return to the BFN

The next day I’m sitting next to Michaela, the Co-ordinator, giving her the feedback from my latest batch of patients, when Richard strides into the office, throws his bag on the floor and takes a seat opposite.
‘Developments on the Helga case,’ he says, folding his arms. ‘When you’re ready.’
Turns out, he’d been in to see her that afternoon for another capacity assessment.
‘My guess is, she has it,’ he says. ‘Although I couldn’t actually prove it. She’s adamant she doesn’t want carers going in. She doesn’t want anyone checking up on her, or bothering her about food and getting washed and what have you. She just wants to be left alone. Which is absolutely fine, of course. She’s perfectly entitled to refuse whatever she likes. The only thing she wouldn’t do is stop cursing long enough to listen to me explain the risks she’s running and then repeat it all back to me. So I can’t sit here and categorically say she understands the results of our actions. But can she look after herself? No, I don’t think she can. Is she a danger to herself? Not in the short term. Do we have a duty of care? Of course! Even though she’ll fight us every step of the way.’
He repositions his glasses, and smiles, his teeth white and clamped together, emphasising a slight kink in the crown line, the perfect fit for a pipe.
‘It’s a tricky one,’ he says, to sum up. ‘But as a general rule you have to assume capacity if there’s no direct evidence to the contrary. She seems okay in herself. Her bedding was soiled but I changed that when she was downstairs feeding the cat. There’s food in the house. I think the nephew drops by now and again. It’s just – I can’t stand here and tell you she’s not vulnerable.’
True to her role, the Co-ordinator zones in on the most salient point.
‘So we still need to send carers in to keep an eye on her until the GP has decided what to do next.’
‘Correct!’ says Richard, standing up and towering over us. ‘I’d suggest first thing in the morning, to see she hasn’t spent the night on the floor. She’s not actually that bad, if you take an aerodynamic approach.’
He picks up his bag and turns to go, but then has another thought.
‘You’re right about the cat,’ he says. ‘The cat’s the key. She likes it if you make a fuss. Yes! Lateral thinking! We must use the cat as a lever.’cat_yellow
‘I don’t think the cat’ll be too happy about that,’ says Michaela, typing it all up on the smart board.
‘Oh don’t worry! I can’t imagine that cat’s too happy about anything!’

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