Additional Legislation Needed to Older People Care

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An advocacy group for elderly rights has called for additional legislation in situations where people’s liberty is at risk.

Sage Advocacy called for the issue to be addressed following a Court of Appeal ruling that a hospital acted unlawfully when it stopped a 93-year-old women with dementia from leaving because it felt a discharge wasn’t in her best interests.

As reported in the Irish Times, Mr Justice Gerard Hogan said this week that the case raised legal and constitutional issues regarding the care and welfare of older, infirm people.

Issues of care and custody

Mervyn Taylor, Sage Advocacy director, said the case summed up the issue of care and custody, commenting that society accepted suspects and prisoners have rights, but in certain situations it was difficult to allow older people their rights.

Thanks to the lack of home care supports, elderly people were effectively deprived of their liberty, he told RTÉ’s Morning Ireland.

Ireland’s Assisted Decision Making Capacity Act is not due to be introduced until 2019. This will allow for the establishment of a decision support service and a director has been appointed.

Sage Advocacy told Morning Ireland they were aware of situations where people were detained for long times in hospitals and other places because of concerns about safe discharge. The Gardai can’t hold people past a certain time, and Sage believes this points to a need for legislation and more integrated systems of support in the home.

Mr Taylor referred to the key tenet, “nothing about you without you”, where people can’t make decisions about you without you, and without your rights, views, will and preference being taken into account.

The new legislation, Mr Taylor believes, will require a key culture shift, which moves towards will and preference. In the case of the 93-year-old, the woman had signed a self-discharge form.

Sage Advocacy hopes to see legislation in the autumn which will address such cases, calling it legislation “we can’t see soon enough”. When liberty is an issue, the person should have an advocate who is independent of the family, care provider or system’s interests. This would stop the phenomenon of “shoehorning people into care in congregated settings such as nursing homes” with people being effectively left and detained there.

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