The Pfizer/ Irish Timeshealth forum in Cork focused on celebrating older people's contributions to Irish society, writes LOUISE ROSEINGRAVE
THE NUMBER of people over 80 in Ireland is set to triple in the next 20 years, requiring crucial planning within the health system. The demographic shift and the appropriate care of the elderly is one of the biggest challenges facing Irish society, the latest Pfizer/ Irish Timeshealth forum on Older People heard.
The event, now in its third year, attracted more than 100 people to University College Cork last week to debate issues including the Fair Deal scheme, community support care and changing negative presentations of older people as a “burden on society”.
In her work with The Irish Longitudinal Study on Ageing (Tilda), Dr Hilary Cronin, consultant geriatrician and medical director of Tilda, aims to identify the health, social and financial circumstances of older people in order to prepare for their future care.
“While we know people are ageing, we actually know very little else about them,” Dr Cronin said.
The shift will take place slowly, giving time to prepare, Dr Cronin said, and she suggested constructive use of that time would include the promotion of positive aspects of ageing.
“Often very silently, older people are contributing, they are looking after grandchildren, giving money to their children to get on the property ladder. There is money, time and energy going up and down the generation streams that nobody knows anything about,” she said.
Chaired by The Irish Timesassistant editor, Fintan O'Toole, the debate featured Prof William Molloy of the Centre for Gerontology and Rehabilitation at University College Cork, who praised Irish society for its care of the elderly, despite increasingly hectic work schedules.
“We are very lucky in Ireland and we should remember that before we start cannibalising each other,” he said.
Kathleen Lynch, Minister for Disability, Equality, Mental Health and Older People, reinforced positive images of the elderly from her own experience of her mother, who “washed children, cooked dinners and gave money” to each of her grown children.
“My mother always said you can encourage your children to be close. We shouldn’t lose that inter-generational connection – because it will serve both sides very well,” she said.
Forms of elderly care and its cost drove the debate to focus on the Fair Deal scheme, which was opposed in its introduction in 2006 by Age Action Ireland.
Eamon Timmins, the head of advocacy and communications at Age Action Ireland, said the group remained concerned about aspects of the scheme.
He said the State would pay for expensive medical treatment for cancer or a heart attack, but if a citizen required residential care for the treatment of dementia, the situation changed.
“The average stay in a nursing home is 13 months, we [the State] will charge you in a very different way and we will be at the graveside to collect that money.
“At the moment the only people who can do this are the Revenue Commissioners and the Criminal Assets Bureau and now the Revenue will also be there to collect for the Fair Deal scheme,” Timmins said.
Dr Cronin said it was incumbent on all of us to work towards creating a situation where nobody needed to go to a nursing home. “We have to absolutely do everything we can to support and promote independent people living in their own home, which is where people want to live and ultimately want to die,” she said.
In the audience, delegate Claire Bailey spoke out in support of the Fair Deal scheme which her 98-year-old mother is part of.
“At the moment the house doesn’t have to be sold, without the Fair Deal it would have to be,” she said.
John O’Mahony, who cared for his mother for the last nine years of her life, said neighbours and community support were crucial for elderly care.
“If you take a person out of their natural habitat, they are going to suffer. It affects them,” he said.
Contributing to the lively debate, Mary Quaid, a development officer for south Dublin, Kildare and Wicklow, drew applause for her comment encouraging older people to take holidays, cruises and “spend all their money”.
In raising the issue of placing general practitioners at the centre of primary care, Molloy outlined a study he conducted in New Brunswick, Canada, in an area where GPs were operating on a fee-per-service system.
“We looked at the number of people GPs were seeing per day and it was a linear relationship – the more patients they were seeing, the more money they were making.
“The GPs seeing more patients were prescribing four times more drugs than the GPs seeing less patients; they were ordering 100 per cent more investigations, they had 150 per cent more fractured hips, 50 per cent more deaths and 100 per cent more hospitalisations,” he said.
The survey results illustrate that health, above all else, needs to be incentivised in GP practices, he said.
Closing the debate, Fintan O’Toole said the ageing process should be central to the way we think about society.
“In the long term, we are all old and unless we start thinking about this as a basic political and social principle then we are going to get nowhere.
“If we do start thinking about it properly, then we can celebrate old people for the first thing that they should be, which is citizens,” he said.