Adult social care

[Louisetopaz21]

I work as a senior practitioner within adult social care and I am a signatory for Deprivation of Liberty Safeguards (DoLS). I am happy to answer any questions you may have.

How do you cope? I used to work in an adjacent area and the number of people who are just abandoned in their old age is heartbreaking

It can be stressful but I love it. I think it is understanding the person's family networks. I think that due to people being supported to remain at home as long as possible there is a high risk of carer breakdown and families just can't keep their loved ones safe. In the 15 years I have been qualified only an handful of people I have worked with where the family have been concerned with their inheritance rather than the person which is sad. Most families do try their best but there is so much you can do when mum is wandering around the streets or not accepting any care due to their dementia diagnosis.

Hello, how easy is it to move an elderly person between local authorities? I ask because my dad has a recent dementia diagnosis but lives four hours away so I want to look at moving him and my mum (who is fine for now) closer to me. Adult social services aren't involved yet but I suspect should be soon. Ideally we'd move them into a new house together, not a care home, to see how they both manage first.
Would it be easier not to involve adult social services before we move them, if we can hang on till then? Is it a massive faff to switch local authorities?

It depends if he had capacity to make the decision. Having an diagnosis of dementia doesn't mean he lacks mental capacity to make the decision so it might be the case of talking to him to gauge his views . If he still can make decisions might be worth exploring LPA for health and welfare if it isn't in place and considering what support he needs. I would need further information to guide you further.

Does DoLS paperwork need to go to hospital when someone goes to A&E and if in a care home, is a carer obliged to go with them?

No DoLS paperwork doesn't need to go to hospital, however a patient passport should do. The DoLS authorisation is only applicable for the care home so if the person was going into hospital and admitted to a ward the hospital should apply for a DoLS. However a&e isn't counted as an admission so they can't apply for one but would rely on the mental capacity act. Carers attending a&e is a difficult dilemma but there are no laws to state they should. Potentially could leave the care home understaffed. I think families should be encouraged to if they can but the wait could be for hours so a decision for the care home manager depending on the situation.

Thanks OP. I ask because A&E don’t have the staff to supervise constantly (and their role is to provide clinical care) and as you say, care homes are reluctant to relinquish staff. And security at A&E are always overstretched.

Yes a really difficult one as they are so busy but I have known security guards being used in certain situations which must be frightening for the person.

Do you see people without any family members doing OK? That is what I will be facing in my old age.

Yes I have worked with people who do not have any relatives either they are estranged or some other reason. Usually we will get an advocate involved if there is a need. Is this something you want to talk about? Does it worry you? Is there anyway you can build up a support network through the community by making connections and friends? Do you feel isolated currently?

Thank you, yes, it worries me a lot. I'm likely going to face old age alone, as I am an only child and I have no children of my own. I know how important it is to have someone who can speak up for you if you are incapacitated, and for me, I just don't know who that person will be!

I'm only 38 years old at the moment, so all of this is a long way off, but it really eats away at me. I do seem to be quite good at making friends though, so maybe I won't be entirely without support or someone who cares. I guess the worry is, if I don't have younger friends, they may all be gone before me. I am hoping to live in a retirement village setting where hopefully I would have support to call upon if needed.

I completely understand why you might be worried so difficult and scary thinking about what could be. What I would say is you are relatively young and you cannot anticipate what is going to happen in the future. Enjoy every moment and if the worst came to the worst if I was your social worker I would listen to your views and would make sure you had someone to advocate for you. I would also make sure your dignity was in tact and ensure that I could make sure your wishes whereever possible were upheld. You could be like my nana and be so independent until your time comes. Just focus on the now and build up the connections and live a full life. You will be okay and try not to worry about something that may never happen. You sound like a lovely person x

Thank you, that is a lovely, kind and reassuring response. I have been worrying so much - in fact, I would say I have made myself ill with worry, which is obviously not a good place to be.

I think the thing I perhaps fear the most is what would happen if I had to go to A&E on my own as an elderly person. You hear about these horrific 15 hour waits, and I can't imagine managing that on my own, especially if I was confused too. Maybe a kind friend or neighbour would come with me though. I know know that if I had an elderly friend or neighbour who needed help like that, I'd absolutely step up and support them.

I am sorry to hear you have been worrying that it has made you ill. Anxiety is awful, I suffer from it and it can have a real impact on your physical health. Is there a trigger to your anxiety? I think mindfulness might be helpful it encourages living in the moment and focusing on the now. I don't think anyone can be fairly confident what is going to happen in the future, but dont wish your life away x

Thank you. Sorry to hear you suffer from anxiety too. I think it really has started to take a toll on my physical health. I always have a fuzzy head, and my muscles ache too. I feel a lot of tension in my body. I also have digestion issues.

My anxiety is triggered by anything that makes me think about my future, loneliness and vulnerability. If I am on a day out, I will see families and think about how they will grow older together and support one another (although not guaranteed I know!), or I'll hear people at work taking about navigating the care system for their parents.

I remember last year at Christmas, I was horribly triggered by something someone posted on Facebook. It was supposed to be a joke / meme kind of thing. It said 'Does anyone know an old person with no family.....if so please, let me know as I'd like to go round and borrow some chairs'.

I will explore mindfulness - thank you. And you are absolutely right that nobody can predict the future. I'm hoping that I can make some more close friends, try to look after my health and stay mobile for as long as possible, and save money and plan to live in supported retirement accommodation.

Thank you again for your kind reply x

I know this is old but wondered how this would apply to a 16 year please? 16 year old lacks capacity, needs constant supervision and cant go out alone.

I know this is old but wondered how this would apply to a 16 year please? 16 year old lacks capacity, needs constant supervision and cant go out alone.

If a condition on a DoL order was to prevent contact between the person and a particular family member, would the family member be told?

I'm having massive problems with Adult Social Care. The people don't seem to make a note of anything or talk to each other, so I have to keep repeating the problems. The elderly person is currently in hospital, but they haven't communicated with the Ward - their office is actually at that hospital! I'm getting very frustrated saying the same things and asking for support for this person.
It's like I'm talking to a wall.
What is going wrong and how do I move forward?

That's such great advice.

We don’t have a joined up system to look after the elderly. My own experiences have been that without money and a family member willing to go the extra mile, the vulnerable elderly are completely abandoned until beyond crisis point, not helped by the fact that any processes designed to help them take forever. When I applied for a Deputyship for an elderly relative (an aunt I had a distant but fond relationship with) it took well over a year. In that time no one could do anything legally - we just intervened and hoped for the best. Without that, in all honesty she’d probably be dead.

It’s not that people don’t care -Adult social care were actually really lovely - but they’re underfunded and the protocols just don’t allow it.

A joined up system is exactly what we need, @Resilience .
The individuals I've talked to have been very kind and definitely want to help, but they seem so hindered.

When I was 39 I broke my back, I'm disabled anyway, having type 2 brittle asthma, a heart condition and osteoporosis.
The hospital that treated me badly told me to call adult services for help when I got home.
I did and was told they only help people over 65.
I said I'd call back in 26 years and had no choice but to manage on my own.

They are absolutely useless.

It would require an application to court of protection to authorise any deprivation and restrictions. The social worker needs to complete a COP DoL also known as a community DoL paperwork and apply to the court of protection. I hope this helps x

Restrictions to contact is under article 8 of the Human Rights Act and DoLS conditions should only include article 5 right issues, they are suppose to support to the reduction of restrictions so contact issues should never be a condition. Depends on the situation but yes they should be told about any restrictions to contact but again it really depends. A DoLS cannot authorise any restrictions to contact and as it is an interference to article 8 rights it should progress to court of protection. I hope that helps if you want to give further info I can comment further x