Thursday 5 December 2019

No country for old men or women - elderly care has all the makings of a crisis

Fashion designer and TV presenter Brendan Courtney
Fashion designer and TV presenter Brendan Courtney
Charlie Weston

Charlie Weston

We are in the midst of an elderly care crisis. Some would go as far as to say this means this is no country for old men and old women. Yeats may not have had the care of the elderly and disabled in mind when he published 'Sailing to Byzantium' in 1928.

But it is hard not to recall the opening lines of the poem when watching the painful process TV personality Brendan Courtney and his family are being put through seeking care options for Brendan's father Frank.

The emotional 'We Need To Talk About Dad' RTÉ documentary this week laid bare the paucity of options available to families with dependant older relatives.

The fashion programme presenter's father has had two strokes. Mr Courtney senior now wants to return home from care.

The family are grappling with either caring for him at home, or using the State's Fair Deal scheme to finance putting him in a nursing home.

The programme is heart-breaking as the Courtneys struggle to get to grips with the complexity and restrictions of the Fair Deal scheme, and the fact it cannot be used to adapt the family home to care for Frank.

Brendan's mother Nuala said: "It's not a Fair Deal. I don't understand why they've made it so difficult for us."

Adding fuel to the fire was the emergence of a memo from HSE's senior legal adviser Eunice O'Raw this week that families are using public hospitals as dumping grounds for people to avoid paying for care.

Her memo singled out farming families for this deliberate "bed blocking". Farming families, it is alleged, want farm assets to be exempt when nursing home costs are being calculated.

This prompted senior Fine Gael figures to promise changes to the scheme to reduce the burden of high nursing home bills for elderly relatives of farmers and business owners.

The problem is the scheme is expensive and cumbersome. Farmers fear they will have to sell parts of their land to meet the scheme's provisions.

Undoubtedly some farmers are gaming the system by refusing to sign off on the release of incapacitated relatives from hospital.

They know if they do sign off on their incapacitated relative leaving hospital they will have to put a Fair Deal scheme in place.

One of the elements of the scheme is that 7.5pc of assets a year are taken to fund the cost of care.

There may be a three-year cap on farms and businesses in certain circumstances, but this provision to take a chunk of the farm assets is still hated by farming families. So we end up with bed blockers.

President of the Irish Cattle and Sheep Farmers' Association Patrick Kent has taken issue with claims farm families are leaving their elderly relatives in hospital beds to protect their inheritance, but has welcomed debate.

"As it stands, the Fair Deal scheme is extremely unfair and unworkable for the vast majority of farmers," Mr Kent said.

The problem is two fold - Fair Deal is not seen as fair by many, whether they are farmers or not, and supports to care for people in the home are hard to come by.

This is despite research showing three-quarters of older people wish to live at home with assistance.

"The bigger problem we encounter is people who want to get out of hospital, who are fit to be released from hospital, but who can't go home because the home care supports simply aren't available," says Age Action's Justin Moran.

There is no legal entitlement to home-care help. The HSE operates a piecemeal system. Someone who has had a stoke, for example, and is discharged from hospital, must apply to their local HSE office for home help hours.

The application may or may not be approved. Often the number of hours granted is less than sought, and there are huge delays between approval and the home help hours being put in place.

Ageing and the care of the elderly is something we need to get a grip on in this country.

Some 25,000 people a year turn 65.

In the next 30 years there will be more elderly people than children in the State.

No wonder more and more people in their 30s, 40s, and 50s see themselves as the sandwiched generation - those who care for their ageing parents while supporting their own children.

As a nation, we have made few preparations for these dramatic demographic developments. It is time we started thinking how we are going to pay for granny and granddad's care. Inaction is no longer an option.

Irish Independent

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