Ageing population a challenge for services

IRELAND’S AGEING population presents a massive challenge for governments North and South, with an additional 45,000 older people requiring care over the next decade, according to a major new report.

Every day over the next 10 years, an additional seven older people in the Republic, and two in Northern Ireland, will require long-term residential care or home help, states the report, to be published today.

There are serious questions about who will provide this care, especially given the likely increase in female emigration and workforce participation, according to the research funded by the Centre for Ageing Research and Development in Ireland.

The report, authored by researchers from Trinity College Dublin and Queen’s University Belfast, also highlights significant differences in the care available north and south of the Border.

It says there is clear evidence that the care assessment system in the Republic is less effective, since it leaves a higher proportion of older people with unmet care needs.

“Although older people are living longer and in better health, Ireland will face substantial extra demands for care of older people every year as the population ages. If care in the community and residential care are not developed appropriately, the pressures on the acute hospital system will be unsustainable,” said Prof Charles Normand of TCD.

The report points out that, in Northern Ireland, there is a legal basis for home help services and an integrated system to assess a person’s need for care at home or placement in a care home.

In the Republic, such assessment only applies in respect of the Fair Deal scheme for placement in a home.

There is a persuasive argument for providing this legal basis and an integrated assessment system in the Republic, especially given fiscal constraints and the rising demand for long-term care, it states.

“We are now facing the challenges previously tackled by other European countries which have managed to build up more comprehensive care systems than we have,” said Maev-Ann Wren of TCD. “Population ageing is independent of migration patterns, as older people don’t tend to emigrate.”

Ms Wren, who was a part-time policy adviser to former minister of State Róisín Shortall until the latter’s resignation last month, said the research provided a number of indications that our present care system was inadequate. The number of over-65s with a difficulty who were receiving no help stood at 14 per cent in the Republic in 2006, compared with just 2 per cent in Northern Ireland. In addition, HSE figures showed there were 690 delayed discharges from hospitals in August, many of them due to a lack of care available outside hospitals.

“It is important to realise that there is a substantial increase not just in absolute numbers of older people but also as a proportion of the population.”

Up to now, inward migration to Ireland had masked the fact that the number of older people was increasing, she pointed out. At present, about 12 per cent of the population is aged 65 or over, but in a decade’s time this figure would be 15 per cent.

Critically, the number of those aged 80 and older, who are more likely to be in need of care, will increase by 53 per cent. The number of over-85s will more than double, from 48,000 in 2006 to 106,000 in 2021.

One piece of good news to emerge is that older people are more likely to enjoy good health than before, so the proportion with a disabling condition that might require care is falling.

However, this trend is more than outpaced by the ageing of the population, so an estimated further 50,000 home care arrangements will be needed by 2021.