Duty of Care – Different Interpretations! Print E-mail

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The following question was asked at a presentation on how to deal constructively with difficult behaviour

What should we do when one of our residents – a lady in her 8o’s, who has dementia – wants to go out for a walk? She cannot go on her own because she can’t find her way back. We try to divert her attention or, if that doesn’t work, we tell her that she can no longer walk on her own in case she gets lost. She then becomes agitated and very angry to the point of being aggressive.

On further questioning, it was revealed that the lady in question, Alice, was physically capable of walking and that she had always gone for a walk each day because she believed it kept her healthy and fit.

Knowing that going for a walk had been such an important part of Alice’s life and that she was physically able to walk, it was important to support her in continuing to take her walks on a daily basis.

Three ways were suggested how this could happen practically:

  1. As part of the care plan, a staff member could provide the support needed to enable Alice to go for her walk each day. (Avoid expressions such as: a staff member could take her for a walk. This is the type of language we use when speaking about what we do with our pets!)
  2. This could be an ideal role for a volunteer to come in and, as a friend, go for walks with Alice.
  3. A rejected Seeing Eye dog could become an integral part of the care team and could accompany Alice on her walks. The dog would be trained to get both back to the hostel. (This solution is already being used successfully in facilities within Australia.)

The staff member who posed the above question responded in strong terms that she did not see how staff could find the time to implement the above strategies, nor would she ever allow this resident to walk outside because she saw it as her duty of care to ensure the resident was safe.

This is a real life story, which represents a very unfortunate and growing trend – one that indicates that the term duty of care is now being used by some carers as a reason to justify the use of power and control, enforcing restrictions on those they are meant to care for, instead of providing support and encouragement to enable the person to live life to his or her fullest potential.

When duty of care is interpreted as justification for restriction and control then the focus is only on the action of duty of care, not on the possible consequences of the action. Whenever we take control over another person and exercise this by using restrictions, we are bound to create strong negative reactions, such as anger and aggression, resulting in most unfortunate negative consequences.

While duty of care is about ensuring that a person is kept safe and secure, duty of care is about ensuring that the person’s needs are fulfilled too.

Further reading – Click topic
  • Duty of Care - Different Interpretations – Members article – Jane Verity (Read the full article for further discussion on the interpretation of “duty of care” as a justification for restriction and control, an enlightening view on “fear of risk”, plus 3 positive interpretations for “duty of care”.)
  • The Eden Alternative – Creating a Life Worth Living in a Nursing Home – Précis/Members article – Jane Verity (Read this article to learn about the birth of Eden and its founder, Dr Bill Thomas; discover the 3 plagues of care; what is an Eden home?; Learn the 10 Eden Principles; and the reason why the Eden Alternative is one of the best options for dementia specific centres.)
  • Checklist for Choosing the Right Aged Care Home – Members Tip Sheet – (Advice on different types of accommodation and home care support for people with dementia; plus comprehensive checklist and guide for comparing facilities and the services they offer; plus contact details for where to get help and advice about aged care, including further helpful links.)
  • Concerns and Complaints in Residential Care – Members Tip Sheet – (Advice on concerns or complaints regarding your rights as a resident or those of a family member in care, including contact details for the Aged Care Information Line and further helpful links.)
  • Hugs not Drugs – Members short article – Jane Verity (Discover 3 factors behind attention-seeking behaviour, the 5 secrets to “great” hugs and 5 hints to check if a hug is creating discomfort in another person; plus a wonderful non-threatening excuse for exchanging a big hug.)
 
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