Advocacy and Communication
Advocacy is not always about outcome. The process of advocacy itself has other significant benefits; Advocacy is person-centred and while we can’t always guarantee a desired outcome, we can give people the opportunity to be heard and have the confidence to speak up.
When someone has been deemed to lack capacity to understand and consent to care arrangements that mean they are not free to leave, the care home or hospital can’t simply stop them from going out.
DoLS is the legal authorisation required by a care home or hospital to deprive a person of their liberty.
Once this authorisation is given, an RPR is appointed to ensure the person’s care needs are being met and that the DoLS remains appropriate, proportionate and in the person’s best interests. Often this role is undertaken by a family member but there are people for whom this is not an option. This is when one of our advocates, Michael, takes on the RPR role.
In his short blog, Michael, speaks about how a more holistic approach helped Bob (not his real name) to open up and communicate so that the advocacy journey could begin. In normal times, the relationship would have been built up in person but, due to the #Covid19 restrictions, all communication was over the phone.
“The referral information explained that Bob had had mental health issues for long periods throughout his life, with over 50 admissions to hospital prior to his placement in residential care. It was noted that Bob could have a quick temper and was prone to verbal aggression.
I rang the care home and asked to speak with Bob. I was told he was in his room, where he spends most of his time and that it was unlikely that he would want to talk with me.
However, Bob did speak with me and when I introduced myself, explaining that I was taking over from his previous RPR (who had left the service), he responded in a grudging kind of way. I then asked Bob what he was doing and he said that he was in his room reading. I established that Bob read a lot, with a particular love of poetry. Bob explained that he had a large collection of poetry books at home. Encouraged, I asked who his favourites were; he said that he liked the war poets, particularly Brooke.
We continued to talk about poetry and I asked Bob if I could recite a poem that l recalled from my school days. Bob agreed, and so I recited ‘Cargoes’ by John Masefield. It is only three verses and by the time I had finished the first Bob joined in repeating the final verse on his own perfectly. Bob asked if I knew any more. I told Bob that my other favourite, of which I only recalled the first few lines, was ‘Night Mail’ by W H Auden as it follows the rhythm of the steam trains on the tracks before they all became continuous rails, da-da-da dum, da-da-da dum. I started to recite the bit that I could recall:
This is the night mail crossing the border,
Bringing the cheque and the postal order
Letters for the rich, letters for the poor
The shop on the corner the girl next door.
To my surprise, Bob took up the refrain and between us we managed the second verse. It was very moving not least because Bob had not spoken to anyone about his love of poetry in the 14 months that he had been in the care home, possibly never to anyone. It felt like that was a good place to end our call that time, so I said that I would have to look up the rest of the poem and we could try it out next time I rang him if he would like me to. Bob said that he would like to talk with me again and finish the poem.
The man that I spoke with is not the man depicted in the Assessment Forms – Bob was assessed as lacking capacity and having memory problems – yet at the same time he is. It just depends upon what you are looking for and how you are prepared to communicate so that someone feels able to open up. This is the start of our advocacy journey and I am very much looking forward to my next call with Bob.”