1.6 Visit to the Idrija psychiatric hospital It is recommended that the form for the patient’s consent on admission to the close surveillance unit includes also the date and time of the signature as they are not necessary the same as the date and time of the admission. We welcome that the hospital’s response report stated that the consent form on the admission to intensive care unit will be updated according to the Ombudsman’s recommendations. It is recommended that the hospital’s gerontopsychiatric unit immediately prepares a room where special protection measures could be properly performed or (always) applies this measure in a room used for special protection measure in other units (in unit L3, for example). We welcome that the hospital’s response report stated that suitable premisses for special protection measures will be ensured in the gerontopsychiatric unit in the same way as in other units. It is recommended that strapping to chairs as a form of special protection measure is performed only in appropriate rooms (onto the bed or chair) under full control of the personnel. The hospital’s response report stated that intensive care ward of the gerontopsychiatric unit accepts patients with delirious conditions or suffering from a progressed form of dementia with mental and behavioural disorders. Worsening of the condition and the need for hospitalisation in the gerontopsychiatric unit often happen concurrently with infectious diseases or conditions after injuries or surgical procedures. Patients with dementia in the gerontopsychiatric unit need appropriate somatic and psychiatric diagnosis and treatment; the accompanying measures ensure optimal conditions for persons who need continuous assistance and care during all activities due to their actual condition. Specific problems of patients suffering from dementia include balance problems and reduced motor skills which result in an increased risk of falls or inability to walk. Since these patients do not fully comprehend their medical condition and have a severe decline in cognitive abilities, they are usually uncritical to their condition and exposed to frequent falls and injuries. The injuries of the skeleton and brain haemorrhage significantly increase the mortality rate of patients with dementia. Given the basic characteristics of the medical condition of patients with dementia which can result in invalidity, the nature of measures and assistance is different than with patients who are not suffering from dementia. Patients need assistance with all activities (hygiene, feeding, movement); to avoid the risk of falls, special safety measures are taken and wheelchairs or resting chairs are used. With this measure the hospital ensures the patients’ safety and that they live in a favourable social environment while staying in the hospital as a part of a therapeutic group or in communal living areas. Despite the severe decline in cognitive abilities, speech impairments and disturbances in perception, cohabitation with other patients and the therapeutic staff is an important prerequisite for achieving appropriate communication skills, emotional response as well as appropriate and suitable supervision. Separating patients with advanced dementia who need increased supervision due to falls and injuries would mean additional social isolation and absence of normal stimuli and communication, made possible when staying in a therapeutic group or communal living areas. The NPM’s report pointed out the difference between protection measures and special protection measures which is also confirmed by the NPM medical expert opinion. The NPM agrees that it is not appropriate to separate patients under protection measures that go on during almost the whole time that the patient spends in the living area. However, the situation changes if there is a special protection measure (in its response, the hospital perhaps erroneously uses this expression when defining protection measures in the gerontopsychiatric unit). We repeat that it is necessary to respect all requirements determined by the ZDZdr when strapping the patient onto the bed or chair is used to prevent or control their dangerous behaviour and when patients pose a threat to their or somebody else’s life or health or when such behaviour causes severe material damage to the patient or others and this danger cannot be prevented with other less severe measures. Since the measure as determined by ZDZdr has a strict time limit, the separation of the patient for the duration of the measure might not have such severe consequences as those which could have resulted from exposing the patient to other patients during the special protection measure. IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2013 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 127