A new report has said that nursing home contracts of care may be unlawfully signed by residents.
It says that people in private nursing homes are treated less favourably than those in public nursing homes, regarding termination of contract.
A nursing home has the right to terminate a contract with immediate effect, for example if a resident becomes disruptive, or aggressive, or their behaviour poses a risk to health and safety.
In addition, extra charges not specified in contracts are being implemented without any consultation with residents and without regard to their ability to pay.
Residents are sometimes not provided with details of incidental or out of the ordinary expenses, in cases where the nursing home holds and manages a resident's money.
Nursing homes can levy charges on residents which are additional to the bed and board covered under the Fair Deal scheme.
The report, Contracts of Care for Nursing Home Residents, was published today by support and advocacy service Sage.
It was launched by Ombudsman Peter Tyndall, who said contracts must be revised to strengthen the rights of residents.
The report says there are mandatory charges in most private nursing homes for activities and other items, and these are reported to be as high as €100 a week in some instances.
Sage chairperson Patricia Rickard-Clarke said there was substantial anecdotal evidence which indicates that contracts are frequently signed by a relative on behalf of a nursing home resident, even when the resident clearly has the capacity to make decisions.
In other cases, relatives sign contracts without proper assessment of the functional capacity of the resident to agree to the terms.
The report says a large proportion of nursing home residents feel under pressure to sign contracts of care, despite having a limited appreciation of what they are signing up to.
It says there is an imbalance in contracts favouring the nursing home's interests over those of the resident.
The provisions in some contracts result in residents being treated less favourably than would apply in a landlord-tenant agreement regarding termination of contract.
The report recommends an overhaul of both the content of contracts of care and the manner in which residents are expected to deal with contracts.
A Decision Support Service has been set up under the Assisted Decision-Making (Capacity) Act 2015 to help adults who have difficulty making decisions without help.
The legislation abolishes the 19th Century Wards of Court system.
Aine Flynn has been appointed as the first director of the support service. It operates within the Mental Health Commission.
Nursing Homes Ireland (NHI) said there is robust legislation in place to safeguard and protect the rights of residents entering and living within nursing homes.
It said the "anecdotes" in today's Sage report are not reflected in complaints brought before nursing homes, or the independent office of the Ombudsman.
The NHI said that contracts within all nursing homes are subject to independent oversight by the Health Information and Quality Authority.
It said the regulations stipulate that nursing homes must ensure contracts of care are clear, unambiguous and contain full details of services to be provided.
The organisation said that any discharge from a home, where required, must be discussed, planned for and agreed with a resident and if appropriate with their family.