JARGON BUSTER 'D'

DAILY LIVING COSTS - The amount people pay for everyday things like food, rent and bills. Social care charging rules mean people must people keep enough money to meet these costs.

DATA PROTECTION - The legal control over access to and use of data stored in computers. In social care this is particularly important given the sensitive, confidential, and critical nature of information that is held about people.

DAY CENTRE - A place offering care and support to people during the daytime. Day centres often provide meals and things to do, as well as a chance to meet new people. Day centres can be privately owned or managed by local councils or the NHS.

DAY SERVICES - Opportunities for people requiring care and support to spend time with other people and have things to do during the day.

DBS – See DISCLOSURE AND BARRING SERVICE

DBT – See DIALECTICAL BEHAVIOUR THERAPY

DDP - See DYADIC DEVELOPMENTAL PSYCHOTHERAPY

DEADNAMING - When a trans person who has changed their name as part of their transition is called by their birth name.

DECOMMISSIONING - Removing or replacing a service. In the case of a local service that provides care or support, the council as commissioner may stop using it or paying for it. This may mean the service will close.

DEFERRED PAYMENTS - Deferred payments mean that people do not have to sell their home in their lifetime to pay for the cost of their care and support in a care home or in supported living. The cost of care and support is deferred and will need to be repaid by the person (or someone acting on their behalf) at a later date.

DEFICIT MODEL - An approach to working with people who require care and support that looks mainly at what they are unable to do and what their problems are. It focuses on ‘what’s the matter with you’ and is the opposite of a strengths-based approach which starts with ‘what matters to you’ and builds on what is strong rather than what’s wrong. This is an approach used by benefit assessors when people apply for disability-based benefits.

DEGENERATIVE CONDITION - An illness that gets worse over time.

DELAYED DISCHARGE - When a person is well enough to leave hospital after an illness or accident, but has to stay there, usually either while paperwork is completed or while the care and support they require at home or in another place is arranged.

DELAYED TRANSFER OF CARE - When a person is well enough to leave hospital after an illness or accident, but has to stay there while the care and support they need at home or in another place is arranged.

DEMENTIA - A general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with people’s daily life. There are different types of dementia, including Alzheimer’s, Vascular, Lewy body and Frontotemporal.

DEMENTIA-FRIENDLY COMMUNITY - A city, town or village where people are aware of dementia and understand it, and people living with dementia are respected, supported and included in their community. It is led by local people, who work to remove the barriers that stop people with dementia taking part in community life. The Alzheimer’s Society has a recognition scheme for dementia-friendly communities.

DEMIROMANTIC - Similar to demisexual, but regarding romantic attraction. Both demiromantic and demisexual are considered part of the asexuality spectrum.

DEMISEXUAL - Someone who only develops sexual attraction to people after establishing an emotional bond. Demisexual can be used as its own label, but many people use it in conjunction with other labels that denote who they're attracted to, such as lesbian or bisexual.

DEPARTMENT OF HEALTH AND SOCIAL CARE - The government department leading the nation’s health and social care to help people live more independent, healthier lives for longer.

DEMIROMANTIC - Similar to demisexual, but regarding romantic attraction. Both demiromantic and demisexual are considered part of the asexuality spectrum.

DEMISEXUAL - Someone who only develops sexual attraction to people after establishing an emotional bond. Demisexual can be used as its own label, but many people use it in conjunction with other labels that denote who they're attracted to, such as lesbian or bisexual.

DEPARTMENT FOR WORKS AND PENSIONS - UK government department responsible for welfare, pensions, and child maintenance policy.

DEPENDENT - A person who relies on support from another person, like a child or a relative.

DEPRIVATION OF ASSETS - When someone deliberately reduces the amount of income, savings or property they have (their assets), in order to qualify for help from their local council with paying for care costs or for various benefits. The council may judge that people have tried to deliberately avoid paying for care and support costs by depriving themselves of assets.

DEPRIVATION OF LIBERTY SAFEGUARDS - People have a human right to liberty. If someone is continually watched and controlled and is not free to permanently leave the place they are in, it is very likely that they are being deprived of their liberty. The Deprivation of Liberty Safeguards – often referred to as DOLS – are legal protection for people who are in a care home or hospital. The care home or hospital is known as the ‘managing authority’, and if they think a person needs to be deprived of their liberty, this will need to be authorised by the local council.

DEPUTY - Someone appointed by the Court of Protection to make decisions on behalf of a person if they lack capacity to make those decisions themself and have not already given someone power of attorney. A deputy can be appointed to make decisions about property and financial affairs, or about health and welfare, or both. Deputies may be family members or friends, or they may be a professional person like a solicitor.

DESIRED OUTCOMES - The things that people want to achieve in their day-to-day life. The main purpose of adult social care is to help people to achieve the outcomes that matter to them in their life. Assessment conversations should focus on people’s desired outcomes, considering the person’s care and support needs, the impact of their needs on their wellbeing, and whether support to meet these needs will help the person to achieve the things that matter to them.

DETACHMENT - In psychology this refers to a state of being emotionally disengaged or detached from a person, situation, or outcome.

DETENTION - Detention for mental health means being held in a hospital for assessment or treatment. This is sometimes called being sectioned.

DFG – See DISABLED FACILITIES GRANT

DHSC – See DEPARTMENT OF HEALTH AND SOCIAL CARE

DIABETES SPECIALIST NURSE - A specialist nurse who is there to assess, plan, deliver and evaluate diabetes management with the person with diabetes, their family / carers. This will include support, advice and education to maximise the potential quality of life and independence at all ages.

DIALECTICAL BEHAVIOUR THERAPY (DBT) - Is a talking therapy that helps people to regulate difficult emotions, by accepting the emotions and allowing them to pass. It combines aspects of cognitive therapies with Eastern Mindfulness techniques. It does not deal with trauma directly but the emotions and behaviours that the previous trauma triggers.

DIAGNOSTIC OVERSHADOWING - When a person is disabled or has a particular health condition, and doctors think this is the reason for any health problems or symptoms they have. It often affects people with a learning disability or people who require support with their mental health and can mean that illnesses are missed or not treated properly.

DIAGNOSTIC PATHWAY - The tests and assessments that are carried out by people working in health care to help them decide if someone has a specific condition or illness.

DIAGNOSTIC STATISTICAL MANUAL OF MENTAL DISORDER 5 - Is the current diagnostic set of agreed criteria for identifying Mental health disorders and illnesses developed by the American Psychiatric Association. Th UK government tend to use the diagnostic labels within the DSM-5 when funding research, however the majority of professionals in the NHS use the ICD-11.

DIAGNOSTIC TOOL - A test to help people working in health care to identify a condition or disease. It may be a medical test or may be a set of questions about what someone is experiencing.

DID – See DISSOCIATIVE IDENTITY DISORDER

DID NOT ATTEND - Often record on health records as DNA and is used to look at a person’s co-operation with medical services

DIFFERENTLY ABLED - A term sometimes used to describe disabled people.

DIGITAL EXCLUSION - When a person is experiencing barriers preventing them from using technology. Barriers can include access, skills, confidence, fear or motivation.

DIGNITY - Being worthy of respect as a human being, and treated as if you matter. People should be treated with dignity by everyone involved in their care and support. If people are not treated with dignity, they may feel uncomfortable, embarrassed and unable to make decisions for themself. Dignity applies equally to everyone.

DIGNITY IN CARE - A national campaign to put dignity and respect at the centre of care services in the UK.

DIRECT ENHANCED SERVICE (DES) - An additional service provided by a doctor (GP), beyond what they would normally provide, to meet a particular need – such as working out who may be at risk of an unplanned hospital stay and finding ways to avoid this happening. GP practices are paid extra for these services and can choose whether to provide them.

DIRECT PAYMENTS - Money paid to people (or to someone acting on their behalf) by their local council on a one-off or regular basis, so people can arrange their own support to meet their eligible needs. The person may choose a direct payment to meet all their needs, or just some of their needs, with their remaining needs met through support arranged by the council or by a third party (usually through an Individual Service Fund (ISF)). Local councils should give people clear information about direct payments so they can decide whether to ask for a payment and should support people to use and manage the payment appropriately. People can request a direct payment during care and support planning, or before or during a review. Local councils must not force people to take a direct payment if they don’t want to, or place people in a situation where a direct payment is the only way to draw on personalised care and support.

DISABILITY - The Equality Act 2010 definition of disability says that a person is disabled if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. The Act requires public bodies to make ‘reasonable adjustments’ to make things like information, buildings and policies accessible to disabled people.

DISABILITY-RELATED EXPENSES - Money that disabled people have to spend on things that non-disabled people don’t pay for, like extra laundry, high heating bills or special clothes. The law says that local councils should look at these expenses when completing financial assessments, to work out how much people can afford to pay towards the cost of care and support.

DISABLED FACILITIES GRANT - Money people can get from their local council if they are disabled and need to make changes to their home. Changes include things like widening doors, adding ramps or installing a downstairs bathroom. The amount people get usually depends on their household income and savings. Disabled children and young people under 18 years old can get a grant without their parents’ income being looked at. People can apply for Disabled Facilities Grants through their local council, if they live in England, Wales or Northern Ireland.

DISABILITY LIVING ALLOWANCE - Is a none means tested benefit for those who have a disability or long-term health condition that affects their day-to-day life – This has now been replaced for the majority of people by Personal Independence Payments (PIP) or Adult Disability Payments (ADP) if you live in Scotland.

DISCHARGE FROM HOSPITAL - Being discharged means you can leave the hospital.

DISCHARGE SUMMARY - A report or letter that is sent to a person’s doctor (GP) when they have stayed in hospital, so that their GP knows what has happened and what needs to happen next. The person should also be given a copy. The report should explain why the person was in hospital, what treatment they received, the results of any tests that were done, what changes may have been made to their medication, and any follow-up care that is needed.

DISCHARGE TO ASSESS - When people who require some care and support leave hospital and are assessed for longer-term support in the right place to best support their recovery, which is ideally in their own home. This means people don’t have to stay in hospital until long-term care and support is arranged.

DISCLOSURE - Telling someone about new or secret information. For example, when an adult or child who has experienced or perpetrated domestic violence or abuse informs someone like a health or social care worker.

DISCLOSURE AND BARRING SERVICE - A government organisation that checks people’s criminal records, in order to prevent unsuitable people from working with children or adults who may be at risk of harm or abuse. This replaced the CRB checks.

DISCRETION - When there is no fixed rule about what should be done in a particular situation, and a person or organisation making a decision has freedom to use their own judgement. For example, local councils have discretion over whether to charge for some services

DISCRETIONARY DISREGARD - When the value of a person’s main or only home is not included in a financial assessment to calculate how much the person can afford to pay towards the cost of their care and support, this is called a ‘property disregard’. There are rules that say when local councils can apply the property disregard. If councils choose to apply the disregard in other circumstances, this is called a ‘discretionary disregard’.

DISCRETIONARY SERVICES - Services that a local council may choose to offer that it doesn’t have to provide by law. These are also known as ‘non-statutory services.’ (Services that the law says councils have to provide are called ‘statutory services’) Examples of discretionary services include leisure centres, libraries and lunch clubs.

DISCRIMINATION - Treating a person, or a group of people, differently to other people because of their sex, age, race or other things. It usually means treating the person unfairly and not offering them the same opportunities as other people.

DISENGAGEMENT - When someone avoids contact from an organisation or doesn’t go to a place they are expected to be.

DISORDER - Dictionaries define ‘disorder’ as ‘lack of order’, ‘a state of confusion’, ‘the disruption of peaceful and law-abiding behaviour’. The term is also used to describe conditions that impact on the way people think, feel and behave, for example ‘Autism Spectrum Disorder’, ‘Bipolar disorder’, ‘Borderline personality disorder’, ‘Post-traumatic stress disorder’.

DISPOSABLE INCOME ALLOWANCE - A fixed amount (up to £144 per week) of a person’s income that local councils must allow a person to keep (if they want to) if they have a deferred payment agreement. The council can require people to contribute the rest of their income towards the cost of their care and support.

DISPROPORTIONATE - When something is too large or too small in relation to something else. Local councils may describe the cost of providing a particular service as ‘disproportionate’ in relation to the overall amount of money that is available.

DISSOCIALITY - Refers to dissocial thoughts, beliefs and behaviours more commonly understood as antisocial thoughts, beliefs and behaviours. These are used by clinicians to help diagnose Antisocial Personality Disorder in the DSM5 or Dissocial Personality Disorder in the ICD11.

DISSOCIATION - Dissociating is the experience of detaching from reality. Dissociation encompasses the feeling of daydreaming, as well as the distressing experience of being disconnected from reality. In this state, consciousness, identity, memory, and perception are no longer naturally integrated. Dissociation often occurs as a result of stress or trauma, and it may be indicative of a dissociative disorder or other mental health condition.

DISSOCIATIVE IDENTITY DISORDER - Dissociative identity disorder, formerly referred to as multiple personality disorder, is characterized by a person's identity fragmenting into two or more distinct personality states. People with this condition are often victims of severe abuse.

DIVERSION FROM HOSPITAL SERVICES - Support provided to people to prevent their admission to hospital, like reablement and falls prevention services.

DIVERSITY - Recognising, respecting and valuing differences in characteristics of people, including race, gender, disability, sexual orientation and religion or belief, and making sure people are included and can participate.

DLA – See DISABILITY LIVING ALLOWANCE

DNA – See Did not attend

DNR – See DO NOT RESUSCITATE

DOMAINS - Specific areas where people may require particular assistance, such as moving around, eating or breathing. Decisions about eligibility for continuing healthcare are made by considering people’s needs in relation to 12 domains, including nutrition, continence, mobility and communication.

DOMESTIC ABUSE - An incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse by someone who is or has been an intimate partner or family member, regardless of gender or sexuality. It can include: - psychological, physical, sexual, financial, emotional abuse; ‘honour’ based violence; Female Genital Mutilation; forced marriage.

DOMESTIC VIOLENCE - An incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse by someone who is or has been an intimate partner or family member, regardless of gender or sexuality. It can include: - psychological, physical, sexual, financial, emotional abuse; ‘honour’ based violence; Female Genital Mutilation; forced marriage.

DOMICILIARY CARE - Also known as home care, this is support that people draw on if they are living in their own home rather than in a residential care home.

DO NOT RESUSCITATE - An order that prohibits medical staff resuscitating an individual when their heart stops. An individual may request this order from a doctor who will record this on their medical notes

DOUBLE HANDED CARE - When a person requires assistance from two people to help them to move. May also be referred to as ‘double-ups’.

DNR – See DO NOT RESUSCITATE - Is a legal order indicating to others, including healthcare staff, that a person does not wish to receive CPR if their heart stops beating.

DoLS – See DEPRIVATION OF LIBERTY SAFEGUARDS

DRAMA THERAPY - Dramatherapy is a form of Psychotherapy. Drama therapists are both clinicians and artists that draw on their knowledge of theatre and therapy to use as a medium for psychological therapy that may include drama, story-making, music, movement, and art; to work with any issue that has presented itself.

DRE – See DISABILITY-RELATED EXPENSES

DSM-5 – See DIAGNOSTIC STATISTICAL MANUAL OF MENTAL DISORDER 5

DSN – See DIABETES SPECIALIST NURSE

DTOC – See DELAYED TRANSFER OF CARE

DUAL DIAGNOSIS - Dual diagnosis refers to the co-occurrence of a mental health disorder and a substance use disorder, requiring integrated treatment for both conditions.

DUTIES - Things the law says that organisations like local councils must do. If organisations don’t follow their legal duties, this may result in legal challenge. Under the Care Act 2014, local councils have a legal duty to promote people’s wellbeing, prevent, reduce and delay care and support needs, provide information and advice, make sure a range of care and support options are available in their area, integrate care and support with other provision including health and housing, co-operate with partners, and ensure continuity of care. Councils also have a duty to carry out an assessment where a person has an appearance of need, to meet a person’s eligible needs, to involve an independent advocate if a person would otherwise find it very difficult to be fully involved in conversations and decisions, and to review a person’s care and support plan and make any changes needed. The Care Act 2014 also requires councils to make enquires, or ask others to make enquiries, when they think an adult with care and support needs may be at risk of abuse or neglect in their area and to find out what, if any, action may be needed, and to set up a safeguarding adults board in their area.

DUTY OF CANDOUR - When something goes wrong with the health or social care that a person receives, the organisation that provides the care has a legal duty to be open with the person, to explain what has happened and to apologise to them.

DWP – See DEPARTMENT FOR WORKS AND PENSIONS

DYADIC DEVELOPMENTAL PSYCHOTHERAPY - Dan Hughes, a Clinical Psychologist, created Dyadic Developmental Psychotherapy (DDP) as a treatment for families with adopted or fostered children who had experienced neglect and abuse in their birth families and suffered from significant developmental trauma. DDP is based on and brings together attachment theory, what we understand about developmental trauma, the neurobiology of trauma, attachment and caregiving, inter-subjectivity theory and child development.

DYSREGULATION - Refers to a poor ability to manage emotional responses or to keep them within an acceptable range of typical emotional reactions. This can refer to a wide range of emotions including sadness, anger, irritability, and frustration.