What do I want?

 

Age does not automatically equal inability or mean that someone doesn't know what they are doing/thinking. 

A specific diagnosis does not cause a blanket inability. Someone can have a dementia diagnosis and still be able to make their own decisions and choices. They can still know where they want to live or what they do and do not want with their care. 

I have a lot of conversations with family members telling me what the person needs and sometimes actually what they are telling me is what they need to make it easier. For their worry to decrease. I understand this from their perspective but also I am there to do the best thing for the person. I am there to advocate on their behalf. If they don't want to be in care and I can do something to support this then I will. 

We work to a home first model in my area and i got into a conversation with someone at a care home about this. They asked me whether that's the best thing for everyone and my response was that we don't force everyone to stay at home and if care is a better option we support with that but we use home as a starting point and work from there. 

Some people genuinely cannot manage at home which is why care homes exist whereas a lot of people could with just a small amount of support or a couple of tweaks. 

I worked a case right at the start of my ASYE where there were concerns about someone with dementia at home, family really struggling and big concerns about fires being set by accident. 

This is where assessing risk and making tweaks plus adding some respite as a rest for the carer was enough to keep that person at home a lot longer. It allowed me to learn about things that are available that I did not know existed such as locks that are put on gas pipes so that hobs can't be left on. This demonstrates how important your knowledge is in Social Work, not just the laws and legislation, theories and models but also on the group/local area resources which exist. 

Sometimes I have families telling me what their major concerns are which actually I don't see as a big risk. It's so interesting how people see risk. I know that when it's your own family it's different because you care about them deeply and love them so it can be a lot scarier. I am looking at it from the outside and with my professional Social Work head on which I believe makes it easier for me. Definitely not easy but easier than if it was my family member. 

This is why the assessment process is so important because it allows us to use our professional curiosity to dig a little bit deeper instead of presuming that what we've been told by family/care providers as gospel. What people are asking for isn't necessarily what is actually needed. There may be other options that they don't even know exist that would actually be the right thing and that's where me going in using my knowledge gives them a better experience and outcome. 

It also gives us the opportunity to record someone's voice and wishes. Especially if we get involved at the beginning before someone loses capacity because that assessment can support us later down the line if we have to make a best interest decision. Also encouraging people to create a living will or advanced directive to have those wishes recorded. Plus power of attorneys so that they have someone advocating on their behalf in the difficult situation where someone does lack capacity to make bigger life decisions. 

We are there for the person and sometimes it can get blurred with all the other voices coming in. We need to clear the trees to see the wood.