Mr and Mrs S (90s): DoLS example from practice

Mr and Mrs S, both in their 90s, have been married for 70 years and are devoted to each other. She has dementia, and is very dependent on her husband for physical care; she lacks capacity to understand her care needs, and is anxious if separated from him. 

Following a fall she was admitted into respite care. She was not badly hurt, but when her husband asked to take her home he was refused: this was because he persistently refused services and support (apart from their family, most of whom lived some distance away), and therefore safeguarding issues had been raised. The care home gave itself an urgent authorisation under DoLS. At the start of the assessment process it was clear that the home staff were convinced that Mrs S could never return home. In the formal assessment process that followed, they were made aware of the devastation caused to both Mr and Mrs S by these breaches of their human rights (her Article 5 right to liberty, their joint Article 8 right to a private and family life) and their view of the risks to her became more balanced within a more holistic assessment of Mrs S’s best interests. 

A short period of authorisation was agreed with a condition that the care providers were committed to working with Mr S to enable his wife to return home. To strengthen his position, he was named as his wife’s representative under the Safeguards, so he felt able to visit often and advise on her care. The supervisory body appointed an IMCA under the DoLS provisions to help him understand his rights of challenge. He agreed to accept a care package at home, and Mrs S returned home, where she lived happily for a further nine months.

Read more: Use of DoLS in care and nursing homes