Mr T (64): DoLS example from practice

Mr T is a 64-year-old with a diagnosis of alcohol-related dementia leading to hallucinations, paranoia, continued drinking, self-neglect, exploitation, assaults in the community and outbursts of violence and aggression.  

He had briefly been detained under Section 2 of the MHA 1983, but his dementia did not respond to treatment. He remained on the ward since there was nowhere else for him to go, and his considerable physical health problems meant that he needed help with medication.

Mr T kept trying to escape from the ward and join his unit as he thought that he was still in the armed forces. Following a best interests meeting it was decided to seek a specialist care home placement. In the interim, it was identified that Mr T’s rights needed protecting, and a request was made for a DoLS authorisation. The eligibility assessor examined carefully the nature of his treatment, and decided that, but for his physical condition and the need to manage this, combined with the difficulty of finding a suitable care home, Mr T would not have needed to remain in the mental health unit. Therefore he was not a mental health patient, and ‘not ineligible’ for DoLS.

Mr T remained on the ward, with the protection of an authorisation, until he was placed in a small specialist unit. During his time on the ward, his paid relevant person’s representative, supported by an IMCA, requested that the supervisory body review the eligibility requirement, since they felt Mr T should have been detained again under the MHA. A different eligibility assessor came to the same conclusions as the first, that the DoLS authorisation was the appropriate legal framework to protect Mr T's rights.

Read more: Eligibility assessment (standard form 4)