A problem area that the activities of the Commissions have confirmed is the placement of younger patients with mental disorders and/or persons with multiple disabilities in geriatric centres and retirement Inadequate freedom of choice with regard to housing or nursing homes. In a senior citizens’ home, a Commission came across a 53-year-old man who is under guardianship, but has unrestricted mobility. He stated to the Commission that he rarely leaves his room and has no interest in contact with others. The psychiatric aftercare that the Commission believes to be necessary cannot be provided by this institution. It was recommended to specify other possibilities to the 53-year-old and his legal guardian in order to enable the freedom of choice with regard to housing required under human rights law. In another case, a Commission found that persons under the age of 50 needing increased care were living in a geriatric centre. This Commission also recommended that the AOB take action. Numerous problems that the Commissions found in homes were due Resource shortages to a shortage of resources, During shift changes the employees do not have sufficient time for information sharing and briefings or for supervision. Due to personnel shortages, the residents of the homes are subject to restrictions, for example, therapy kitchens are used too rarely or persons with mobility impairments cannot get daily assistance to use the gardens that have been landscaped for dementia care. Inadequate psychological care, particularly with regard to end-of-life care, was also observed. A common issue were the menus that cannot be categorised as balan- Malnutrition ced and that can result in malnutrition. In one case, the sole alternative to a meat-based diet were sweet dishes. In one psychiatric clinic, the excessively small servings were criticised. With regard to a group home for dementia patients, part of which Safety risks was in a completely separate building, a Commission questioned its safety, as personnel was never present during the night in one part of the facility, even though the facility guarantees the 24-hour presence of qualified care personnel (orderlies) in both residential wings in its contracts. The initiation of an investigative proceeding was recommended. In several facilities, inadequate accessibility for persons with disabilities was found. In the case of one facility for senior citizens, for ex- Inadequate accessibility ample, the thresholds at the access to the showers and at the exits to the terrace were too high and the corridors too dark. The doors could not be opened automatically so that access for persons in wheelchairs was almost impossible without assistance. 53