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  • 29th October 2018 | by David Jolley

    I was outraged by the damage done by mindless legislation which created DoLS (Deprivation and Liberty Safeguards) and progressively changed it by questionable case ruling precedents: Thousands of people lacking capacity but content with the care they were receiving have found themselves subject to certification at massive and useless cost. Any movement to hospital or another care setting requires additional costly assessments and paper work. For many months all deaths for people dying whilst detained under DoLS had to be dealt with by the coroner. Thankfully this last most bizarre twist has been corrected but all the rest of DoLS’ havoc remains quietly, expensively and perplexingly in place.

    It has been a pleasure to make small contributions to the work of the Law Society in its review of DoLS, eventually producing a scholarly but practical report based on their wisdom and knowledge and informed by fieldwork in care situations, formal consultations and further informal discussion with people who are involved (‘stakeholders’). I was impressed by the comprehensive, positive and ingenious recommendations of that report.

    This report was passed to Parliament as it prepared to revise the DoLS legislation.

    I have been aware that there have been further discussions and comments from colleagues and others who would have views; but I have not followed the progress, feeling that as I do not now have direct clinical involvement with services I have become less equipped to have a significant voice. This decision has, no doubt, rescued me from much pain. I have presumed that the clout of the Law Society is such, and respect for their work so secure, that something worthwhile would emerge from the scrummage.

    First twinges of uncertainty came a couple of weeks ago at our Friday meeting where I was told the draft bill would not extend to people (with dementia or other causes of lost capacity) who are not already in care. This week an email from a friend drew my attention to a letter ‘Ministers must rethink how to care for the most vulnerable in society’ to the Times - Red Box October 22nd from Baroness Thornton www.thetimes.co.uk/article/ministers-must-rethink-how-to-care-for-the-most-vulnerable-in-society-g906zt77k In this she drew attention to shortcomings in the current proposal for amendment of the Mental Capacity Act.

    The Law Society had worked hard and thoughtfully to produce an inspirationally well informed, costed and balanced report. This has been butchered and weakened beyond recognition.

    The Law Society had produced a characteristically elegant, but never-the-less forthright briefing for the House of Lords: The Law Society Parliamentary Brief: Mental Capacity (Amendment) Bill 2018. House of Lords Committee Stage September 2018. In this they say:

    • The proposed scheme will weaken safeguards
    • Resource constraints do not justify failing to implement the safeguards recommended by the Law Society fully
    • Getting this wrong now will affect thousands of people for many years
    • Lacking sufficient safeguards, the proposed Bill is not fit for purpose. It requires serious reconsideration and extensive revision
    • The new Bill must include the right of individuals to object and to challenge the arrangement. If the individual is unable to object, there must be an independent review · The wishes and feelings of cared for people must be centre stage
    • The scheme must comply with the principles of the Mental Capacity Act 2005 and the United Nations Convention on the Human Rights of Persons with Disabilities
    • It must ensure that assessments are independent and there is an effective review process
    • The situation of young people (aged 16-17 years) has to be reconsidered

    It is clear that there are many basic flaws in the current draft. The proposal is that the new bill will adopt the name: ‘Liberty Protection Standards’, which is the name suggested by the Law Society. For this to be right, the new bill must clearly comply with the standards which the Law Society has presented in its report and restated in this briefing.

    You look away – and just see what happens!

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    24th October 2018 | By David Jolley

    Somehow we are all so much more visible, and vulnerable, when moving from place to place. Police programs show us how rogues and worse can be identified by a combination of their bad driving and information linked to registration numbers. Those who offend in this one aspect of life are often up to mischief elsewhere too.

    This week both of us travelled by rail on different days to East Anglia – It is an awkward journey which requires travel from West to East and back, and North to South and back. The trains go a long way – too and from the South Coast through London, from West to East coast via Manchester. On both days there were delays because: ‘A person has been hit by a train’ – many miles away, but fusing the system from one end to the other for hours.

    This gives time to reflect on the sadness and desperation which individuals must have felt to end their lives in this way. Suicide rates in the UK, having fallen for some years, have latterly been rising https://www.theguardian.com/society/2015/feb/19/number-of-suicides-uk-increases-2013-male-rate-highest-2001 Such deaths may be related to personal illness and circumstances, but the general increase might well be linked to other measures of chaos within our community in the grip of cuts to basic services and the publication of stories which make these widely known https://www.theguardian.com/uk-news/2018/apr/09/rise-in-violent-not-due-to-police-cuts-alone-figures-show.

    Other deaths on the go related to an elderly driver and his wife, driving a caravan the wrong way down a motorway only days after being involved in another accident: https://www.birminghammail.co.uk/news/uk-news/elderly-caravan-driver-who-drove-15296155.

    These are dreadful, dreadful events. It is not possible to dismiss them as random and unrelated. We surely should expect changes to our services to return to a safer more civilised state.

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    16th October 2018 | By David Jolley

    A burst upon us as an angry man – furious at what life has dealt him and his wife, who is three years into dementia while still physically able and in her early 60s. Furious too with doctors who are content to make a diagnosis and offer no ongoing support. Disenchanted with experts who offer courses which begin and end, and cost.

    B came early and joined in setting up for the afternoon. She smiled a lot and was pleased to engage with an older couple. Not quite sure why she was with us, nor about some of the topics, but this felt like good company for a couple of hours.

    C had been encouraged along by his caring wife. He had been reluctant last month so that she came alone. This time he was braver – ‘thinks he might be missing something’ – C also smiled a lot and took opportunity to say a few things.

    D knows about dementia by family experience and professional involvement. He is involved in church dementia-related activities and can share with us information that shows how far churches are indeed taking a more active and well-informed role.

    They were joining a group which has a core that has been here over two years. Here is welcome. Here is understanding. Here is somewhere that will last and live with reality.

    The fiercest exchanges, perhaps the strongest bonds, involve the halves of younger couples – seeking reason – inches from denial that this can really be – putting together a patchwork of caring, coping and cussing but refusing to give up on pleasures shared.

    There are no magic bullets, compliance with the best health promotion advice is no guarantee of avoiding dementia, training regimes can take you only so far – and the pattern of needs moves on, so that continuous rejigging is required. Care plans are what we make ourselves out of whatever strengths we come across.

    Cake, tea and catch-ups are the cement.

    Oh – and we quite like to know about natural remedies that old wives have told us about – and music.

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    8th October | By David Jolley

    We have glorious horse chestnut trees on our park. They are threatened by the canker which is affecting so many of this species worldwide https://www.forestresearch.gov.uk/tools-and-resources/pest-and-disease-resources/bleeding-canker-of-horse-chestnut/ but for now they survive with dignity and deliver their precious crop of shiny conkers every autumn. Mums and dads and grandparents hunt amongst the fallen leaves alongside small people, searching for the free gold. There are stories after stories as memories of hunts over the years flood back to consciousness, beckoned by the feel and sound of the leaves and the scent of autumn all around. Good therapy for anyone, including those with weakened memory function.

    Amongst the chestnut combers we find an older lady studiously filling her cotton bag with conkers. Is she collecting these for grandchildren?

    No but for friends who have an aversion for spiders. She and many others have belief that conkers have magical powers to scare away the creepy blighters. An old wives’ tale – but might it be true? We have been disappointed to learn that experiments declare that slugs munch on lettuce impervious to the hazards of traditional ways to discourage them: https://www.bbc.co.uk/news/science-environment-45652170

    But maybe conkers have magic powers to counter spiders. Probably not says the Woodland Trust – No evidence to support the myth. But I’d not be too dismissive. It is believed that conkers exude an aromatic substance ‘triterpenoid’ which is toxic to moths – so conkers are recommended as an alternative to moth balls. Extracts from conkers have been used to deal with sprains in horses – hence ‘horse chestnuts’. The anti-inflammatory ‘aescin’ is the chemical said to be responsible for this power. And ‘saponins’ from crushed conkers produce have soap-like properties and were used by the Vikings to keep clean.

    Well – this is conkers and we do not have a direct link to brain research – but the wonderful Elaine Perry and her daughter Nicolette have been creating a garden devoted to growing and researching plants with healing properties, especially for brain dysfuction. http://www.hexham-courant.co.uk/features/16613493.healing-plants-to-soothe-the-brain/

    I am hopeful and optimistic that they will strike gold. In a way they have already.

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