone to appoint a Welfare Attorney (WA) to act on their behalf should they lose capacity. Scotland has areas of major socioeconomic deprivation associated with lower life-expectancy and with a lack of knowledge about and consequently difficulty accessing services. The effect of socioeconomic deprivation on WA registration was investigated. A complete list of registered WAs was categorized by deprivation. The Public Guardian, Scotland indicated whether patients admitted to ICU at Glasgow Royal (April 2006-May 2009) had a WA registered. All Scottish ICU admissions (2004-2008) were categorized by deprivation. Twelve of 1152 ICU patients at Glasgow Royal had a WA. Of 165,997 WAs registered, 5984 were in the most deprived and 27,970 in the most affluent areas. Overall, 3.9% of the Scottish population had a WA (1.4% in the most, 6.5% in the least deprived population decile). In conclusion, the uptake of WAs was low, especially in deprived areas. The reasons could include a lack of knowledge, not anticipating the need for a WA or not being confident in the process. Any educational package needs to target the most socioeconomically disadvantaged.
authors.affiliation: Glasgow Royal Infirmary, Glasgow, UK. malcolm.booth@nhs.net
authors.forename: M G
authors.initials: MG
authors.lastname: Booth
authors.forename: E
authors.initials: E
authors.lastname: O'Neil
authors.forename: C
authors.initials: C
authors.lastname: Haddow
authors.forename: B
authors.initials: B
authors.lastname: Cook
authors.forename: J
authors.initials: J
authors.lastname: Kinsella
mesh_terms: D000328:Adult; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D033241:Lawyers / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D016743:Mental Competency / Q000331:legislation & jurisprudence; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D011203:Poverty; D012606:Scotland; D012923:Social Class; D020458:Third-Party Consent / Q000331:legislation & jurisprudence*