IN OLDER and Bolder, we meet older people all over the country who share a common message with us: “I want to grow old at home.” We hear from people who are afraid of losing limited but highly valued homecare supports.
As one individual told us recently, “My home help comes every day for one hour. I am 96 years old. If I was to lose this service, I would not be able to live alone.” The fact is that we have yet to meet a politician, a civil servant or a public servant who argues against the idea of ageing well at home.
However, this gives cold comfort to older people who observe the reality that cuts to respite services, home help services and daycare services are imposed even as Ministers repeat the mantra that they should be supported to remain in their homes for as long as possible. It is little wonder many older people and their families are fearful.
Those fears are heightened during a time of national economic crisis, but the current crisis does not explain problems in our system of home and community care which are more than 20 years old.
When Minister of State for Older People Kathleen Lynch addresses the Seanad today in response to its report on the rights of older people, we need to hear from her on specific and long-standing issues that concern older people and their advocates.
Take access to home and community care services. Some 88 per cent of people believe that the State is obliged to provide you with homecare services if you have an age-related illness or disability (according to a recent Ipsos MRBI poll conducted for Older and Bolder).
In fact, while the State is legally required to provide in-patient hospital services to citizens, it is not legally obliged to provide community care services. These are available on a discretionary basis. Most people do not realise the implications of this legal deficit until they find themselves in a crisis or an emergency: the diagnosis of illness, discharge from hospital with a disability or the transition to the role of carer.
Will you get a homecare service in these circumstances? It depends on where you live, who you speak to, the state of the budget in your regional Health Service Executive office, and local custom and practice. Pathways to services and supports for individuals are unclear, unreliable and nationally inconsistent.
The Seanad report on the rights of older people recommends that homecare entitlements should be clarified and put on a statutory footing.
The question is this: will the Minister agree? Take the planning of long-term care services for older people. The advice for more than 20 years has been that policymakers need to plan to meet a continuum of care needs among the older population.
Home and community care services are at one end of the continuum and nursing homecare are at the other end.
In Ireland, we have set up the Fair Deal scheme and prioritised the planning of institutional care over home and community care of older people.
We now need an audit of community care services so that we can map the services that are available, identify the deficits, plan effectively for the future and introduce greater transparency into an opaque system.
The Seanad report has recommended the use of an existing HSE system, HealthStat, to conduct an audit of community care services for older people.
If the Minister were to commit to this audit, the findings could inform the forthcoming review of the Fair Deal scheme and also include community care in that review. Ultimately this could reduce premature admissions to nursing homes and unnecessary stays in expensive acute hospital beds.
With reduced resources, the Government cannot afford to make poor decisions. A planned approach to population ageing is vital and that is why older people have campaigned for six years for the delivery of a National Positive Ageing Strategy.
The official approach to the strategy has been lacklustre and the cross-departmental group of civil servants and NGO liaison group set up to assist the Minister and her officials are simply not functioning.
Older people continue to hope for more from the Minister and the Government. As one older person told Older and Bolder: “I want to live in my home for as long as I can and to live in a country that is the best place for older people to live out their lives.”
Patricia Conboy is director of Older and Bolder, an alliance of age-sector organisations: Active Retirement Ireland, Age Opportunity, Alzheimer Society, Carers Association, Irish Hospice Foundation, Irish Senior Citizens Parliament, Older Women’s Network and the Senior Help Line. Make Home Work is a campaign for the right to age well at home