Almost 90 per cent of residents in nursing homes have a disability, compared with just 30 per cent of those over 65 years of age and living in the community, according to a new study.
It found that nursing home residents had, on average, 4½ disabilities ranging from hearing and visual problems to difficulties remembering and concentrating.
The study's authors, Prof Desmond O'Neill, consultant geriatrician at Tallaght hospital, and Marianne Falconer, a specialist registrar, said the data suggested there was a high degree of memory problems among nursing home residents that would be suggestive of a high prevalence of dementia.
"In our data, nursing home residents are almost eight times more likely to suffer memory problems than older people in the community, possibly one of the factors that contribute to nursing home admission," according to the study.
Prof O'Neill said yesterday that, in general, the system of long-term care in Ireland "had not been set up to cater for the complexity of care needs of older people in nursing homes".
This included a host of issues, including staffing levels, and the provision of a range of services such as speech therapy.
"We hope the study will serve to highlight this and help to move things on," he added.
Prof O'Neill said he had been surprised at how little data had been available on nursing home residents and disabilities when he began the study.
The study found that fewer than 15 per cent of those aged 65 and over in a nursing home had no recorded disability.
The authors said this led to questions over the reason for admission, although some of these may have been resident in welfare homes.
"Evidence exists of a tendency of private nursing homes in the Republic to refuse those with significant dependency when other data suggests that new admissions into long-term care facilities with low dependency needs were more likely to be self-funding," according to the authors.
Their study said resources needed to be targeted towards home-based care for those with lower dependency.
"Our data reaffirms that nursing homes are populated by the most frail group of older people, and highlight the need for appropriate health and care resources for older people in nursing homes," according to the study.
"Most of these residents may benefit from activity and therapy services, but there is inadequate provision of these services when compared with their age- and disease-matched community peers."
The study showed that almost three-quarters of nursing home residents were unable to go outside alone, compared with 15 per cent of those living in the community.
More than two-thirds of nursing home residents had a condition which limited one or more basic physical activity.
It also found that 64 per cent of residents had difficulties dressing, or bathing or moving, while 58 per cent had difficulties learning, remembering and concentrating.
The study used data from the 2002 Census which included questions on various physical conditions, including disability.
It collated the data with those over 65 years of age living in nursing homes and in the community.
The authors said currently there was little information comparing levels of disability within nursing homes and the community, and there were no mechanisms for monitoring changes in this disability ratio longitudinally.