Care home referral- DOLS

[Old Flopsy]

Today I have had an hour long phone call from a social worker which has really upset me.

She said she was responding to a request from the care home OH is in and mentioned DOLS and 'best interests'.

She will be interviewing OH in his care home tomorrow and if he is still saying he 'wants to go home' a doctor must also get involved.

She said she needs to decide if he 'doesn't have capacity'. She wants to appoint a representative for DOLS- probably someone from Mind to ensure that OH's views are taken into account.

What on earth is this all about. I am so worried.

 

[northumbrian_k]

Hi @Old Flopsy
This sounds like Deprivation of Liberty Safeguarding which can be applied for if a person needs to be held somewhere for their own protection. My wife first came into this category when she went for short respite stays. The DoLS statements were put together by a best interests coordinator and required that my wife was interviewed by suitably qualified professionals, one of whom was a doctor. It is to do with finding the least restrictive way of safeguarding the person, which is usually by a locked and controlled exit door.

If this is what it is then there is nothing to worry about. On moving to her care home a new DoLS was granted for my wife. She is unable to understand her care and accommodation needs. The DoLS authorisation enables her to receive the 24 hour care that she requires in her care home, under continuous supervision, which has been deemed the least restrictive option and in her best interests. I have been appointed as her Representative and have copies of all the paperwork.

It is a shame that this wasn't explained properly to you during the long phone conversation. I hope that this helps.

 

[Izzy]

I’m sorry you’re in such a worrying situation @Old Flopsy. It might be useful for you to contact the Dementia Connect Support Line to talk this through with someone there. They’re open until 8pm tonight.

Dementia Support Line

If you need dementia support, we’re here for you. Get personalised information, support and advice by calling us on 0333 150 3456.

www.alzheimers.org.uk

 

[Old Flopsy]

@northumbrian_k - oh yes that has made it much clearer-thankyou.

The social worker rattled on and on saying this probably won't happen, but OH's best interests must be considered if he says he wants to 'go home'. His views must be taken into account. He has only been there two weeks so I was hoping that with time he would settle as I can't keep him safe at home.

She asked me if I wanted to be the representative for DOLS but said it would mean making a decision that I wouldn't agree with, so she finds relatives don't usually want that role.

The phone call has really left me so worried about what is going to happen, but your explanation is helping me to get my head round it!

 

[Sarasa]

Hi @Old Flopsy , @northumbrian_k has explained it well , but here is the fact sheet from the Alzheimer's Society that explains things in more detail in case that helps as well.
www.alzheimers.org.uk/get-support/legal-financial/deprivation-liberty-safeguards-dols
I moved my mother to a care home as she was putting herself at risk at home. She certainly didn't want to be there and kept on trying to escape to go home. At the time she did vaguely know where she lived, but didn't understand what risks she was taking with her behaviour. She thought she was fine, and it was neighbours or me that were making her life so difficult. A social worker and a psychiatrist interviewed her shortly after she arrived in the home and agreed that she didn't have the capacity to make decisions about where she should live and the DOLs order was granted. I was there when the social worker came six months later and asked mum about going home, mum talked about her parent's home, and it was obvious she had no real idea where she'd lived before moving into care. The DOLs order was extended at that point for a year. I haven't heard anything since then, but I assume Covid has delayed mum being assessed this year.
Like you I was worried that the first assessment would agree that mum could go home, as at the time she could sound very together. Although most of what she said wasn't true it sounded credible. I'm sure the social worker and psychiatrist will realise that your husband hasn't the capacity to make decisions about where he lives any more, but following up @Izzy's suggestion and phoning the support line sounds like a good idea.

 

[Old Flopsy]

@Izzy and @Sarasa -thankyou for your kind explanations. I think I was so shocked as I hadn't expected to have such a conversation, now it's much clearer what the purpose of the phone call was. The social worker is ringing me after she has seen OH so I will wait for the call.

 

[canary]

Yes, my mum had a DoLS too. Its pretty routine for people in dementia homes. The emphasis is on the word safeguarding. Very few of them want to be there and most of them want to "go home", but they have to be in a secure environment to keep them safe. This, however goes against their wishes, so a doctor needs to assess their mental capacity and a Best Interest Meeting needs to decide whether this is the least restrictive solution for them (it usually is, by the time they get to a care home).
I was mums DoLS representative, but you dont have to do it.

 

[Old Flopsy]

@canary thankyou- I always value your wise words- you are so knowledgeable about this dreadful disease and all the regulations involved. Perhaps I will calm down now.

 

[DennyD]

I also was informed not so long ago that the unit my husband was/is placed in until he moves to a more permanent care home, put a DOLs in place. I was however, asked to act as representative for him. No issues here were raised around difficulties with family members not wishing to take on this role. I see it as an extension of the POA Health & Welfare. I would have been surprised if they had overlooked me. It was the term Deprivation of Liberty that shocked me initially - it has such strong connotations. But I understand why it is needed, a simple example would be that staff can administer medication, attend to his personal needs and keep him safe from wandering out of the building and get him back should he escape! Acting as representative gives me added reassurance to being kept in the loop what is happening, and advocating in my husband's interests while he is unable to make decisions for himself. If you can and feel able to I would consider taking on the role of representative, especially as he is expressing wishes to go home, when it may not be in his best interest to do so. You would then have the ability and authority to query why they would consider it would be in his interest to go home.

 

[northumbrian_k]

As @canary has said the most important of the four letters is the S for Safeguarding. Deprivation of Liberty sounds harsh but really isn't. It is just a term used to help car homes keep their residents safe by not allowing them to leave and wander at will. As for being the Relevant Persons Representative (RPR) this may be a friend or family member who will ensure that the rights of a person being deprived of their liberty are protected. I am RPR for my wife and so far all it has entailed is being a party to renewals of DoLS authorisation (as these are normally granted for up to 12 months).

 

[blackmortimer]

Today I have had an hour long phone call from a social worker which has really upset me.

She said she was responding to a request from the care home OH is in and mentioned DOLS and 'best interests'.

She will be interviewing OH in his care home tomorrow and if he is still saying he 'wants to go home' a doctor must also get involved.

She said she needs to decide if he 'doesn't have capacity'. She wants to appoint a representative for DOLS- probably someone from Mind to ensure that OH's views are taken into account.

What on earth is this all about. I am so worried.

There's absolutely nothing to worry about @Old Flopsy . As others have said it is a legal means of ensuring that a person who may not be able to make their own decisions can be deprived of liberty (i.e. kept in hospital or care home) and they can be restrained from leaving of their own accord. It also prevents relatives from taking them out of hospital or care home. My wife, Margaret, was put on a DOLS when she was in hospital which enabled them to keep her there and also to transfer her to the nursing home where she now is. As long as all the family are agreed that the situation is for the best it raises absolutely no problems and indeed can be a source of comfort for in particular partners who might be guilt-tripped into taking their relative back home to care for them themselves when in fact they couldn't. It has been a help to me when at my low points - my daughter always reminds me that the authorities wouldn't have allowed me to carry on caring single handed whether I wanted to or not. Believe that can be a comforting situation. So don't worry.

God bless

 

[Jaded'n'faded]

@northumbrian_k - oh yes that has made it much clearer-thankyou.

The social worker rattled on and on saying this probably won't happen, but OH's best interests must be considered if he says he wants to 'go home'. His views must be taken into account. He has only been there two weeks so I was hoping that with time he would settle as I can't keep him safe at home.

She asked me if I wanted to be the representative for DOLS but said it would mean making a decision that I wouldn't agree with, so she finds relatives don't usually want that role.

The phone call has really left me so worried about what is going to happen, but your explanation is helping me to get my head round it!

This is exactly what happened to me after I moved mum to a care home. She kept trying to leave so in order to prevent her from leaving, the CH had to get a DoLS, because obviously locking someone up against their will is kidnapping! So in order for someone to be kept 'locked up' it has to be shown that the person does not have capacity to understand that it would be dangerous to leave or live elsewhere. That's what all this is about.

The social worker will appoint an RPR - the Relevant Person's Representative. This can certainly be a relative but as she has told you, this may involve a decision you don't agree with! Again, this happened with me and someone else (from MIND I believe) was appointed. The problem is if your loved one says, 'I want to go home', it is the job of the RPR to represent their wishes and support their decision, no matter how crazy or dangerous it might be. I imagine you know very well that he needs to be in the care home so you really cannot support his decision! You can only be RPR if you are 'on the side of' the person the DoLS order is for.

I found the system quite adversarial because the appointed RPR was going into my mum and asking leading questions, like 'Wouldn't you rather live in your own place? A nice little flat or something?' Then she reported back to the social worker. I had to battle for about 6 months - the social worker agreed to grant a temporary DoLS until mum had a further scan and subsequent diagnosis. Mum had gone into the home after a fall/hospital stay and her deterioration had been very sudden. She was able to present very well at that time. 6 months later I was present for the next DoLS assessment with the social worker. Mum talked to her about rice pudding for over an hour... The DoLS was granted and - I think - became permanent at that point. (I believe the system has changed recently - it used to be a yearly thing but I think they can do permanent ones now.)

 

[Banjomansmate]

The Banjoman had to have an Independent Advocate when we were trying to get him to agree to move into residential care when he was in hospital. Thankfully by that point we had finally got him to agree to the move but if he had still been defiant about it he could have been there for months and it could have gone to COP if the Advocate had insisted he didn’t want to go into care. He had a DOLS whilst in hospital and everybody agreed he didn’t have the mental capacity to understand his own needs but the Mental Health Act or whatever it is says he had the right to make wrong decisions and they should be recognised! Bloody stupid! The hospital wanted him out but it was their legal team that said he had to have the Independent Advocate to fight for his rights which would have kept him in hospital because of the DOLS.

 

[Old Flopsy]

Thankyou all for your responses- they have really helped me to understand the issues.

The social worker visited OH this morning and will ring me tomorrow morning with her findings.

I visited OH this afternoon and I am relieved to say it went well this time- phew! I asked him about the morning visit from the social worker- he said some woman came and talked a load of ****- oh dear.

The carer said another person is to visit OH on Monday morning- arranged by the social worker, so hopefully tomorrow I will find out more.

 

[Sarasa]

Glad the visit was better this afternoon. The visit on Monday may be a psychiatrist to give their opinion on whether your husband has capacity.
Is he still wanting to come home?

 

[Old Flopsy]

@Sarasa -yes I thought it would be a psychiatrist that is coming to interview him, so I hope it goes well. Today he said he had been out all day yesterday, and had been shopping at the Co-op this morning, although it was along walk (even though he is locked indoors). No he never mentioned 'take me home' which was such a relief! He said some really nice girls are looking after him.

 

[jennifer1967]

@Sarasa -yes I thought it would be a psychiatrist that is coming to interview him, so I hope it goes well. Today he said he had been out all day yesterday, and had been shopping at the Co-op this morning, although it was along walk (even though he is locked indoors). No he never mentioned 'take me home' which was such a relief! He said some really nice girls are looking after him.

thats about the best outcome you could have hoped for @Old Flopsy

 

[Sarasa]

Phew, that sounds like he is beginning to settle @Old Flopsy. It's not based on anything scientific, and a sweeping generalisation, but I do often think men settle better into care homes as they expect to be cared for, whereas women expect to do the caring.