Nursing homes - We all have a duty of care and vigilance

THAT hackneyed, black-humour warning seen on car stickers — “Be nice to your children, after all they will choose your nursing home” — has taken on a macabre relevance.

Three years after the nursing home abuse scandal of Leas Cross, where neglect was institutionalised and the elderly residents were treated like cattle, the Health Services Executive (HSE) has upheld 50 complaints against nursing homes.

In one instance of callous indifference, at Hillcrest House nursing home in Letterkenny, Co Donegal, a woman fell last summer, and though she complained of severe pain she was not admitted to hospital for two months. Medical staff diagnosed a broken shoulder.

The elderly woman had a broken shoulder for two months and the nursing home staff did nothing to alleviate her difficulties; they did not take her complaints seriously enough to have them investigated.

Imagine trying to move, imagine trying to sleep, with a broken shoulder over two months. The physical discomfort would have been great, but the sense of powerlessness must have dramatically undermined that woman’s confidence and psychological well being.

If that unfortunate woman had been a horse and its owner allowed it to endure a broken shoulder for two months they would have been taken before a court under cruelty legislation and faced a stiff fine. They might have been banned from keeping a horse for life.

In the other sorry case, staff at the HSE-run Falcarragh Community Hospital put socks on the hands and arms of a patient and then tied them together to stop him removing an incontinence garment. Think about that for a minute: an old man was tied hand and foot so he could not remove a garment that was causing him discomfort. This was done presumably to suit the nursing home staff rather than the unfortunate, fully aware man.

What is worrying about all of this is that three years ago we saw what could go on in nursing homes, and we were assured that a strengthened inspectorate would work to ensure that standards were improved. These reports are part of that commendable process, but the number of complaints upheld — 50 — suggests that the home owners or managers are not sufficiently concerned about either being caught, or the penalty the health authorities might impose.

Of course the penalties are limited, as in too many instances authorities are unable to impose the ultimate penalty — closure — because our health service would not be able to offer alternative accommodation.

There are many lessons to be learnt from this. One is that we all have a duty of care; a duty to be vigilant and to be confident about demanding the highest standards.

Another is that we should realise what can happen when we entrust the care of the ill or weak to an organisation whose objective is profit rather that the well being of their clients. And, of course, we should heed the warning so plainly stated on that car sticker.