“There is often no transparency, no clarity and no fairness around the additional charges levied,” he said.
Mr Tyndall’s office has been able to accept complaints about private nursing home since 2015 and additional charges are causing the greatest concern.
“We have made it very clear and will continue to insist on this — that all additional charges must be laid out clearly in the contract of care and agreed upon when signing the contract,” said Mr Tyndall.
He was speaking at the launch in Dublin of a report recommending an overhaul of nursing home contracts of care. The report was completed by Sage, a support and advocacy service for older and vulnerable people.
The ombudsman said the scale of the additional charges was such that they not only depleted an individual’s resources but required the input of family members as well.
“These additional charges can effectively wipe out the remaining income, leaving little for extras such as taxis for hospital visits or services such as hairdressing, chiropody,” said Mr Tyndall. “In some cases, they can be an additional burden on families.
“We are impoverishing people through this system of charges, and it needs to be looked at again to enable people to have sufficient resources left to be able to have some choice as to how they spend their money and what they spend their money on.”
Additional charges have already been considered as part of the 2015 review of the Nursing Home Support Scheme. Health Minister Simon Harris has also tasked a working group to examine the issue.
“In the meantime, residents and their representatives need to be aware that the time to agree on these additional charges is when the contract of care is being finalised,” said Mr Tyndall.
“People are often afraid to complain. They are afraid for a good reason. One of the things the report highlights is the lack of security of tenure they have in nursing homes.”
Mr Tyndall said his office received 45 complaints so far this year about private nursing homes, a 50% increase on the 30 received the previous year.
“It is often the case that complaints about nursing homes are not submitted to my office until after a resident has left the nursing home or has sadly passed away,” he said.
He said the discussion document provided practical advice on how the contract should be restructured.
“From the experience of my office, it is clear that when a person enters a nursing home, often the overriding concerns are the availability of a place and the location of the nursing home,” he said, adding that contracts were often signed without being properly understood.
Sage chairwoman Patricia Ricard-Clarke said there was anecdotal evidence that contracts were frequently signed by a relative on behalf of a nursing home resident, even when the resident had the capacity to decide.
The discussion paper calls for an overhaul of both the content of contracts of care and the manner in which residents are expected to deal with them.
Nursing Home Ireland said there was “robust legislation” in place to safeguard and protect the rights of residents in nursing homes.
Meanwhile, human rights solicitor Áine Flynn has been appointed as the first director of the new Decision Support Service for elderly and other people whose ability to make decisions for themselves is restricted or impaired.