Future care
22 It was submitted on behalf of the plaintiff that:
(a) he requires care 24 hours per day 7 days per week as a result of his accident caused disabilities;
(b) it should be accepted that the plaintiff's partner is no longer able to provide care for him or that it would be unreasonable for her to be required to do so;
(c) the care should be provided commercially by three 8-hour shifts per day, two being active shifts and the other inactive, 7 days per week.
23 The defendant accepted that commercial care was required 7 days per week but disputed the plaintiff's submission that such care was required 24 hours per day. The defendant's primary submission was that the plaintiff's daily care needs would be met by paid care from 8am to 8pm provided by two carers each working a 6 hour shift irrespective of whether the plaintiff's partner remained with him or not.
24 The area of debate was thus what care, if any, was required by the plaintiff from 8pm to 8am. Each party sought to support its submissions by reference to the plaintiff's history during the period since his discharge from hospital.
25 The following aspects of that history were particularly relied upon by the parties:
(a) The plaintiff is a heavy smoker. He is unlikely to give up that habit. There is a risk that as a result of the tremor in his right arm he may drop ash from his cigarette whilst he is smoking or drop bits of cigarette when trying to light it. This has occurred on a number of occasions. The risk is increased as the "second skin", which controls the tremor, is flammable and cannot be worn when smoking. The plaintiff's clothing has cigarette burn holes in them. On one occasion (which I find was whilst the plaintiff was in hospital) the plaintiff set his chest hair alight whilst smoking. The plaintiff and his partner have agreed he should smoke only in the kitchen (where there is a tiled floor), at his bench or outside and not in carpeted areas. The plaintiff said he never smoked elsewhere in the house though his partner said on a very few occasions she had had to ask him not to smoke in the lounge room. The plaintiff gave evidence that if his partner was not there he would "smoke anywhere". There are "no smoking" signs at the gymnasium which the plaintiff attends. The plaintiff heeds those signs;
(b) Prior to the accident the plaintiff was a heavy drinker of alcohol. On many days after work he would go to the hotel with his mates and come home late affected by alcohol and abusive. On some occasions he would not arrive home until 2 - 3am after drinking with friends. On three or four occasions since injury the plaintiff has gone out by himself and returned home after dark having been drinking with others. On one occasion the plaintiff bought alcohol from the Glossodia bottle shop and went to a friend's place and got drunk. On another occasion he got drunk with a neighbour and returned home in such an abusive state that the police were called. The plaintiff gave evidence he had since sworn off the grog. However this was not confirmed by the plaintiff's partner or his carer. The plaintiff's partner gave evidence she limits the plaintiff to 2 -3 drinks per day as a fourth drink "sends him over the edge". The plaintiff gave evidence that if his partner was not there he would make sure the fridge was full [of alcohol] and if he started drinking at a retail outlet he would not stop. The plaintiff says the Glossodia bottle shop was two hours away by wheelchair. It closed at 7.30 or 8pm. There was thus no point in the plaintiff setting out for the bottle shop after 6pm. He also acknowledged there was no point in going to friends' houses after 8pm. The plaintiff's carer said the plaintiff would buy alcohol from the bottle shop when they visited the Glossodia shopping centre. The plaintiff would take the alcohol home to drink;
(c) The plaintiff said he was a moody person before the accident and was more so now. Anything could set off his temper and he starts to lose the plot if asked to wait. When moody he gets frustrated, yells abuse at his partner, strikes objects about the house and drives his chair at parts of the house. He takes medication which helps calm him and has done an anger management course. He forgets to take his medication a couple of times per week;
(d) The plaintiff does not like to be left alone for more than 1 - 1.5 hours. If left alone for longer periods he becomes angry and starts banging things. He constantly telephones his partner on her mobile phone if she is out. The plaintiff said he felt he couldn't stay in the house alone at night;
(e) The plaintiff is competent in transferring to and from his wheelchair and can do so quickly if necessary. He has had some falls from the wheelchair when he has been unable to get himself back into his chair. There are no footpaths in his street and he drives the wheelchair on the road. On occasions he has exhibited scant regard for the potential risks posed by other traffic;
(f) On one night an intruder entered the grounds of the plaintiff's home. The intruder was a drunken boy. The plaintiff wanted to go outside and bash him. His partner locked the door to prevent the plaintiff going outside and called the police;
(g) The plaintiff stays at home most nights not because he wants to but because his partner prefers it. On some occasions he sleeps very heavily, on others he wakes up with some regularity and gets up to have a cigarette. The plaintiff generally sleeps with his partner. On occasions he will wet the bed. The frequency of this occurrence is unclear. The plaintiff says probably twice per week, his partner says once per week, whilst examining doctors recorded once per month, twice per month or twice in three months. Usually when this occurs the plaintiff changes his pyjamas and goes off to sleep on the lounge. When the partner is woken by these events ("every three to four weeks") she gets up and changes the bed linen something which the plaintiff is unable to do;
(h) The plaintiff's morning routine is to arise between 6 and 7am, toilet, breakfast (with mixed success), shower and dress himself and then interact with the children. His partner arises a couple of hours after him. She does not perceive any need to rise when the plaintiff does. In the evening the family has dinner and puts the children to bed between 7pm and 8pm.
26 The plaintiff's medical experts pointed to the plaintiff's history since his discharge from hospital as illustrating that he was at significant risk of harm from such things as causing a fire, falling from his chair and being unable to get up, becoming intoxicated, acting impulsively and so on such as to make it unsafe for him to be left alone at home at night. The plaintiff's partner gave evidence to similar effect.
27 The plaintiff's experts gave evidence that the presence of the plaintiff's partner at home had had a moderating influence on the plaintiff's behaviour either because of the overall routine and structure which her presence brought to the plaintiff's life (Dr Buckley) or because he did not wish her to leave (Dr McCarthy). However in the event the partner left it was their opinion that the plaintiff would be likely to behave impulsively, putting himself at risk, almost certainly smoke in bed and other unsafe areas of the house, access alcohol, attempt to do things he was not physically capable of and become extremely frustrated and angry.
28 The defendant contended that the history showed that over a period approaching four years the plaintiff had not caused any fires, rarely got drunk or left the house alone or acted impulsively so as to put himself at risk. He was able to deal with the situation if he wet the bed and if he had fallen from his chair that generally had occurred in the daytime when outdoors. Accordingly the defendant contended that at most the risks of harm to the plaintiff between the hours of 8pm and 8am were "a very remote, extremely occasional possibility only" and not such as reasonably required the provision of care at night.
29 The defendant's qualified specialists, Dr Yeo and Dr Zeman (rehabilitation specialists) and Dr Maguire (a consultant psychiatrist), supported the defendant's contentions. Dr Maguire, whilst conceding that having regard to the various possible risk factors to leave the plaintiff alone would place him at risk, considered the risk low as there had been insufficient incidents recorded to justify the provision of care. Dr Zeman considered care between 8pm and 10pm would be required if the partner was not present, but there was no need for care from 10pm to 8am as there had been very few instances of care been required during the night. Dr Yeo had left the question of the need for an observer's role to Dr Maguire who had not recommended it.
30 I have concluded that the evidence establishes, on the probabilities, that:
(a) Whilst the plaintiff's partner continues to live with him the level of risk to the plaintiff between the hours of 8pm and 8am is at a very low level and not such as reasonably to require the provision of commercial care between those hours;
(b) Should the plaintiff's partner leave the plaintiff taking the children the risk of the plaintiff behaving in such a manner as to expose him to serious risk of injury would be greatly increased and the risk, in my opinion, would be at such a level as to reasonably require the provision of commercial care 24 hours per day 7 days per week.
31 These conclusions give rise to three sub issues:
(a) Is the plaintiff entitled to be compensated under s 128 of the Act in respect of the period 8pm to 8am whilst his partner remains with him?'
(b) Is the relationship of the plaintiff and his partner likely to fail, if so, when?;
(c) In what manner is full time commercial care to be provided for the plaintiff?