When someone with Alzheimer’s or dementia no longer has the capacity to consent to their care, and their treatment in a hospital or a care home requires the restriction of the person’s freedom for the sake of continuous supervision, the care provider must follow strict Deprivation of Liberty Safeguards (DoLS) processes.
DoLS can be beneficial for a patient under the appropriate circumstances, but you must ensure that the correct procedures are followed. Eldermera’s dementia care services can provide the guidance you need.
Under the Mental Capacity Act, these safeguards have been drawn up to protect patients from being unlawfully detained. These are complicated circumstances, as someone who lacks mental capacity may not want their routines and care decided for them, even when it is clear that the agreed course of action is in their best interests.
This is where Deprivation of Liberty Safeguards can prove beneficial, with a set of checking procedures designed to ensure that the person’s care is appropriate even where their liberty is restricted. Naturally, these processes only apply to those in hospital or in a care home, and there are some clear examples of when they have to come into force, such as preventing someone from leaving the establishment or walking around unattended during the night.
“Eldermera can support you through the Deprivation of Liberty Safeguards assessment processes and our team of elderly care advisors have the legal expertise to help you challenge an existing authorisation, if needed.”
The general rule of thumb is for care staff to restrict as little as possible, but sometimes cases necessitate the deprivation of liberty because the patient requires continuous supervision and control to protect them from harm, even when this is without their consent.
In cases where a hospital or a care home decides that Deprivation of Liberty Safeguards must be applied, they must give the patient a representative to monitor their care and provide independent oversight. That representative is given the right to challenge deprivation of liberty at any stage through the Court of Protection, if they think it is inappropriate.
The first stage of the process usually entails the care provider requesting a Deprivation of Liberty Safeguards assessment. If you think that the person you are helping to care for in a hospital or in a care home is being deprived of their liberty, you should discuss this immediately with those in charge, as they need to apply for deprivation of liberty authorisation. Eldermera’s legal services for the elderly can help guide you through the process.
DoLS only applies in England and Wales and can only be authorised where you or your loved one meets all of the assessment criteria.
You can ask for a DoLS assessment to be undertaken on behalf of the patient and this involves your local authority appointing a doctor as a mental health assessor, and a ‘best interests’ assessor, typically a qualified nurse, occupational therapist, psychologist or social worker.
There are six stages to the assessment which cover the age of the patient, their current mental health, mental capacity, their best interests, whether they are liable to be detained under the Mental Health Act, and finally whether DoLS authorisation is in direct conflict with the provisions of any previous legal documentation regarding treatment, such as a Lasting Power of Attorney, deputyship arrangement or advanced decision.
It is important that hospital and care home staff consult with family members and carers. Occasionally, they may need to make an urgent DoLS authorisation in a case of emergency, but that can only be put in place for a week and when a standard DoLS assessment has also been requested.
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