Homes bill elderly for 'hidden extras' of up to €600 per month
ELDERLY people and their relatives are being hit with hidden nursing home fees of up to €600 a month, an unpublished Department of Health report has shown.
The extras are on top of the average weekly cost of €1,000 for nursing home care and include bills for transport, toiletries and incontinence pads and even "activities" for bed-ridden residents.
The charges are detailed in a dossier being compiled by the Department of Health, which is examining the future of the Fair Deal scheme.
Under the scheme, the State subsidises the cost of nursing home care.
However, submissions to the Department of Health -- released to the Irish Independent under Freedom of Information -- detail a litany of hefty additional bills which residents thought were already included in the total cost of their care.
These "hidden extras" include contributions towards the nursing home's registration fee, while some elderly clients are charged for social activities even though they are bedridden.
Although private nursing home owners are getting an average of €1,000 a week for each resident, a lack of regulation covering top-up charges means there is no limit on them.
The dossier shows many nursing home owners say the state fees are too low and homes in urban areas receive higher fees than their rural counterparts for the same level of care
The documents reveal:
• One woman in her 90s is charged a €100 taxi fare for hospital appointments and a levy for a carer to escort her.
• She has an "activities" levy of €40 a month and also pays for incontinence wear, physiotherapy and foot care.
• Another elderly woman pays €40 to €50 a month for social activities, toiletries and laundry.
• A resident in a Dublin nursing home must pay the owner €125 a month for "extras" but the invoice is not itemised.
Five women whose husbands have dementia told of their heartbreak at being pressurised to pay bills for extras, which are "spiralling out of control".
"Many older people pride themselves on paying their bills on time and never being in debt," they wrote in a poignant letter. "However, now in long-term care they are faced with weekly added costs and genuine confusion."
The National Financial Abuse of Older People Working Group has previously called for an examination of the practices.
It said new residents were being presented with a contract listing additional costs a month after their arrival.
These costs would not have been made known to the resident on admission, said the watchdog.
The Health Service Executive's Dublin South-east/Wicklow section called on the Department of Health to introduce new rules to control these costs, saying they were causing hardship.
Several nursing home owners told the department that the monthly fees, which are negotiated for each individual home by the National Treatment Purchase Fund, are inadequate and discriminate against nursing homes outside of cities.
The department told the Irish Independent that residents should not be asked to pay on the double for services or items not set out in their contracts.
The monthly fees cover bed and board, basic aids and appliances and a laundry service.
Tadhg Daly, chief executive of Nursing Homes Ireland which represents private homes, said the deed of contract that owners sign to join the scheme makes clear that the fee they get from the State excludes cover for extra items such as physiotherapy.
"We need a new contract to reflect the full cost of care of the nursing home resident," he said.
The weekly basic fees per resident paid in an HSE-run home were more than 40pc higher than those that private providers were getting, said Mr Daly.
When asked about charging bed-ridden residents for social activities, he said the service may involve aromatherapy and reflexology.