Elderly man with dementia found to be severely dehydrated , court hears

An elderly man with dementia was found by a hospital to be severely dehydrated after his family insisted on his urgent transfer there from a nursing home, the High Court has heard.

The family “understandably” object to the man going back to the same nursing home and he is to remain in the hospital until an alternative nursing home is located, the president of the High Court, Mr Justice Peter Kelly, said. Solicitor Aileen Curry, the man’s court appointed guardian, agreed with the family’s objection, he noted.

Ms Curry told the judge the family have lost confidence in the nursing home as a result of the deterioration in their father’s condition following his admission there.

The man is now stable and ready for discharge from hospital, the family are happy with its care for him and efforts are continuing to identify an alternative nursing home, she said.

Aged in his eighties, the man has severe dementia. Arising from their serious concerns about his ability to manage safely at home, his family last April sought assistance from the HSE due to his strong opposition to going to a nursing home.

In the context of intended wardship proceedings, the HSE, represented by Paul Brady BL, secured orders for his transfer to the nursing home. While there, he refused food and water over a period. His daughter told the court this week family members had expressed serious concern on a Sunday evening about his deteriorating condition and sought a hospital transfer.

She said they were told no doctors were available that day and he was not moved to hospital until the next day, Monday.

A hospital doctor told them the salt levels in her father’s body indicated he was badly dehydrated and had not had food or water for a week or more, she said.

The family are “adamant” he should not go back to that nursing home and are actively seeking an alternative. She said some homes have waiting lists and other have said they lack facilities to deal with his condition.

After his transfer to the hospital, the HSE had to secure court orders permitting it to feed him by naso-gastric tube. Because he was physically unable to tolerate tube feeding, peg feeding orders were later obtained and he has made progress. Mr Justice Kelly said a court appointed medical visitor who assessed the man had reported, due to his advanced dementia, he lacks capacity to make decisions about his welfare and finances.

Based on that report and additional medical evidence and noting there was no objection to wardship, the judge made orders taking the man into wardship and appointed two family members as his committee. The family themselves had chosen the first nursing home but, arising from the deterioration in his condition while there, are disappointed with his care and they and his guardian agree he should not go back there, the judge said.

The judge said he would not authorise return to the nursing home and, although an acute hospital was not a solution, not least due to risk of infection, the man will remain there until a suitable home is found.

A son of the man thanked the court, guardian and the hospital for the care it had shown to his father. Mr Justice Kelly thanked the family for attending and Ms Curry for acting as guardian on an emergency basis.