Man with dementia and frostbite to be detained in hospital, court rules

An elderly man with dementia who was admitted to hospital with frostbite in his feet due to “extreme self-neglect” in his “squalid” home is to be detained in hospital on foot of a High Court order.

Aged in his 70s, the man, who lives alone, has a long history of alcohol abuse, and says he wants to go home and intends to continue drinking two bottles of wine daily.

He has a history of hospital admissions, including intensive care admissions and for malnutrition, and was found on occasions at home in states of undress and shivering despite the house having central heating available, the court heard.

Before being admitted to hospital in recent months with frostbite in his toes, he lived in a home of “significant squalor” with excrement, decaying food and maggots throughout, and home helps refusing to visit, Paul Brady BL, for the HSE, said.

The man has been separated from his wife for many years and while his adult children and others have sought to be supportive, he has declined their help, counsel added.

He was unable to manage himself and relied on others to turn on the heating and manage the household.

Alcohol is delivered on a regular basis to the house, the court heard.

Mr Brady sought the hospital detention order pending an inquiry into whether the man should be made a ward of court.

Counsel said the man has indicated he wants to go home and a treating psychiatrist had assessed him, as a result of dementia, as lacking capacity to make decisions about his welfare.

The psychiatrist considered his self neglect was partly as a result of alcohol abuse but mainly due to cognitive impairment. The hospital’s concern was, if he sought to leave, it would be in a position to legally prevent that from happening.

High Court president Mr Justice Peter Kelly said he was satisfied, on the evidence, it would be “highly detrimental” to the man’s health, “and perhaps his life”, if he returned home to live in such squalid conditions.

The judge said the man is highly educated and had a professional career but was cursed by his alcohol addiction and years of alcohol abuse.

The man’s dementia seemed to be the result of brain damage caused in many instances by over indulgence in alcohol, which continues to play a large part in his life, the judge noted. The man also had a history of hospitalisation, including to tackle his alcohol addiction, but to no good effect.

The judge made orders permitting the hospital to detain and treat the man. He directed an independent medical visitor to assess him for the wardship inquiry and appointed a guardian at litem to represent the man’s interests.