Right and choices for individuals with dementia Essay
Right and choices for individuals with dementia
Human Rights Act 1998
Under this act residents of the United Kingdom are entitled to seek help from the UK courts if they believe that their human rights have been infringed. The human rights act guarantees:
•The Right to life
•The right to freedom from torture and inhuman or degrading punishment
•The right to freedom from slavery, servitude and forced or compulsory labour
•The right to liberty and security of person
•The right to a fair and public trial within a reasonable time
•The right to freedom from retrospective criminal law and no punishment without law
•The right to respect for private and family life, home and correspondence
•The right to freedom of thought, conscience and religion
•The right to freedom of expression
•The right to freedom of assembly and association
•The right to marry and found a family
•The prohibition of discrimination in the enjoyment of convention rights
•The right to peaceful enjoyment of possessions and protection of property •The right to access to an education
•The right to free elections
•The right not to be subjected to the death penalty
Because of the introduction of the Human Rights Act, the Government had to show commitment to protecting the most vulnerable adults as well as children so now that everyone can access their rights. In the Health care sector lots of organisations are covered by the Human Rights Act. Anyone working in health and care will be working within the requirements of the legislation on a daily basis. The act is about respecting and promoting the rights of individual people. Within social care making sure peoples’ rights are protected is a key part of your professional role.
Just because an individual has dementia does not mean they don’t have the same human rights as anyone else. Their rights are not any less important just because they are unable to defend them. The act clarifies exactly how public services should be delivered and interpreted and ensures that the people delivering the service know what their responsibilities are. The legislation states that all public bodies ensure that human rights are at the core of their day to day work. Equality Act 2010
The Equality Act sets out the different ways in which it is unlawful to treat someone, such as direct and indirect discrimination, harassment, victimisation and failing to make a reasonable adjustment for a disabled person. This act replaces many other previous acts and protects different kinds of people under just one act.
•marriage and civil partnership
•pregnancy and maternity
•religion or belief
The equality act helps protect people with dementia by ensuring they can maintain their independence by enabling them to continue to work for as long as possible. The Act ensures that employers must make reasonable adjustments to enable and individual to do their job and ensure that they cannot be discriminated against because of their condition.
Mental Capacity Act 2005
The primary purpose of the MCA is to promote and safeguard decision-making within a legal framework. By empowering people to make decisions for themselves wherever possible and by protecting people who lack capacity by providing a flexible framework that places individuals at the heart of the decision making process By allowing people to plan ahead for a time in the future when they might lack the capacity for any number of reasons This Act is very important for people with dementia. Because of the MCA people must now have the opportunity to consider and make decisions for themselves wherever possible. Just because an individual has dementia it should not be assumed that they cannot make decisions. It is not the outcome of the decision that a person makes that is looked at but the persons ability to go through the process of making the decisions.
Deprivation of Liverty Safeguards (Dols)
These safeguards are in place to ensure that assessments are carried out before anyone can be detained in hospital, residential care or any other facility ensuring that someone who is unable to give or refuse consent cannot be detained. People that do have their liberty restricted must have a Relevant Person Representative. This is usually a family member or friend. Their role is to ensure that the persons rights are respected and that they understand as much as they possibly can why their liberty is being restricted.
Safeguarding Vulnerable Groups Act 2006
The SVG act is intended to prevent unsuitable people from working with vulnerable people and to reform current vetting and barring practices. Mental Health Act 2007 This act protects the rights of people in England and Wales who are assessed as having a mental disorder including dementia. If an individual is considered to be in danger or harming themselves or others then they can be detained or sectioned under the mental health act. The act also allows individuals to appoint someone as their guardian to make decisions on their behalf. Previously this would have been the nearest relative, now an individual can request someone they want.
Here at Omega Oak Barn and in any other organisation that you might work in there will be policies and procedures in place to ensure that peoples right are protected and that you are working within the law and national guidelines. This is called a Duty of Care and it is there to ensure that people can make their own choices and decisions about how they want to live, it does not mean taking their rights away and wrapping them up in cotton wool. As a duty of care you should ensure an individual has their needs met whilst if they have capacity they have the right to refuse help if they wish too even if you don’t agree with their choice. Within the social care field in the UK we have what is called Codes of Practice for both employers and the workforce/carers. For employees these are a list of statements set out to ensure that the best practice and professional standards are achieved by care works as they go about their duty.
They Codes of Practice for employers sets out the responsibilities they have in the regulation of social care workers. Employers must follow the standards set out in the codes and help employees to follow there codes. If employees are not meeting the codes and standards then employers must take action. I think that the codes of practice are a good idea. It sets out for everyone just exactly what they should be doing. Explaining what is expected of them. This helps to ensure that all service users receive the same treatment and a higher standard of care. If it wasn’t in place employers and employees would treat people how they thought was correct rather than letting them have their own opinions.
Rights covered by code of practice:
Diversity and respect for differences
Right take risks
Equality in care practice
Control over own life, choice and independence
Dignity and privacy
In the UK we also have what is known as National Minimum Standards. In England we have the Care Quality Commission. They are responsible for inspecting all social care facilities to make sure they comply with the standards. There are different types of standards for different types of services. The standards set out the minimum quality of care that an individual can expect to receive for an organisation and also sets out that they have to provide information there services that is easy to understand so that service users know the level of care they should expect to receive. This is important as it ensures that people know the minimum standards. If they know what they are expected to receive then they know if the service is failing them or not meeting the proper requirements so then they can make a complaint. The national minimum standards also help care workers as they set out what should be delivered to the service user in your work setting.
Here at Omega Oak Barn we also have policies and procedures in place to ensure the rights and choices of individuals that we care for. Moving and Handling – this sets out how people should be moved and handled, using aids such as hoists or slide sheets where needed ensuring that the service user and ourselves are not injured in anyway. All staff must receive training in moving and handling before they attempt to assist somebody. This is an important policy as it ensures that no one gets hurt. If it wasn’t in place carers could seriously injure themselves or someone else by pulling them about or not know correct techniques.
Policy and guidelines for medication – This is an extremely important policy as it sets out how medication should be stored, how it should be administered and who can administer it, how it should be recorded on MAR sheets and how it should be disposed of. It also explains how individuals have a right to refuse medication. If this policy didn’t exist medication could fall into the wrong hands, the wrong individual could end up taking it or an individual may administer something when they are not trained to do so.
Confidentiality – this sets out how an individuals’ confidentiality can be protected Whistleblowing – this is another important policy. It explains what you can do if you are concerned about an individual. Such as about how they are being cared for or perhaps if you suspect abuse. It explains what procedures to go through and who you can talk to about it. This is of great importance. It ensures that everyone knows the correct procedure, ensuring that everybodys welfare is protected. There are many other policies and procedures and they are all extremely important and ensure that the care received is of a high standard. They are available for staff to read at all times. If a member of staff is unsure of something they can refer to them when needed.
The Caldicott Standards are based on the Data Protection Act 1998 and are set out in the form of Principles.
1) Justify the purpose for which the information is needed. 2) Only use personally identifiable information when absolutely necessary. 3) Use the minimum personal identifiable information possible – if possible use an identifier number rather than a name. 4) Access to the information should be on a strict need to know basis. 5) Everyone should be aware of his/her responsibilities to respect clients confidentiality. 6) Understand and comply with the law. The most relevant legislation is the Data protection Act 1998, the Police & Criminal Evidence Act 1984 and the Human Rights Act 1998.
Data Protection Act 1998
The Act sets out in principles, how personal information must be handled and gives clear rules on how any processing of that information should be carried out. the information should only be used for the purposes explained when it was collected the information should not be disclosed to anyone who has no right to see it the information collected should be relevant and contain no more than is necessary for its purpose the information should be accurate when collected and where necessary kept up to date individuals should have access to the data held about them appropriate security measures should be taken to prevent unauthorised access to data.
All information given by an individual or on behalf of an individual is confidential and should and cannot be disclosed to anyone without their consent. It is important that the people you support especially if they have dementia understand that there will be records and reports about them and that confidentiality affects them. With an individual with dementia you may need to tell them often that the information they share is confidential as they may forget or explain in a different way so that they can understand you. If you need to share information with other professionals you must always seek agreement from the person concerned even if relates to their health. It is good practice to ask an individual if you can let other people know about their situation. Unless they say it is acceptable to do so then everything should remain confidential.
In some circumstances information can be passed on to others on a need to know basis. This could be for example to others involved in caring for or supporting the individual, such as other colleagues, manager or other professionals working with the person. Even then consent should always be given and it should be explained to the individual that relevant information will be passed on. When information is passed on to others it is also on the understanding that it remains confidential.
It is important that you check who you are giving information too such as checking proof of identity so that information doesn’t fall into the wrong hands. In some circumstances you may find that you have to pass on information because keeping it to yourself could result in harm to the individual you are supporting or someone else or even yourself. This is always difficult when dealing with people who have dementia. Because of the illness a persons capacity needs to be continually re-assessed as to whether they can make their own decisions and review risks taken when they make them. The well-being of the person should help you to decide whether or not to pass information.
Individuals with dementia may need support to make decisions but this does not mean they are unable to make them. They may be able to make decisions on a day to day basis about what they want to eat and drink, or what they want to wear or watch on the television but may have difficulty with sorting their finances or paying bills. Just because an individual lacks capacity in one area does not mean they lack capacity to make all decisions. This is set out as one of the principles in the Mental Capacity Act 2005. It also states that unless proven otherwise then it should be assumed that everyone has capacity to make their own decisions. If an individual has communication problems and has trouble explaining what they want then all necessary support should be provided such as using alternative measure like flash cards or pictures.
It is important even with individuals that suffer from dementia that they feel in control of their own lives. It is part of our human rights to be able to make our own choices. It is also good for self esteem and overall well-being. Individuals with dementia can also make advance decisions. These are recorded and usually called an advance care plan. These are often done before dementia progresses and while they are still able to make decisions for themselves. Advance care plans can be about any decisions the individual wants to make in advance. Such as where they want to live, what future care they wish to receive, medications they want to take and even how they wish end of life care to be given. All this can be referred to and looked back on by professionals when needed. It also helps the individual to feel involved in all decisions being made and takes into account their wishes.
Individuals with dementia often have a fluctuating ability to make decisions. They have good days and bad days or even change their moods within the same day which can result in them not being able to make a constant decision. Because of this they may be able to make a decision about something one moment but not even remember it an hour later. Physical factors can also be accountable for an individual with dementia fluctuating with decisions. It could be that there not feeling well or are in pain. Being tired also affects people with dementia. They are often more unsettled on an evening so less able to make decisions that they could of made earlier in the day. Also emotions can affect how a person with dementia understands the information given in order to make a decision. If they are feeling anxious, depressed, frustrated or angry they may find it hard to retain information.
Conflicts between carers and a person with dementia often occur. This could be because the individual with dementia may want to be involved in activities, do things that give them independence and make their own decisions resulting in exposing themselves to risk or harm. The individuals family/carers may disagree with them doing these things and want to protect them and not want them to any risks so try to stop them. This is a conflict of interests. Even when working with individuals with dementia it is there right to make their own decisions if they have the capacity to do so. It is your duty to support he individual with dementia but at the same time you have a duty to the persons carers/family to try and resolve the situation. A capacity assessment can be carried out although it still may not be easy for a family to accept the outcome if the decision goes against them or seems foolish to them.
All service providers or organisations have complaints procedures. There is always clear imformation about how to complain and who too and the timescale for the matter to be dealt with. Organisations learn from complaints they can be used as a way to improve the services offered. If nobody complained then organisations wouldn’t know they are offering poor service. Complaints procedures should be made available for people to use. As a carer it is important that you make service users and their families aware of complaint procedures or even support them to make a complaint. Individuals and carers/families may find that decisions are being made on their behalf even though people with dementia should be in charge of their own decisions.
People may find it hard to challenge a decision or complain. They fell intimidated by professionals or not realise that they have a right to complain. They may not know how to go about it or just simply lack confidence to do so. You should offer practical help and advice and encourage and support individuals with dementia and their carers to speak out and exercise their rights. Everyone has the right to complain about poor service. It should be made clear that to operate to high standards complaints are used as a process to monitor and improve services. At Omega Oak Barn we have our own complaints procedure and this is readily available to anyone who wishes to use it.
If an individual needs help with personal care it is important that they maintain privacy and dignity. You should ensure that you knock on the door before entering their room an do not assume it is ok to just walk in. Before carrying out any form of personal care it is important that you ask permission and explain exactly what you intend to do. Do not just take over and do everything for them. Support them with the things they are able to do for themselves and assist where needed.
Perhaps they just need prompting to have a wash rather than having it done for them. If someone does need maximum support with personal care privacy can still be maintained. Towels and sheets can be used to cover them as much as possible so that they aren’t totally naked an embarrassed. Also make sure that the door is shut and that you are uninterrupted. If they are using the toilet shut the door and let them have privacy, give them a buzzer to ring when they need assistance or explain that you will come back in a couple of minutes don’t just stand and watch.