How does a Deprivation of Liberty Safeguard affect dementia care?

Despite the grim sounding name, a Deprivation of Liberty Safeguard is actually an important piece of law designed to make sure that someone with dementia is always kept safe and gets the treatment they need and deserve

In a nutshell

If your loved one has reached a point where they can't make decisions which are in their own best interests, in some circumstances they may need to be ' deprived of their liberty' in order to keep them safe. Try not to worry, this should only happen in exceptional circumstances. For example, if they're in hospital for an important operation but keep wandering off, or refuse to have it due to a 'lack of capacity', then the medical staff may need to intervene and, if necessary, sedate them. This is called being deprived of 'liberty' because they are being stopped from doing what they want.

Why do we need the Deprivation of Liberty Safeguards?

Depriving someone of their liberty is a very serious matter and safeguards are necessary to make sure the person affected is looked after properly and kept safe.

If you've been told that your loved one may need to have their liberty ‘deprived’ in a particular situation, a special agreement called a Deprivation of Liberty Safeguards (DoLS) Authorisation should be in place.

A DoLS Authorisation covers people in England and Wales over the age of 19 who have a mental disorder such as dementia or a learning disability.

How does a Deprivation of Liberty Safeguards Authorisation work?

1. The medical or care team must follow strict parameters laid down by a Code of Practice within the Mental Capacity Act.

2. They’ll need to apply to the local council or health trust (known as the supervisory body) for a DoLS and an assessor will be sent out to evaluate the situation.

3. It is the assessor who will decide if the person with dementia needs a DoLS.

4. If the assessor decides that the person is being deprived of their liberty, but it’s in their best interests, they’ll be issued with a Deprivation of Liberty Safeguards Authorisation. The process may involve a few changes until this is provided, or the assessors may decide the person should not be deprived of their liberty.

5. Once a DoLS Authorisation has been issued, the person affected will get a special representative who will visit them to make sure they are being looked after in a way that keeps them safe.

6. At any point, a review can be requested to check on this, and if the person affected or members of their family disagree about the DoLS, they can ask the Court of Protection to make a final decision.

Other examples of a deprivation of liberty:

- Staff in a care home having control over decisions in your life.
- Medication being given against a person’s will.
- Staff deciding whether a patient can be released into the care of others or to live elsewhere.
- Staff refusing to discharge a person into the care of others.
- Family, carers or friends not being allowed to visit.
In all the above situations, a deprivation of liberty should only happen if it’s for the greater good of the patient and to keep them safe.

- Have you or anyone you known ever received a DoLS? What were your experiences with it? Let us know in our Community section.