Tuesday 17 September 2019

Michael Kelly: 'We must stop forcing older people to pay with their homes for age-related illnesses'

Fair Deal?: Forcing our elderly to pay for their age-related illnesses with their homes needs to be addressed. Photo: Stock
Fair Deal?: Forcing our elderly to pay for their age-related illnesses with their homes needs to be addressed. Photo: Stock
Michael Kelly

Michael Kelly

As a teenager, one of the soundtracks to my youth was the wonderful Mary Schmich essay which became the 1999 spoken-word song 'Wear Sunscreen', brought to life by the genius of Baz Luhrmann.

Set as a classic US commencement speech, it liberally dispenses advice to the earnest graduates chomping at the bit to take on the big bad world.

Christina Aguilera or Jennifer Lopez it was not, but I was always a bit more of a nerd than a follower of popular fashion and the song seemed to me at the time to contain the sum of all human wisdom, and even now I frequently turn to the lyrics for inspiration.

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Amid the pearls of wisdom in the song is the sage advice to "accept certain inalienable truths: prices will rise, politicians will philander, you too will get old, and when you do you'll fantasise that when you were young prices were reasonable, politicians were noble and children respected their elders".

Whatever about prices and politicians, getting older is a fact of life, and like most of the rest of the Western world, we are an ageing society. As well as the fact that the proportion of older people in Ireland is on the increase, we're also - thankfully - living longer.

Life expectancy in Ireland is now 83.6 for women and 79.9 for men. Contrast that with 1980 when - on average - men could expect to live to just 70.1 and women to 75.6 years. In 1960, it was just 68.1 for men and 71.9 for women. You get the picture.

By 2031, there will be a million Irish people over the age of 65 - a massive 86pc increase from the 2016 population. Fast forward another 15 years to 2046, and experts at the Mercer's Institute for Successful Ageing at St James's Hospital, Dublin, predict that the number of people over the age of 80 will be half a million.

You don't have to be a genius to know that we have a serious issue in how we will cope with this dramatic increase in the number of older people.

Many of them, of course, will live healthy, fulfilled and independent lives into old age. Many others will need some form of assistance or residential care.

The concept of the extended family is not what it once was and, as a whole, we're having fewer and fewer children so the ability to burden-share elder care within families is limited and will diminish further.

The Irish Farmers' Association (IFA) last week highlighted the fact that many farm families are now forced to consider selling off portions of their family farm (and therefore livelihoods) because of a delay in implementing a long-promised cap on the proportion of the asset the State will take to pay for long-term care.

As part of the so-called Fair Deal scheme, assets are levied at 7.5pc per year, although this is capped on family homes at three years.

The farming community has sought and received a commitment the same cap will be applied to farms. But this has, so far, not been implemented.

Depending on where one lives, nursing home care can cost between €40,000 and €50,000 a year. It's a considerable outlay, and not one most families can afford. Hence Fair Deal and the lien the State puts on the family home of people requiring care.

But there's a deeper and more difficult question that we have to face as a society with an ageing population: is Fair Deal, in fact, fair?

Is it reasonable that people suffering from age-related conditions are the only people expected to sacrifice their savings, their pensions and a proportion of their family home to pay for their medical needs?

At the moment, the Government's answer is 'yes'. This is despite the fact that older people are the only ones expected to pay for their own medical care because they have the misfortune of being ill.

Take people suffering from other chronic or terminal illnesses. There would - rightly - be an outcry if the family of a child undergoing cancer treatment was asked to dip into their savings or give the State a lien on their home in return for the tens of thousands of euro their treatment may cost.

Oncologists will also frequently prescribe drugs costing tens of thousands of euro to prolong the life of a terminally ill patient for a short period because it is the compassionate thing to do for the patient and their loved ones.

We instinctively know that this is the right thing to do without much consideration for the cost.

Exchequer spending on the Fair Deal scheme is expected to hit €1bn this year and as this newspaper revealed last week, emergency funding will be required when demand inevitably increases.

But extra funds are only a short-term solution to an issue that is going to become more and more pressing as the number of older people increases.

We need an urgent conversation as a society about how we set aside resources to care for people when they are in need - regardless of their age.

The realisation that one can no longer be adequately cared for at home but needs to go to a nursing home is a painful one.

It is not a lifestyle choice akin to choosing to move to a lodge on the edge of a golf course. The age-related illnesses that make this wrenching choice a reality for many people should be treated no less than those illnesses that afflict younger people.

Irish Independent

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