60 Opening the Narrative on Deprivation of Liberty for the Older Person in Residential Healthcare Facilities: A Legal and Ethical Dilemma (Age and Ageing)

AbstractBackgroundWhile many people enter residential care of their own free will and because it is their preference, the evidence tells us that there are also many who if they had the choice would remain in their own homes. Lack of appropriate community supports may provide some impetus to enter residential care. According to Care Alliance Ireland, an additional four million hours of homecare needs to be provided to cope with the successful ageing demographics, at a cost of EUR110 million.There is no statutory or common-law power to detain a patient in a Healthcare Facility outside of the application of the Mental Health Act 2001. This presents legal, ethical and moral dilemmas for Healthcare Providers when caring for a person who lacks capacity wishes to self - discharge. A duty of care obligates healthcare professionals to act in the best interest of the individual. Under the Health Act 2007 the requirement is to provide for a `safe discharge`.Pending advancement of the Assisted Decision Making (Capacity) Act 2015 which provides a statutory framework to assist and support individuals to make legally-binding agreements about their welfare, their property and affairs we are currently acting under the Lunacy Regulations (1871).MethodsWe developed a `Deprivation of Liberty` form which enable comprehensive Interdisciplinary Team discussion and direction of care. Presumption of capacity, respect for the resident`s wishes and consideration of all possible supportive actions up to and including sourcing community support services were considered.ResultsThis format has enabled comprehensive discussion and robust adherence to human rights for three residents thus farConclusionThe situation remains that there is no legal framework to guide healthcare providers currently. Using a Human Rights based approach is imperative to guide us while awaiting advancement of the ADMA (2015) and Deprivation of Liberty legislation to be included in this act.