When making a best interest decision it is important to gather as much information as possible in order to make an appropriate decision. This is Ben’s story. Should Ben have the flu vaccine? Who makes that decision?

BEN

Ben attends day care and sometimes has short breaks away from home. He can make some decisions for himself about day to day things and wishes that staff, family and friends would listen to him more. He finds it difficult to understand the long term consequences of his treatment. Last year he was really ill and did not enjoy being in hospital (where he felt he wasn’t listened to). Ben communicates verbally but can sometimes be hard to understand if people don’t give him enough time. His behaviour can sometimes be challenging, but this is usually out of frustration at not being listened to and people making assumptions about his abilities. Ben is scared of needles.

BEN’S PARENT

Ben is one of four children and has always taken up much of his parent’s time and energy. He is dearly loved. Ben’s parents do not believe in the flu vaccine as Grandma died in the same year she had it. Ben has been offered the vaccine. Whilst his parents do not want Ben to go to hospital again the thought of getting him ready to have the vaccine exhausts you as he may become angry or distressed and will be difficult to live with for the next week.

BEN’S GP

Ben’s GP has cared for him and his family for many years and he is well aware of the complexity of his condition and behaviour. He believes the flu vaccine would be helpful and is encouraging the family to bring him to clinic.

DAY CARE WORKER

Ben’s keyworker knows him well and encourages him to share his thoughts and feelings using his preferred communication style, Makaton and words. She has a close working relationship with him and understand his needs and families concerns. She would be more than happy to facilitate any interventions for him that are thought to be in his best interest. She feels she is a good advocate for him.

CONSULTANT NEUROLOGIST

Ben has been known to his neurologist since transitioning into adult services. He has sometimes had poor attendance to clinics. You are aware that his last admission to hospital was quite traumatic. In order to avoid another admission he feels having the flu vaccine is a good option. He has encouraged Ben’s GP to follow up the offer of a vaccine. He has recommended a clinic which he thinks would be suitable.

DISTRICT NURSE

The lead district nurse of the clinic has good experience of working with patients with similar needs to Ben’s. She is happy to support the referral. She will be the person to give the injection.

THE PERSON MAKING THE DECISION WOULD BE THE DISTRICT NURSE. SHE IS THE PERSON CARRYING OUT THE PROCEDURE. SHE SHOULD TAKE INTO ACCOUNT THE VIEWS OF ALL PEOPLE CONCERNED. SHE WOULD NEED TO ASSESS WHETHER SHE FELT THAT BEN HAS THE CAPACITY TO MAKE THE DECISION FOR HIMSELF AND WOULD ALSO NEED TO DECIDE ON THE DAY IF IT WAS THE RIGHT TIME TO GIVE THE INJECTION. FOR INSTANCE IF BEN WAS REALLY DISTRESSED, COULD IT BE GIVEN ON ANOTHER DAY. PREPARATION WORK WITH BEN COULD ALSO BE CONSIDERED.