inhumanity in nursing homes in Ireland

 Who is to blame?

 

Recovering my equilibrium following last Tuesday’ RTE investigates’ programme has been difficult. RTE showed two nursing homes, where abuse, neglect degrading and humiliating treatment seemed to be the norm was heartbreaking.

One nurse knew it was bad, said she would “not put her mother or father here”.  Did she do anything about it? Another nurse said, “if we do this, we will be creating bed sores”. She knew harm would result. It was deliberate harm, a known consequence of a behaviour. Nurses are mandated to report abuse.  Disciplinary action should be taken if they did not report it.

More and more revelations are published, a cleaner who resigned tells of call bells being disconnected at night and staff going to sleep on another floor. A psychiatrist writes about the increasing demand for psychotropic drugs to keep patient’s ‘calm’. Which generally means “so we can have an easier time’. ‘The chemical cosh’ – to knock out ‘difficult’ patients.

Why have psychiatrists and geriatricians not advanced on the Government in droves before now? Were they complicit? Supporters of cruel and degrading regimes? Why do nurses, HCA’s (health care assistants) doctors, not say; “enough is enough”. Front line staff have a duty of care. We all do, from cleaner to psychiatrists. Accountability is key. Heads should roll.

Is it Irish culture to treat people so badly? Old people, disabled people, sick people. Maybe it is. You have only to read some of the reports; Ryan, McClean/Kilcornan, Kennedy, Brandon, McCoy, Leas Cross, McIlroy, Farrelly, to realise perhaps violence, degradation, and poor and inadequate care, then secrecy, was/is part of Irish culture! The culture of the HSE, practitioners and workers. What else accounts for ongoing vulnerable people being abused, degraded, humiliated?

It has become so normalised…and acceptable. They can not see abuse, degradation, harm. Or at least they didn’t see it enough to take action.

When HIQA can say ‘non-compliant’ or ‘repeat non-compliance’, without consequences there is no safety.

In the Emeis Homes one staff nurse, the whistleblower, saw and acted.

This has all happened before. Let’s refresh our memories about ‘Emily’, raped by a carer multiple times, in another nursing home (2020). Marcella Leonard, a top social work specialist, with a safeguarding team, was brought in to review the files, of other residents to see if there could possibly be further victims. What happened?

The team sent an interim report to the HSE in April 2021, to give it "a very clear message" that the review was uncovering "systemic evidence" that Emily was not the only victim”.  Yet her teams work was shut down.  

" What does it say about an organisation (HSE) rather than providing that team with more support to continue to find the evidence, they shut them down” (Leanard).  No one asked or answered “why?”

In 2023 safeguarding expert Jackie McIlroy was brought in.

The Irish Association of social workers (IASW) 2023, said the (McIIroy) report vindicated the work of the safeguarding social work team in the Emily case. They added; Adults at risk of abuse are paying the price for poor oversight of safeguarding at both local and national level in the HSE," the group said.

This is a stunning observation, but I know it to be true. Poor oversight of safeguarding is not an observation of professional good practice. It is a standard of shame. It leaves vulnerable disabled older people at risk. The leaders, the managers, are not up to scratch. They are failing. They are not fit for the job.

Then quite shockingly, IASW said in 2023, it welcomes HSE chief Bernard Gloster's "genuine commitment to reviewing safeguarding structures"…was there really a genuine commitment to review safeguarding structures in 2023 following the McIlroy report? Where are these reviews? Where is the new legislation? Where are the new structures? Where is the evidence?

I still await a reply to my own letter to Bernard Gloster. It’s urgent, has been urgent for several years, but I cannot penetrate the HSE answerphone system and they never phone back.  All you get is; “I am sorry I am not available. Please leave a message and I’ll call you as soon as I can”. They don’t.

It is my very sad belief, that elder older people and disabled people are not considered full citizens in Ireland. We are expendable. Nothing becomes urgent. There is no urgent in our care. They wait for us to die. Quality of life has an end point – age 65.

Are we going to sit back and allow that? When does abuse humiliation and harm to older people, older disabled people become urgent?

 

The HSE and HIQA are both responsible for large numbers of vulnerable people being abused in Ireland, both in institutions and the community. Do we now say both organizations are not fit for purpose?

This is a Teabag!

 This is a Tea Bag!

Dr Margaret Kennedy

 

Watching RTE investigates last night, 4^th June, on the care practises in two nursing homes was the equivalent of watching and being in the midst of a nightmare, a horrifying spectre in front of my eyes. It was like some monster with powerful tentacles reaching, through the screen to grab me. Pulling me into such a place – to hell. Most days I see that hell. And I fight not to enter it. I have written my letters, to no good effect.

The only way we can now reach the politicians who have power to change, is via the visual impact of an undercover programme. Telling them verbally or writing to them seems to cut no ice.

As an older woman aged 72 with a rare neuromuscular disease, a full-time wheelchair user, incontinent and needing care in my home, clinging on to staying at home, none of what the programme showed surprises me. We saw the ‘known’. We know. HIQA knows. The abuse and neglect, the lack of care. lack of staff, lack of training… it’s all known, It’s not a secret.

From my vantage point, age 72, older disabled or ill citizens are abandoned in Ireland. We are being warehoused. ‘Living’ is not discussed. Where did we see life, enjoyment, community in those places?

I have been in three nursing homes for respite care. In one nursing home I lasted 12 hours overnight, in another nursing home - four days, and in a third, a newly built, 100 beds, I lasted 24 hours. I could not stomach the humiliation, disrespect. degradation and the annihilation of who I was. It was excoriating, mentally, physically and emotionally. I have a PhD and yet, a care worker saw fit to tell me what a tea bag was. At that point, enough was enough. Out.

There is less and less community support, help from the HSE.  When I could not fill some gaps in my care rota, I told the elder care team manager, his response “I hope this message finds you well. Unfortunately, I do not have carers available to assist you, this area does not have a statutory home support agency, so we neither have carers available or employed to redirect to you”.

 No help from the HSE is common.

I met Bernard Gloster in March 2024, the HSE CEO for an hour. He made promises. A part time social worker would be employed to sort out my needs. He was kind, listened. Then he sent me an official letter with the agreements made. I felt very hopeful and very happy. So, what did happen? Over a year later - nothing.

Two new part-time social workers have been in post for about six months, now working with other people... but not for me. Not allocated. No reason given. I have written to Bernard Gloster; he has not replied. A year later, the HSE despite Bernard Gloster’s Directive/promise, ignored his letter.

A nursing home will probably be my next step, because there are few carers in the community. More and more nursing homes are being built, I will not be going there. I have made that clear.

A nursing home in Mayo was inspected by HIQA and was found to be non-compliant. It has 69 residents needing nursing care, convalescence, respite, dementia and palliative care. HIQA found overly restrictive practises. There was an over reliance on the use of television to entertain. Many residents were seated in a row in front of the television for long periods, with little engagement or stimulation provided. Residents who spent the majority of their day in their bedrooms were not observed to have any social interaction or access to meaningful activity other than television or radio on the day of inspection. More than ten emergency bells were missing from the resident’s bedrooms. A repeat finding. Water and tea were left too far from reach. I cannot say more. It is too distressing. Are we not human?

I have read many HIQA reports, nearly all report similar findings. The inspections are done, but do conditions improve? When will we call being seated in a row in front of a television all day, emotional and psychological abuse?  When will we say the residents are not safe? When will we call this abuse? Nothing changes. We are warehousing, we do not care for our elderly people. Sitting in front of a television is not quality of living.

We should be inspecting for ‘quality of life’, not just feeding and cleaning, not just dressing and washing. ‘Quality of life’ is about living. Feeling part of the community, being stimulated, having enjoyable things to do. Feeling useful. We should have a meaningful lifestyle even at 80 and 90 years old.

 “I’m not dead yet”, my life should be useful and fulfilling. I will not be warehoused. I will never be warehoused.