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Nursing homes are a mix of very good and very bad
The leaked East Coast Area Health Authority report on conditions in a Co. Dublin nursing home again highlights the vulnerability of the elderly to institutional abuse. Following staff complaints, the health authority carried out an investigation of Ardeeshal Lodge Ltd, Upper Glenageary Road, Co. Dublin. Like all private nursing homes, patients were placed there at great expense. However, after a meeting with staff and an inspection of the home last June, a public official reported that complaints had been made about unhygienic conditions and a lack of basic care for patients. The shortage of clean bedclothes meant linen which was soiled with faeces was turned and re used on a number of occasions. The shortage of properly trained staff across the nursing home sector seems to also have affected Ardeeshal Lodge as complaints were made about the hiring of foreign staff with insufficient English. Commenting in the wake of the leak, Alex Connolly, communications director with the East Coast Area Health Authority, said action had been taken to regularise the situation and the authority was continuing to monitor the home. “Yes standards were quite bad, but we understand that the recent appointment of a new matron has made a significant difference,” Mr Connolly said. Under the Health (Nursing Homes) Act 1990, private nursing homes must be visited twice a year and an annual report compiled by medical professionals. According to Kieran Healy, national development officer of the Alzheimer’s’ Association, feedback from members suggests a “mix of very good and very bad homes.” There are more than 500 publicly run institutions around the country which care for an estimated 10,000 older people. However, ironically, public nursing homes remain outside the loop as far as inspection is concerned. Visiting committees travel to public institutions but do not have the power to inspect standards of care or draw up reports. Because of current structures, anecdotal evidence of abuse in homes tends to remain just that anecdotal. And lack of inspection can mean that if staff blow the whistle they place their jobs in jeopardy. “If you want to root out abuse, you have to make disclosure easy and create a system that has the confidence of patients, relations and staff, “ said Anne O’Loughlin, spokeswoman for the Irish Association of Social Workers. That report called for the establishment of a body which would be responsible for dealing with the problem of abuse, and a proper complaints procedure with protection for whistle blowers. However, she said there is little evidence that this advice had been acted on. The Alzheimer’s’ Association say there is a greater need for ‘dementia specific’ homes as many homes are not equipped to cater for the specialist needs of patients. As Alzheimer’s is a progressive illness whereby symptoms worsen over time, it is not unheard of for homes to insist on patients suddenly presenting with the disease, to be removed from homes, said Kieran Healy. “There is also a great need to educate people that appropriate care — illness specific care — is what needs to be provided to ensure people are given the dignity they deserve,” he said. Many of the more progressive homes are now beginning to recognise this and are opening specialised dementia units, he added. The almost Dickensian conditions reported at Ardeehsal Lodge are worrying in themselves. But coupled with recent reports of a soon to be published Ombudsman report on how the State effectively denied elderly patients their right to subsidised care over many years by illegally including their families in the means test — suggests that when faced with cutbacks, even the Health Boards thought nothing of flouting the law. Nothing short of a radical overhaul of the whole sector is now needed. |
