By Ruth Mercer
The High Court has continued protective orders for a 62-year-old woman identified as A.M. for a short period while the HSE arranges her transfer from a nursing home to a less restrictive step-down placement.
A.M. has consistently said that she wants to leave the nursing home in which she has lived under court orders and return to the home she previously shared with two daughters. She told the court she would consider an interim placement if it was reasonably close to home and allowed her greater freedom.
The central issue before Mr Justice Barry O'Donnell was whether A.M. currently has capacity to decide where she should live and to make complex financial decisions.
Her medical picture has changed significantly. A 2023 diagnosis of behavioural variant frontotemporal dementia is no longer considered correct after her cognitive condition stabilised and improved. Recent evidence instead suggested that her difficulties should be understood against a history of trauma and a condition described as Disturbance of Self Organisation.
Three consultant psychiatrists gave evidence. One considered A.M. capable of making residence and financial decisions. Two others concluded that she could understand and retain information but had difficulty properly weighing important risks, particularly those connected with returning home and her relationship with a daughter on whom she was described as highly dependent.
The judge preferred the latter evidence. He found that A.M. could not adequately factor into her decision the possibility that her daughter might not support her return home or the risks associated with another person living there. He also found that she currently requires protection in relation to major financial decisions.
The existing orders will therefore continue temporarily so A.M. can move to an identified open step-down facility. The court said any later restrictions should be narrowly defined and indicated that, once detention is no longer necessary, future decision-making support should ordinarily move into the framework of the Assisted Decision-Making (Capacity) Act 2015.