PART TWO - CHOOSING ADULT CARE

Choosing the right care option to suit your needs is essential.

1 in 3 of us over the age of 65 years will need some care and support.  Most people would like to stay in their own home for as long as possible.

As we are living longer the cost of care is something we are likely to be faced with but few of us consider until it becomes unexpectedly urgent.

Planning can reduce additional worry and stress at a time of crisis, enable you to remain in your own home for longer and ensure continuity of care, reduce costs, and help make things easier for your nearest and dearest.

 

So, what are the options and who can help?

CHAPTER 18 -HOUSING OPTIONS

Living at home

Most people would prefer to stay at home, the NHS, and Local Authority recognise this and may be able to provide, arrange

or help with access to care and/or services (regardless of who pays) that support people to stay at own home independently.

 

The NHS provisions at home may include community services such as; falls prevention clinics, incontinence products,

services of the GP and District Nurse, Community Matrons, mental health workers and other specialist medical professionals.

With care and meal provision, adaptations to the home and innovations such as stair lifts, sensors, community alarms,

assistive/enabling services, and technology available it is often possible to stay in your own home.

Sometimes because people are stoic or not aware of the need for help creeping up on them it is left for too long without

being addressed or realised until reaching a ‘crisis’ point.

It may be that a care need is being masked by the care provided by a loved one and it isn’t until that person can no longer manage that you realised the extent of the care being provided.

Support for family and carers may also be possible, please don’t wait until you are no longer able to manage, please ASK for support as it may enable you to continue to look after yourself and a loved one!

Extra care/assisted care/ supported living schemes/care and retirement villages

Independent living schemes vary enormously and may provide Independent living with varying care provision.

Housing schemes can be privately rented, shared or owned properties or have a social landlord.

Some schemes such as shared lives are provided within a family home others may provide warden assistance.

There are assisted living schemes that provide meals and a small amount of personal care, others you can buy in your own care or use an onsite care agency.

It is worth contacting the District Council as they may have a housing officer or adviser, some areas have a main register for those interested in a new home whether sheltered accommodation in a complex or private.

A specialist housing service such as Shelter may also be able to offer advice.

 

Permanent Homes

For those who are no longer able to live at home or in the one of the supported schemes there may be a time when a move into permanent care needs to be considered.

So, which types of home?

There are lots of names for them; old people’s home, care home, residential home, nursing home, EMI, Dementia care….……

Specialist Property

Some organisation’s specialise in an illness or disability and can give advice on the options that may be suitable or available for those specific needs, this may even include accommodation for example Epilepsy, Multiple Sclerosis, Parkinson’s Society, or specialist residential accommodation (short and long term) for people with learning disabilities or mental health issues.

 

There are cultural needs that may need to be met in a specific environment for example catholic home for Italian residents or homes specifically for Jewish communities.

 

There may also be some provision for service personnel with a need for permanent placements and other occupational provision, for example the church, RAF.

Moving in with Family

A big house can be hard to manage, feel lonely or be too expensive to run. You may have the opportunity to move in with a family member or have them move in with you. This may have both financial and legal implications and the appropriate advice should be considered.

 

Property Downsizing

Selling your existing home and buying a smaller, less expensive one instead could free up some money to pay for your care costs but remember it may be disregarded if someone else is living in it for benefits and Local Authority assessment or a deferred payment agreement may be an option, please seek regulated financial advice.

 

Equity Release is a way of raising money against the value of your home. It is vital to seek financial advice to make sure you consider the possibilities and implications.

 

Renting out your home if you’re not living there to pay for your care? Bear in mind this income may be considered for means tested benefits and Local Authority financial assessment. This may also have taxation implications and regulated financial advice may be required.

CHAPTER 19 - TYPES OF CARE

Domiciliary Care

Care at home doesn’t always have to mean personal care it could be a hot meal or a laundry service, help with cleaning or keeping the garden tidy or;

  • Support around the home: Housekeeping, cleaning, changing bedding, laundry, ironing, shopping for weekly groceries, or help with meal preparation  

  • Personal care: Dressing and undressing, washing and bathing, shaving, assistance with hair and makeup, nail care, incontinence care.

  • Companionship: Conversation, help with reading and keeping up correspondence, accompanying on holidays, day trips or short breaks

  • Home from hospital: Escort home from hospital, home preparation and rehabilitation

  • Fulfilling lives: Encouraging and supporting hobbies and interests, arranging and accompanying people on social occasions, prayer meetings, day centres or other or a doctor’s appointment.

This need may be occasional or short term for a specific reason for example hospital discharge or a break for a carer.  Regular help with personal care or a longer-term need for support with a specific illness or disability for example someone living with Dementia. The need for care at home can be assessed by the Local Authority, NHS community based services and voluntary sector services may be invaluable for contributing towards living independently at hom

Residential Homes 

If you need more help with day to day personal care, and/or your needs can no longer be met at home, these homes have care assistants but don’t provide

Health/Nursing care

There are residential homes that have a registered nurse on their staff but that doesn’t mean they are registered as a nursing home.

 

Nursing Homes

If your needs include a medical element then provision of nursing care by a registered nurse and a higher staff/resident ratio of a Nursing home may be a more suitable option.

 

Sometimes if two carers are needed to help with transferring or using a hoist for lifting, even though it may not be a health or medical need a higher staffing ratio may be needed to make sure that all residents have their needs met appropriate.

Both of these types of permanent care setting may also provide Day Care or Respite Care

 

Dual Registration

Some homes have both Nursing beds and Residential beds and may be suitable for people whose needs are likely to increase or change in the future. Bear in mind that if you have NO nursing need even if you move into a Nursing home the Funded Nursing Care payment won’t apply.

EMI/Specialist care

EMI stands for Elderly Mentally Infirm which is an outdated term but means a more specialised need with often has a higher staffing to resident ratio and possibly a more secure environment which may be needed as Dementia progresses through the stages.

 

It is worth seeking specialist advice for this type of care need and making sure that if you move into a ‘home’ that if a more specialist type of care is needed at a later stage the chosen home can provide this whether this is Residential home or a Registered Nursing Home.

 

Dementia care home are advertised and many can care for residents living with many forms of Dementia but some may struggle if the need increase/changes leading to a move later, for example issues raised by inhibition or aggressive behaviour.

Please check how this will be managed if it were to become a requirement in the future as a move later can be distressing especially if unexpected.

 

Please be aware that the Local Authority will only contribute financially if they consider the ‘type’ of care that you have chosen to be appropriate – the Local Authority criteria for your care need may NOT be in line with yours!

 

Please request an assessment from your Local Authority to make sure that they consider the chosen care to be appropriate to avoid a possible move later and check Continuing Healthcare eligibility.

Example

The nurse at the hospital has told Jean that her mother Diane needs 24/7 care for her discharge, nursing homes have been mentioned and her social worker says that the care needs could be appropriately met in a residential home.

Diane wants to go home with Jean’s help but Jean works full time and is not able to give all the ongoing support that Diane needs to be discharged hone, she doesn’t want to let her Mum down and knows how important it is for her to go home.

Does Diane have to go into home?  If so what type of home is she looking for a residential home or a nursing home? If not does Jean must agree to provide all care?

This will depend on her Diane’s capacity to make her own health and welfare decisions, what is reasonable, appropriate, and safe.

Just because the social services worker has been assessed an eligible need for residential care does not exclude the possibility of a return home and ALL agencies should work towards this wish if it is safe and the care need can be met appropriately.

Support for discharge could include up to 6 weeks’ free care from either NHS and/or Social Care. It may be possible for a district nurse to provide medical attention at home for example with dressing wounds and social services/adult social care may be able to arrange meals, care and support services and periods of respite to help Jean manage the care.

Of course, it is not always possible or safe to return home but explore the options with the possibility of rehabilitation and ongoing care and support for both the cared for and a carer.

Local Authorities are developing prevention and reablement services which may help people to stay at home.

If Diane’s home isn’t suitable or can be adapted or a suitable property can be found then it may be possible for her to return home with support for Jean to help her provide the care Diane needs. It could also be possible for Jean to return to her Daughters family home if there are appropriate space and facilities or if it can be adapted to provide them.

If a Hospital bed is needed the NHS may be able to arrange that and with community health services it may be possible for the nursing needs to be met at home.

Continuing healthcare should be considered as this can be paid wherever you live.

This is a lot to organise for someone who is in Hospital, the Adult Social Care and NHS teams can help but even with Jean’s help she may also find an advocate (informal or independent) useful, someone to help make her wishes clear while looking for her new home or making sure specific arrangements have been made.

For care fee planning, caring support and arrangements Jean and Diane may require specialist financial and/or legal advice

CHAPTER 20 - LIFE STAGES AND CARE NEEDS

While everything is fine we don’t tend to think about needing care or support in the future.  Too busy chasing our own

tails or just enjoying life so much that preparing for a possible future care need doesn’t feature on the ‘to do’ list!

 

Life stages - the things that happen to us in common phases throughout our lifespan.

 

None of us are getting any younger – it’s a sad fact, but along the way many wonderful things may happen such as getting

a job or buying your first house, having children, the arrival of grandchildren and retiring to look after them!

 

Sadly, not everything that happens to us is wonderful but it doesn’t mean that these things can’t be positive in some

way and although it may be life changing preparing for them may help you to live the life you choose as far as is

possible and ease any worry for you and those around you at a time of crisis.

 

This chapter looks at the life stages and care needs;

Hospital Admission and Discharge

Moving into a Home

Becoming a carer

Illness/Disability

Losing a loved one

Struggling with every day things

 

 

Hospital admission and discharge may lead to the need for the same things to be considered but equally raise quite different questions or problems.

 

Hospital admission

Whether this is sudden admission or planned this can be a worrying time especially if you are;

  • Living alone without a network of support close by when you may worry about securing a property or looking after a pet, managing money or being able to return home.

  • Caring for someone else and reluctant to agree to a stay in Hospital because you aren’t sure how they will manage when you aren’t there.

  • Scared of Hospitals for fear of being in for longer than expected or don’t like not sleeping in your own bed, being kept awake all night or not being in control of your own routine

  • Frightened of having to stay in for longer than expected, not being able to go back home or make your own decisions.

 

These are all very real issues for many people. Not knowing how long you are going to be in Hospital can be a dilemma as you aren’t sure what plans you should make or for how long.

 

Hospital Discharge

his is one of the most common points of crisis for care needs.

 A stay in Hospital may be the very thing needed to make us feel better and able to return home but it can also make you feel more dependent or make you realise that maybe you weren’t managing as well as you had thought.

Many people want to go home but maybe feeling tired, less confident, or unable to manage. A spouse/partner, friend, or family carer may feel unable to cope or manage the care needed. Sometimes this need is being highlighted for the first time, it’s a shock and the situation can seem unmanageable.

 

BOTH Local Authority and NHS teams may be able to support a discharge home, please ask about the help that is available from either and/or both

 

Some Hospitals have social work teams based within them, but if not the Local Authority can still do an assessment while you are in hospital. Please DO NOT presume that this will be done before you are discharged as it may not have been requested.

 

It may be that with several medical professionals in charge of your care you aren’t sure who, if anyone, has done an assessment. This is NOT uncommon!

 

Ask the nursing staff or Patient Advisory Liaison service (PALs) if you aren’t sure or ring the Local Authority Adult Social Care to check if they have done an assessment.

 

Moving into a care/nursing home 

When someone moves into a care or nursing home it can often be with the intention of a short-term stay.  A time of crisis is not always the best time to make permanent decisions and the possibility of rehabilitation and recovery shouldn’t be overlooked. Needs may change and what you choose now may not be an appropriate way to meet your care needs in the future. A permanent move may be premature or unaffordable in the long term and there may be other housing and care services and options that you didn’t know about so please ask for an assessment of your care needs from the Local Authority and make sure that Continuing health care has been considered if your care needs are primarily health or medical as this can be paid regardless of where you live.

Don’t forget if the property is empty it may have a council tax exemption if you move into permanent care

 

Consider; Local Authority assessment, benefit check, continuing care, funded nursing care payment, financial/legal advice/provision.

 

If a permanent move is inevitable and it appears daunting there are people who can help. Guidance from the Local Authority on the type of care needed and/or an assessment of needs from the home itself.  Some Local Authorities have Support Brokers who can help, some voluntary organisations may be able to provide support or an advocate. Check the CQC reports and have a look at the care home checklist for guidance on the questions you may want to ask.

Losing a loved one 

People living in isolation, especially in rural areas has been highlighted particularly over the last few months because of the impact of loneliness on people living alone at home without support networks.

The loss of a loved one is hard at any time, at any age but it can be magnified if the person left behind is older and unable to get active easily or manage the daily tasks because of an illness or disability.

 

Sometimes the person who has passed away was also the main carer and coupled with grief and loneliness this can also raises a worry about finding someone else to support care needs.

 

What needs to be done first?

A death certificate can be collected from the GP or hospital doctor and will be needed to register a death (which must be done within 5 days). The registrar of Births, Deaths and Marriages will issue the documents you need to arrange the funeral and notify the relevant agencies/organisations.

 

Consider

If you are recently bereaved and have no one to help make arrangements an advocate may be able to help with this. Asking the Local Authority to do an assessment of your own care need or for support as a recently bereaved carer.

A benefit check will consider possible bereavement benefits, funeral payments, and other entitlement. Care, support, counselling and legal/financial services and advice may support long term planning.

 

Struggling with everyday things  

This is a life stage for many people and it is at this point that there may be quite a lot of support available and an opportunity to plan for a future change in need.

 

Planning finances and maximising benefit entitlement may help, ask the Local Authority or Local DWP office for a benefit check. For regulated financial advice and care fees planning refer to a SOLLA accredited financial adviser for specialist advice.

 

Some voluntary organisations can offer benefit checks and help with applications as well as support for carers, advice, guidance, and advocacy.

 

The Local Authority and the NHS realise that with some help earlier on the need for care may be delayed and even reduced and have developed services which may be useful and enable independent living.

 

Please ask the Local Authority and/or GP how they can help as many of these services are FREE.

 

Limited capacity for work; Sick pay, ESA, IB are benefits for those unable to work because of an illness or disability. Support from the Jobcentre may also include a disability officer/adviser, and/or an access to work programme.

 

Disability/Illness

An accident or illness could happen at any time, how can we prepare for that not knowing what help, if any we may need in the future?

 

It may be that legal provision for children, a spouse or partner or someone else or making sure that your wishes are considered can give peace of mind.

Health professionals can give guidance as will specialist illness/disability organisations.

 

Consider;

  • Benefits; DLA, AA, PIP. Council Tax disability reductions/exemptions.

  • Local Authority assessment

  • Continuing Healthcare and health services.

  • Financial advice, legal advice, and provision

  • Voluntary sector services and support.

  • Access to work and other unemployment services and benefits.

Becoming a carer

This can be especially hard if it is a parent that you are looking after, changing roles can be difficult especially if it involves personal care.

 

Juggling care with work and dealing with family life can also be a tiring challenge. Please ask for support, there are services that can help you provide the care, although it may not be easy if the person who needs care is reluctant to accept help from anyone else.

 

Consider;

  • Carers Allowance, carer credit and/or a low-income top, help with housing costs.

  • Requesting a carer assessment from the Local Authority who may provide services and support and/or there may be local carer support services

  • Carers UK 0808 808 7777 may be able to offer advice

  • Local Carer support groups and organisations

  • If it is a specific illness/disability there may be a specialist group such as the Alzheimer’s Society who can offer advice and support for those who are caring for someone living with that illness/disability

 

Changes in care need

If you already have a care need there is a possibility that this may change in the future, being informed can help you to plan for this. Seeking advice from the specialist organisation and/or health professionals for your illness/disability are vital, it may be a medication review with the GP that’s required or an additional specialist medical professional.

 

If your care needs have changed request a reassessment or a new care needs assessment if you haven’t had one before from the Local Author

Remember this is a common reason for unclaimed benefits, especially upgrades to an existing disability benefit as the changes may creep up slowly and without realising it there may be a significant increase in need and it may be months later before they are realised

CHAPTER 21 - PREVENTION AND INDEPENDENCE

Information and Advice enables people to make informed decisions, access their rights and entitlements.

 

There is a wealth of information and advice available but for it to be useful it needs to be accurate and relevant to the

circumstances. Specialist advice is provided by organisations with knowledge and experience of specific illness’s and

disabilities such as MIND, Alzheimer’s Society, or age related issues for example AgeUK, Solicitors for the elderly and

Society of Later Life Advisers are invaluable sources of information and advice and often provide their own factsheets.

 

  • Information from Health services or Local Authority may give access to social activities or services in the area, for example

  • it may that a new singing for the brain group has started in the area or a change in home visiting from the GP surgery

 

  • Advocacy - ensures that people can speak out, express their views, and defend their rights

Many advocates are volunteers and work for voluntary organisations/charities. There are specialist mental health advocates

, and independent advocates paid for by the Local Authority if someone is not able to take part in their care needs assessment.

If you aren’t sure how to access an advocate contact the Local Authority.

 

  • Prevention services may be provided by health authorities for example falls prevention clinics and/or it could be a Local Authority provision such as assistive technology which may include things like pendant alarms, key safes, door sensors, medication dispensers, movement sensors……...

 

  • Carer services for people who are providing care can help to support them to be able to continue and may be provided by the Local Authority, commissioned by them or a separate provision and managed by the carer themselves, these can include a break from a caring role or additional support for short or long term periods.

 

  • Reablement services help people maximise their independence, these services may be provided by the Local Authority and/or Health service to support a Hospital discharge and are usually free for up to 6 weeks.

 

  • Sensory services vary, in your area it may be that there is an organisation for sight problems and a separate one for hearing impairments. These may be integrated services and have support from Adult Social Care, voluntary organisations, and health. Again, if you are not sure how to contact one ask the Local Authority how to access theses services which may include hearing loops, re tubing a hearing aid, sight aids for reading or kitchen utensils, speech, and language therapy….

 

Mental Health

Start with your GP for Mental Health issues, specialist mental health charities can often offer advice and support also but to access specialist professional health services the Doctor will make the appropriate referrals

 

Learning Disability services

These disabilities can affect older people as well as young and there are services available to help fulfil lives and may be a health or social facilitator or a Job Centre Plus liaison or care and support from the Local Authority.

 

Community Health Services can range from GP’s district nursing, health visitors and home-based rehabilitation programmes, to NHS walk-in centres, specialist diabetes services and educational nutrition. Falls clinics, physiotherapy, podiatry, speech and language therapy or palliative care…………

 

Social Activities/Day centres/day activities can be provided by the Local Authority, Health authority, charity or private.  Many are run by volunteers and some organised by charities, voluntary organisations or the church for example carer support groups, Alzheimer’s Society or AgeUK coffee/information mornings, job clubs for people with learning disabilities or friendship groups run by the church or a mental health charity…. These opportunities are in addition to the traditional day centre which may be private or public funded.

 

Local Authority services

The Local Authority can assess and support both people who need care and those who provide it.

The services are varied and differ from one Local Authority to the next but the common theme is a determination to help people stay independent in their own home for as long as possible. Some of these services may include;

Brokers who can help you buy the care and support services you need. A personal assistant can provide an assessed care need. Information, Advice and Advocacy, prevention and reablement services. Welfare benefit checks, a corporate deputy. Shared lives schemes, assistive technology, home library service, chiropody, hair dressing. Safeguarding services and services for people with learning disabilities or mental health issues. Carers assessments and support services for carers.

CHAPTER 22 - BE PREPARED

  1. Access care and carer support services

  2. Maximise benefit entitlement

  3. Manage finances

  4. Make Legal provision

  5. Stay safe

  6. Looking after loved ones

  7. Protect a property

 

1. Access care and carer support services

Local Authority - Care Needs Assessment 

The Local Authority can do an assessment of your care needs and are often able to help with other support services that may delay or prevent the need for care services, these could include help with the garden, a pendant alarm or an advocate who may be able to do things like organise a tradesman, write a letter or ring a utility company…

 

Local Authority - Carers Assessment

This is different to a care needs assessment for the person who needs care. A carers assessment considers what care and support is being provided, by whom and how the carer could be supported to enable them to continue providing the care and relieve any carer stress. This could be a sitting service to give the carer a break or the chance to pursue a hobby or interest. An assessment is valuable if for any reason the carer can’t provide the care whether it is for a short time for example a hospital stay or additional caring support to help a full-time carer to be able to continue.

2. Access supporting services

There are many support services that we don’t consider until a time of crisis, some of these can help long before that and even avoid it all together, please don’t carry on in stoic silence when something as simple as a perching stool, an adapted car or back scratcher could make life easier.

Don’t forget to have a check-up with the GP as part of a routine being prepared list

 

3. Maximise benefit entitlement

Please think about asking for a benefit check, there are some good calculators on the internet, some Local Authorities have benefit teams, the Department of Works and Pensions has visiting officers if you are struggling to get out or make an appointment.  Some of the voluntary advice agencies can do a benefit check and even help with an application form.

 

4. Managing finances  

If you are looking for  financial advice, wealth management or tax planning but not sure where to go contact Society for Later Life Advisers (SOLLA), who have a list of the Financial Advisers who are accredited and will be able to advise you on financial planning for later life and long term care. See chapter 17.

 

Funeral Plans

Preparing in advance may include paying ahead with prepaid funeral plan or just making sure your wishes are known, whether you prefer to be buried or cremated, how you feel about organ donation.
Arranging your funeral will ensure your family do not have to, making sure the funeral reflects your wishes, choose your own hymns or request donations to a given charity instead of flowers.

 

5. Make legal provisions

Who would manage your finances or health decisions if you are no longer able to? Do you have an Enduring or Lasting Power of Attorney? Please don’t assume as many do that ‘it’s ok because my wife/husband/children will’ they may not be allowed if there is no legal provision, a third-party agreement with the bank may not be enough and don’t assume that if the bank account is held in joint names that a partner or spouse can continue managing the finances for the family as this may not be the case.

6. Looking after loved ones

Pets - Charities like the Cinnamon Trust may be able to help you walk your dog if you are no longer able or help arrange for them to be rehomed. PAT dogs can come into your home if you are missing the company of a pet and the RSPCA may be able to help you with short or long term arrangements. Some care homes will accept pets so it’s worth asking when considering that type of care provision.

 

Children, Spouse/partner - Making sure your wishes are known and documented can give some peace of mind. Consider making a will and other legal provision for your children and others close to you. See chapters 17 and 18.

It may be that you are the main carer for a loved one and arranging care is your priority, there are schemes for example the in case of emergency that are sometime run by carer support organisations which record alternative arrangements In Case of an Emergency (ICE), it is also worth keeping an ICE Number on a mobile phone as a quick point of reference for the emergency services if ever they need one.

 

7. Protecting Property

The Local Authority can secure a property if anything happens but it may be the more mundane things like paying the bills and making sure the pipes don’t freeze that can be a worry. If there is someone you can ask it may be that making sure they know who they are is all that is needed for peace of mind, it is also possible that one of the voluntary organisations in the area offers this service or an advocacy service to help you make these arrangements.

 

Stay Safe

Some Authorities work with the emergency services and other agencies to provide home safety checks, local voluntary organisations may provide something like this and may fit smoke alarms, door/windows locks….

 

You may be able to access the schemes to help heat or insulate your home on the other benefits pages.

 

Leave a list of key numbers somewhere obvious that anyone who needs to access your care services knows who to contact.

 

I’m sure that I have missed so many things that are just as important, please make a checklist of the things that are important to you and make plans for the least impact of the ‘what if’s’ on our nearest and dearest.

CHAPTER 23 - SAFEGUARDING

Safeguarding means protecting people’s health, wellbeing, and human rights, and enabling them to live free from harm, abuse and neglect.  Everyone can play a part in preventing, detecting and reporting neglect and abuse.

 

Abuse

Abuse is a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person’. This definition has been adopted by the world health organisation from a definition put forward by Action on Elder Abuse.

 

What is abuse?

Abuse can be intentional or unintentional, happen once or be repeated and it may be criminal.

 

Physical: Hitting, pinching, kicking, burning….

 

Psychological/Emotional: A common theme is a perpetrator identifies something that matters to an older person and then uses it to persuade them into an action. It can be verbal such as name-calling, ridiculing, blaming, or nonverbal such as ignoring, silence or emotional blackmail…

 

Sexual; Unwanted contact or indecent acts or forcing a sexual act or conversation….

 

Financial: It may be deception, misrepresentation, undue influence, or theft and can include fraudulently acquiring or using a power of attorney….

 

Neglect: Lack of food, water, clothing, comfort, or warmth….

 

 

What can you do?

If someone tells you something or if you see or hear something that makes you feel uncomfortable or concerned about the care of a vulnerable adult, or if you feel that you are a vulnerable adult being abused – share your concerns

 

Who to share concerns with?

If you work for an organisation there should be clear policy and procedures for reporting suspected abuse, this may begin by raising a concern with a superviser or manager. If you do not have these clear procedures report concerns to any local adult safeguarding board and/or;

Action on elder abuse; 0808 808 8141l

Local Authority health and social care safeguarding services

Court of Protection; 0300 456 4600 

Police

 

Dignity in Care

Dignity in care, the kind of care, in any setting, which supports and promotes, and does not undermine, a person’s self-respect regardless of any difference.

 

Led by the National Dignity Council, Dignity Champions form part of a nationwide network who work to put dignity and respect at the heart of UK care services to enable a positive experience of care.

 

The poem ‘Cranky old man’ on the next page was found amongst the belongings of a gentleman who lived in a care home, the nurse that found it was so inspired that she shared it and it I think it fits into the ‘Dignity in Care’ part of the book.

 

 

Cranky Old Man (author anonymous)

What do you see nurses? . . .. . .What do you see?

What are you thinking .. . when you're looking at me?

A cranky old man, . . . . . .not very wise,

Uncertain of habit .. . . . . . . .. with faraway eyes?

Who dribbles his food .. . ... . . and makes no reply.

When you say in a loud voice . .'I do wish you'd try!'

Who seems not to notice . . .the things that you do.

And forever is losing . . . . . .. . . A sock or shoe?

Who, resisting or not . . . ... let’s you do as you will,

With bathing and feeding . . . .The long day to fill?

Is that what you're thinking?. .Is that what you see?

Then open your eyes, nurse .you're not looking at me.

I'll tell you who I am . . . . .. As I sit here so still,

As I do at your bidding, .. . . . as I eat at your will.

I'm a small child of Ten . .with a father and mother,

Brothers and sisters .. . . .. . who love one another

A young boy of Sixteen . . . .. with wings on his feet

Dreaming that soon now . . .. . . a lover he'll meet.

A groom soon at Twenty . . . ..my heart gives a leap.

Remembering, the vows .. .. .that I promised to keep.

At Twenty-Five, now . . . . .I have young of my own.

Who need me to guide . . . And a secure happy home.

A man of Thirty . .. . . . . My young now grown fast.

Bound to each other . . .. With ties that should last.

At Forty, my young sons .. .have grown and are gone,

But my woman is beside me . . to see I don't mourn.

At Fifty, once more, .. ...Babies play 'round my knee,

Again, we know children . . . . My loved one and me.

Dark days are upon me . . . . My wife is now dead.

I look at the future ... . . . . I shudder with dread.

For my young are all rearing .. . . young of their own.

And I think of the years . . . And the love that I've known.

I'm now an old man . . . . . . .. and nature is cruel.

It's jest to make old age . . . . . . . look like a fool.

The body, it crumbles .. .. . grace and vigour, depart.

There is now a stone . . . where I once had a heart.

But inside this old carcass . A young man still dwells,

And now and again . . . . . my battered heart swells

I remember the joys . . . . .. . I remember the pain.

And I'm loving and living . . . . . . . life over again.

I think of the years, all too few . . .. gone too fast.

And accept the stark fact . . . that nothing can last.

So open your eyes, people .. . . . .. . . open and see.

Not a cranky old man.

Look closer . . . . see .. .. . .. .... . ME!!  

 

                           

Deprivation of Liberty safeguards (DoLS) are part of the Mental Capacity Act 2005

Mental Capacity (Amendment) Bill [HL] 2017-19 - proposes to change DoLS to Liberty Protection Safeguards

The Deprivation of Liberty Safeguards aim to protect people who lack mental capacity, but who need to be deprived of liberty so they

can be given care and treatment in a hospital or care home.

 

At time of printing if a person’s right to liberty needs to be infringed in other settings, an authorisation must be obtained from the

Court of Protection.

In March 2017, the Law Commission produced its final proposal on a replacement for the Deprivation of Liberty Safeguards (DoLS) and suggested amendments to the Mental Capacity Act 2005  

 

 

The new Liberty Protection Safeguards (LPS) is due to come into force in October 2020 via the Mental Capacity (Amendment) Act 2019. The LPS will replace the Deprivation of Liberty Safeguards (DoLS) as the system to lawfully deprive somebody of their liberty.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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