Mr Q (90): DoLS example from practice

When his wife died, Mr Q (90) came into a care home from the smallholding where they had lived for many years. He was incommunicative, and staff thought him very suspicious of them, and somewhat confused. They found Mr Q very resistive to bathing and showering; in their words, ‘It was a battle to get him to keep clean or change his clothes.’ He also worried them by wanting to go out alone. Although he was quite mobile, there were concerns that he might get lost, and the home had twice notified the police, who had found Mr Q several miles away, but saying he knew his way back to the home. Mr Q’s daughter-in-law supported the staff’s actions in restraining him, saying he’d always been ‘difficult’. The care home became worried that the battles were getting worse, and applied for a standard authorisation.

The best interests assessor identified that Mr Q had capacity to refuse their interventions: Mr Q explained that he wasn’t used to bathrooms, and preferred to wash at the sink. He also thought they were being nosy asking him where he was going, and wanting him to change his clothes so often – he resented the implied criticism. He thought he was unlikely to fall, but he would take that risk: he couldn't bear being indoors or with other people all day.

Mr Q was then invited to help staff draft his care plan, which, with his input, consisted of minimal intervention, more stews at dinner time and acceptance from the staff that he was free to wash how he wanted, wear what he wanted, and go for long walks.

Read more: Use of DoLS in care and nursing homes