Funding care for the elderly

Madam, - For over 15 years, we in the Irish Association of Older People, a group of older volunteers, have been promoting a modern…

Madam, - For over 15 years, we in the Irish Association of Older People, a group of older volunteers, have been promoting a modern view of ageing. We provide information and support for local community-based groups and work in partnership with statutory and voluntary agencies to express the voice of older people and campaign on their behalf.

In anticipation of a Cabinet decision on the future funding of care for elderly citizens may we draw attention to the following:

1. In a rapidly ageing world, Ireland, with 11.2 per cent of its population over the age of 65, is currently at a very advantageous demographic stage, though the situation is projected to deteriorate somewhat in the near future.

2. Over the past 25 years the dependency rate has been reduced from a rate of 70 per cent to the current rate of 47 per cent.

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3. The proportion of elderly who will require long-term care, lasting for an average of two to three years, is estimated to be 5 per cent of the elderly population.

The Tánaiste and Minister for Health must be commended for addressing the debacle in relation to the financing of care provision and for her commitment in both word and deed to a policy of supporting home-based care as a first option. This in turn, of course, will require the provision of a trained workforce to deliver standardised, person-centred and needs-led domiciliary services not just here and there but throughout the country.

In regard to rumours that older people will be obliged to contribute substantially towards maintenance and care, it is worth noting that international, evidence-based research has demonstrated that funding by way of capital grants and revenue subsidies has served as a perverse incentive towards long-term institutional care.

It is therefore reasonable to assume that any method of co-funding involving the release of equity on the one capital asset which older citizens, through thrift and frugal living possess - and which, due to unprecedented accretion in value, is already attracting the interest of a multiplicity of financial institutions - is likely to fuel the market for care and repeat the mistake of introducing another perverse incentive meeting wants rather than needs in a system already lacking capacity.

It may also have the effect of inducing older people to take the advice of Maureen's partner in the Equity Release Scheme advertisement to exhaust the equity in the family home on holidays and other luxuries in the hope that they will not be among the unfortunate 5 per cent requiring long- term care.

In our rapidly changing society what we need is a reconfigured welfare model within which the most equitable system of managing the costs of caring is identified and implemented. In its most recent report "The Developmental State", The National Economic and Social Council points the way forward and provides the context within which this issue could be satisfactorily decided.

Let us hope that in their quiet moments our political masters will listen to and heed good advice. - Yours, etc,

SHEILA SIMMONS, Honorary Secretary, Irish Association of Older People, University College, Earlsfort Terrace, Dublin 2.

Madam, - I have been following with interest recent debates concerning long-term care for frail older people, and note that much of this debate has focused on the issue of refunding illegally charged fees to occupants of public beds.

While the withholding of a portion of one's pension is seen as a "scandal" by many politicians, nobody seems to question the fact that, owing to the shortage of "public" beds, other residents of the same institutions have to pay over €700 a week for the same care services.

How can the Minister for Health then assure the public that there is "no question" of people being forced to sell their homes to pay for nursing care, when many current residents of nursing homes have had no alternative but to do so (The Irish Times, February 16th)?

I await with interest the Minister's decision on the future funding of long-term care. I trust it will be more transparent and more equitable than current arrangements. - Yours, etc,

EILEEN M. ROGERS, Murphystown Road, Dublin 18.