The High Court will decide later this week whether to sanction the transfer of a man in his early 60s to a nursing home some five months after he became fit for hospital discharge.
Mr Justice David Nolan said he appreciated there were constitutional issues at play in the case, as the man objects to the move. The judge said he would be inclined to grant the orders sought by the acute hospital in which the man remains, but he will wait to hear further submissions on Thursday.
The man’s situation is before the court’s “inherent jurisdiction” list because he lacks mental capacity as a result of alcohol-related cognitive impairments and a dementia-like condition called Korsakoff syndrome. The court heard he needs 24-hour supervision due to his difficulties with daily living.
The hospital’s barrister, Ciara Dowd, told the court on Tuesday that the man has been fit for hospital discharge since the summer and her client wants an order providing for his transfer to a nursing home. She said the patient opposes the transfer, while a doctor said the placement would be “disappointing”, given the man is in his early 60s.
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The man’s court-appointed advocate, David Hickey of Curry & Hickey solicitors, wanted to explore the potential for the man to be placed in Health Service Executive (HSE) disability services instead of a nursing home, said Ms Dowd. The HSE assessed the man and concluded he did not meet the criteria for disability services due to having Korsakoff syndrome and an alcohol-related brain condition, she said.
Alan DP Brady, counsel for Mr Hickey, said constitutional issues arise as the man is “very clear he does not want to go” to a nursing home. The court must be satisfied before ordering such a limitation on the man’s right to liberty and must strike a “very delicate constitutional balancing” act, he said.
He acknowledged the administrative issues arising from the man taking up a bed space in an acute hospital that is “not an appropriate place” for him. However, the move would be against the man’s will and he would potentially be required to part-fund his nursing home place via the Fair Deal scheme, said Mr Brady.
Ms Dowd submitted that the man is not only against moving to a nursing home but is also opposed to assisted living.
Mr Justice Nolan said he was concerned that residential places had been lost because of time elapsed in the case, but luckily a new one had been found.
He adjourned the hospital’s application for 48 hours, when he will want to know the likelihood of the nursing home bed being kept for the man in the event of delay. He gave permission for Mr Hickey to serve the HSE with the legal papers.
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