When I was young, like many people, I was a bit scared of Dolls. They gave me the heebie-jeebies. Perhaps it was the fact they were alien to me, as a football and Army obsessed youngster, or more likely I’d probably seen some dodgy hammer style horror film that planted the seed of fear.
Perhaps unsurprisingly I’d never heard of “DoLs” as the term didn’t really exist in the sense that it does now. If I was asked what a” Deprivation of Liberty” was I would probably have guessed that it had something to do with prison. Fast forward thirty five or so years and I’ve outgrown my fear of Dolls but developed an aching and persistent fear of DoLS. It’s tricky considering they are a significant part of my day to day work as an IMCA! An IMCA is an Independent Mental Capacity Advocate. I don’t know if there is a special name for this fear but if not I may have to come up with one.
The root cause of this fear is the increasing realisation that old age brings Deprivation for huge numbers of people. The argument that it is in the best interest of the individual is a persuasive and powerful one but for an old fashioned advocate it doesn’t really cut it. We, as a nation, are corralling vulnerable people into identikit care where providers have no incentive to be person centred and where it is deemed acceptable that ‘care needs are met’ but little consideration is given to array of other needs we have as people. We have care homes full of people that don’t really want to be there and have had any sense of control or choice about where to live removed from them.
Like it or not the brutal reality is that many people rarely get out of care homes to access their communities or do normal things like go shopping, go to pub or enjoy the cinema unless family members are able to facilitate this. Perhaps the guess I would have made about prison is somewhat uncomfortably close to the truth.
We should not forget that these are the very people that I was taught to revere as my elders, the very people that may have voted for a government that created the NHS, the very people that have contributed in national insurance and other ways for decades. They deserve better.
The DoLs process isn’t all bad, after all it’s designed to make sure people are only deprived when they really have to be, the trouble is we’re not very good at providing care that means people don’t have to be; the kind of care that keeps people at home and happy, albeit not always quite as safe as they might be in registered care.
DoLS has perhaps helped to identify just how many people were routinely being told they couldn’t go out, just how many people had little scrutiny of their care, just how often people spend the last years of their lives in a place not of their choosing but too often it seems not to take quite enough account of what the person at the centre of this deprivation actually wants and we are all too willing to accept “adequate”. Well, in my experience much of the care older adults receive wouldn’t be considered adequate in other care sectors.
Learning Disability and Mental Health services are far from perfect but they have benefited from cultural revolutions around person centred care, choice and control. They have sought alternative models to generic and institutionalised care settings. It is, without doubt, essential that the same kind of revolution occurs in older adult care if we are not to be truly guilty of Depriving people of their Liberty.
If you work with clients who go through the DoLS process, take a look at our website to find out if you can refer your clients through us for a supportive experience through deprivation of liberty — ensuring that the best option for the client is what is chosen.