The right of older people to make decisions about their care is increasingly being infringed, according to an advocacy group working with residents of nursing homes.
Up to 70 per cent of the cases dealt with by Sage, a support and advocacy service for older people, involve family conflicts over care arrangements, it says.
The situation is being exacerbated by a delay in implementing new laws to provide older people with guaranteed rights on their independence. The Assisted Decision-Making (Capacity) Act was signed into law by President Higgins a year ago but most of it has yet to be commenced.
Sage says it has worked on cases where the views of older people on their care provision have been ignored, where older people have been kept in nursing homes against their will, and where gardaí have had to be called to protect their property and other rights.
Property
Bibiana Savin, a development worker with the group, says disputes within families are often about property, whether the older person should go into a home, which home the person should go to, or the provision of private care.
In some cases the conflict is between their adult children, while in others the focus of differences is between the older person and some or all of the children.
Often family members are motivated by good intentions, legal adviser Mary Condell points out.
“Families want the person to be safe. They’re afraid of a fall, for example. But falls happen in nursing homes too. If this is a risk the older person is willing to take, they are entitled to make up their own mind.
“Age does not change the entitlement to make decisions for yourself. There is acceptable risk, and there is locking people up to keep them safe, in denial of their human rights.”
Cases involving people who are in nursing homes but wish to leave are becoming more common, Savin says. “Some older people find they are absolutely miserable in a home but their chances of leaving seem to depend greatly on the family dynamic.
Independent advocate
“This is compounded in some nursing homes which try to hold on to their residents, and staff whose attitude is ‘she’s here now, back off’.”
She says a minority of nursing homes make it difficult for older people to access an independent advocate even though this is explicitly provided for in official regulations.
“Sometimes nursing homes collude with adult children to deny us access,” says Ms Condell, who refers also to the “absolute misconception that next-of-kin have rights” to speak for the older person.
The new Act, when it is fully commenced, will see the setting up of decision-support services to assist where people do not have full capacity.
Ms Condell welcomes the related move away from the “appalling” ward of court model to a new “social” test of a person’s capacity. “Older people have the same rights as anyone else, including the right to make an unwise decision.”
