Better deprivation of liberties safeguards for older people after Supreme Court decision is implemented

I didn't cover the Supreme Court 'Deprivation of Liberties safeguards' decision in the 'Cheshire West' case six months ago or so on this blog, but on my more professionally oriented 'Social Work and End-of-Life Care' blog, which you can look at for more details.

Link to deprivation of Liberties safeguards posts on 'Social Work and End-of-Life Care' bog.

Link to the Supreme Court decision.

But there's a fairly recent professional commentary on the Community Care website for social work professionals which demonstrates the aftermath, that local councils have been inundated with applications for Dols authorisations. This means that older people (and others, but older people are a substantial group affected) are having their rights better protected.The writer makes the point that the decision enshrines social work values in the law.

Link to Community Care article

There are now quite a lot of commentaries on the effects of the decision. A particularly good one is on the mental health law online website, which also has loads of links to previous relevant legal decisions and to good explanations of the law, including a video of Lady Hale, the supreme court judge, explaining it in Court.

Link to Mental Health Law online. 

The MHLO summary of the effect of the decision is also helpful, as follows:

 (1) The 'acid test' for deprivation of liberty is whether the person is under continuous supervision and control and is not free to leave. (2) The following are not relevant: (a) the person's compliance or lack of objection; (b) the relative normality of the placement (whatever the comparison made); and (c) the reason or purpose behind a particular placement. (3) Because of the extreme vulnerability of people like P, MIG and MEG, decision-makers should err on the side of caution in deciding what constitutes a deprivation of liberty.

Link to Lady Hale video.

Excellent film on dementia not always taking away identity, love and social connection

Really good film on dementia, provided by the Social Care Institute for Excellence. Focuses on four people talking about their experience of dementia, with their relatives also telling something of their stories. It's striking how even quite disabled people are able to express their personality and identity, and relatives their continuing loving and social connections.

Link to the film

The commentary says: This brutally honest film reminds us that although dementia causes the loss of some abilities, people's feelings remain intact. The people in this film talk about their emotions: fear, guilt, embarrassment, isolation and powerless. They give a deeply moving and personal insight into an often overlooked aspect of the condition.

It also offers practice points:
1. People living with dementia can still be alert and aware of their condition
2. It is important to know the person with advancing dementia as an individual and support them to maintain their own identity
3. Although dementia causes the loss of some abilities, people's feelings remain intact; it is essential to empathise with people's emotions
4. Caring and supportive relationships help people to cope with the difficult experience of living with advancing dementia.

What makes older people happy?

The Age Demands Action campaign is having a social media campaign inviting older people to say what makes them happy. You can make statements or provide videos, photos etc, using a hashtag (#). Examples on their website.

Link to 100 days of Happy Older People website

EU regulations - you have to give allergen information if you provide food

A worrying bit of advice for people who run care homes or deliver mobile meals: there are new EU regulations that require you to provide allergen information to customers, users and residents; it's very detailed and covers a lot of types of food that you might not have thought of.

Link to legal advice note

Returning to an important place is forward-looking, because it's a trip with a purpose

I could not resist this starting sentence in a news report: Do memsahibs take a phaeton ride to the ghats of Sovabazar?

What could it be about? It's about older women who are widows, being taken to visit the town or area where they grew up. One woman describes being given the 'cold shoulder' by her in-laws (presumably living with her former husband's relatives); a voluntary organisation looking after a thousand widows plans to offer them the chance to take a tour to a major town that many of them originated from during Durga Puja (I had to look that up, it's a Hindu festival).

You can see nostalgia and wanting to see the old places as too backward-looking, but it's forward-looking to plan a trip with a purpose, rather than an idle holiday.

Link to the original article. It's on the website of the voluntary organisation, the 
Sulabh International Social Service Organisation

Retirement: avoid supermarkets at the weekend

A study for the Oddfellows supports the government's 'mental well-being' aims (my last post was  about the quality standard for mental well-being in care homes) more broadly. A survey of their retired members found that maintaining and building friendships, keeping active and avoiding the supermarket at weekends are both important advantages of being retired.

The Oddfellows is a friendly society that provided financial and other benefits for working people: it still does this through various mutual insurance schemes, but also provides local social clubs, one of the ways of making friends if you're feeling isolated.

If you're a joiner type person, rather than a keep yourself to yourselfie; in which case, you probably don;t have problems with finding things to do in retire,et anyway.

Link to report of the survey

Link to the Oddfellows. If you're ever wondered where organisations with strange names like the Oddfellows come from, try looking at 'About us' on their website. It's also a good example of how organisations change their functions over time.

Care services for older people should help them feel good and keep their minds in trim

A 'Quality Standard' aimed at social care services, and particularly care homes, published in 2013, focused on older people's mental well-being in care homes. If you're familiar with these things, you'll know that quality standards are a list of things that services should be achieving, published by the NICE (the National Institute for Clinical Excellence), which researches the best standards which services and professionals are encouraged to pick up on. There are six statements in this one:

1  Older people in care homes are offered opportunities during their day to participate in meaningful activity that promotes their health and mental wellbeing.
2  Older people in care homes are enabled to maintain and develop their personal identity.
3  Older people in care homes have the symptoms and signs of mental health conditions recognised and recorded as part of their care plan.
4  Older people in care homes who have specific needs arising from sensory impairment have these recognised and recorded as part of their care plan.
5  Older people in care homes have the symptoms and signs of physical problems recognised and recorded as part of their care plan.
6  Older people in care homes have access to the full range of healthcare services when they need them.

Link to the guidance for care homes.

It's good to see this sort of thing being done: older people should be able to feel good, and keep their minds in trim; basic care that only permits existence rather than personal development is just not good enough.If a care home is doing this stuff, their residents should not be sitting round (or marooned in their own room) watching telly.  Instead they should have the chance to take part in useful and interesting activities, which means much more than periodic sessions of bingo. I was disappointed to see in the film that accompanies the publicity about the publication of the standards that a bingo session was used to illustrate activities; bingo requires quite a large audience to be interesting and this means that lots of people get dragooned into it, and don't get their minds stretched by a variety of arts, sports, or creative activities.

The standards come about because a lot of research says that older people are depressed, lonely and unstimulated in care homes and in their own homes if they receive care there because they are frail. Because they are receiving care services because they are unable to manage their own lives fully, they also don't get the kind of detailed attention to their routine healthcare needs, such as dental, hearing, sight and podiatry services that would make those lives more comfortable.

There is a film about the quality standard (see the illustration in this post), but although the principles are well-expressed, it officialdom in video: it starts by telling you how wonderful it is that NICE has done this and how the inspectors are going to use the standards, but mostly has people wittering on at a conference to promote the standard to people in the field. This was held in the wood-panelled splendour of the place where the Chelsea Pensioners live, and they took part in their scarlet and bemedalled uniforms, telling the participants about their experience of older people's services. But most of the film is preachy platitudes from senior people in social and health care, so the whole thing is not incisive or practically helpful either for people trying to operate the services or trying to improve them as residents. An opportunity missed in a rather expensive way.

Link to the film.

More useful for professionals are the resources intended to support services trying to do something about it: they cover research studies on issues on mental well-being of older people in care and more information on what you can do about it. Print wins our again: you really have to be very thoughtful about what your audience is for a video: it takes time to watch a video, and you can't skip the boring stuff as you can in a document. every second needs to be clearly focused on the needs of your audience and puffs for NICE and nice people pontificating platitudinously just encourages you to turn it off.

Link to useful resources.

Only marketing in social care is suspect: a critique of austerity pressures is crucial

It's a pity that the present home care system's financing relies on commercial attitudes and a marketing approach, rather than a total focus on older people and their needs. A Guardian blog by someone who had a good experience of her mother's death and wanted to work with older people to give something back, presents caring principles (hour-long visits by her carers, good use of technology for efficiency) in the service she set up. But actually the blog post is an unashamed advert for her service and says nothing about what she charges for this luxury provision. The criticism of services that do not meet her principles does not look critically at the cost pressures on services that may have to provide care in austerity England. An approach to social care that is focuses on marketing is always going to be suspect.

Link to the blog post.

Disappointing conference report on portraying ageing without visial reference materials

You can see the contributions to a British Library conference last April on 'Portraying Ageing: Cultural Assumptions and Practical Implications'. An interesting topic with top speakers, including stuff on the arts, photography and creativity, but only with videos of the speakers' whole speeches with interpolated bullet point PowerPoints. You would have thought on these topics and with the BL's resources, they could have curated an interesting collection of visual reference material.

Older models and care home leaflets: starting Greyamble blogging after a gap

A friend is thinking about a care home, so we are looking at leaflets. It occurs to me that the proliferation of need for care homes is going to be a bonanza for older photographic models for the pics that all their leaflets need for grey-haired and slightly wrinkled but lively-looking and positive residents. All looking, I must say, more with-it that most care home residents I come across.

You'll have gathered that I've taken a gap from Greyamble blogging to do other things for a while, but I'm starting up more regularly again now.