Doubt about coercion. Summary of countrywide supervision of compulsory health care for patients in nursing homes in 2011 and 2012

Compulsory health care for patients in nursing homes was the theme for countrywide supervision in 2011 and 2012. We investigated whether patients who lack the competence to give consent receive necessary and adequate health care. The summary is based on supervision reports from the municipalities that were investigated.

Supervision was carried out in 103 municipalities. Breaches of the statutory requirements were detected in 89 of these municipalities. There was little difference from 2011 to 2012.

The supervision authorities detected widespread use of compulsion and coercion that was in breach of the legislation, and found that the regulations were not well known and used in practice. Many members of staff were unsure about the regulations concerning compulsory health care, what the concept of coercion involves, how resistance can be identified and dealt with, how and when patients’ ability to give consent should be assessed, and who is responsible for making such assessments. We identified deficiencies in training, inadequate overview of the staff’s need for training, and inadequate routines for reporting. Many of the municipalities that were investigated faced serious challenges in order to ensure that management and control of use of compulsory health care for patients in nursing homes is adequate.