ADULT Safeguarding Day is taking place today – Friday November 10, 2023. The event is a nationwide initiative, coordinated by Safeguarding Ireland and supported by the HSE, to raise understanding of adult safeguarding and help to help prevent abuse. The emphasis this year is on actions all adults can take to Plan Ahead and reduce their risk of adult abuse.
The recommended ‘go to’ actions that Safeguarding Ireland recommends all adults take are to:
1) Make an Enduring Power of Attorney
2) Nominate a Designated Health Representative
3) Understand Decision Support Arrangements.
Planning ahead important life decisions on finances, property, healthcare and medical treatments – and appointing a trusted person to act on our behalf if needed – means that these important decisions are recorded on a legal basis, and in the care of a person we have chosen and trust, for if ever in the future we need help.
Doing so is relevant for all adults including if younger and in full health. Providing this clarity not only safeguards our future selves – it also reduces potential for confusion, conflict and tension in families and helps healthcare professionals to know what treatment we would want.
RED C research commissioned by Safeguarding Ireland, and launched today, found that more than 90% of Irish adults have not set out their wishes and preferences for future healthcare and treatments – and the majority are not aware of the need to do so, or how to do it.
Just 4% of Irish adults have completed a legally recognised plan for their future care and treatment, called an Advance Healthcare Directive, while 72% are either unaware of the option to do so or would not know how to put one in place.
The survey of a representative sample of 1,000 adults found that just 6% of adults had nominated a ‘Designated Healthcare Representative’, and 5% had documented their wishes on where they would like to be cared for.
With regard to finances and property, just 11% had made an Enduring Power Attorney which is very low by international standards.
Adult Abuse happens when a person’s rights, independence or dignity are not respected. This can be deliberate, or caused by a lack of knowledge, or omission of care. However, all circumstances of not respecting a person’s rights are abuse. There are many forms of abuse including – emotional and psychological, physical, financial, sexual, organisational, online, neglect, coercive control or discrimination.
More than 10,000 cases of alleged abuse are reported to the HSE Safeguarding and Protection Teams each year, although the actual figure (including what is not reported, or reported to other authorities) is much higher.
Abuse can affect any adult at any stage of life – but is more likely to occur at times of challenge such as living with frailty due to age, a physical or intellectual disability, an acquired brain injury, a mental health condition, or in situations of coercive control.
Responding to the research findings, Safeguarding Ireland recommended three steps that all adults can take to best protect their future.
1. Make an Enduring Power of Attorney – this means appointing legal and financial decision-making powers to a chosen person for if we lack decision-making capacity in the future.
Banks and An Post can advise on good planning of money and property. Also, the Decision Support Service (DSS) is available explain how to make an EPA (queries@decisionsupportservice.ie / 01 211 9750).
2. Nominate a Designated Healthcare Representative (DHR) – as part of an Advance Healthcare Directive (AHD), which is a legally based future health plan. It puts in place a trusted person to ensure that our requests for healthcare and medical treatments are followed if in the future we no longer had decision-making capacity.
People can talk with their doctor about an Advance Healthcare Directive. Also, the Irish Hospice Foundation has a resource called the Think Ahead Planning Pack which includes a template Advance Healthcare Directive (www.thinkahead.ie / 01 963 1161).
3. Learn about the Decision Support Arrangements – which have become law this year under the Assisted Decision-Making (Capacity) Act. These arrangements have legal standing and provide clear protocols for circumstances when a person has a challenge with decision-making and support is required.
There are three levels of assistance including: a) A Decision-Making Assistant b) a Co-Decision Maker and c) A Decision-Making Representative (queries@decisionsupportservice.ie / 01 211 9750).
RESPOND to Adult Abuse – REPORT it
If you are suffering abuse, neglect or coercive control, or this is happening to someone you know, the best thing to do is to report it.
Depending on each circumstance, different responses are recommended:
· If there is an immediate risk or danger call the Gardaí at 999 or 112.
· For an ongoing safeguarding concern that needs support, contact the local HSE Safeguarding and Protection Team. There are safeguarding and protection teams covering all regions in the country, and the contact details are at www.hse.ie/safeguarding Explanations of terms used
· Enduring Power of Attorney: Appointing legal and financial decision-making powers to a chosen person for if you lack decision-making capacity in the future.
· Designated Healthcare Representative: Nominating a person to make sure the requests in a person’s Advance Healthcare Directive are carried out.
· Advance Healthcare Directive: A specific document in which to record future healthcare requests refusals and on treatment approaches, surgery, medicines and resuscitation.
· Place of Care Decision: Setting out your wishes on the place where you wish to receive care.
· Decision Support Arrangement: Used when a person needs assistance to make a decision and includes three levels which have legal standing. These are a Decision-Making Assistant, a Co-Decision Maker and a Decision-Making Representative.
More Information:
· Safeguarding Ireland: safeguardingireland.org
· Decision Support Service: decisionsupportservice.ie
· Think Ahead: thinkahead.ie / 01 963 1161
· HSE Safeguarding Teams: hse.ie/safeguarding
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