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A survey commissioned by Sage, which promotes the rights of vulnerable adults and older people, has revealed widespread and serious misunderstanding about the meaning of the term “Next of Kin”.

An online Red C poll showed that 52 per cent of those questioned believed, wrongly, that anyone named as “Next of Kin” can make healthcare or other major decisions on another person’s behalf. In fact being named as “Next of Kin” only means that that person should be contacted in the event of an emergency.

This misunderstanding is a serious issue for anyone undergoing medical care, and especially for vulnerable adults and older people. It is also a vital issue for their relatives, friends or anyone directly concerned about their well-being.

Sage is now calling for a change in the way computer and paper based forms are structured which would drop all use of the term ‘Next of Kin’ in hospital, nursing home and primary care settings and any location where vulnerable adults or older people are cared for.

The new policy for inputting personal information should require

(a) a section for recording details of persons to be contacted in the event of an emergency.

(b) a new section relating to consent and decision making.

“It is particularly worrying that 52% believed that ‘Next of Kin’ was ‘someone who can make a decision about life support treatment for me’ and 35% believed that ‘Next of Kin’ was ‘The only person to be given medical or personal information about me’” said Mervyn Taylor, Executive Director of Sage Advocacy, the organisation that runs the service.

Responding to the findings,  Prof Shaun O’Keeffe, a Consultant Geriatrician in University Hospital Galway, and the HSE’s lead for the acute hospital sector on the implementation group for the Assisted Decision-Making Capacity Act (2015,) stated that “the term ‘Next of Kin’ is widely used by healthcare staff and by relatives, often with the implication that someone designated as the ‘Next of Kin’ of a person has some decision-making authority if the person lacks capacity to make a decision themselves.  This is not and never has been the case,”

Sage commissioned the survey arising from their work on nursing home contracts in 2017 which identified problems with residents’ contracts being signed inappropriately by ‘Next-of-Kin’, sometimes when the person about to enter a nursing home had the capacity to decide for themselves.  “It’s time to stop using the term ‘next-of-kin’ said Mervyn Taylor: “the next step is for all health and social care providers to stop using the term”.

“To reflect the new assisted decision-making legislation we should plan to record if a person has a Decision-Making Assistant, a Co-Decision Maker, a Designated Healthcare Representative (if a person has made an Advance Healthcare Directive), an Enduring Power of Attorney or a Decision Representative – a court appointed decision making role that will replace wards of court” said Taylor.

Commenting on the survey Patricia Rickard-Clarke, Independent Chair of the National Safeguarding Authority, said “the results of this survey indicate the extent to which people think they can make decisions on behalf of others and it highlights the need for safeguarding legislation to deal with situations where adults who may be vulnerable effectively have their lives, their assets and their decision-making capacity taken from them by avaricious relatives” she said.

Download the survey results

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