You could approach this from the point of view of helping the person concerned to take action, or take it on their behalf. Either way, the same considerations apply. There are a number of actions which could be taken, but it can be useful to first give some thought to what might lead to the best outcome in a given situation. It helps to clear at the outset what it is that we’re trying to achieve. If the desired outcome in this situation is for the care to be improved, then a useful next step would be to consider both who could be approached about the situation and how they could approached to the best effect.

On the matter of who would be the best person or agency to approach, it is worth considering who, or which body, has the power to make a difference, and quickly if that is necessary. Sometimes, discussing concerns with those directly providing the care can lead to satisfactory improvements. However, in situations when this doesn’t happen, either because you have experienced indifference or resistance, or because you feel that the concern is more widespread than can be dealt with by approaching providers directly, then there are other avenues you can explore. These could include statutory bodies for health or social work, campaigning groups such as AgeUK or The Dignity Challenge (in the UK or equivalent groups if you are outside the UK), your local MP or similar. If you feel unconfident about doing so, then you might want to discuss the matter with someone you know who has been on a similar journey – in that respect, you might be able to find support online too. Having support can help with assertiveness, but so too can planning. How, for example, are you going to present your concerns to whoever you have chosen to approach? Clarity is key here, so are you clear about:

The nature of the complaint Is it all of the care or just specific aspects? All of the time or on a specific occasion? The ethos and practices of a whole organisation or just those of isolated individuals?

The quality of your evidence For example, have you witnessed problems yourself or is it just hearsay? It is difficult to respond to vague information, so clarity of thinking and expression can make all the difference to a positive outcome.

Your manner of approach For example, complaining in an aggressive or confrontational way can often lead to the other party ‘putting up the defences’, thereby making it more difficult than it might have been to end up with an outcome that everyone is happy with – the win-win outcome that being assertive (but not aggressive) can promote.

And finally, in the face of many media reports about substandard care, don’t assume that this is too big a problem for one person to tackle. Whether it is in an immediate sense (playing a crucial role in making life better for one person) or contributing in the longer term to changing the way organisations providing care ensure good practice on the part of their staff (by challenging taken-for-granted assumptions, and so on), there is a great deal you can do, whether as an individual or as part of a campaigning group.

Dr Sue Thompson

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