Care and ‘congregated settings’

Sir, – It was interesting to see Simon Harris tweet that he accepted criticism of flawed policy in caring for older people in light of the shocking toll the Covid-19 pandemic has had on nursing homes in Ireland. Perhaps the impact of a pandemic could not necessarily have been foreseen, but the dangers of institutional care has been laid bare before, including the report that followed the Leas Cross scandal which said that the standardised mortality ratio in nursing homes is six times the community rate and also that people were living longer in their own homes with home support.

We should not forget that the use of institutions is not limited to older people as mental health treatment utilises institutional models, as does the delivery of residential support to people with intellectual disability in so-called “congregated settings”. It has been State policy for almost a decade to close these settings, but implementation of that policy towards the deadline of 2018 has been inadequate and over 2,000 people with disabilities remain in these settings.

Individuals need more than the Hobson’s choice of institutional care or relying on family to assume caring responsibilities. This challenge will be even harder in the economic climate that lies ahead, but the alternative is reliance on a model that dehumanises and leaves people in vulnerable situations.

It would seem utterly obvious that congregated living and social distancing are utterly incompatible, and if this is our “new normal” as we continue to live with Covid-19, then we also have to have an honest and mature conversation about our models of health and social care. – Yours, etc,

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SARAH LENNON,

Shankill, Dublin 18.