Liam Quaide (Cork East, Social Democrats) | Oireachtas source

I raise the human rights issue of adults under 65 with an intellectual disability or acquired brain injury who end up living in nursing homes or who find themselves stranded in psychiatric wards due to a lack of community-based supports. This is a desperately sad situation and another example of how much distance is opening up between our economic prosperity, on one hand, and the vindication of our disabled citizens' basic rights, on the other.

In May last year, there were in excess of 1,200 with disabilities living in nursing homes. The Ombudsman, Ger Deering, has warned that Ireland will look back with regret at how it treated these citizens. His office has authored a report on their plight, poignantly titled Wasted Lives. Mr. Deering has appealed to the new Government to include improved funding for the HSE to relocate these young people. He said he is "deeply unhappy" with the funding allocated in budget 2025, warning that a huge amount of work implementing the recommendations of the Wasted Lives report may now be in jeopardy. He noted that there needs to be a separate budget to help to relocate people who have been misplaced in nursing homes.

The findings from a 2018 study by the Disability Federation of Ireland showed that some younger people with disabilities were being placed in nursing homes as a result of the breakdown in family care arrangements. This might, for instance, involve an ageing parent or the decline in the health of a family carer, rather than because of the disability itself. When a community-based rehabilitation and residential placement becomes fragmented, underdeveloped or under-resourced, nursing home care may be the only option for some younger people with disabilities. It was clear from this study that several of the applicants would have preferred to return home. Others expressed a preference for living in more supportive accommodation or moving to an independent-living, community-based placement. Nursing homes were also being used for temporary care for people awaiting a placement in the National Rehabilitation Hospital.

I had the good fortune of working with the Peter Bradley Foundation, now known as Acquired Brain Injury Ireland, in Glenageary in my 20s. The organisation provides community living and rehabilitation for people with an acquired brain injury who would otherwise have ended up in nursing homes. It has transformed the lives of many service users throughout the country. Yet, so many people referred to ABI Ireland have to be told that their residential placements are massively oversubscribed and they have no prospect of being placed in one.

Adults diagnosed with a mild intellectual disability who also experience mental health difficulties are further neglected within our system. Those who are most in need of intensive support and residential care often fall between services and can spend prolonged or even indefinite periods of time misplaced in psychiatric settings. In this context, their psychological state and behaviours can deteriorate. In the absence of tailored supports, they may be over-medicated as a means of managing their distress and unsettled behaviour. There can be an intensive concentration of staff supports during the psychiatric admissions. However, because the setting is unsuitable a lack of improvement or even a sharp deterioration in the person's psychological state occurs and nursing homes may become the only placement option. This is a psychological and social dead end for people who may be quite young with considerable potential for rehabilitation.

People with an intellectual disability who are living in the community without family supports can be extremely vulnerable, at risk of sexual and financial exploitation and associated health consequences. They are sometimes linked with mental health teams that are ill-equipped to protect them from predatory behaviour. They should be able to avail of long-term specialised residential care in the community. They should be able to live somewhere they can call home, where they can feel safe, form healthy relationships and pursue meaningful goals. They should be fully supported to take part in their local community. If the UNCRPD is to mean anything, we need to see the kind of investment commitment that can put an end to this shameful situation.

I will come back to the Minister on the following area in more detail at a later stage but I want to mention the importance of recognising foetal alcohol spectrum disorders as a disability and to progress with standard criteria for diagnosis and supports. Foetal alcohol spectrum disorders are estimated to affect up to 7.4% of the population and are associated with lasting physical, mental, educational, social and behavioural difficulties. They are a serious neurodevelopmental condition and there is a great deal of work to be done in prevention, diagnosis, treatment and supports. The former Minister of State, Deputy Anne Rabbitte, committed to supporting the aims of FASD Ireland and I hope the current Government will honour that.

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