Elderly people are being left financially "impoverished" because of the additional charges they are forced to pay in private nursing homes, Ombudsman Peter Tyndall has warned.
Mr Tyndall could see the "unfairness to a resident" who is paying 80pc of their pension for their nursing home care and must use the remaining 20pc for social activities, for which they have no inclination or may be physically unable to participate in.
"My main concern is that there is clarity, transparency and fairness around any additional charges levied. All additional charges must be laid out clearly in the contract of care and agreed upon when signing the contract. The additional services should also be separately itemised and costed," he said.
"These additional charges can effectively wipe out the remaining income, leaving little for extras such as taxis for hospital visits, or services such as hairdressing and chiropody. In some cases, they can be an additional burden on families."
The Ombudsman has received 45 complaints about private nursing homes this year - a 50pc increase in the number of complaints received in 2016.
He was speaking at the launch of 'Contracts of Care for Nursing Home Residents - Issues of Policy and Practice,' a damning report by Sage, the support and advocacy service.
The document highlighted major flaws including allegations contracts are being signed by relatives on behalf of nursing home residents, even when they "clearly have the capacity" to make their own decisions.
Sage chairwoman Patricia Rickard-Clarke stressed this casual approach to signing of contracts of care must stop, in order to protect vulnerable older people.
In many cases, contracts are signed without being read or understood due to complex and legalistic language.
Nursing home residents are left with no security about their accommodation and told to leave by the homeowner, who has the balance of power in the termination of a contract.
Termination can be done with "immediate effect".
Many older people are forced to go into a nursing home because there is no other reasonable alternative.
They are "put there" by concerned relatives, it was claimed.
They can face an increase in additional charges of €25 a week, without consultation.
The report found some contracts set out visiting restrictions and the right to transfer the elderly person to another nursing home.
Sage has received concerns about the level of control by some families over the older person's finances.
There was also a need for protocols where a person's finances are being handled by the home, but money is not being drawn down to enhance their quality of life.
Mr Tyndall backed calls for an overhaul of these contracts and said the Government must also ensure better availability of home care.
Nursing Homes Ireland, which represents private nursing homes, said contracts are subject to independent oversight by Hiqa, which carries out inspections.
Any discharge from a nursing home must be discussed, planned for and agreed with a resident and where appropriate, with their family or carer, the regulations stipulate.