The Hanafin Brief

It's time for the government to wake up and care for the elderly





It's time for the government to wake up and care for the elderly

Ministers wake up and do your job that you are supposed to be equipped to do, says Tipperary Star columnist Peg Hanafin.

According to IMO Vice-President and Consultant Geriatrician Dr Christine O'Malley, a sign of how service provision for the elderly has deteriorated in recent years, is the number of beds currently available for the care of those getting older.
Ireland's population has been getting steadily older since the 1980's. In Census 2016, 37.2% were aged 45 and over, compared with 34.4% in 2011 and 27.6% in 1986. The number in the 65 and over category increased by 102,174 – more than twice the 15-64 age category.

The 65 years and over group saw the largest increase in population since 2011, rising by 102,174 to 637,567, a rise of 19.1%. The 2016 census recorded 456 centenarians, an increase of 17.2% on 2011. Over half a million or 577,171 in this older age group lived in private households, an increase of 19.6%, while those in nursing homes increased by 1,960 to 22,762.

So, with all these figures readily available it is difficult to see why Government agencies are not making better provision for the elderly population.
Dr O’Malley and the IMO says the failure to provide appropriate care for the elderly is a significant cause of the ongoing A&E crisis. So, if this is common knowledge why isn’t something being done about it?

While an ageing population is celebrated, it presents healthcare challenges. In 2016, 52.9% of men and 53.5% of women aged 65 and over reported chronic illness or other problems, according to the Department of Health. The increased provision of home-based multidisciplinary professional care, in collaboration with enhanced support from the voluntary services, will continue do much to make this a reality.

Those who need continuing therapy can receive home-based services including physiotherapy, occupational therapy, speech and language therapy and mental health care. We have many Nurse Specialists now catering for cardiac problems and many other areas of need and they serve the community in an excellent manner. Many of these services are being delivered today and is alleviating older people being hospitalised, and more are needed.

In 2017, the government allowed a change to a nursing home Bill which will change how we care for the elderly. The Bill aimed to meet the wishes of 85% of the population – to be cared for in their old age at home. Previously, the options for elderly people who had physical or mental conditions, too severe to care for themselves, would be that their adult children or relatives care for them, or that they move to a nursing home. If they are to now avail of a nursing home, the State’s Fair Deal scheme is available – which offers to subsidise the nursing home care option.

A Fair Deal it may be for the government, but a cheap deal it surely is not. For those who take it up (or their loved ones, in cases of mental capacity, such as dementia), they end up contributing a percentage of their income and assets towards nursing home care, which would be too expensive to afford otherwise. Criticism of the scheme stems from the fact that inheritances and family businesses and farms are taken as means-tested assets – in theory making the passing down of a farm or business from one generation to the next more precarious. This doesn’t just extend to businesses, but even gifts passed on from parent to child could be means-tested as part of assessing how much an individual can contribute.
It costs three times as much to care for someone in a nursing home than in their own home. So, it is only prudent and common sense for the HSE to put in place facilities that allow older people live in the comfort and security of their own homes.
For our ageing population you would think the Government would do everything in its power to look after the elderly, and to give them the comforts of staying at home where the vast majority want to be. The Society of the St. Vincent de Paul, whose services include areas of visitation and befriending, report that loneliness was the biggest individual problem faced by older people living alone. Older people value their independence, participation, care, self-fulfillment and dignity, all these will pose challenges, but it will also bring great opportunities.

As the winter of life approaches, are people not entitled to be cared for in a way that makes the remaining days happy and contented and free from stress about money and the future? We need practical thinkers and implementors to take charge of the needs of our older population and see that their wishes are granted. We will all get older, that is a fact of life, so it behoves those within whose remit it is, to put in place structures that apply to everyone across the board, that the end of life is secure with care to match the needs of those vulnerable and needing care, especially when we live in the 5th wealthiest country in the developed world.
Ministers wake up and do your job that you are supposed to be equipped to do.

Peg Hanafin, MSc. Psych/ Rehab Couns.
Author of:
Getting more out of Life, Thoughts for your Journey, Never Give Up. I Wish I had Known.