Upholding Rights & Safety in Life Changing Decisions

Thoughts from Cal, an Independent Mental Capacity Advocate (IMCA) from Advocacy Support Cymru

For over a decade now I have practised as an Independent Mental Capacity Advocate (IMCA) in various regions throughout England and Wales: advocating for members of society to ensure that their rights are upheld and that they remain safe.

It is a role I very much enjoy, a role that I believe to be important in foregrounding the wishes and feelings of people who lack issue-specific capacity, and who are un-befriended: people who in the past may have been marginalised and excluded from the decision-making process.

Looking back to when I first started, I can recall my first visit shadowing a colleague to meet an elderly woman with advanced dementia. The woman was sadly unable to undertake any conversation regarding her wishes and feelings around residing in a care home, and I remember coming away from the meeting feeling overwhelmed, wondering how was I going to manage in this job?

How was I going to uphold the rights of people who could not tell me what they wanted to happen?

How can you ensure that someone with advanced dementia is treated with dignity and respect and given every opportunity to take part in decisions being made for them?

How do you uphold the rights of someone who is determined that they do not need care, whose dementia means they forget that they require help, and who just wishes to be left alone? How do you keep them safe?

All these years later, after hundreds of varied cases, my initial worries and concerns have now, thankfully, been worked through. These include advocating for people in decisions around their serious medical treatment, long term moves, safeguarding, DoLS and care reviews.

Each of those decisions involve a person at the centre of the process and really that is what the IMCA role in essence boils down to: zero-ing in on that person, their wishes and feelings, their right to the best quality of life possible.

As an IMCA lots of times you tend to hear things along the lines of: ‘ah well, yes, they lack capacity you see…’ as if lacking capacity is a catch-all that invalidates whatever it is that person wants from life.

Social justice is a huge part of our role – the sign, surely, of a good, caring society is one that ensures that we are all afforded the same rights and protections, especially at our most vulnerable.

And so, we pick up cases, talk to clients, talk to professionals, access the Court of Protection if we need to: all the while insisting that our clients are listened to, respected, treated with kindness and dignity: treated as we would wish to be treated ourselves.

All these years later and I’m very glad to be working day to day helping people who really need help. ASC supports advocates to support others: the IMCA team is small but really-well bonded – we know our roles and we bounce ideas and frustrations off each other in a way that really helps you fulfil your role.

Advocacy is important, empowering and a great area to work in. It can be a battle, it can be distressing at times (IMCA work in particular often revolves around end of life matters) – but the realities of life on the wards and in care homes of the people we support, contributes greatly to our own progression as members of society.

Advocacy Awareness Week is about more than what people are entitled to, its about doing what is right in our society. We do not always achieve the desired outcomes for our clients, but we always strive to ensure that the professionals involved in these life-changing decisions are aware of and recognise the importance of the process we are undertaking together. It is challenging and rewarding in equal measure. I look forward to the next 10 years!