2. The International Context

In the UK, The Human Rights Act 1998, The European Convention on Human Rights and The Human Rights Act 1998 (HRA) provide the UK with a legal framework to implement the European Convention on the Human Rights (ECHR).

After the Second World War the United Nations, led by Eleanor Roosevelt, drew up the Universal Declaration of Human Rights in 1948. The Rights contained in the Declaration are not in themselves ‘law’ but they are enshrined and embedded in the laws and policies of the nation who have ratified (adopted) the UDHR.

This short video will give you a brief history of how and why human rights became fundamental to our understanding being a person:

The UK helped draft the ECHR and all the ECHR rights apply to everyone in the UK. Our laws, government policy, and the decisions, actions and behaviour of government and public authorities, including the NHS and local government, must comply with these rights.

So, the Human Rights Act 1998, gives the ECHR the full force of law in the UK and enables people to take cases under the ECHR to British courts which can then be referred to the European Court of Human Rights. 

Click here for more information about the Equality and Human Rights Commission

Your Practice

Thinking about the Principles of the Health and Social Care Standards and your requirement to registration with the Scottish Social Services Council you will understand that you are already adhering to standards of practice and care which should mean that rights of people using services are always upheld. This section will provide you with an opportunity to safely explore areas of practice which are specific to people with dementia and their rights.

As a care practitioner working with those living with dementia there are some articles, or the ‘rights’, in the ECHR that are very relevant when supporting those people to have their rights upheld:

• Article 2 – the right to life
• Article 3 – prohibits inhuman or degrading treatment or punishment(with no exceptions or limitations) 
• Article 5 – everyone has the right to liberty and security of person (subject to lawful arrest or detention, which can include people with mental disorders) 
• Article 8 – the right to private and family life
• Article 14 – freedom from discrimination, including on the grounds of disability.

Activity 1: Reflection

Thinking of your own work role, what do you do that uphold these rights? Are there times when you have curtailed someone’s liberty because they are living with dementia? How about the right to privacy?

(Click on the flip charts to reveal the answers)

Human Rights - A Case Study

Aileen – 101 year old widower, retired primary schoolteacher, mum of three children, grandmother and great grandmother. Aillen is living with symptoms of middle stage dementia but is physically well, reduced mobility but can walk independently with her walking frame.  

Aileen is continent and fully aware of when she needs to go to the bathroom but requires the support of a care worker to assist her whilst in the toilet.

Aileen is sitting in her usual chair in the main lounge area of the care home where she has lived for two years. Aileen needs to go to the bathroom, Aileen calls “Excuse me nurse” the care worker who has popped into the lounge whilst bringing another resident back from the dining room. The care worker hears Aileen calling and responds saying “I’ll be with you in a minute Aileen.”

Another ten minutes pass, Aileen is becoming uncomfortable but can see no workers, still she calls “Nurse I am needing to go to the bathroom.” There are around 20 other residents sitting in the lounge along with a couple of visitors. Aileen may have dementia – she also still has her dignity. Ten more minutes pass the same care worker from before returns looking round the room and Aileen catches her eye and raises her voice to be heard above the sound of the TV which is playing a music channel loudly in the background. “Nurse can you take me to the toilet please, I’m really needing to go”. “Yes Aileen, I’ll be five minutes I just need to finish clearing the dining room and setting up for tea-time” (teatime is two and half hours away).

Aileen is becoming stressed and repeatedly call for someone to come and help her for the next 15 minutes. One of the visitors, concerned for this lady who is clearly upset and needing help, leaves the lounge and comes back with another care worker. The care worker approaches Aileen who is now visibly distressed. Aileen, almost crying says “I’ve been waiting nurse and shouting for someone to help me, I really needed to pee.” Whilst walking to the bathroom it is apparent that Aileen had not been able to hold off her need to urinate.

Questions

1. Would you consider this a breach or Aileen’s right as per Article 3 – prohibits inhuman or degrading treatment or punishment (with no exceptions or limitations).
2. What should have been done to prevent this situation?
3. Does this make you reconsider the significant difference of this incident being referred to as ‘an accident’ now you are aware this is breaching a person’s human rights?
4. Would you recognise when a person’s rights were being overlooked in practice?
5. Can you think of other examples from practice which may disregard the rights of people living with dementia in practice?