Elderly Care:
Long-term nursing home care is a difficult decision for families and their loved ones, and should be as anxiety free as possible.
It is in this vein that I am striving for a 20-year national strategy to plan for the care of elderly people, setting out an all encompassing vision for nursing care, a detailed step-by-step plan to achieve the goal, developing a sustainable funding model with built-in five-yearly reviews.
Planning for long term care for our elderly is one of the most important duties of any society and it should be one of the easiest strategies to formulate -after all statistics and projections give us an accurate idea of how many older people we are going to have in 20 years time.
There are currently 504,000 people over 65 with 125,000 over 80 and we have 24,429 residents in nursing homes. Within the next 20 years these figures are set to double.
Population projections predicted that Ireland by 2030 will have more than one million people over 65 of which 270,000 people will be over the age of 80. This will present a huge challenge to our health and social services and I believe it is imperative we plan for it now.
Such an increase in the numbers of people in these age brackets make it incumbent upon policy makers to plan now for the challenges we will face in the future. These figures require a comprehensive, holistic plan to ensure that those who have spent their lives working and contributing to our society and economy are properly cared for.
The approach of the Department of Health and the HSE (including its predecessors the Health Boards), which they have adopted since the 1970s, can at best be described as piecemeal and haphazard lacking coherence and direction. There was no eye on the future, there was no forward planning, and there was no big picture.
The nursing home care system in this country has been at the centre of some controversy in recent years particularly the Nursing Home Charges Scandal, when it was revealed that over 300,000 people were charged illegally over a period of 28 years.
Time and again the HSE, its predecessors the Health Boards, and the Department of Health have been criticised for failures in the provision of nursing home care. The Department was strongly criticised by Ombudsman in her recent report entitled “Who Cares? An Investigation into the Right to Nursing Home Care in Ireland”.
This report made the following stark findings:
“Access to nursing home care…. Has been marked by confusion, uncertainty, misinformation, inconsistency and inequity”
“Both the Department and the HSE have challenged the jurisdiction of the Ombudsman in conducting this investigation and both bodies have refused to provide information and documentation required by the Ombudsman for the purposes of the investigation. In this case of the Department, the refusal to co-operate extends to virtually all of the material sought. In the case of the HSE, while it provided material in relation to individual complaints, it refused to provide much of the other material required. In their submissions to the Ombudsman, having considered material from a draft of this report, both the Department and the HSE made further, and (in the case of the former) very detailed challenges to the Ombudsman’s jurisdiction to undertake this investigation and to report on it to the Dáil and Seanad.”
This was an ideal opportunity for the Department of Health and the HSE to identify mistakes that were made and to work together towards avoiding such serious errors in the future.
We should see this as the opportunity it is: to take care of our elderly, to recognise them, to show our respect and to honour their contribution to this country. We need to develop a system designed to meet the needs of double what the current system is handling. We need to make certain that any system of care has at its heart: humanity, respect for humanity dignity, and compassion. Any strategy must have at its core a fundamental respect for the wishes of the individual and their families.
We need to ensure that a whole community approach is adopted comprising solutions incorporating families, the voluntary and private sectors as well as the public system. No person should fear growing old in Ireland unsure as to whether and how they are going to provide for themselves and their care.
Community care, home help, day centres, community homes and nursing homes will all have a role to play to make sure Ireland is a country where adequate care and resources are available. All these services and facilities must be part of the mix in a long-term plan.
The goal of any system of elder care must be to enable our elderly to live in their own homes and communities for as long as they wish. Creative solutions must be employed so that this aim can be achieved. We should look to other countries who are further along the demographic path we are heading, emulate what is good and learn the lessons from their mistakes. When we are drafting these plans remember we are planning for own future care.
