The nursing-home controversy raises broader questions about our attitude to older people, writes Robin Webster.
The appalling sights and sounds of elder abuse in a nursing home in the Prime Time programme have rightly shocked everybody. There has been an outcry against such a low-level service in homes, where frail and vulnerable people should feel secure when they or their families can no longer cope at home.
Instead, we saw older people with gaping bedsores, lying in dirtied clothing, and heard them being bullied and threatened by some "care staff".
The Government must take urgent action to stop such abuse immediately, to sanction the people responsible and to put measures in place to ensure that such abuse does not recur. What it must not do is treat this as an isolated case that requires limited action with the hope that the fuss dies down.
There are nursing homes that provide high-quality care for vulnerable older people, who are treated with dignity and respect. At least people report that there are such homes, but the truth is we do not know. The twice-yearly inspections of private nursing homes are limited in nature, and public nursing homes are not inspected at all.
There are few sanctions against nursing homes that do not comply with the limited standards that do exist. In our present system, as we saw in the programme, some faults are exposed, and a nursing home may be asked to correct the faults, but with no urgency and little determination.
The programme was yet another argument for legislation to assert the right of citizens, especially frail citizens, to receive high-quality care services and to impose corresponding duties on the bodies providing the sources.
The Government has strenuously argued against such rights-based legislation, for example, in the flawed Disability Bill going through the Dáil. Its priority is to protect the State from excessive demands for additional public expenditure. Surely it is time for the Government to give priority to protecting citizens at risk and not wait for the next scandal to force its hand.
Our worst fear is that this minimalist approach to ageing and older people is based on age discrimination, the attitude that older people are not really important, that they are unlikely to complain and, anyway, they have had a "good innings".
Coming so hard as it does on the heels of the scandal of the illegal charges imposed on older people with medical cards in nursing homes, it is difficult not to see a pattern of official neglect.
This attitude has to change. We have one of the fastest ageing populations in Europe, and the number of older people will increase dramatically as we catch up with other EU countries in the next 20 years. We have to learn to celebrate ageing as a modern miracle, and put in place services that will ensure all older people can live in dignity and independence.
There has to be urgent review of all nursing homes, both public and private, and all residents and their families should be encouraged to report on any form of neglect, abuse or poor service.
The Government and the Health Service Executive have to be ready to take action to examine and if necessary to stop any form of reported abuse. That is the only way that public confidence in the residential care services for older people can be restored and the reputation of good nursing homes protected.
This will be a painful process because there is little doubt that more examples of appalling practice will be revealed.
The Government will then have to take action to establish quality standards for long-term care through legislation, regulation and training.
We do not have to travel far to look at what we need to do, because Northern Ireland has many of the remedies that we have been urging for years, particularly an independent inspectorate with power to impose sanctions, and adequate staffing levels.
The number and quality of staff are vital to the establishment and maintenance of high standards of care. All staff, and especially care assistants who are the bedrock of the care system, should be properly trained and supervised so that caring for older people becomes an attractive career.
Long-term care is an important part of an overall positive ageing strategy which we will have to develop in the next 20 years. By 2025, we should demand that Ireland is the best place in the world in which to grow older.
The Prime Time programme demonstrated how far we are from this aspiration, but the programme-makers should be congratulated for their fine journalism in jolting us all into reality and, hopefully, into action.
Robin Webster is chief executive of Age Action Ireland