EDITORIAL: Challenges of an ageing population

RECOMMENDATIONS made by the Citizens' Assembly on the topic of ‘How we best respond to the challenges and opportunities of an ageing population' will form the basis of a report on the topic for submission to the Houses of the Oireachtas for discussion in the autumn by a committee of TDs and senators. Among the Assembly's recommendations are – first and foremost – that the government urgently prioritises and implements existing policies and strategies in relation to older people; the introduction of a mandatory pension scheme to supplement the State pension and the abolition of mandatory retirement based on age.

Separately, Minister for Health, Simon Harris TD, and Minister of State for Mental Health and Older People, Jim Daly TD, have opened a public consultation on home care services, which will inform the development of a new statutory scheme and system of regulation for home care services – something that is very badly needed, as the more older people that can be cared for in their homes, the better the quality of life they will enjoy in their twilight years in the familiar surroundings in which they have lived their lives, rather than facing the trauma of being institutionalised.

While the majority of nursing homes offer excellent care, it is not quite the same as being looked after in one's own home. Proper home care needs to be more than a home help calling a few times a week; as Sean Moynihan, the CEO of ALONE, the charity that supports older people to age at home, said, ‘a more rounded home support system should be put in place for older people and carers.'

This would involve the participation of the wider community, as ‘without a wrap-around of services, any new homecare scheme would fail,' he suggested. It is clear, therefore, that a more holistic approach needs to be considered in this consultation process, as the number of people over 65 continues to increase. The majority of people in that age bracket are able to look after themselves, but about 20% receive some form of support from the State.

Family carers are also an integral part of home care and feel their essential role is undervalued by the State. Today, according to Family Carers Ireland, one in 20 people in Ireland is a family carer, providing some €10 billon in unpaid care each year. 

They estimate that, by 2030, demographic changes will require one in five to take on a caring role. This makes the current public consultation on home care services all the more vital, if those in need of care are to be adequately cared for now and into the future.

In recent years, home care resources have become more and more stretched. There have been cuts in beds available in public nursing homes, many of which need modernisation to meet the higher standards rightly demanded by HIQA, as well as staff shortages. 

This has contributed to the transfer of respite beds to long-stay beds, which has had the knock-on effect of reducing opportunities for family carers to avail of some respite they both need and deserve. Also, the waiting list of people seeking to avail of free home care supports has risen from 4,381 at the end of last year to 4,600 now, showing that the situation is getting worse in spite of an improving economy.

We've also had recent reports of people being priced out of the Fair Deal scheme because of extras being charged by a minority of private nursing homes, leading to calls for more transparency about their charges. Indeed, in some cases, these extras are the difference between some families being able to afford private nursing home care for a loved one or being forced to join the waiting list for a public bed.

So, there is a lot to be fixed in terms of supports for the elderly who need them, with a complete overhaul needed and adequate funding provided. The consultation must not only consider the needs of those being cared for at home, but also those who are doing the caring.

Everybody can have their say between now and August 31st next by logging on to www.health.gov.ie/consultations