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Older Persons Advocacy
 The
Matrix approach to older persons advocacy is based on
the same principles as for adult
mental health advocacy. The advocate must be prepared
for what might take a long time to engage with the client and then where
possible, receive instruction. If this is not possible and the advocate
believes the clients rights are not being protected, the advocate can
act on a best interest model.
Communication
with clients is central to the advocacy process. Good communication can
sometimes be difficult in older persons advocacy because the
communication skills of people with dementia are
profoundly affected as the dementia develops. It can be difficult at
times to get a clear understanding of what the client may want.
The advocate will always strive to find ways to keep the client with dementia as actively involved
as possible throughout the process.
Referrals for older people are taken
as self-referrals by the
client (patient) wherever possible but may also come from relatives, carers
and on occasion, ward or clinical staff.
Models of Older Persons Advocacy
An
advocate will always endeavour to follow direct instructions from the
client (patient) wherever possible. This represents an Instructed Model.
Where
a client (patient) cannot give an informed decision, the advocate will
act independently in the clients best interest and ensure their rights
are protected. This represents a Best
Interest Model.
An example of an instructed model:
Amy asked ward staff to contact the Service for
her. Advocate arranges to meet with Amy who is is concerned about unpaid
bills at home and not wanting to ‘burden’ her family with the task of
settling them. The advocate asks Amy what she would like done. Amy
instructs the advocate to draft letters on her behalf to the relevant
agencies letting them know that she is in hospital and she is able to
write cheques to cover the bills. Amy checks the letters signs them and
writes out the cheques. The advocate copies the letters and cheques for
Amy’s records and posts them.
An example of a best interest model:
George has no family and has been diagnosed as
having dementia. The advocate goes to the ward regularly to introduce
the service to new patients. The advocate observes George is in a
lounge on his own shouting in an agitated way. The advocate enters the
room and introduces himself to George, but is concerned to see cuts and
bruises on George and that he appears to be ‘soaking wet’ from his groin
down to his slippers. The advocate speaks to the ward manager and is
told that George is a regular ‘faller’ and often loses his balance hence
the injuries. Ward manager also says that George is incontinent. The
ward manager immediately dealt with the wet clothes by washing and
changing George and wrote in Georges notes that he would benefit from
close observation whilst in the lounges and open areas. This is a best
interest model where we would monitor Georges’ situation on a regular
basis. In the event of further recurrent episodes a formal complaint
would be made to the manager on Georges behalf.
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