Services for elderly people are at breaking point and a major crisis is on its way, Friends of the Elderly has warned, writes MICHELLE McDONAGH
‘THE NUMBERS of elderly waiting for a homecare package or a place in a public nursing home is a national scandal and increasing every month. If something is not done, we will be going back to the 1970s when elderly people were found dying and dead in their homes.”
Dermot Kirwan, spokesman for Friends of the Elderly (FOE), has warned that care for the elderly services are at breaking point and a major crisis is hurtling down the line towards us.
The problem, according to FOE, is that the HSE “wildly underestimated” the cost of the Fair Deal nursing home support scheme launched by former minister for health Mary Harney in 2009 and the homecare package.
They also underestimated the numbers and the life expectancy of the applicants, says FOE, a volunteer-based Irish charity that aims to alleviate social isolation and loneliness among older people through friendship.
The Fair Deal nursing home and homecare package schemes have run out of money and are virtually closed to new applicants, according to Kirwan.
“The HSE set aside one billion to care for the elderly during 2011 – the money ran out at the end of April and the whole scheme has been on life support ever since,” he says.
“Given the growing numbers of our elderly and our increased life expectancy, even if we found another billion for the rest of the year, it would not be enough to satisfy demand for the services.”
The HSE’s response has been to reduce the number of places in public nursing homes and cut back the availability of homecare packages and reduce the hours for those who receive homecare, says FOE.
And it warns that a new change to the nursing home support scheme is causing huge additional anxiety and uncertainty to the elderly and their families. The date of payment of the scheme has been revised from the “date of application” to the “date of application approval”.
“Waiting for approval can take over three months. Some families will have to empty out their savings while waiting for a decision,” says Kirwan.
“In other words, you won’t know if you are okay for nursing home support or not until you have been in the nursing home for a few months and spent €12,000-€15,000 and even if you are, you can’t get your money back.”
It is inevitable, warns Kirwan, that elderly people who can no longer live at home and are unable to find the €1,000 a week it costs to stay in a private nursing home, will end up in long- term hospital wards, which will cost the State about €2,000 a week.
When questioned about the situation regarding funding of care for the elderly services, a HSE spokeswoman said the HSE must operate the Fair Deal nursing home scheme within the budget allocation from Government which was just over €1 billion in 2011.
“For the period January to June 2011, 5,832 applications for NHSS [Nursing Homes Support Scheme] have been received and 4,573 new clients have been supported under the NHSS in private nursing homes. This was a net increase of 1,812 people in receipt of a nursing home place during the period. [Some] 2,547 applications have been granted funding approval since the scheme recommenced in June.
“Applications continue to be processed and granted on a weekly basis,” she said.
The provision of homecare package services has grown significantly in the past number of years and the HSE in 2011 would spend €138 million on packages for more than 11,000 people, she said.
“This year, the HSE will spend €211 million on home help services to approximately 54,000 people. Almost 12 million hours will be provided to clients in 2011 to support people to continue living in their own home or to return home from hospital,” according to the spokeswoman.
However, Sharon Creggan, SIPTU home care organiser, points out that the number of home helps employed by the HSE dropped from 12,356 in January 2007 to 9,620 in June 2011. Meanwhile, the number of service users has increased from 54,736 in 2007 to more than 56,000 in 2011.
“The number of home helps employed by the HSE has decreased while the number of service users continues to increase. On top of this, home help hours have also been cut and we expect further cuts in the home help budget this year again,” she says.
On the other side, the homecare package scheme, which is delivered mainly by the private sector, has increased by 71 per cent.
There are now 20,000 elderly in public nursing homes and 65,000 elderly benefiting from homecare support and this figure could double over the next 20 years.
Friends of the Elderly has come up with a proposal which it believes could help solve this impending crisis in care services.
Kirwan points out that more than half of all homecare for the elderly is non-medical care and can be administered by neighbours, community workers or students when the family is not available.
Companionship and domestic caring, he suggests, can be delivered by anybody with very basic training and the right attitude.
“The Care of the Elderly Fetac Level 5 is a simple course that all home carers are expected to have. Imagine if it were on the school curriculum, within five years we would have a generation of young people with the skills to care for the elderly in their own community.”
The FOE proposal suggests that community service hours should be obligatory for students over 18, while transition year should become community service year. A community service year or payback year should be introduced between the end of second level and the beginning of third level, it says.