Approach to nursing home contracts ‘may be illegal’

The current approach to signing contracts for entering nursing homes can be too casual and may even be illegal, support and advocacy for the elderly agency, Sage, has said.

Sage manager Mervyn Taylor on Thursday called for independent advocates for people entering nursing homes.

He also called for nursing home contracts to be simplified and claimed that they are some times illegally signed by relatives.

"Contracts are written in complicated language, they need to be simplified. Residents feel under pressure to sign them and contracts are frequently signed by a relative despite the capacity of a nursing home resident to sign these documents for themselves," he told RTE's Morning Ireland.

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“There is an alarmingly casual approach by some nursing homes with people in a state of crisis wondering if they can get a place in a nursing home. They are also concerned that they cannot care for themselves and in some cases their family might not want to care for them.”

“It’s a very difficult time, some times you feel a sense of relief, some times you are conflicted, some times you might not understand what is before you.

“In some cases people who can actually understand the contract have it signed by someone else, people who call themselves the next of kin on behalf of a person and that’s clearly and utterly wrong.

“This is possibly illegal, they sign on the resident’s name, next of kin - who are they? They are a contact in an emergency, but there’s a very widespread view among the public and in health and social care professionals that next of kin actually have some legal powers - they don’t.”

Mr Taylor said he was very concerned that the structures are pretty loose. “In many cases, people are presuming that because a person has diminished capacity they’re finding it difficult to understand, that there may be cognitive impairment, slowly advancing dementia, but there’s a sort of presumption that that if you have any loss of capacity that you have total loss of capacity.

“There’s no consideration of supporting the person to understand and make the decision for them,” he said.

He said there is an Assisted Decision Making Capacity Act 2015 which Sage hopes will be commenced in full next year. “That will help the situation, it provides for people to be supported in decision making.

“The question is - who is actually helping you make a decision if they have an interest in making the decision themselves.

“That’s where independent advocacy is important - you can tease out the options, but it is important that they’re not part of the family, they’re not part of the system of provision or not part of the wider health system.

He said Sage will be asking the Government to introduce protocols and procedures to be followed if a potential resident does not have the capacity to understand a contract.

“These contracts are incredibly quite complex, some of them totally unnecessary so. We need plain English. I don’t see what that’s so difficult to do.”

Meanwhile it was announced that a human rights solicitor has been appointed to head up the new Decision Support Service as provided for under the Assisted Decision Making Capacity Act 2015 .

The new director Aine Flynn was a partner in law firm KOD Lyons, with a particular experience in mental health law and capacity and wardship issues.

The service will work to support decision-making by adults who have difficulty making decisions without help. It will be responsible for delivering many of the changes brought about by the Act. The service is within the independent Mental Health Commission under the Department of Health.