The Home First scheme is a joint initiative between Beaumont Hospital and Dublin's Northern Area Health Board and has been running for more than three years. A person on the scheme will be visited a number of times each day by nurses and care workers. A physiotherapist, an occupational therapist and social workers are also involved in providing care to the elderly person.
There are currently about 30 people on the scheme, with five more being assessed, and there is a waiting list of 13. The care provided to each person depends on their needs. Ms Gretta Thompson of Beaumont Hospital, who co-ordinates the scheme, says it was set up in response to feedback from older people who wanted to stay as home for as long as possible. The costs are comparable to the cost of keeping a person in a nursing home but that "in terms of quality of life, it makes a huge difference", she says.
The Home First scheme also gives families the choice of caring for elderly parents at home. After Joan Doran's mother, Carmel, got a brain haemorrhage at age 67, she decided she wanted to take care of her. But she was told that it wouldn't be possible, that Carmel would need 24-hour care. Joan also stresses that the nursing home staff were very good but says that leaving her mother in a nursing home "just wasn't for us", that she couldn't bear to see her in an institution. Inevitably, at times when she visited the blanket would have fallen from around her mother's legs or her hair mightn't have been brushed. The Home First scheme made it possible to bring Carmel back to her Coolock home and to keep her there even when her condition deteriorated recently. Joan gave up her job in childcare to look after her. She praises the flexibility of the Home First arrangements and the supportive approach of the staff - extra help was sent on an occasion when her father was also unwell.
"I feel we are all together again now. My brother and sister can call around. And it's great to be able to see her in the morning when she's at her best. And I know she's happier at home," says Joan.
An audit of the scheme by the health board confirmed its value. The board's assistant director of public health nursing, Angela Kennedy, says that while it is comparable to nursing home costs, you can't put a cost on patient satisfaction.