Saturday 21 September 2019

Judge rules woman with dementia to be forced into hospital

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Tim Healy

An elderly woman with advanced dementia is to be moved to hospital by emergency High Court order after being described as malnourished, dirty and living in "appalling" conditions at home.

The woman, aged in her eighties, had been found spreading faeces on bread, the court heard.

She sometimes wandered from her home seeking her husband who died some years ago and had answered the door clad only in a cardigan.

Her situation has deteriorated in recent months and she has aggressively and sometime violently resisted efforts by carers and others to feed and clean her or her home, the court heard.

Her doctor had reported she is doubly incontinent, urinates and defecates on piles of clothes on the floors of her home and urinates into bowls she later tried to drink from. She has also claimed her food was poisoned.

Her son said his mother was first diagnosed with dementia late last year and he tried over months to have the necessary two doctors certify she lacks capacity to make decisions in the best interests of her welfare and finances.

He was told by one consultant, because his mother voiced a clear refusal to leave her home, then "freedom trumps safety".

That consultant had since agreed his mother lacks capacity, he said.

He had been told nothing could be done unless his mother suffered a serious fall at home which incapacitated her. He had also gone to a Garda station for help but was told they could do nothing.

Before the dementia diagnosis, the woman received some home care funded by the HSE, the court heard.

She had fallen twice at home in recent days but refused to be treated or to go to hospital. She has pressure sores on her body and there is concern she may also have fractures or other injuries following the falls.

Mr Justice Peter Kelly, who first became aware of the woman's situation yesterday morning after her son sought to have her made a ward of court, has directed an inquiry into her capacity with a view to wardship.

He also directed the HSE and general solicitor for wards of court be immediately notified of the situation which he said should be urgently addressed.

Later in the day, he was told a bed had been found for the woman in a hospital.

At the request of Paul Brady BL, for the son, and David Leahy BL, for the HSE, he made orders permitting removal of the woman from her home to hospital, using minimal force, restraint and/or sedation if necessary, and permitting her detention there for the purpose of all necessary treatment for her welfare and safety.

The judge said this was an interim measure and any transfer onwards from the hospital would have to be sanctioned by further court order.

The judge thanked the son for his efforts to try and resolve a "very upsetting" situation and said he was sure it was very difficult for him to see his mother in such condition.

On the existing medical evidence, the judge said he was satisfied the woman lacks the necessary capacity to make decisions pertinent to her own well being.

The descriptions of her living conditions are such she requires to be treated for malnutrition, possible fractures, pressure sores and general decrepitude arising from her inability to make decisions for her own good, he said.

He had been provided with affidavits, including from her GP, who has diagnosed her with advanced dementia of Alzheimer type and senile self neglect syndrome and it seems she has not had capacity for some time, he added.

Irish Independent

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