A High Court judge ordered that a vulnerable woman with “extensive” care needs should be transferred, against the wishes of herself and her family, to a nursing home about 50km away from her home.
The nursing home was the only one of 30 approached that said it can take the woman, who suffered several infections while in hospital for almost a year and was at risk of harm if she stayed there, Mr Justice Mark Heslin said.
The HSE has approved funding for the woman’s care in the nursing home. The weekly cost of care is €6,149, inclusive of €1,310 under the Fair Deal scheme.
Aged in her 70s, the woman expressed a wish to return home once deemed medically fit for discharge but her family, treatment team and a multidisciplinary team, believed her care needs could not be met at home.
Boy (11) stabbed at primary school in north Dublin
Paddy McKillen jnr puts Magheramore Beach lands up for auction at €550,000
Zelenskiy ready to sign minerals deal and ‘work under Trump’s strong leadership’ toward Ukraine peace deal, he says
Why the hell is Ireland v France on at 2.15pm on a Saturday? This is a rugby rivalry for the ages
Her family opposed her transfer to the proposed nursing home on grounds including its distance from their home, making visits difficult.
The woman’s husband and daughter, her caregivers for many years, have been experiencing “significant carer stress” for reasons including that she was refusing necessary care for her specific condition, having incidents of aggression and experiencing falls, the judge said.
A consultant who assessed her capacity to decide on her long-term care needs found she has irreversible cognitive and physical impairment, lacked insight and did not have the capacity to make a decision to be discharged home.
In a recently published judgment, the judge made an order under the High Court’s inherent jurisdiction that the woman be transferred to the nursing home once she is deemed medically fit for discharge from the hospital. The order does not prevent continuing efforts to find a closer placement.
While sympathetic about the “undoubted inconvenience” the transfer would cause her family, the judge said he had to consider the “very clear” evidence of risk, and “actual harm”, of the woman remaining in the acute hospital setting once fit for discharge.
The hospital had several outbreaks on different wards of flu, RSV and Covid-19, the woman was at high-risk of picking up one of those and she had developed a new hospital acquired pneumonia in early February.
There was evidence of benefit to her from being discharged to a care setting which can better meet her needs, he said. The nursing home placement was among the few that can take patients with laryngectomy/tracheotomy and also provides specialist nursing in a dementia-focused unit.
The court’s primary concern must be the woman’s welfare and the vindication and protection of her rights, including to life, bodily integrity and equal access to necessary care, he said.
He refused the hospital’s application, made in the context of the woman’s expressed wish to return home, to order her detention in the nursing home.
The court’s inherent jurisdiction extends to making orders which go no further than necessary to vindicate the rights of a vulnerable citizen lacking capacity and the evidence was the woman was not physically capable of either leaving the nursing home herself, or organising her departure from it, he said.
