Author Topic: Interesting judicial review re care  (Read 2539 times)

Sunny Clouds

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Interesting judicial review re care
« on: February 16, 2012, 02:09:41 AM »
http://www.telegraph.co.uk/health/healthnews/9084053/Obese-woman-demanding-50-hours-care-a-week-went-to-pop-concert.html

This news story is about a woman with psychological problems and diagnosed with a personality disorder with symptoms including paranoia who is judicially reviewing her local council's decision not to provide full-time care.

Her local authority argues that she "requires no care services whatsoever, that she's over-reliant and it's a question of choice".

The Telegraph predictably made a thing about the fact that she is obese and also that she apparently attended a music concert. 

Good, isn't it?  The odd trip out and she needs no care whatsoever. 

I had a friend with a personality disorder who required a lot of help.  The state is no longer geared up towards substantial help for people with psychiatric/psychological needs.  Once upon a time, there were asylums, then there was don't-care in the community.

I'm assuming this is supposed to be either borderline personality disorder or dependent personality disorder, and given the references to paranoia, probably the former.  This would tie in with the general attitude towards BPD, but like I say, this is just an assumption on my part and assumptions can make a person look foolish. 

I remember many years ago having my first psychotic breakdown and trying to get help and a receptionist at my GP's (fortunately no longer my GP's) surgery telling me I was an attention seeker.  I asked her if she would call me an attention seeker if I was having an asthma attack or a heart attack and begged for help.  I think that attitude is all the worse for people with a pd diagnosis, but there for people with a variety of other diagnoses too, from me to substance dependency.

On the other hand I have a friend I have little contact with these days who has severe BPD and in the end I had to back off because it all got too much and I found myself wondering how we'd ended up with a welfare system that couldn't give people like that the right level of support.  If she had kidney failure, they'd hook her up to dialysis for hours every week, but she has, I don't know, can we call it emotional regulation failure, and she doesn't get hooked up to psychological care for several hours a week.

Very difficult.  With my friend, she would turn to different friends in rotation expecting us to deal with her frenzied self-harming behaviour, having an all-or-nothing relationship.  For years, I maintained boundaries, but in the end I gave up and backed off.  I think that's what the professionals do.

There used to be residential facilities for people with severe PDs, but they're out of fashion.  So is round-the-clock one-on-one care in the community the answer?  Is it feasible?  Would it work? 

My friend used to call saying things like "I'm down by the canal in my pyjamas and I've taken an overdose, come and get me".  Suppose someone does that with a carer, will it make any difference?  Won't they just have to call the same emergency services that the person they're caring for would have called in their absence?  Or will their presence make a difference?

I don't know the answer, but if this woman wins her case, I'd like to think there'd be some sort of follow-up in, say, five years time to see whether round-the-clock support would help as she says it would, or merely increase dependency as the local authority says it would.

Meanwhile, I hope the media don't expose her name.  This is a really important test case and I think that it raises a lot of issues that are fundamental to what it is reasonable to expect from the welfare system/society.

Although my diagnosis is  bipolar not a pd, I've been briefly diagnosed with BPD a couple of times in the past because there are large symptom overlaps and I was horrified at the difference in attitudes amongst doctors, nurses and social workers when I had the pd diagnosis.  When I backed off from my friend, I felt guilty but had to accept that it was a matter of self-preservation.  I could not bear the burden of making daily decisions for her as to whether she should kill herself or not when I had my own problems to deal with.  But I manage my problems largely with an awful lot of social support, including online.  Should that be enough if you have a pd?  Or if you have some other mental disorder?  Or a physical disorder?  Should it make a difference which?

I hope we get a really detailed judgement and that there's some fruitful discussion about this in the media, and not just knee-jerk 'she's fat and went to a pop concert' stuff.

I'd be very interested in reading what others here think about this.  I'm very much in two minds about how to support people with this sort of problem.  I do see painful need for some sort of support, though.

(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Prabhakari

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Re: Interesting judicial review re care
« Reply #1 on: February 16, 2012, 04:06:35 AM »
The lady had a good period and was able to see a band.

She has got problems which are not visible.
So easy to judge; she will be tried by newspaper comments. It is in the Mail as well.
Life may well become much harder for her, because of the newspapers.

I have experienced how a council can offer help. In my case they did not discuss the best solution, but a single man just decided on the spot. I was not given any say in the matter, even though his solution would have created a new problem which was serious for me.
The Occupational Therapist who was present was completely useless. Might as well been a shop mannikin.

I did not accept their 'help'.
So still have major difficulties that I cannot cope with now.

This woman will have many aspects to her needs that we will not be told about.
She needs long-term assessment with trained medical staff to see what she can do, and what her mental state is over a period of time. I would say six months.
How can lawyers, councils and judges have the medical training needed to make a real assessment?

I hope you are coping, Sunny.
With metta, Prabhakari.
Bless 'em all, bless 'em all,
The long and the short and the tall.

seegee

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Re: Interesting judicial review re care
« Reply #2 on: February 16, 2012, 09:54:57 AM »
The Telegraph has attached a poll to that story inviting people to vote on whether the woman should or should not be paid benefits.  >yikes<  :-(
There isn't nearly enough information about her condition in the story for even a well-informed person to be able to make such a judgement - very irresponsible of the paper to be encouraging people to do this kind of ill-informed long-distance judging.  >steam<

KizzyKazaer

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Re: Interesting judicial review re care
« Reply #3 on: February 16, 2012, 10:10:17 AM »
This seems to be almost a Daily Mail style of reporting going on - I too am annoyed that her obesity has been fixed upon in the headline, just to stir up initial 'anti' feelings from some readers that may well prejudice the way they read the rest of it  >angry<

An interesting point is made about the possible pitfalls of extra care, though:

She has become "emotionally and psychologically dependent" on council-funded support and, based on the advice of a consultant psychiatrist, she needs to "take responsibility for her own life and break her reliance on the support of others".

Whilst agreeing that she "requires treatment" for her "psychological" problems, too much care and support from others for her "perceived needs" will be "counter-therapeutic" and "detrimental to her well-being".

It is actually possible for a person to have too much help to the extent that they lose their own motivation and self-determination and constantly look to others to sort their life out for them.  I've seen it in my journeys through various institutions and half-way houses... Sometimes it really will harm more than assist. I think it's called 'learned helplessness' in psychology circles...




hossylass

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Re: Interesting judicial review re care
« Reply #4 on: February 16, 2012, 10:30:16 AM »
If its not enabling its disabling?

My ex-husband was an expert in being helpless. Unfortunately for him I was an expert in not being emotionally blackmailed... Classic stand-offs were regular occurances - maybe people paid to enable dont want the hassle of, and are not paid to, make the client more able.

Prabhakari

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Re: Interesting judicial review re care
« Reply #5 on: February 16, 2012, 10:30:26 AM »
Once upon-a-time, there used to be a special training area in hospitals, where patients learned to do things, so that they could look after themselves as much as possible.

This is now a fairy story, children.
Bless 'em all, bless 'em all,
The long and the short and the tall.

Hurtyback

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Re: Interesting judicial review re care
« Reply #6 on: February 16, 2012, 11:06:58 AM »
One of the problems, as I see it, is that people in caring professions often have a need to be needed*. Hence there is a vested interest in keeping someone dependent. I am not saying that everyone does this, or that it is a conscious decision but it does happen.
 
Of course the other problem is that, with cuts to both staff and other resources, the 'quick fix' solution is frequently to do something for someone, rather than taking the time to teach/help them to be self sufficient.
 
* I speak as a nurse, I recognise this trait in myself and have to work hard to supress it.

Prabhakari

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Re: Interesting judicial review re care
« Reply #7 on: February 16, 2012, 11:52:36 AM »
I am not used to having any help.

When I first saw a disabled club, I was amazed at how all the members just sat back and let everything be done, and organised for them.
It was a good example of how too much help is a disability for the mind.

The trick is to get the balance right.
I get knocked out now if I just try to sweep the floor with a wheelchair-designed broom; but I still do it, even though it really hurts.
The only snag is, I am too weak to sweep up the dust into a dustpan; it has to be left until I have recovered enough strength.

Yet, if anyone were to ask me if I would like them to do it for me, my answer would be no. Not until I am truly unable to do this. Pain and weakness has to be fought against, or we become helpless.
I would love to have some help for some things.
Getting rid of glass. Cardboard. waste paper that pours through the letter-box each week. The washing..... but not all the time. Just when it gets too much.

I am as independent as I possibly can be. Not had any help from anyone for a while. Except for my kind neighbour, who get rid of glass for me.

I know what I can do.
No-one else does.
It is completely wrong to judge this lady.
The Daily Telegraph is acting shamefully.
How would you feel if this paper, and others were to judge your ability?
Trial by the mob?

I hope that things will get better. We were a fairly good country once.
Bless 'em all, bless 'em all,
The long and the short and the tall.

Sunny Clouds

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Re: Interesting judicial review re care
« Reply #8 on: February 16, 2012, 02:32:58 PM »
I've just gone back to look at that poll, which I didn't see before.  It's frightening.

My gut feeling about this is that she needs an all-round package of help geared up towards helping her to be less distressed and more independent whilst not abandoning her without any help she needs.  But that's based on very limited information and that's why I'm hoping the judgement will be released in full so that we can see the whole picture.



(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Prabhakari

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Re: Interesting judicial review re care
« Reply #9 on: February 16, 2012, 02:36:34 PM »
I voted for her getting all the help she needs.

The biggest vote is for taking everything from her. The modern version of not allowing a witch to live.
Bless 'em all, bless 'em all,
The long and the short and the tall.

Sunny Clouds

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Re: Interesting judicial review re care
« Reply #10 on: February 16, 2012, 03:07:46 PM »
I've just found the Mail's version.  Even nastier.  Emphasis again on how fat she is but little mention of what the cases is for why she needs help.

I think I may survive the worst of what is happening.  I have hopes of sufficient recovery to do a bit of work and in the meantime I'm looking after my father and if I lose my current benefits, I'll be able to claim carers allowance.  That will be socially acceptable for the time being because he has dementia and the grey vote is still important to politicians so they're not stigmatising that yet. 

But what sort of world are we living in where I am thinking not in terms of recovery to feel better and gradually contribute more to society, but recovery to survive and not starve?  Because that's what it's going to be for some if we don't manage to reverse this trend. 
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Prabhakari

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Re: Interesting judicial review re care
« Reply #11 on: February 16, 2012, 03:36:04 PM »
Advert:
Why not play the music from the Nice Thread. It may help to raise your spirit up high.




With metta, Prabhakari.
Bless 'em all, bless 'em all,
The long and the short and the tall.

devine63

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Re: Interesting judicial review re care
« Reply #12 on: February 16, 2012, 07:40:57 PM »


Hi

"learned helplessness" is a conditioned response - the organism (it was identified first in rats) learns from its various experiences that nothing it does makes any difference to the outcomes of those experiences and as a result the organism goes into a state (which is essentially non-responsiveness or "stops trying") called learned helplessness.   It's interesting to note that learned helplessness was observed to be associated with poor health outcomes for the helpless individual.

regards, Deb

hossylass

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Re: Interesting judicial review re care
« Reply #13 on: February 16, 2012, 07:46:08 PM »
A poll?

Sick, sick country.


KizzyKazaer

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Re: Interesting judicial review re care
« Reply #14 on: February 16, 2012, 09:05:25 PM »
I must say I expected a whole lot better from the Graniaud....