introduction

Asist has identified the problems associated with providing advocacy for a person who has little or no communication skills. It is important within advocacy to make sure that the person being supported has information about the issues on which their views are being sought, and that this information is given in a way they find meaningful. However, advocacy has problems when the advocate and the person are unable to communicate meaningfully with each other. The advocate cannot represent an opinion that a) has not been given by the person and/or b) has not been understood by the advocate. Although a person may not be able to get their opinion across to others, or simply may not have an opinion on the choices and issues involved, this does not lessen their right to a good quality of life. Everyone has certain needs that are fundamental to their well-being - even if they are unable to express them. These include:

• Access to Satisfactory Care
• Freedom of Choice
• Promoting Self-Value
• Opportunities for Progression.
  

These basic needs can be classed as a person's ordinary life principles and are encompassed within the *'Eight Domains to a Quality Life' which are set out at the end of this leaflet.

the dilemma

The fundamental problem facing an advocacy service is simple. If there is little or no meaningful communication between the advocate and service user the advocate cannot then be expected to represent something that does not exist. This aspect of advocacy is looked at in more detail in information booklet no. 5 - Advocacy & Information. With nothing to offer, the advocate is faced with walking away from the situation. But who then protects the rights of the service user? Their fundamental needs and rights still exist even if they cannot express them. So what do we do? Asist argues that a form of advocacy can be supplied even where there is little reliable or even no communication - we call it keeping a 'Watching Brief'.

our justification

For many reasons, some people are not in a position to make an empowered choice about having an advocate. This can be either because of their mental state at the time or because of their own limitations in grasping the concept of what an advocate does. Asist works on the principle that there is an adequate justification for supplying advocacy where empowered permission from the service user is unavailable. Asist argues that if the service user was able to make a choice s/he would agree to receiving advocacy as a right. (This has the same validity as providing life saving procedures to an unconscious accident victim who is obviously unable to physically say "save me".)
Asist already takes referrals from carers and service providers where a 'lack of a negative response' justifies our providing the service. (This may have philosophical holes but we can leave the mental acrobatics to the philosophers!)
The same concept can be applied to the protection of a person's 'ordinary life principles'. Although you may not be able to communicate the fact that living in a dry, warm comfortable environment with sufficient food and adequate stimulating activities is what you want - it seems obvious that this is what you would say if you were able. To Asist it seems reasonable to argue that the advocate should protect the principles underpinning 'ordinary living'.

It is imperative that the advocacy offered retains the fundamental axiom of not offering opinion. It is legitimate for the advocate to seek to ensure compliance to the principle of ordinary living through applying the breakdown within the 'Eight domains to a quality life'. However, the content of the service resulting from compliance is the preserve of the service provider who has the skills and resources to make judgments on the matter of how to best meet these fundamental life principles.

putting it another way

A practical example may make this clearer. Imagine you are an advocate in partnership with a service user with severe learning difficulties. The user lives in a care home having lived in a hospital for most of his/her life. The service user has virtually no vocabulary and does not use a recognisable sign language. Despite the advocates best efforts over a period of time s/he is unable to elicit any meaningful choices or views. What does the advocate do? As we have argued, the service user still retains the right to enjoy a quality of life ; fostered by a package of services tailored to their individual needs within the limitations of their state of physical and/or mental health.
In these sorts of situations, the advocate's role becomes one of:
· examining the services already being supplied
· questioning whether they are focusing positively to the 'Eight Domains'; or conversely negatively! Encouraging providers to apply the concepts embodied in the Eight Domains to provide an appropriate care package for the service user

Consider, for example, the concept a 'community presence' - (2 in chart). The advocate can legitimately ask the care home workers what they are doing to foster a community presence for this service user e.g. using the swimming pool during open sessions. Conversely, the advocate may seek justification for the supply of services that effectively segregate the user from the public and local community e.g. arranging closed sessions at the pool. By applying this technique to all aspects of their partners life the advocate can play a very active role in assuring a continuous and positive improvement in the quality of life of their partner; or counter actions and services which detract from the potential quality of life of their partner.

Even in situations where the advocate is implementing the 'Watching Brief' it is crucial that s/he maintains a position of not expressing a view. There is a distinction between actively probing the process by which providers reach solutions as against proffering an opinion between alternatives. The advocate must be acutely aware that if they begin to offer opinions on content they are, in effect, saying "I know better than you". This is, as in all advocacy situations, beyond the role of the advocate.

summary

Thus with the watching brief principle we have to ensure that a number of issues are clear.

• The advocate must ensure that the service providers are made explicitly aware that the advocate is protecting ordinary life principles by utilising the eight domains to a quality life and not expressing a view of the service user. This distinction is crucial.
  
• The advocate must be clear in their own mind as to the difference between arguing for the service user's ordinary life principles and disputing the service provider's methods of care implementation.
  
• Advocates must refrain from actively arguing for or against a particular care package; or any element of it. The advocate's role is to use the elements within the 'Eight domains to a quality life' to question and seek justification in order to promote services which undeniably meet the needs of service users.