Just needed to be heard for a little while

Waves_and_Smiles

Hahahahahaha I love CBP! Mean penguin!

We could do, JM! It depends how interested people are. There are some topics that will be covered that I won't post on here about medical decisions where there is no right or wrong answer so it is a judgement call on all sides. Some are clearly painful choices for all involved so the course covers what a healthcare worker should take into consideration before reaching a conclusion.

I have made decisions like that, for example whether to return a client to long stay hospital after they had been in community care for 2 years, thus losing them their place in residential care. They weren't able to make the decision for themselves and the choice was mine and their psychiatrists, they had no family. I remember crying an awful lot, it was heartbreaking. I think we did make the correct decision for them but I had many sleepless nights, it is very hard to be responsible for someone's future especially when you can't allow your own emotions to influence your decision.

jobbingmusician

I think (but am not sure) that the Mental Capacity Act has changed that now, so it would be an independent person who made the decision (but maybe you were that independent person?)

I'll start a thread by discussing something which came into my head this morning which I thought could be related to the questions you originally set us, and we'll see what interest there is.

Waves_and_Smiles

Sounds good, JM! It wasn't an independant person when we made that decision which was very wrong looking back. It was on the shoulders of his psychiatrists and me representing his residential care, if he had had family they also would have been involved. An independent person is a much better choice because trying to put my emotions aside after working closely with him for 2 years was incredibly hard, plus being such a rescuer meant I felt as if I was admitting I had failed if I opted for him to return. I obviously had to discuss it with other staff, too who fell into different camps so whatever we chose was going to upset someone.

We did actually agree that he should go back. He had been institutionalised for 30 years previously and was moved into community care within 3 months and it was way too fast. The poor man sunk into a deep depression and gave up on life, he wouldn't leave his room, talk, eat or drink. Within a month of being returned to hospital he was going out again and back to laughing and having fun. I recommended that he eventually could live in the community but needed a far longer transition time than 3 months, all that did was take away everything he had ever known. It still makes me sad.

Pyxis

jobbingmusician wrote: »

I was thinking of your course and the thread, WaS, and was entertained by the idea of us trying to discuss bioethics on a thread where we are very penguine aware. I wondered if we ought to have a special penguin bioethics penguin thread where we could discuss stuff (keeping off known triggers)?


The..................

Bioethics Thread! (Don't Ask!)......(All Right Then, Ask!)





I also came up with a new acronym - CBP* - for the sort of penguin which attacks immediately rather than sidling up and pretending to be friendly

Crotch biting penguin

Wot, like this, you mean?

Waves_and_Smiles

Hahahahahaha I do love your pics, Pyxis. Somehow you manage to get them spot on everytime.

elsien

jobbingmusician wrote: »

I think (but am not sure) that the Mental Capacity Act has changed that now, so it would be an independent person who made the decision (but maybe you were that independent person?)

Theory and practice...
People who lack capacity have an IMCA, an independent advocate. However due to time constraints the IMCA may only meet them once or twice before a best interests meeting. So if you have someone with a severe/profound learning disability, the IMCA doesn't have a snowball's chance of getting to know them, their needs or preferences in that time. So they rely on people who know them - carers and family to provide the information.
So with my home closing, family and other providers weren't involved in the decision for a number of reasons. Which left me, the IMCA and the social worker who'd also only met the person 3 or 4 times over a couple of months. I think it's fair to say my opinion was the one that carried most weight as I'd also provided all the information for the care assessments and care funding calculators.
The social worker was the best interests decision maker. She had 3 months to assess the person, look for suitable alternatives, go to panel to agree funding, have the best interests meeting, and move the person out. And she was under all sorts of financial constraints and had her hands tied by county council procedures.
So independent? Not in this case.
Edit - I do think the mental capacity act was on balance a good thing. But it relies on people having someone to shout and scream on their behalf sometimes. And I do worry for people who don't have family or anyone looking out for them. Because an annual "are you alive" review from social services is completely insufficient for people who have no families. As all the information comes from the care provider who could be lying through their teeth. And IMCAs come in to deal with specific decisions, then sign off again. There aren't any long term advocates, not in my area anyway.
As you may be able to tell, I've become very cynical about social care and its workings of late. I'll get off my soapbox now.

jobbingmusician

The very one! CBP!

Bioethics thread is at https://forums.moneysavingexpert.com/discussion/comment/66328213#Comment_66328213

(I can see I've sort of painted myself into a corner, as I won't be able to give that level of detail very often )

Just seen your post, elsien. Thank you! That's really very informative. I sort of knew it, but you paint a very realistic picture, sadly I hope it wasn't too much of a penguin for you as I know leaving your job was awful

Waves_and_Smiles

Oh, that's awful, elsien. The red tape certainly doesn't help. There still seems to be so many flaws in the system, it seems nothing much has changed since I was working. In my case it was at the great care in the community push when long-stay hospitals were being rapidly closed and people were just being pushed out as fast as possible into community care. There was very little transition time and some of these people had been in hospital for 30-40 years. It was ridiculously handled, even walking down the street terrified them. I am all for people being housed within the community but not that fast, it was like putting them on a different planet and expecting them to immediately adapt.

(How's Gitdog?)

dibuzz

I managed to go to my neighbours funeral today. The hardest bit was actually going out through the door and walking over to his house.
One of his old carers was there which helped and I went into the club after as well. If she hadn't been there I'd have just gone back home.

Waves_and_Smiles

Awww, I am glad that you made it dibuzz. Gentle hugs. I think you will feel better that you went and you were very strong to be able to manage that with everything that you are going through.