Edward is a 70 year old man who has Dementia and physical disabilities. Edward lives in a nursing home. He is non-verbal and communicates through nods and expressions. He doesn’t have any friends or family who visit.

Sylvia, a POhWER advocate, is Edward’s Relevant Person’s Paid Representative (RPPR) and she visits him regularly. When Sylvia first met Edward, staff were caring for him in bed. It was deemed unsafe for Edward to sit in his chair as there was a high risk of him falling forwards and out of the chair.

Edward’s room is down a corridor away from the life of the home and quite isolated. Although staff visited Edward to see to his physical care, they are stretched and could not spend any substantial time with him, despite their best efforts.

Edward often became agitated and distressed, calling out and slumping down in his bed. He occasionally needed to be given Lorazepam to help him to calm down.

Sylvia worked in a non-instructed way using Edwards’s rights under Deprivation of Liberty Safeguards (DoLS) law and the Human Rights Act as her guide.

After discussing these issues with the nursing staff, Sylvia asked them to request a referral via Edward’s GP for an Occupational Therapy (OT) assessment to be carried out, so that a suitable chair could enable Edward to spend time out of bed and in the home’s communal areas to reduce his isolation. The OT could also assess the support he needed in bed to prevent him from slipping down.

This request was made via the home and GP, but it took a very long time – months in fact – for an Occupational Therapist to respond.

Sylvia continued to follow this up and when there was no progress she eventually called for a Review of the Deprivation of Liberty Safeguards (DoLS) as Sylvia considered Edwards’s liberty to be severely restricted by having to be cared for entirely in bed, in isolation. Sylvia considered the need for a Safeguarding alert, but decided against this as the home was following the correct protocols in attempting to meet their resident’s needs.

The DoLS was reviewed, and with the Best Interests Assessor’s help, and after many calls to follow up the OT referral, they succeeded obtaining a visit and assessment from the Occupational Therapist. A further delay was experienced due to a decision needed over funding for the chair, but this was eventually resolved.  

An appropriate chair was then provided for Edward and necessary adaptations were made to his bed. Edward is now much more contented and settled. His periods of agitation and distress are much less frequent and he has not needed to have any Lorazepam for some months. He seems to appreciate being out of his room in the lounge, watching the activity and life of the home going on around him.

Edward has had his right to liberty and security upheld as he is now cared for in the least restrictive manner possible to meet his needs. He is now able to access the social life of the home and appears much more content.