Eilish O'Regan: 'As the nation ages and we all live for longer, this scheme will have to evolve accordingly'
The pressure on the Fair Deal scheme, which provides financial support for nursing home care, is not because of a huge surge in older people applying for the subsidy.
It has more to do with elderly people resident in these homes living longer.
The number of people availing of the scheme has consistently been around 23,000. But this year 23,228 were being supported in nursing homes by the end of February, which was around 180 more people than budgeted for by the HSE.
The most recent analysis from Nursing Homes Ireland found that new applicants for the scheme had been dropping over time.
Around 194 fewer residents had their nursing home fees supported by the Fair Deal scheme at the end of June 2018 compared to December 2013.
Over 18 months to June 2018 there was a fall of 329 in the numbers availing of Fair Deal.
More older people seem to be staying at home for longer, either through family support, a HSE homecare service or increasingly privately paid-for homecare.
However, we know the population is ageing and the number of people aged 65 and over will grow from one-fifth of the working population to more than one-third over the next 20 years.
So however good the promised new homecare scheme from the Government is in the coming years, demand for nursing homes will rise.
It may be the case that the terms of the scheme have to be revisited to ask people to pay more.
This clearly needs to be done in a way that should put little stress or hardship on the nursing home resident.
As it is, many are having to pay top-up charges out of their own pockets in private nursing homes to cover "extras" not covered by the Fair Deal, such as social activities. One area that could be looked at - which would also have benefits in helping to alleviate the housing crisis - is making it more attractive for older people in a nursing home to sell the family home while alive.
Currently, many of these homes lie empty because if sold the house is a liquid asset, liable to the 7.5pc levy every year with no cap.
If the same house is sold now after a person's death, the 7.5pc is capped at three years.
Applying the same cap to the house sale proceeds during the resident's lifetime would be advantageous for the State, generating funding early rather than waiting for lengthy probate.
The resident could also benefit from the proceeds.