From Ovid to Covid: The metamorphosis of Advanced Decisions to Refuse Treatment into a safeguarding issue

Purpose This paper aims to examine Advance Decisions to Refuse Treatment (ADRTs) in the context of the COVID-19 pandemic. We consider the development of ADRTs, the lack of take up and confusion among the general public, clinicians and health and social care staff. Design/methodology/approach The paper is a conceptual piece that reflects on ADRTs in the particular context of COVID-19. It considers professional concerns and pronouncements on ADRTs. Findings ADRTs have a low take up currently. There is misunderstanding among public and professionals. There is a need for raising awareness, developing practice and a need to allay fears of misuse and abuse of ADRTs in clinical, health and social care settings. Originality This paper is original in considering ADRTs as a safeguarding issue from two perspectives: that of the person making the ADRT and being confident in respect for the decisions made, and of clinicians and other professionals being reflexively aware of the need to accept advance decisions and not acting according to unconscious biases in times of crisis. Practical implications We make recommendations that reflexive training and awareness becomes the norm in health and social care, that reform of ADRTs is undertaken to prevent misunderstandings and that the person becomes central in all decision-making processes

De-collectivization and employment problems: the experiences of minority ethnic workers seeking help through Citizens Advice

This article draws on a study of the experiences of (primarily non-unionized) minority ethnic workers in seeking advice and support for employment problems in the context of the de-collectivization of employment relations in Britain. It focuses on one of the main recourses identified in the research, the Citizens Advice Bureau, its relationship with community organizations and with trade unions. Workers’ testimonies about their experiences of help with workplace grievances are supplemented with views of advice providers, community-based organizations and trade unionists. Findings illuminate the specific experiences of minority ethnic workers, as well as similarities with majority ethnic non-unionized workers and highlight the paucity of individual employment advice and a growing crisis for workers’ rights with the decline in collective union representation

Elder Abuse and Adult Safeguarding in UK

This chapter will provide an overview of elder abuse, with a particular focus on the UK. The issues and developments that have occurred globally will be briefly explored. Over the last ten years, there has been increasing global recognition of the abuse and neglect of older adults as a social problem in need of attention. The UK was one of the earliest of European countries to undertake work in this area. However, the identification of abuse remains somewhat problematic and defining abuse remains difficult, perhaps even more so when the abuse occurs within an institutional setting. Techniques of intervention with victims of abuse and those who abuse are in comparatively early stages of development, although in recent years there has been progress in the production of policies and procedures for healthcare and social care professionals. A number of national and international organisations have been established to respond to abuse and abusive situations; there are differences between different nations of the UK in how abuse is responded to. Various research initiatives are underway. Education and training for professionals is taking place concerning recognition and awareness of abuse and intervention skills. This chapter aims to examine some of the pertinent issues from a UK context. Responses to the problem of elder abuse will be explored with a concentration on techniques of intervention from a UK perspective, together with some exploration of a number of prevention strategies. Possible future developments and the potential for international action to resolve this problem will be considered