In Care of Friends:

INTRODUCTION

The mentally ill have always been with us, but for no family is this truer than for the Eustace Family. For five generations, for nearly two hundred years, they have cared for the mentally ill, have lived with them and have accepted them as part of their normal daily lives. While the treatment and care of mental illness is, in our day, accepted as one of the duties of a caring society, we must remember, that when John Eustace opened the doors of Hampstead Hospital in 1825, old attitudes were only beginning to change. The mentally ill were still outcasts, still ‘lunatics’, the majority of them being treated with coercion and restraint. The State’s policy of providing asylums was only developing and it would be a long time before these became caring and therapeutic institutions.

John Eustace was, however, a Quaker, and was influenced greatly by the Quaker philosophy of ‘Moral Treatment’ - compassion rather than punishment- expounded by William Tuke in The York Retreat. Tuke’s basic belief that the care of the disturbed patient should be holistic rather than purely medical has been central to the development of the Eustace family’s approach to the mentally ill. In this context, holistic extended to include sympathetic surroundings with space to work, space to walk, space to relax. Hence the beautiful lands of the Eustace Estate formed, from the start, an integral part of the treatment; and because the Eustaces always lived on the Estate, indeed, for a long time in the same houses as the patients, the history of the Eustace family is inseparable from a history of the development of the Eustace Hospital Group itself.

THE FIRST GENERATION

JOHN EUSTACE (1791 - 1867)

John Eustace, who was born in 1791, was the son of Cork Quaker, Benjamin Eustace, and his wife Mary Fawcett. The Eustaces of Cork were originally merchants and John was to become the first doctor in the family, studying first in Edinburgh and later in Trinity from whence he qualified in 1815. The family’s connections included other influential Quaker families like the Pims and Harveys who were among the moving spirits in the establishment of Bloomfield Private Mental Hospital in 1812. Through these connections, John Eustace’s Aunt Jane successfully applied for the post of housekeeper to the hospital shortly after it opened. She subsequently recommended her nephew John, for the post of lay superintendent, a position he took up in May 1813.

Once he had qualified as a doctor in 1815, John continued on at Bloomfield as visiting physician but from 1816 it was only on the condition that he would have sufficient time (11 to 4 daily) to develop his own private practice. Even at this early stage in his career, it is clear that he was sympathetic to the idea of a “Moral Treatment.”

He began to emulate the ideas of the Quaker superintendent of the York Retreat, Dr Daniel Hake-Tuke, the first medical doctor of the Tuke Family. The Bloomfield Committee Papers show that John was arguing in 1816 for the enlargement of the hospital grounds so that a more effective employment of moral treatment’ could be practised. It is also clear from the reports that, as his own private practice developed, relations with Bloomfield deteriorated, mainly because John was unable to attend regularly, and indeed, poor attendance was the reason cited when his services were discontinued in 1831. From 1822, John also added the position of Temporary Physician to the Cork Fever Hospital to his work load, so it is not surprising that his time was limited.

At the same time, John was preparing the way for the establishment of Hampstead Hospital. Along with Dr. Isaac Ryall and Dr. Richard Grattan, a Deed of Partnership was entered into on November 1st 1825, to form an Establishment at Hampstead, to be named, The Asylum and House of Recovery for Persons affected with ‘Disorders of the Mind’. Dr. Ryall had already bought the land, which included Hampstead House, from Sir Robert Smith Steele, and he co-leased the house and an acre of land to the two other doctors. It was three months before the first patient, the son of a baronet, was admitted on 2nd February 1826. This patient was discharged, much improved three months later.

The partnership, however, was to be short lived. Isaac Ryall left in August 1826 and went to live in Devon, while Dr. Grattan left the partnership in December 1830. So, at the age of 29, John Eustace became the sole proprietor of Hampstead Asylum. In the beginning the asylum had found it difficult to attract patients, probably because the fees were five guineas a week John now took advantage of his Quaker connections and wrote to London Quaker, Thomas Johnson, asking him to distribute advertising brochures to “thy medical acquaintances”. By the time John had been asked to leave Bloomfield, Hampstead seems to have provided him with a quite comfortable income. He quickly added more land to the estate, taking over in 1836, the ease on an adjoining 23 acres, including – Hampstead Lodge, (now called Hillside). John could now boast in his advertising literature that his establishment was in “an elevated and very salubrious situation with the purest air, particularly suitable to nervous constitutions”. In 1844 he built The New House, Hampstead Cottage and Hopetoun Cottage.

At the beginning, Dr. Eustace did not live on the premises, but his two sisters Jane and Mary did. In 1852, he was joined by his son, John II. John Eustace was a firm exponent of the moral treatment where every comfort was offered to patients in a family setting. There was no restraint on patients, no “locking up”. From the mid 1850’s when Marcus Eustace joined his father and brother, the two second generation doctors were living on the premises with the patients. This was deemed necessary to secure the “oversight and personal superintendence upon which so much depends; also promoting social intercourse between the patients and the family”.

The Moral Treatment, did not, of course, mean that no medicine was used. The Eustaces were, first and foremost doctors, and took advantage of the medical advances of the day. Patients were also encouraged to seek outside medical advice if they so wished. Dr. Eustace had tried other methods earlier on in his career which were not completely orthodox. One of these unorthodox methods, commonly used in mental institutions at the time, and believed to work, involved the use of a circulating chair. The chair - resembled a metal cage in which the patient was suspended and rotated rapidly. It was thought that the shock would result in a cure.

Dr. Eustace was advised by the inspector to the hospital that the practice was unacceptable, and he immediately ceased using it. Shortly after this, John gave up any belief that a medical cure for insanity would be found. However, he did write many articles, based on his observations of the mentally ill, which were published in various journals of the day including The Lancet.

During this period the villa system of treatment (which allowed patients to live in separate supervised accommodation) was becoming quite popular, and several cottages were available on the Eustace estate for this purpose.

Having the patients living with the family could, of course, lead to problems. There is a endearing little “Suffering” which John put down on paper, and which can be seen in the Quaker Library in Bloomfield, in which he laments the stealing of some of his silver spoons. He neither condemns nor accuses in the note, but is clearly upset about their disappearance, almost as if he has been betrayed - reflecting perhaps a certain naiveté in expecting patients with mental problems to have the same respect for other’s property as would the sane person. On the other hand, of course, it indicates that John was a very astute business man who knew exactly what he owned, (even down to the cutlery), and who ran a very tight ship.

By the time of John I’s death in 1867, the Eustace ethos of holistic care was firmly established, the farm giving work and therapy to the patients, (as well as providing food for the hospital), while the well set out grounds were the perfect setting for exercise and relaxation. From a very early stage, male and female patients were catered for in separate buildings, and the pleasure grounds were strictly segregated also. It would appear that the farm was always a very successful operation. During the famine years, the Eustace Family offered the government several tons of home grown potatoes to relieve the crisis, unfortunately, the offer was turned down. This is a telling episode, which shows more clearly than words could express, the very real stigma attached to mental asylums and anything associated with them.

THE SECOND GENERATION

JOHN EUSTACE (1827-1899) & MARCUS EUSTACE (1831-1885)

John Eustace I joined his father in Hampstead in 1852, followed by Marcus in1853, both having qualified from The Royal College of Surgeons. John I now relinquished his sole control of the hospital, and a Deed of Partnership between the three was drawn up on 14th March 1853. The advertising of these years shows the change, not just in leadership, but in the new thinking of the second generation. In 1852, the brochures were for an Asylum for the Care and Cure of patients under the proprietorship of John I. By 1855, a subtle change had taken place. The brochures then advertised a Private Medical Establishment for the Treatment, Cure and Residence of patients, conducted by the proprietors i.e. the three Doctor Eustaces in partnership.

Shortly after this, in 1857, John I retired. The two brothers very quickly put their partnership on a professional footing by drawing up Articles of Agreement in 1861, in which, among things, each had to agree to the other’s marriage. A legal name for the business - ‘Doctors J & M Eustace’, which is still extant, was agreed upon. Before long, a new phase of development gathered momentum with the leasing of Highfield and 10 acres of surrounding land from Dublin Corporation. Highfield was then opened as a separate establishment for ladies only to be followed shortly by major improvements.

It would appear that John I was the prime mover in the aggrandisement of the estate - when he discovered Highfield needed a new roof in 1865, he decided to take the opportunity when repairing it, to add a third storey. He and Marcus then lived in the third storey, Marcus later moving to Elmhu By 1892, seven years after Marcus’s death, “Doctors J & M Eustace” owned 150 acres of land, extending over the townlands old Hampstead and Drishogue on one side of the Swords Road, and into Clonturk and Highfield on the other side. To the west of Hampstead House, land had also been bought. On this land were located the ruins of Hampstead Castle.

Another major development at this time was the building of Elmhurst. The stones from the derelict Hampstead Castle were used to build Elmhurst house in 1869. The house was built with the financial help of a wealthy patient, who agreed to be pay for it on the condition that Dr. Eustace would live in the house with him to take care of his needs. Marcus was the first Eustace to live in Elmhurst. Inspector’s reports from then until the patient’s death in 1905, pay tribute to the high living standards this man enjoyed, with his own suite of rooms and bathroom in the house. Elmhurst was used as a private house until 1924 when it was registered as a hospital.

John Eustace II was a most meticulous man, who recorded every detail regarding his business. Carbon copies of every letter he wrote can still be seen in the many ledgers he left behind. Presumably this was necessary in the partnership, but the letters continue after his brother’s death right up to his own death in 1899. John became a Justice of the Peace in 1855 and, like his father before him, wrote many articles which were printed in the medical journals of the day.

Marcus, who was the first of the Eustaces to live in Elmhurst, died in 1885 at the age of 54. After the probate of his will, all the property on the estate, which had been jointly owned by Marcus and John, had to be reassigned to the business of “Doctors J & M Eustace”. This was as a result of the terms of the agreement of 1861 in which a ‘survivor take all’ clause was inserted. Marcus’s widow was to receive £10,000 for Marcus’ share, but John Eustace while a business man was also a fair man and he duly added another £2,000 so there would be no feelings. This clause led to difficulties later and it was eventually removed.

Dr. Marcus Eustace had a large family, and two of his sons, John Marcus and George Wallace (named after Marcus’ wife Elizabeth née Wallace) became doctors. John Marcus went to Persia, losing his children to yellow fever. George Wallace served in the British Army in the First World War and settled in Arundel where he became Lord Mayor. His only son died at 18. Marcus third son Gerald Needham Eustace, died unmarried and so, Marcus’s direct Eustace line died out. Marcus was the first of the family to marry outside the Quaker faith.

Shortly after Marcus’ death, John developed diphtheria and the hospitals were run for seven years by a series of locums including, from 1887 to 1890, the famous Doctor Leeper who would became so well respected for his work in St. Patrick’s Hospital. A copy of the reference written for him by John, when the former was applying for the post in St. Patrick is amongst the papers John left for posterity.

When John returned to take charge, he was soon joined by his sons John Neilson Eustace in 1892, and Henry Marcus Eustace in 1895. John II continued to be active right up to his death at the age of 74 in 1899

John I displayed, like his father before him, an almost uncanny business sense. He, very early on, saw that the only way to avoid fragmentation of the estate and to ensure the continued success of the hospitals was to make the above mentioned agreement of 1861 which was binding on each partner. The survivor take all clause, was, to him, the business equivalent of primogeniture. This agreement was drawn up by John II’s father-in-law, a solicitor named William Neilson. The clause worked very well at the beginning as there were only two families concerned. Any problems relating to it did not surface until later years, by which time the clause had achieved its end in consolidating the fame and fortune of the hospitals.

THE THIRD GENERATION

JOHN NEILSON EUSTACE (1867-1894)

HENRY MARCUS EUSTACE (1869-1927)

BENJAMIN FAWCETT EUSTACE (1870-1919)

WILLIAM NEILSON EUSTACE (1875-1948)

By the time the third generation of the family came along, it was obvious that the medical profession was a family trend, and that the family business would continue for a long time to come. Three of John II’s four sons became doctors, while the fourth, Benjamin, took on the running of the farm.

One of the advantages of living on the estate was, of course, that the Eustace children grew up being aware of the mentally infirm, and had not the narrow, prejudiced views of many others in society towards mental illness. This attitude set the Eustaces’ Hospitals apart from other private institutions, many of which were seen as being run by “speculators who carry on a trade in lunatics”. (Report of International Congress, Chicago, 1893),

The third generation carried on in the same caring and benevolent way as their predecessors. John Neilson Eustace (RCSI) who was the first to join his father in Hampstead and Highfield, did so in 1892, shortly after John II’s return to health. Before this he had been a ship surgeon up the Amazon, and then had done some locum work. John Neilson was greatly interested in hypnotism as a means of treatment, but his father did not approve of it. It was, however tried in Highfield, without much success. John Neilson unfortunately, contracted T.B shortly after this. In spite of going first to Crief Hydro in Scotland and then to Switzerland to find a cure, he died in 1894 at the young age of 27.

Henry Marcus Eustace qualified from Trinity in 1890 and shortly after, he too, went as a ship’s surgeon, this time to Canada. He subsequently worked in Morningside with Dr. Clouston but was asked to return to Hampstead to go to Switzerland with his brother John. When John Neilson Eustace died, Henry Marcus joined his father, and after his brother’s death continued on his own until William Eustace joined him in 1902. Henry Marcus was a very private man who was extremely conscientious in his treatment of his patients. While he did not have the drive of his father, nor, later of his brother William, he, in his own quiet way did just as much to ensure the continued success of all the establishments. It was he who ran the business when William joined the Royal Army Medical Corps, and he who took over the running of the estate when Benjamin was not available, continuing to do so after Benjamin’s death in 1919 with the help of Benjamin’s widow and stewards. He continued his father’s practice of taking the patients away to a summer house in Killiney and also arranged entertainment on a regular basis in the hospitals. Among the many letters left behind is a hand-written one from Percy French from his home in Mespil Road, arranging a date for a recital.  Henry Marcus Eustace was married but had no children. He lived in Highfield with the patients until the death of his mother in 1912, when he moved to Elmhurst. The same year Shournagh was built to accommodate his two sisters, Eleanor and Annie. Henry Marcus Eustace died as he lived, among his patients suffering a stroke in the dining room of Highfield, causing much consternation and excitement until he was removed to Elmhurst.

Benjamin Eustace, in spite of family pressure to become a solicitor like his Neilson grandfather refused to do so and instead, in 1890, took over the running of Hillside Farm and the family Estate. He was a very able farmer and after a fire which burned down lot of the out offices, organised the building of many new haysheds and buildings.

His reputation as a farmer was widely recognised, not just because he was a prominent member of the Royal Dublin Society, but also because animals from Hillside were frequently among the prize winners at shows. His success in his chosen career was recognised by his peers when in 1912 he was elected President of the Irish Farmer’s Association, and Chairman of the Co. Dublin Farmers’ Union. He also had time to make alterations to Hillside house adding an extension at the front in 1902. He was the first family member to administer the land on a full time basis, but, unfortunately died from diabetes in 1919 at the age of 49, leaving a widow and a young family of five.

William Neilson Eustace qualified in 1901 from the Royal College of Surgeons and worked for a time in Bicton Heath Mental Hospital before joining his brother Henry in 1902. He built Lisronagh in 1908 and moved into it when he married in 1909. The following year, the three brothers formally entered into legal partnership, just as their father and uncle had done fifty years before. This time, there was a time limit of twenty years on the partnership, during which time if any partner died, his share would be purchased by the remaining partners. William joined the RAMC during the First World War and shortly after his return, in 1919, Benjamin died. The two remaining partners worked on together, both being qualified psychiatrists, and consolidated the reputation of Hampstead and Highfield as “Private Hospitals for the care and cure of Patients of the upper class suffering from Mental and Nervous Diseases”. When Henry Marcus died in 1927, William Neilson was the last remaining partner, and therefore; sole owner of the hospitals as the partnership would not have expired until 1930. Henry’s widow was offered a settlement on her husband’s death, which was increased later onto take account of land which had been sold shortly before Henry’s death.

After Henry death in 1927, William began to make considerable improvements to the establishments. He built the Badminton Hall and added onto the billiard room which John I had built. He moved the entrance to Hampstead to the East side and installed the ornate steps which are there today, adding the porch at the same time. In 1938 he also added a sun room to Highfield. During this time, be ran the hospitals with the help of assistants and engaged stewards to manage the estate, aided also by Benjamin’s widow Edith Maud, who curiously was treated as still being a partner until her death in 1945. In spite of having received full payment for her husband’s share on his death, she was paid a very substantial share of the profits annually for quite a long time after. The main reason for this was, of course, that Edith had a very young family to rear by herself, and these arrangements allowed her to retain her pride by giving her the independent means to do so. Of her five children; three sons and two daughters, only one Jocelyn Eustace became a doctor. Jocelyn would, in time, become one of the fourth generation doctors who worked in Hampstead and Highfield.

William Eustace also had three sons, two of whom became doctors. One of these, Philip Faulder Eustace chose to work in England, while William Desmond Eustace would work in the family hospitals. The third son Terence Eustace, became an engineer and then, like his uncle Benjamin, took on the running of the farm and estate.

THE FOURTH GENERATION

WILLIAM DESMOND EUSTACE (1912-1990)

TERENCE NEILSON EUSTACE (1914-1988)

HENRY JOCELYN EUSTACE (1908-1996)

Jocelyn Eustace was the first, (and also, due his longevity, the last) of the fourth generation to take an active part in the running of Hampstead. Jocelyn was the academic of the family and was to become a lecturer in Trinity, and Consultant Psychiatrist in the Rotunda, Sir Patrick Duns, The Royal Victoria Eye and Ear, and the Dublin Fever Hospital. Due to his high academic profile, he was much sought after for medical committees and was president of the section of psychiatry of the Royal Academy of Medicine of Ireland in 1972. Although never a partner in the business, he helped his uncle William Eustace during the war years and he would, along with Desmond, after William’s death, introduce the latest medical thinking to the hospitals. During these years, William was also helped in the hospitals by Dr. Mary Brown, the niece of Henry Marcus Eustace’s widow, Susan. Jocelyn’s brother Frank was to help also at this time, taking over the running over the estate for two years.

William Neilson Eustace had his sons educated at Military Colleges in England and then in Dublin. While the Army tradition was very strong in the Eustace family, William had not foreseen that his two elder sons Terence and Desmond would serve in a Second World War when he sent his children to school in England. Philip Faulder Eustace, who was the youngest, would eventually decide to practise in England, while Desmond and Terence would return to Hampstead.

Desmond, who qualified in 1936 from The Royal College of Surgeons, first served as a Captain in Catterick Military Hospital before going to Singapore. Once war broke out, he was recalled and then sent to North Africa where, after eighteen months, he contracted amoebic dysentery in 1942. Recovering from the illness after two months, he spent the rest of the war years working in military hospitals in Britain and Northern Ireland caring for those suffering from what is now called Post Traumatic Stress Disorder It was during these years that Desmond acquired his wealth of psychiatric experience. He was honourably discharged in 1945 with the rank of major, and returned home. When his father suffered a stroke in November 1946, Desmond had immediately to take over the running of the three hospitals.

Terence, who had served in the R.A.F. in the later years of the war; returned to take over the management of the land. He had previously worked in the Far East laying runways, being a qualified engineer from Dublin’s Trinity College. When he came back to Hampstead and took on the farm, he became the second family member to take on this role on a full time basis. While Terence was to give to his job the same dedication as his uncle Benjamin, changing times and later the EEC’s agricultural policies, made his job much harder. The growth of the city around Hampstead, and the increasing demand for more housing, led to the sale of land during these years, while a serious outbreak of brucellosis decimated the herd. The large number of badgers in the vicinity and the alleged relationship between them and the spread of the disease, made it unwise to rebuild the dairy herd. In retrospect the change in farm output was inevitable with the days of the viable small farm being numbered. While the farm is still very much a going concern, it is now mainly an arable farm. Even without the brucellosis outbreak, the change in patient profile with fewer being fit to help on the farm, the introduction of milk quotas, land set aside, and other EC restrictions would have changed the direction the farm took.

However, the beauty of the estate and the attention to nature was never lost in these years. Desmond Eustace replanted a lot of the estate, where Dutch elm disease and root damage had wreaked a lot of damage. This care of the environment, the knowledge that we have to plant today for tomorrow, is another fascinating feature of the Eustace family. It can be seen as far back as John Neilson who died so young, in 1694. He was the first to seriously replant the estate, bringing back many rare plants and trees from abroad. Terence, too, had this inherent family love of animals and nature which seems to permeate all generations of Eustaces. Essentially a very quiet, private man, farming and the solitary nature of it suited Terence very well. He continued to manage the estate, latterly with the help of his wife’s nephew, Dermot Kelly, until Terence’s death in 1988.

After William’s death, Jocelyn and Desmond worked together in the hospitals. They had two very different personalities - Jocelyn’s ambitious drive would lead him to pursue the intellectual side of medicine. Desmond, the responsibility of running the hospitals, sought a less public profile. He often would take patients with him down to the docks

It is perhaps fortuitous that the two should have been so different for it ensured that each allowed the other enough space to develop in his own way and get the most out of his chosen way of living. Jocelyn would receive many well deserved accolades; become an expert in so many different areas including antiques and history. Desmond, was the complete antithesis of his cousin, an environmentalist before the word became fashionable, gentle and warm, happy to spend his free time working outdoors on the estate.

While neither were Quakers, both espousing the Church of Ireland faith, there could never have been any doubt that they both were of Quaker descent. Their courtesy, their quiet manner and their sense of caring were redolent of their Quaker ancestors. Whereas Jocelyn had the sharpness of speech which so often goes with sharpness of mind, Desmond appears to have had warmth of character which made him a great favourite with the patients. He continued the practice of taking them out for drives, only, this time; he took them himself in his own car. When he was asked to take over a shipping medical practice, he often would take patients with him down to the docks for the diversion it would give them, While this may not have been totally orthodox, Desmond quite obviously knew his patients well and chose his companions carefully. His attitudes towards them are a clear vindication, if any were needed, that dose interaction {both socially and medically), between patients and doctors, worked, and worked well.

Desmond’s children have vivid memories of Christmas mornings in Shournagh, serving refreshments to the guests - all the male patients - and of their mother serving afternoon tea to the ladies on St. Stephen Day. Their acceptance of these practices as being part of the Christmas ritual shows that normality is relative. To the Eustace family, the appearance of the patients in the family home was the accepted norm. There can be no doubt that the fourth generation of Eustaces gave to their patients a real sense of normal living, which was not experienced in many other mental institutions.

Jocelyn, for all he was an academic and someone who, in his day, rubbed shoulders with men like Freud and Jung never lost sight of his patients. They were always his first concern,  He was proud to represent his country at conferences abroad, was rightly honoured with a Foundation Fellowship of the Royal College of Psychiatry and would hold many prestigious positions on medical committees. However, Jocelyn always believed that his greatest, and most positive achievement, was to be the first in Ireland to hold psychiatric out-patient clinics, and the first to do out-patient E.C.T. Like the generations of Eustaces before him, he had the caring ethos which is so central to this family’s way of life. Right up to his death at the beginning of 1996, at the age of 87, he always took a very keen interest in the developments in the hospital, took delight in the fifth generation’s achievements, and, right to the end, was keenly interested in the health and well-being of all the patients.

The post war years were to be a most exciting time for psychiatric medicine, a time when a new drug would revolutionize the way of treating the mentally ill. Before the 1950’s, the normal way of treating the patients was through medical or psycho therapeutic methods. Both of these methods were practiced in the Eustace hospitals. In 1954, the great change came with the introduction of a group of medications called phenothiazines. Their most surprising effect was to help those suffering from mental illness. By using them, schizophrenia could at last be treated decisively. Before long, a whole new phenomenon was to take place - the doors of mental hospitals were opened and by the 1960s patients were let out to take their place in society again. The success of this new drug, and later the tricyclic anti-depressants can be measured by the statistics relating to the length of stay of patients in hospital. In the 1940s the average stay was 6 months to 2 years. By the 1960’s it was down to 6 to 8 weeks, and now it is down to almost three weeks.

For Desmond and Jocelyn Eustace, living through this era, it must have been both a very exciting and a very challenging time. While they were delighted to see the rapid recovery of their patients, the opening of hospital doors threw up another problem which had not been foreseen. Long term patients, who had become institutionalised, could not cope out in the world, and the trauma which they experienced led to a new type of patient - the new’ long stay patient. As fewer and fewer new patients needed to be hospitalised, a change in patient profile took place. More and more, the incurables, who were invariably the old who could not recover, made up the majority of the patients at Highfield, Hampstead and Elmhurst. In the space of a generation, the whole emphasis in the hospitals thus changed from acute to chronic psychiatry; to the psychiatry of old age. This was the position when the fifth generation took over. The way in which they rapidly responded to the challenge this posed, shows once again how in tune the Eustaces are with their patients needs.

THE FIFTH GENERATION

MICHAEL PETER EUSTACE B. 1946 & DENIS PATRICK EUSTACE B. 1949

Desmond was the only member of this fourth generation of Eustaces who worked at Hampstead who had a family, although Philip in England also had a daughter. Desmond had four children. John, the eldest, is a doctor working in general practice. John did two years as locum in the hospitals and, although no longer actively involved, he continues to take a keen interest in the day to day running of the business At the tine of writing, John’s eldest son Andrew is the first of the sixth generation to continue in the family tradition, having qualified from The Royal College of Surgeons in 1993. Judy, Desmond’s only daughter worked with Ib Jorgenson and was well known in the fashion world as a dress designer. The other two sons, Michael and Denis, are the two fifth generation members working in the hospitals.

As his children got older, Desmond must have been concerned about the future of the hospitals as a family business. None of his children showed any inclination, at this time, of joining him at Hampstead. John and Denis showed no interest in psychiatry, while Michael on leaving school had not decided on any specific career. However, the curious twists and turns of life were to lead both Michael and Denis back to Hampstead a destination neither had foreseen, nor expected.

Michael, unsure of what he wanted from life, first joined the Royal Enniskillen Fusiliers, serving in Spandau Prison in Berlin where he was to look after Hess, Von Schirer and Speer. In 1967 he returned home and obtained a post in the sales department at Wavin. This company was experiencing the boom of the sixties, expanding rapidly and, therefore, needing many more employees While at Wavin he trained in the Irish Management Institute and then took a degree in Personnel Management. By the early 70’s Michael was responsible for all recruitment, industrial relations and training of staff at Wavin.

Denis, in the meantime, had qualified from The Royal College of Surgeons in 1974, being the fourth generation of Eustaces to have done so. He had no desire to study post graduate psychiatry. Indeed, be was not impressed by what he saw as a student attending the large state psychiatric hospitals in Dublin in the early 70’s.

He did not begin to reassess his career until, working in Jervis Street Hospital in the drug addiction centre, he was moved by the numerous victims who were both physically and psychologically damaged by the ravages of heroin abuse. Subsequently, he chose a four year rotational training programme in St. Patrick and St. James Hospital. In 1960, he received his membership of the Royal College of Psychiatrists and the following year obtained a consultant psychiatrist’s position in Canada, at the young age of 32.

Whilst Denis was working in Canada, Michael’s ability to take on new roles and responsibilities was soon to be put to the test, in a totally unexpected way. By the early 80’s his father was expressing grave concern about the viability of the hospitals. The new medications available had lead to low admission levels and empty beds. Finance and administration had never interested Desmond and Terence, while Jocelyn’s many other commitments left him little time to assist in this area. Desmond, to his eternal credit, appealed to his son to help him sort out the problems. Coincidentally, Michael was, at this time, becoming disillusioned working for a multi-national company in a climate of recession, He took up the challenge, identifying very quickly the hospitals major difficulties. He firstly decided that the family needed Denis back home and as a result of Michael’s strong persuasion, in 1983 Denis arrived back in Ireland.

Michael continued on in Wavin until July 1984. He then started full time in Hampstead. He and Denis saw that the three hospitals were over-staffed, and most were losing money. Denis knew immediately that he would have to start from scratch to attract new patients, and without delay began an out-patient clinic, while Michael began to plan the changes in the hospitals.

Elmhurst, with only nine patients, was closed and all the patients transferred to Highfield. Seeing the need for a high standard convalescent home on the north of the city, Elmhurst was completely refurbished, New kitchens were installed, the heating system updated and the building was rewired. Subsequently, double rooms were divided into single rooms resulting in accommodation for 16 patients. The new convalescent home was opened in May 1985. This was followed in 1985-B6 by extensive improvements to Highfield, where a passenger lift was installed and numerous bedrooms were reorganised. Hampstead, which had always been very busy, was in 1987-88 refurbished: with old staff quarters being changed over to bedrooms.

Within a space of four years, a complete about-face had taken place. Major financial problems were dealt with, and archaic office systems were changed. For the first time a full-time secretary was employed and the telephone service was also updated. The farm, however was still being run separately and it was not until Terence died in 1988, that Michael was able to become administrator of the whole estate. There continues to be a farm manager, Dermot Kelly, nephew of Terence, who reports directly to Michael.

Michael and Denis next identified a gap in their range of care. Within their existing hospitals, there was no suitable area to care for mobile people with dementia. The buildings were full of stairs and dead ends - quite unsuitable for patients who needed to work off the incessant restlessness which is the hall-mark of dementia. Denis had, while in Canada seen purpose-built dementia care centres, and with these models in mind, he and Michael soon decided that this was the way forward for them. Over a few years, they began to research the design of such a building. They visited similar centres in England, Northern Ireland and other European locations, attending numerous conferences on how to care for this new type of patient. They launched the idea of a purpose built centre at the International Alxheimer’s Conference held in Trinity in 1989. The resultant publicity and positive response made them decide that the development was worthwhile. Construction of the building commenced in August 1990. Sadly Desmond did not live to see it open, dying suddenly in October 1990. The Alzheimer Care Centre opened in May 1991 the first of its kind in the Republic of Ireland. With its bright airy design and central garden atrium, the Care Centre gives the peace and tranquility so necessary for those suffering from this devastating illness and enables their dignity be maintained for as long as possible.

The Care Centre was the first new Eustace hospital since the building of Elmhurst in 1869 and marked a watershed in two ways. It firstly showed the new direction which the Eustaces were following, and secondly, it led to a streamlining of the administration. An administration block incorporating offices and a chapel was included in the new building. The business team had already been strengthened by the employment of a full time book-keeper. This was further strengthened in 1993 when a development manager was employed to promote the services of the hospitals, to the public in general, and to general practitioners in particular. In 1995, the first full time accountant was employed.

Denis’ workload expanded rapidly over this decade and, as Medical Director he is now solely responsible for all four separate units and 135 beds. The bulk of his work involves dementia sufferers. He has set up a comprehensive assessment and day care programme. He also has introduced a carers’ information package--- a first in Ireland), a telephone help line and he holds structured monthly support groups. Denis is deeply committed to individual family counseling in this area, and believes that this type of counseling is essentially important. He is a strong exponent of the power of personal contact and insists on seeing every patient daily, believing that a friendly face and the touch of the hand is vitally important to the patient’s welfare.

During these last years too, Michael Eustace strengthened and consolidated the administrative side of the business. He has welded the four separate hospitals into a single entity known as the Highfield Hospital Group, and applied consistent procedures and standards throughout. He is a founder member of the Independent Hospitals Association of Ireland becoming Honorary Treasurer, thus giving the group a strong identity among the top providers of private healthcare in the country.

Aware of ever increasing legislative requirements in the areas of health and safety, he presided over a major capital investment programme, involving structural and other improvements throughout the other buildings of Hampstead, Highfield and Elmhurst including the residences Shournagh, Lisronagh, Hopetoun, Hampstead Cottage, Hillside Farm, - modernising, refurbishing and maintaining them for future generations.

As the Alzheimer Care Centre started to prove successful, Michael and Denis then concentrated their thoughts on Elmhurst. Knowing that Elmhurst could never hope to cater for more than 16 patients, plans for a 22 bedroom extension in the style of the Care Centre were drawn up. Planning permission was sought, and as a result, this premier centre opened in the summer of 1996.

During the last 12 years, Michael and Denis have addressed many challenges However, the greatest challenge of all, and the one which presents the biggest threat yet to the future of the business - that of inheritance taxation and succession planning - remains to be conquered. It is incumbent on this generation to; once and for all, secure the overall business and land for future generations. It will inevitably involve taking some very hard decisions, but one can have little doubt that these decisions will be made and that a sixth generation will be at Hampstead and Highfield to meet the needs and challenges of the 21st century.

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