Most of us like to think that when the time comes, we will have the means to care for ill or ageing family members, who given the choice, would rather be in their own homes than in a hospital or nursing home.
This is where the Home Care Package comes in – a range of services provided by the HSE to facilitate the care of older people in their own home. Whether it’s therapy, home help, respite, transport to and from medical appointments or day care services, the package aims to make it easier for people to remain independent for as long as possible.
But it isn’t as easy as just signing up, as a spokeswoman for the HSE says an assessment must be undertaken before services are granted.
“A Care Needs Assessment identifies your overall health needs and your level of dependency” she says. “This is done to make sure you get the right care in the right place by a healthcare worker. The assessment will look at your needs, including:
- Your ability to carry out activities of daily living, eg bathing, shopping, dressing and moving around.
- Any medical, health and personal social services being provided to you.
- Your family, social and community supports.
- Your wishes and preferences.
“This assessment may also include a physical examination by a healthcare professional. Then when a Home Care Package is provided, we will make an arrangement for regular reviews of your needs to ensure you are receiving the level of care you require.”
But while the service is free of charge as part of the public health service, demand is high and quite often the best model of the programme is not always viable.
Catherine Cox of Family Carers Ireland explains what the ideal home-care situation should look like.
“Good home care provision ideally supports both a medical and social model of care whereby both the carer and the cared-for person are supported physically (with therapy, respite and home help) and psychologically,” she says.
“The care package should be flexible enough to meet the needs of both the carer and the cared-for person while supporting dignity and independence. This might include support in the morning with getting someone up, showered, dressed and fed and likewise at night getting them to bed and making them comfortable.
Efficient package
“It should allow the carer time to get a much-needed break to revive their batteries (even if it is just running errands outside the house or taking a nap) and come back refreshed and ready to care again. An efficient home-care package should also include appropriate therapies such as physio, occupational therapy, and speech and language therapy.”
Cox says more should be done to help families caring for loved ones at home.
“The current budget for home care packages is €126 million with an additional €6 million for intensive home care packages, while the budget for home help hours is €192 million,” she says.
“Unfortunately the current status is quite bleak given the recent announcements that home-help hours and home care packages are being suspended in some HSE areas whereby no new packages or home-help hours will be awarded to families in need. These cuts will only serve to place more pressure on a system already creaking by forcing delayed discharge from hospitals, resulting in more people being re-admitted to hospital due to inadequate supports in the community and home.
“This will also result in greater health and safety risks for both the carer and cared-for- person and a far greater cost to the State.”
Costs of care
The Family Carers director says it costs up to €1,300 per week for hospital care, between €800-€1,200 per week for nursing home care and just €639 per week for the intensive home-care package including a carers allowance – resulting in a “significant” saving to the State and supporting care in the home and community which is the “preferred choice” for most people.
Vetted rigorously
But the HSE says it’s not that simple and people must be vetted rigorously before approval.
“Upon application the HSE will carry out a Care Needs Assessment,” says a spokeswoman. “This will look at your overall health care needs and your social circumstances, and will identify what level of care you are currently receiving and what other supports you may need.
“In order to be allocated a Home Care Package, this assessment has to confirm that enhanced levels of service/ support are required. If the assessment shows that additional services/supports are not needed, the application for a Home Care Package will be refused.”
