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Human rights and the care of older people: a UK perspective. UN Open-Ended Working Group on Ageing: fifth session 30 th July to 1 st August 2014 Ruthe Isden, Health Influencing Programme Director, Age UK. Plenty of reports…. And headlines….
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Human rights and the care of older people: a UK perspective UN Open-Ended Working Group on Ageing: fifth session 30th July to 1st August 2014 Ruthe Isden, Health Influencing Programme Director, Age UK
UK Parliamentary Joint Committee on Human Rights 2006/7 Inquiry into hospitals and care homes • Malnutrition and dehydration (Articles 2, 3 and 8) • Abuse and rough treatment (Articles 3 and 8) • Lack of privacy in mixed sex wards (Article 8) • Lack of dignity especially for personal care needs (Article 8) • Insufficient attention paid to confidentiality (Article 8) • Neglect, carelessness and poor hygiene (Articles 3 and 8) • Inappropriate medication and use of physical restraint (Article 8) • Inadequate assessment of a person’s needs (Articles 2, 3 and 8) • Too hasty discharge from hospital (Article 8) • Bullying, patronising, and infantilising attitudes towards older people (Articles 3 and 8) • Discriminatory treatment of patients and care home residents on grounds of age, disability and race (Article 14) • Communication difficulties, particularly for people with dementia or people who cannot speak English (Articles 8 and 14) • Fear among older people of making complaints (Article 8) • Eviction from care homes (Article 8)
Dignity and respect • Weak regulation – inadequate information, ‘tick box’ inspections and inadequate expertise • Process and target driven management and policy making • Deeply embedded professional and institutional cultures that mitigate against dignity or a rights based approach • Lack of emphasis on care of older people or a rights based approach to care within professional training • Chronic lack of training for health and care assistant workforce • Low awareness of rights amongst service users and front line staff – e.g. NHS Constitution
Poor access and inadequate processes • Denying people rightful access to health and care services – e.g • Low referral rates to specialist services • Limited access to primary care services within care homes • Failure to offer best practice treatments – i.e. talking therapies • Inappropriate processes or failure to apply processes appropriately – e.g. • Deprivation of liberty orders • Do Not Resuscitate orders • Discriminatory decisions making – e.g. • Clinical decision making based on assumptions about age and frailty • Inappropriate medicating of dementia patients
National policy frameworks • Care Act will introduce significant new legislation but challenges remain • High bar for eligibility • Insufficient care provided • Failure to afford protection to private care users • Failure to tackle embedded age discrimination • Explicit age ‘cut-offs’ embedded in national outcomes frameworks