Nursing home standards will be discussed at a meeting of geriatricians in Galway this week, writes Eithne Donnellan
Concerns about standards of care in nursing homes across the State have increased in recent years, not only as a result of the findings of nursing home inspection reports being made public, but also as a result of undercover film footage of the manner in which residents have been treated at one home in particular.
As the cost of care in private nursing homes rises, with some families now having to fork out €800 a week or more, those footing the bill are more frequently questioning the type of care given and whether they are getting value for money.
The findings of a new study, to be presented at a conference later this week, indicate that public concern about the standards of care in nursing homes is well founded.
It established that 37 per cent of a group of GPs surveyed in Dublin had witnessed substandard care in nursing homes, but they reported this to nursing home matrons only.
It also revealed that while medical care for nursing home residents in the Republic is provided mainly by family doctors, a significant number of GPs feel they do not have adequate training in geriatric medicine to care for this patient group.
Some 500 GPs were surveyed for the research and although 85 per cent of those who responded rated themselves as confident in treating nursing home residents, only 63 per cent felt they had received adequate training to care for these patients.
It also emerged from the research that recent investigations into private nursing home standards had increased GP workload and responsibility for simple decisions in nursing homes.
It was felt there was a need for increased liaison between GPs and consultant geriatricians to manage nursing home patients.
The authors of the study, who are based at Tallaght hospital, will present their findings at the 54th annual scientific meeting of the Irish Gerontological Society in Galway on Friday.
Meanwhile, a separate study to be presented at the meeting looks at the degree of satisfaction with their care among elderly patients recently admitted to a publicly funded private nursing home bed after being discharged from hospital.
Some 70 patients were surveyed and the results indicated that while 88 per cent of them needed to be seen by a GP following their admission to the nursing home, only 60 per cent were satisfied with the medical care provided. However, the majority of patients were satisfied with all aspects of their nursing home care.
The standard of care in the home was termed completely satisfactory by 73 per cent of respondents, satisfactory by 23 per cent and fairly satisfactory by 4 per cent.
Not one person rated the standard of care as poor.
The majority of those surveyed in this study, carried out by staff at St Mary's Hospital in the Phoenix Park, were also pleased with the information they were provided with prior to choosing their nursing home.
However, a range of factors can delay the discharge of older patients from hospital to a nursing home. Staff at Tallaght hospital, who examined the specific factors which delayed the discharge of its patients between March and July this year, will also be presenting their findings at the Galway meeting.
There were an average of 20 patients in the hospital who needed to be discharged to long-term care settings each week during the period of the study.
Up to a quarter of them were found to be medically unfit for discharge when beds became available in long-term care settings. Between one-third and two-thirds of the patients or their relatives refused the long-term care beds offered them, sometimes because they were considered to be too far from the family home. One patient refused six nursing home beds.
In addition, eight patients were refused private nursing home beds as a result of them having MRSA or because of their high dependency.
Other research to be presented concludes that more than a quarter of long-term care referrals could be avoided if the appropriate level of community support was available.
This research, conducted by the Department of Gerontology at Cork's Mercy Hospital, looked at all referrals for continuing care in Cork city between February and May this year.
A total of 139 people were referred over the period and it was established that 37 of them (some 26 per cent) could have been avoided if appropriate community services were available to support these people in their own homes.
A range of other pieces of research which have been tabled for debate deal with topics such as stroke care, preventing falls in the elderly, potentially inappropriate medication use among the elderly in the community and in nursing homes, and regional differences in prescribing for chronic conditions in the elderly in the Republic.
The meeting takes place at the Corrib Great Southern Hotel, Galway on Friday and Saturday.