Describe how to ensure an individual with dementia, carers and others feel able to complain without fear of retribution

Complaint procedures must be easy to use and readily available to all. We must acknowledge all forms of complaints as soon as we receive and handle strictly with confidentiality. We must provide written instructions of complaints procedure before commencing the service. We should also encourage individuals, carers and others to make complaint when such a situation arises. We must explain to them about their rights and available internal and external support. We must provide full assistance if individuals are unable to write and forward complaints. Feedback or comments about the service from service users are the other way to aware of any potential complaints about the service.

 Md Foisal Miah Talukdar

Describe how a conflict of interest can be addressed between the carer and an individual with dementia whilst balancing rights, choices and risk

Conflict of interests may arise between carer and individual with dementia from time to time. There is also dilemma may arise while you working with an individual with dementia. In those situations, carers or individuals may need counselling, advice and guidance from senior care worker or manager. As a carer, you must always be aware of your role, purpose of your role and professional boundaries. Persuading and compromising behaviour are keys to address this sort of issue. A group training session including possible scenario will definitely be helpful to address this kind of issue at workplace.

Md Foisal Miah Talukdar

Describe how the ability of an individual with dementia to make decisions may fluctuate

Dementia is a set of symptoms and different types of dementia affects individual’s ability differently. Individual with dementia may be able to make decisions about everyday choices and preferences, but an individual may find very hard to making any complex decision, as they may not be able to understand and retain the information to make right decision. However, ability of an individual depends on types and stages of dementia.

Individuals with vascular dementia may suffer from memory problems (such as recalling recent or past events) and problems concentrating due to slower thought. They may not be able to speak very fluent or not be able to speak at all. Giving consent and taking decision may become very difficult for them. In early onset of the symptoms they may be able to make decisions without any interruption.

Individuals with fronto-temporal dementia can exhibit inappropriate behaviour or ruthless comments to others. Due to their behaviour and lack of empathy to others, decisions taken by them may not be legible for the purpose.

Individuals suffering from dementia with lewy-bodies may have disorganised speech or struggle with planning and decision making.

It is very important to understand that at the beginning of the symptoms of dementia, an individual can make own decisions and plan for their own care ahead even with little help and support. At later stage, it is almost impossible for them to make any decision or contribute to it at all.

Md Foisal Miah Talukdar

Demonstrate that the best interests of an individual with dementia are considered when planning and delivering care and support

One of the legal requirement for delivering care and support is person centred care. Therefore, all providers must create a person centred care plan for each individual they provide care and support. It must meet individual’s choices and preferences and be planned with the individual. However, when we create person centred care plan for an individual with dementia, it is not always possible to determine or establish their choices and preferences due to their memory impairment, poor mobility, medical conditions, poor judgement and inability to retain information and take decision. If choices and preferences of an individual with dementia cannot be readily established then we must take decision considering individual’s best interests. Best interests decisions are usually taken in the presence of various professionals (depending on the specific decision), individual and family members after assessing all the available information.

Example: One of the individual with dementia would like to go out himself for shopping. Due to individual’s forgetfulness and other associate behaviour, it is not suggested to let him go for shopping on his own.

Best interests decision: After reviewing all the available information and taking into account of individual’s and public’s health and safety, it is being decided that we can introduce online shopping to the individual. If it still does not fulfil individual’s preferences then one carer can escort him to do the shopping.

Md Foisal Miah Talukdar

Explain the impact of key legislation that relates to fulfilment of rights and choices and the minimising of risk of harm for an individual with dementia

Key legislation:

                Human Rights Act 1998 

        Health and Social Care Act 2008 Regulations 2014 

                Mental Capacity Act 2005 

                Adults with Incapacity (Scotland) Act 2000 

                Mental Health Act 2007 

                The Disability Discrimination Act 1995 

                Safeguarding Vulnerable Groups Act 2006 

                Carers (Equal opportunities) Act 2004

An individual with dementia may become deprived of their liberty, rights and choices. They are also at greater risk of harm and abuse. Therefore, government put various legislations in place to protect individual with dementia from harm and abuse and promote their rights. The basic principles of Human rights act 1998 and the disability discrimination act 1995 are no one should be treated unfairly, due to their age, race, gender, disability. belief and sexual orientation. Everyone should be treated equally. These pieces of legislation support the rights of an individual with dementia. The health and social care act 2008 (regulated activity) Regulation 2014 emphasized on ‘Person-centred care’ which promotes rights and choices of individual with dementia. This legislation states that ‘The care and treatment of service users must – be appropriate, meet their needs and reflect their preferences’. Mental capacity act 2005 impose rule about deprivation of liberty for individuals with dementia and other mental illness. It also stated that if it is established any individual does not have mental capacity, then service provider or designated person must act on individual’s best interest. In order to minimise the risks of harm and abuse to individuals with dementia, Safeguarding vulnerable group act 2006 put rules of vigorous screening system for the worker prior to coming in contact with vulnerable adults.

All of these legislations must be maintained in practical work environment by service provider. Violating or non-compliance of these legislations can be heavily consequence such as operation closure, license provoked, reprimand and imprisonment. 

Md Foisal Miah Talukdar