Your Money: Homing in on care plans for OAPs
The pros and cons of alternatives to HSE's Fair Deal for looking after the elderly
Recent reports of a blockage on proposed legislation protecting farms and business assets from the Fair Deal scheme emerged after civil servants identified a range of 'what if' scenarios which would place it in jeopardy.
Not for the first time, this otherwise excellent scheme has been undermined by its own flaws. This week, I'm looking at the alternatives providing ever more expensive elder care to an ageing population.
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Nursing home support scheme
The statutory basis of Fair Deal means anybody requiring full time residential care can access it anywhere they choose, with their financial contribution fixed as a percentage of their pension income plus a portion of their assets (see panel).
The problem is that most people don't want nursing home care; they'd prefer to stay at home, with supports, but Fair Deal does not allow this. A public consultation was promised in 2017 to see how it would work, but the HSE warned it would take a minimum of three years to put in place. Nobody has challenged this, despite Minister for Older People Jim Daly professing to want it.
Instead, they must rely on inconsistent and largely budget-constrained Home Care Packages (see below), or engage private, and expensive, home care. If you are able to stay in your own home as long as possible, providing assistance for that is proven to be cheaper, better and more desirable. So, what's available?
Home care package
Not means-tested, HCP hours are available to anyone who meets the medical criteria depending on geography, budget and month. It is not an entitlement. Around 50,000 people receive HCPs, on average 6.5 hours per week, and despite the budget increasing by 30pc since 2015, there is estimated to be 6,000 on the waiting list with many finding it extremely difficult and time consuming to get their application processed.
Private home care
Agencies, often employed by the HSE to offer HCPs, also provide private care hours. Senior Care, Bluebird and Home Instead are examples. Costs vary from around €20 - €30 per hour, depending on needs, which range from 'companionship' to full nursing support. There is tax relief available on fees, however given that most pensioners are not in the tax net, it is left to family members to pay the bill if they wish to claim it.
There is a dearth of purpose-built developments for seniors. Minister Daly calls it the "third option" and it has a champion in broadcaster Vincent Browne who is backing the building of rural community hubs for older people to live in cheek by jowl, as advocated also by the Social Democrats' Roisin Shorthall.
This could be PPP-funded and provide suitable properties in a step down facility which has the added advantage of freeing up larger family homes. Alone's latest research pointed to a need for 16,308 'shared and supported' housing units including co-housing and retirement villages which are used abroad. They call it 'right sizing', rather then downsizing. One is the Portumna Retirement Village in Galway, which opened in 2007 and proved popular, renting to independent seniors with a caretaker, nurse and social centre in situ.
Although care agencies provide 24/7 care it can be prohibitively expensive. Another option is a mature foreign or Irish student who is in need of accommodation. Elder Home Share is one organisation matching seniors with companions who provide basic (non-nursing) light housekeeping and company in exchange for bed and board.