When a person experiences a life-changing health event, decisions about their future care and accommodation can feel overwhelming, especially when they have no family or close friends to support them. This case study highlights how Independent Mental Capacity Advocacy (IMCA) made a vital difference for Alan* (name changed), helping ensure his wishes were heard, his rights were upheld, and his independence remained central to the decision-making process.
Alan’s story
Alan was living independently in a privately rented flat when he suffered a stroke and was admitted to hospital. Shortly before his planned discharge, he experienced a second stroke.
Hospital staff reported that Alan was now confused, had left the ward unaccompanied more than once, and at times became verbally abusive. Although he was deemed medically fit for discharge, the hospital’s Occupational Therapist (OT) expressed concern about Alan’s safety at home. His cognition had been affected, and his left arm was broken and not yet functional.
A Mental Capacity Assessment concluded that Alan lacked the capacity to decide where he should live following discharge. With no family or friends to support him, a referral was made for an Independent Mental Capacity Advocate (IMCA) to assist with the decision about his accommodation.
Advocacy in action
One of our advocates visited Alan in hospital to talk to him about his situation and to get a sense of what was most important to him.
Alan described himself as a very independent person who had travelled widely for work and had always enjoyed good health. The sudden limitations caused by his strokes were difficult for him to accept. He told the Advocate clearly that autonomy was central to his sense of identity and that he wanted to remain self-reliant.
Together, they discussed his needs, wishes, and the options available. Alan was clear that he wanted to live in his own home again, where he could follow his own routines. However, they also talked about the concerns raised by professionals and the possibility of a short-term stay in a care setting.
Alan initially resisted the idea of moving into a care home – he did not want to live communally and feared losing his independence. Through several conversations, they explored what a short-term stay could look like, how rehabilitation support might work, and how it could help him move closer to his goal of living independently again.
Alan eventually agreed that if returning home immediately was not possible, he would accept a short-term placement where he could receive support to rebuild his independence. He also gave consent for the Advocate to share his views and preferences with professionals involved in his care.
Collaborative working
The Advocate met with Alan’s social worker to discuss his wishes and ensure his perspective was understood. They agreed on a clear timeframe for reviewing his short-term stay and outlined what support would be available to help him regain independence.
Alan’s feelings about communication with professionals were also shared and he explained that his willingness to engage depended greatly on how people spoke to him. This feedback was crucial, as effective communication would help build trust and encourage his active participation in his recovery.
They also agreed that Alan’s mental capacity should be reassessed, as there was a strong likelihood that his abilities might improve with time and rehabilitation.
Outcome
Alan moved into a care setting on a short-term basis. Although the transition was initially challenging, he gradually began engaging with staff and participating in his rehabilitation programme.
A subsequent Mental Capacity Assessment confirmed that Alan had regained capacity to make decisions about his accommodation. When asked where he wanted to live, Alan was clear: he wanted to return to independent living.
From that point forward, Alan took an active role in discussions, decisions, and planning for his move back home.
During one of the final conversations with the Advocate, Alan said: “This is the first time I’ve been listened to – I’ve got hope back.”
These simple but powerful words capture the essence of advocacy. By listening, supporting, and empowering Alan to express his views, advocacy helped him take back control of his life.
