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Many under 65s in nursing homes have 'wasted lives' with limited options, report finds

The Ombudsman investigated the placement of younger people in nursing homes.

YOUNGER PEOPLE IN nursing homes have “wasted lives”, according to a new report from the Ombudsman. 

Peter Tyndall has published a report about an investigation into the placement of people under 65 in nursing homes. 

There are more than 1,300 people in this situation, according to the HSE. One-fifth of these are under 50. 

The Ombudsman held 28 visits with people directly affected by this issue and spoke with representative groups. 

Tyndall said that the people he spoke with told him they had “no option but to live in nursing homes due to a lack of support from the State”. 

The Ombudsman said nursing homes are inappropriate as accommodation for younger people with a disability, but the report was not a criticism of nursing homes themselves.

“One of the people we met during the investigation said that he had wasted the best years of his life in an institution. Another, who had suffered his injuries in an assault, said the person convicted would one day leave prison – he had no prospect of leaving the nursing home,” Tyndall said. 

Some younger people with disabilities said they didn’t give informed consent about being placed in nursing homes on a long-term basis. 

Many residents interviewed said they believed they would be temporarily staying in the nursing home.

The Ombudsman said the health system and the way care is funded in Ireland is “biased in favour of institutional settings”. 

He also said there is no system to record the number of people affected and how they are impacted. 

He added that many activities in nursing homes are not suitable for young people. 

The recommendations from the report include: a national survey to identify those in these situations, establish a budget for each HSE area to “improve the quality of life” of those affected and implementing strict guidelines for staff involved in processing applications for the Nursing Home Support Scheme to ensure fully informed consent.

Case studies

The report outlined a number of cases of those interviewed. 

Adam was 45 when he fell and suffered a brain injury. He was admitted to a nursing home from the hospital, where he thought he would remain for a few weeks as respite.

He ended up spending for five years. He’s now living independently at home with a few hours of support most days. 

He said he signed a form for the Nursing Home Support Scheme, but said he didn’t realise what he was signing. 

The account said the HSE told him he wouldn’t have been in a position to remember this due to his condition at the time, leading him to wonder why he was asked to sign the form if this was the case. 

Another person, Francis, was 52 when he suffered a brain injury after falling from a ladder. 

He has been in a nursing home for eight years where he is described as “very unhappy”.

His own home is now wheelchair accessible, but he can’t get a care package to assist him to live in his own home. 

Mark, who was 48 when he suffered a stroke, has been in a nursing home for nine years.

The report said he wants to leave as he is not happy in the nursing home.

He’s a musician and toured the world with international acts before his stroke. 

He also said he doesn’t recall filling out the nursing home form and said he wasn’t given another option.

There are no activities for younger people in the home, he said, and no choice for when he eats, what time he gets up or when he goes to bed.

Response  

The HSE said it “broadly welcomes” the publication of this report. 

A HSE statutory home support scheme is under establishment at the moment to help people live as independently as possible in their own homes. 

“For some people, and based on assessed need, Nursing Home interventions are appropriate and where the required clinical supports are available and best met,” the HSE said. 

“However, the HSE agrees that this must be the subject of a care and case management approach that facilitates structured reviews and where the will and preference of the individual is of paramount importance.”

Anne O’Connor, the chief operations officer of the HSE, said work continues to address the kinds of issues raised in this report. 

“We will also prepare an action plan with a view to implementing the recommendations of the report, as appropriate, that come under the remit of the HSE,” O’Connor said. 

It said a person’s clinical and support needs are the major determining factors for placement in a nursing home, as opposed to their age. 

The Health Minister Stephen Donnelly said “alternative solutions” are needed to give younger people accommodated in nursing homes more “independence and choice in their daily lives”. 

Minister of State for Disability Anne Rabbitte said €3 million of the additional 100 million investment in specialist disability services will go towards a HSE pilot project to facilitate 18 people in nursing homes to move to “more appropriate housing options in the community”. 

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