'Exceptionally challenging' to report abuse and neglect in nursing homes

RTÉ Investigates revealed mistreatment of residents by staff at Emeis nursing homes.

Too many people in nursing homes or centres for people with disabilities are at risk of serious and often preventable harm, the Oireachtas health committee heard on Wednesday.

The committee was meeting with members of Safeguarding Ireland and the Irish Association of Social Workers (IASW) and heard of neglect, abuse and widespread financial abuse.

Much of the discussion focused on nursing homes in light of mistreatment of residents at Emeis nursing homes revealed by RTÉ. 

Safeguarding Ireland chairwoman Patricia Rickard-Clarke warned: “The closed nature of nursing homes makes it exceptionally challenging for either residents or staff to speak up and report abuse or inappropriate care.” 

She said it was now over a year since the Law Reform Commission published an analysis of the gaps in policy and legislation.

In April 2024, the proposed draft adult safeguarding legislation pointed to the need for an adult safeguarding authority.

“While the current focus is welcomed, it should not require an exposé to generate political and public engagement on the exploitation of adults in Ireland,” she said.

She also stressed abuse happened within families, especially financial abuse, with little State oversight of who draws down pensions, for example.

“There is a lack of real understanding of what is happening at the coalface,” she told Labour health spokeswoman Marie Sherlock.

"I suppose in our culture in Irish society — particularly if you take older people — decisions are made for them, their money is taken from them and everybody turns a blind eye." 

IASW chief operations officer Caroline Walker Strong also focused on the increasing reliance on institutions.

“Older people enter nursing homes and rarely return to participate in community life,” she said.

“They are never again seen in their local restaurants, at their GAA club, or library. Why? In other jurisdictions, the connection between residents and their local communities are nurtured.” 

Sarah Donnelly, associate professor of social work at University College Dublin and IASW adult safeguarding adviser, called for awareness of what abuse is.

“Our very chequered past history in terms of Emily, Grace, Brandon and RTÉ Investigates is very clear evidence that often poor care is constructed as not-institutional-abuse,” she said referring to scandals exposed in recent years.

She noted low staffing levels and bad pay for carers in centres and in homecare was the “elephant in the room” when it came to making reforms work.

Safeguarding Ireland board member Mervyn Taylor raised concerns about how large many nursing homes had become.

“If you look at that RTÉ programme, you will see effectively a hotel-style design,” he said, noting physical design of buildings impacts culture in any environment.

“Why are we talking about large numbers of people, some places are as big as the local hospital. They can be broken down to small units whereby people have to interact with each other, they can relate far better. That is good design.”