Implementation of the Duties and Powers of the National Preventive Mechanism in 2012
The ward for dementia sufferers was opened at the time of the visit, and the residents’
freedom of movement was not limited. This was confirmed by the residents who were
interviewed, in fact, they also stated that they had neither any wish nor any need to leave
the ward or even the nursing home.
A question was raised by the NPM, how the protection of residents at the Lastovka ward
is guaranteed when they may also just leave the premises (by themselves). In particular,
when persons lacking orientation in time and space and in need of constant assistance and
supervision are considered. If they may leave freely, there is actually still a possibility for
them to get lost, or hurt when outside of the nursing home, or cause a situation that may
put them or others in danger. As a result, it was proposed by the NPM that, together with a
psychiatrist, it might make sense to develop a safety assessment for residents suffering from
dementia, and determine on its basis whether the freedom of movement of an individual
resident should urgently be limited for reasons of safety. In a case of such a decision, it
would obviously be necessary to obtain a consent by a resident, or notify the competent
court of the limitation, in accordance with the provisions of the ZDZdr.
In its response report, the nursing home explained, among other things, that relatives and
residents-to-be are informed upon their admission that there is no secure ward within the
facility. However, the method and the concept of work are then presented to them, the
presence of a psychiatrist in the institution is made known to them, and in cases when
it is believed that the safety of a resident may be at risk, such a resident is referred to
an institution having such a ward at its disposal. It was also stated that in no case had a
psychiatrist issued any at-risk assessment up until now. The method of work adopted in
the nursing home does not limit the movement of residents, but there is a method of work
with dementia sufferers on how to guide them back to the nursing home in a friendly and
respectful manner, in cases of confusion and distraction, and how to prevent unwanted
departures. It was on the grounds of enabling a free exit of residents that the construction
of a new ward for dementia sufferers actually began, specifically, on the ground floor of the
building where the first residents started to be received at the end of January of the year of
the visit. Free exit to the outside park will be provided at this ward, and a fence will be set
around the park. Residents suffering from dementia can move around there without fearing
any unsupervised departure. The nursing home also planned to install cameras at the exits
of buildings in the year of the visit, which will ensure further supervision of the exit and the
entrance area.
Considering the explanation given by the nursing home, the NPM established that a form
of protection of residents suffering from dementia was actually involved which is defined as
a high level supervision ward by the Guidelines for the Work with Persons Suffering from
Dementia in the Field of Institutional Care of the Elderly, prepared by the Ministry of Labour,
Family and Social Affairs.
It was proposed that the conduct by the nursing home be compliant with the ZDZdr and
notification to the court be made in regard to persons accommodated in the ward in the first
floor of the castle, as well as of persons to be accommodated in that ward in the future when
persons defined under Article 2 of the ZDZdr are concerned and in accordance with Article
74 of the ZDZdr, such persons do not provide or cannot provide their consent (on their own
or by a statutorily representative in cases of a person declared as contractually incapable).
In such manner, the final assessment as to whether the secure ward fulfils conditions under
Article 2 of the ZDZdr will be left to the court.
National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to
the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
89
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