Dorothea is a white British lady in her mid-80s. She is a wheelchair user, had polio as a child, and has had a long history of depression. Recently she has been showing signs of cognitive impairment. Dorothea had been living alone with a package of care but was admitted to hospital following a self-harming incident. 

Dorothea was assessed to lack mental capacity to make a decision about her care and residence. After an assessment, it was decided that her care needs could not be met adequately in the community due to a risk of choking, suicidal behaviour, and self-harming. Dorothea was therefore moved to a residential care home three years ago. 

Last year, Dorothea was deprived of her liberty and so a Standard Authorisation was granted, and she was referred to POhWER for support from an RPPR.

Ollie, a POhWER RPPR, was appointed to support her and visited regularly. Dorothy appeared to be a shy, softly spoken lady who was gradually willing to engage and talk as Ollie built up a rapport. Dorothy enjoyed crocheting and Ollie would sit with her and ask about this to develop trust.

The care home staff reported that Dorothea was very unsettled, that she often raced her electric wheelchair along the corridors, putting others at risk, and smashing into the front door. Dorothea had managed to abscond a number of times saying she wanted to go home. 

Dorothea told Ollie that she did not want to stay at the care home, she felt lonely, and she could not get on with anyone there. Ollie informed Dorothy of her right to seek a review or to appeal the deprivation of her liberty. Dorothea said she wanted to appeal, so Ollie supported her to appoint a solicitor and an appeal against her deprivation was issued in the Court of Protection.

Dorothea also told Ollie that she did not like the food at the care home because it was too spicy. She also said, “I’m not happy here and I’m thinking of not eating and going on hunger strike.” Ollie reported this to the care home manager and the kitchen staff were told not to provide her with spicy food. But Dorothea was still reluctant to eat, and her weight reduced to under 5 stone. 

Dorothea also said she felt the cold; she attributed this to having had polio and said that none of the staff listened when she told them. Ollie reported this to the care home manager and Dorothea was subsequently provided with a new thicker duvet and three blankets. 

When Ollie first started to visit, Dorothea would be sitting out in her wheelchair, sometimes in the lounge and sometimes in her room. But at subsequent visits, Dorothea appeared to be low in mood and chose not to get out of bed.

Ollie discovered that Dorothea had not been taken out of the home at all since moving there three years ago, other than for hospital appointments or to the garden. Once Dorothea had begun to abscond, she was even stopped from going out into the garden as it was seen by the staff as a risk in case Dorothea tried to leave through the side gate. Dorothea told Ollie, “I’ve forgotten what fresh air smells like.” 

Dorothea has three daughters who did not live close by, so it was difficult for them to visit. However, during the Court proceedings, one agreed to visit to take Dorothea out locally; Dorothea enjoyed the outing very much.

Dorothea told Ollie that she would like to live near to one of her daughters. She also wanted to live somewhere “more friendly” than the care home she was in. Ollie reported this to the Local Authority. Her daughters wrote to explain that they had been taken into care as children, and that they now wanted the opportunity to build a relationship with their mother as she approaches the end of her life. The Local Authority started looking for placement options close to one of her daughters.

A placement was found close to her eldest daughter and Ollie explained to Dorothea where the new placement would be and showed her pictures. Dorothea confirmed to Ollie that this is what she wanted.

This year, Dorothea moved to a care home close to her eldest daughter. As a result, all her daughters are now able to visit more regularly, and the eldest has been in to see Dorothea every day since she moved. She has also said that she will now be able to take her mother out more often.

Dorothea is reported to be like a different person since the move, she is said to be “bright and bubbly.”  She participates in activities and has been out on trips to the garden centre. She has been eating at mealtimes and has already put on some weight. She is enjoying socialising with other residents. She also has a phone line in her room and can speak to her best friend every evening (previously she had not spoken to her for three years before that). 

With Ollie’s support Dorothea’s wishes and needs have been heard and her rights upheld. Decisions were then made with Dorothea’s well-being in mind and her life has been much improved by the change in her accommodation and the re-establishment of her relationships with her family and best friend.