Am I violating this resident’s human rights? The balance between encouragement and enforcement
One member of staff was anxious and asked, “Am I violating human rights if the resident says they do not want to take part in an activity but I encourage them to do it because I know they have enjoyed it in the past?”
We explored this scenario and balanced out the person’s right of self-determination: (article 8 of the Human Rights Act 1998 which covers personal autonomy) coupled with the staff’s knowledge that the individual’s diagnosis of dementia can make her apathetic but when she joins in she really enjoys the activity and it gives her a boost for the rest of the day and improves her mental and physical wellbeing.
The staff member said that she would never force the resident to go but would encourage her and observe the resident and if they were getting anxious or upset during the activity, she would support the resident to leave. However, this has never happened and she has always enjoyed herself when she has attended.
We also explored how our approach can have a profound effect on how someone perceives the idea of doing an activity – a fresh face can help if someone has been having an unsettled morning with the same support worker. We also spoke about never assuming – just because someone has said no 100 times in the past, we could naturally assume they don’t want to try an activity – or by having an “this is the way it has always been” attitude we can hinder someone’s right to personal choice of trying new experiences. It is very important to remember to be curious and never assume you know what a person’s reaction will be, they might just surprise you. This is as much true of relationships in care as it is in everyday life. What remains important is that the encouragement is balanced and proportionate and never gets to the stage of enforced coercion, bullying and manipulation. To achieve to our potential and to gain psychological and physical integrity is a core part of the realisation of our Article 8 rights.
The idea of balance and proportionality lies at the heart of most caring and support relationships. We often become who we are and reach our potential through the encouragement and support of others to go that extra mile. We concluded in this case that gently encouraging someone to do an activity you know they have enjoyed before is not a violation of their human rights. PHEW! However, staff need to remember that the person has the right to not participate too if they really show they do not want to or are not enjoying it.
The staff team said this was really bothering them and they were happy now that they had the knowledge and confidence that they were working within the right ethical boundaries
Wellbeing 1.25: “I can choose to have an active life and participate in a range of recreational, social, creative, physical and learning activities every day, both indoors and outdoors.”
1.26: “I can choose to spend time alone.”