A brain-injured woman is to be detained in a nursing home by High Court order because of concerns about the quality of care in her home and that her husband may seek to have her discharged back there once Covid-19 restrictions are lifted.
There has been a Covid-19 outbreak in the nursing home and one Covid-19 related death but the woman’s court appointed guardian had said she is isolated in her own room and he considered the situation was being appropriately managed, the court was told.
The woman, aged in her sixties, had organic brain injury and other conditions involving a high level of care needs, Paul Brady BL, for the HSE, told Mr Justice Anthony Barr on Wednesday.
She had been cared for at home by her husband until early last February but concerns about the level of care being provided to her dated back some two years.
Those included her husband had cancelled evening visits by home carers and appeared to have gone out in the evenings, leaving the woman in her room for long periods, resulting in heavily soiled pads, Mr Brady outlined.
Other concerns included the husband had refused to co-operate with recommendations as to her care or to have her assessed for long term care and that he may be developing Alzheimer’s disease.
The concerns lead to the woman being moved, by court order, to the nursing home last month from a hospital where she was treated for an infection, counsel said. While in hospital, she had said she wanted to go home but she appears to have settled since into the nursing home, he added.
Mr Brady sought orders, in the context of an inquiry as to whether the woman should be made a ward of court, permitting her detention in the nursing home pending the wardship inquiry or further review in July.
Two medical reports concerning the woman's capacity to make decisions had been provided for the inquiry, he said.
The woman's court-appointed guardian was not in a position to attend this court hearing but had provided a report supporting the HSE's application.
While her husband appears happy for her to stay in the nursing home for the time being, there is concern he may try to take her home once the Covid-19 restrictions are removed and the professionals involved in her care believe that is not in her best interests, Mr Brady said. Her GP had reported her condition has been satisfactory since she went to the nursing home.
Mr Justice Barr said two things were very clear from the most recent report from a court-appointed independent medical visitor who assessed the woman.
These were that the woman lacks capacity at this time to make decisions concerning her own welfare and her husband may seek her discharge back home which could be very much against her best interests in terms of her health, welfare and maintenance, he said.
On foot of the evidence, he would make the orders sought, he said.
If the Covid-19 situation worsens in the nursing home, a home return for the woman "may be the lesser of two evils", the judge added. He granted liberty to apply if evidence indicated "extreme circumstances" which made home the "least worst" option.
For now, he was satisfied, on the evidence, her health is best served by leaving her where she is, he said.