A man in his sixties with severe epilepsy and brain disease who was at the centre of the first ever High Court sitting in a nursing home is to remain there, the president of the High Court has directed.
The nursing home hearing last August was to assess whether the man, who told Mr Justice Peter Kelly then he wanted to go home, had the necessary capacity to decide that or should be made a ward of court.
Doctors clashed at the hearing about his capacity.
The man’s treating geriatrician since 2013 and a court-appointed medical visitor both found he lacked capacity.
His treating doctor expressed concern a return home could result in his death.
She said he has no family supports here, his condition had seriously deteriorated since his mother died in 2012 and he had had multiple hospital admissions and had not engaged with home supports.
Two consultant geriatricians who assessed the man at the request of the elder advocacy group Sage, considered he has capacity.
One said there are daily risks in discharging people but he believed the man understood seizures can kill and was able to reason “what was the point of being safe if he was not happy”.
The case returned for review before Mr Justice Kelly on Monday when he concluded the evidence supports the man remaining where he is.
Sage should ensure what it says about the case is “accurate and comprehensive” and “ does not give rise to a possible misunderstanding of the situation by members of the public”, he also said.
Well settled
The judge said the man’s treating geriatrician had said he is well settled in the nursing home and had not asked her about going home or visiting his mother’s grave although visits could be organised. The doctor also said the man had not been visited by representatives of Sage since August.
She said she had investigated whether a nursing home closer to the man’s home was an option but it was not an approved facility for people aged under 65.
An independent social worker who visited the man reported he is doing well where he is and likes his routine, the judge noted.
The social worker reported the man still aspires to go home when asked about that but is not motivated to do anything to facilitate that, such as learning cooking skills, and a home care package was not being recommended in the circumstances.
Based on the evidence and the fact the man had two grand mal epileptic seizures in August and another in September, it appeared the unit is working well for him and he is in “the right place”, the judge said.
When the man was at home, he was unable to look after himself and was admitted to hospital several times, including for malnutrition, he said.
In all the circumstances, the court would continue the placement and review the matter next March, the judge said.
At the application of Alan Brady BL, on behalf of the man, he granted the man’s costs of the nursing home hearing.
