As for the elderly ... who cares?

Growing old is not for wimps. Nor is caring full-time for the old

Growing old is not for wimps. Nor is caring full-time for the old. As a friend and carer puts it, to understand you have to walk the walk, writes Kathy Sheridan.

Having her ailing, 82-year-old father to live with her is like having a helpless baby in the house again, minus the gummy smiles, the joy or the hope.

The children don't bring their friends home any more. Her husband works longer hours. The siblings who swoop in to agitate about whether Daddy is quite warm enough never seem to be around for the incontinence, the night wanderings, the soul-scarring bouts of rage, sadness and vulnerability.

As a nation, we can handle death. It's the interval before it that we are unwilling to confront.

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This is why Age Action Ireland welcomed Mary Harney's recent remarks - not because it agreed with them, but because they might ignite a debate of some kind. Any kind.

Ms Harney hit a nerve. More needed to be done, she said, to encourage families to look after their loved ones, and this should involve a "carrot-and-stick" approach. "Is it fair that people require the State to pick up the bill [for a parent's long-stay care] and then they get the benefits when people die?" she asked. "I think we have to ensure that we encourage people to live up to their responsibilities " It makes economic sense. We live in a time when the most modest two-up, two-down in the right location can be worth a fortune.

Take two scenarios. Mrs O'Brien moves in with her son, sells her own house and provides him and two more neglectful siblings with a sizeable windfall. She has also left herself, legally, without an asset to her name. Five years later, when she needs full-time institutional care, the neglectful ones are home free and the State picks up the full tab.

In the next bed lies Mrs Murphy, who has clung on to her little house in the prayerful hope that some day she will make it home, if only to die. In the eyes of the State, therefore, she has assets. So she gets a minimal State subsidy towards her bed.

To meet the full nursing home costs, her three adult children must pony up €100 each, a week, at considerable sacrifice.

This throws up two questions. The O'Briens' windfall may be legal, but is it moral? And shouldn't the Murphy offspring stop whining and see their weekly sacrifice merely as a sound investment? The problem is that nothing about this issue can ever be so clear-cut, mainly because of the inaction and chicanery of Government itself.

Junior O'Brien may have a moral case to answer, says Paul Murray of Age Action Ireland (AAI), but from their vantage point, all the evidence is that the vast majority of adult children are "more than heroic" in caring for their elderly relatives - as Ms Harney has acknowledged.

It's only a few years since this State was caught conspiring to keep its citizens in ignorance of their rights by pretending that the means of an elderly parent included the income of all his or her adult children.

Offspring were subjected to an illegal and grossly intrusive means test, while frail, elderly parents - those stoics and stalwarts who built the nation and paid their dues though times of hardship and penal taxation - were left in no doubt that the system saw them as economic nuisances, with fewer rights than a child.

While that disgusting scam has been exposed, the system continues to operate through a murk so vague, incoherent, arbitrary and outdated as to drive the most right-thinking people into a moral maze.

The cheapest private nursing home bed costs about €25,000 a year, yet, as Age Action has said, "people don't know what the hell they are entitled to".

If an old person's house is worth over €95,230.36, the health board is entitled to refuse any subvention. Subventions are set at such ridiculous levels that they are appealed routinely. The outcome could depend on what side of the bed someone climbed out of that morning.

If people are deliberately diluting or concealing their assets, it's out of terror - terror that the same numbskulls behind such "policies" are perfectly capable of leaving them to end their days strapped shivering and naked onto a commode in some odorous, never-inspected hell-hole.

Government policy, re-stated ad nauseam over decades and again, laudably, by Ms Harney, is to enable old people to remain at home for as long as possible. Yet the story is of miserable cutbacks in home-helps, chiropodists, public health nurses and caring supports. Last year's Mercer report was unequivocal: the absence of community care was "forcing" people to opt for private nursing homes.

And yet. Only 5 per cent of our elderly end up in nursing homes, suggesting that most enter only in extremis. Some 13,000 people who need high- to maximum-dependency care continue to live at home. How many acts of everyday, Irish family heroism do these figures represent? And who do you think has earned the carrot here? Or deserves the stick?