There will be a broad welcome for the report from the National Council on Ageing and Older People on the quality of life for older people in long-stay care.
A pivotal point is its emphasis on the importance of quality of life for residents of nursing homes and not just quality of care (which is vitally important in itself). Recent emphasis on quality of care is understandable, however, following revelations about two private nursing homes and the public shock that older citizens could be abused. Indeed, quality of care issues must remain high on the agenda, particularly as debates about latter day residential care have tended to be fixated on financial issues. As yet, despite Government promises, there is still no statutory inspectorate for both public and private nursing homes.
The Council report, Improving Quality of Life for Older People in Long-stay Care in Ireland, which was published on Tuesday, must be seen also in the wider context of the overall care of older people, only 5 per cent of whom will ever live in a nursing home. Elderly care will only be optimal if it is seen as part of a continuum of high-class provision, both inside and outside residential care. A recurring major difficulty is the inability of our social and health services to ensure a smooth worry-free transition for older people from one type of care to another.
Nursing home residents, as the report says, want their care to be a "home from home" where they can shape their days according to their wishes. They want to be seen as unique individuals and to be equal partners in decision making and in their own care. Most importantly, there is a strong desire among many residents for a room of their own. These wishes may only become successful demands, however, if older people are assisted to champion their own cause through advocacy projects such as those developed by Age Action Ireland.
As suggested by home managers and staff who participated in the compilation of the report, the nursing of older people must be given enhanced status, therapeutic activities need to be increased, and there must be an adequate and a proper skills mix in staffing, as well as independent inspection and strong regulation.
The council itself says that new facilities should be purpose built with en suite facilities and that large shared rooms should be phased out. It advises careful consideration of the location of nursing home facilities and that there be an analysis to assist in the strategic planning of long-stay services. This would be better than the current hotchpotch where, in the absence of direct public investment, nursing home building is fuelled by entrepreneurs rather than being based on strategic and caring needs.