'He doesn't want to go to a nursing home. He's much happier at home'

Tue, Apr 10, 2012, 01:00

CENSUS STORIES OVER-65s:BILL GUEST (71) was an imposing garda in his day, over six feet tall and 16 stone in weight.

Nowadays he can’t move as a result of a rare degenerative condition that has robbed him of almost all his mobility.

His wife, Kay (58), is totally reliant on home care to help lift, wash, clothe and feed him.

“The home help is very important. I couldn’t manage without it. If I lost even half an hour, I’m not sure I could cope,” says Kay, who lives near Nenagh in Co Tipperary.

“He doesn’t want to go to a nursing home. He’s much happier at home. But with all the cutbacks to home care packages and support, we can’t be sure what will happen into the future.”

It’s a dilemma also facing the Government and health authorities. This year alone, the HSE is planning to reduce the number of home help hours by 500,000. In addition, it is seeking to close 500-900 public nursing home beds.

Yet, census results for 2011 published earlier this month show that Ireland is ageing and the number of older people living alone is on the increase. The greying of the population is a challenge facing Ireland and many European countries over the coming decades for health services, pensions and social care.

Pensions are just one of the issues looming on the horizon. Unless people stay longer in employment, either pension adequacy is likely to suffer or an unsustainable rise in pension expenditure may occur.

With the Government struggling under the weight of excessive debt and shrinking public finances, there is no pain-free solution.

That’s why Minister for Social Protection Joan Burton announced plans recently to increase the qualifying age for the pension from 65 to 66 in 2014, 67 by 2021 and 68 in 2028.

By European standards though, Ireland is in good shape. Our high birth rate – the highest in Europe at last count – means the population is quite young and is set to keep growing. In Germany, on the other hand, a consistently low birthrate is leading to an ageing and shrinking population. In fact, experts forecast that the numbers living in Germany could shrink by 20 per cent by 2060.

These challenges may be some way down the road – but there is less time to cope with more immediate issues, such as provision of home care, nursing home beds and other supports.

Already the Fair Deal scheme – which provides for affordable nursing home care in private nursing homes – is being cut back.

Home care packages, which seek to keep older people out of nursing homes, are also being trimmed back.

This will make it harder to for vulnerable older people to live at home, while making it more difficult to afford a nursing home bed for those who need it.

There has been plenty of rhetoric about keeping people in their own home – but it hasn’t always been matched by the reality on the ground, according to Patricia Conboy, director of the campaign group Older and Bolder. “Our member groups are experiencing cuts in day services. Home-help packages for many older people are being cut. All of this is having a knock-on effect on the services designed to increase the capacity of older people to live safely at home,” Conboy says.

There is plenty of doom-mongering when it comes to whether developed countries can cope in the future with older populations. Phrases such as the “pensions time-bomb” are alarmist. But Conboy says a society that plans for the future can actually afford to grow old.

“We need a positive ageing strategy that draws on the support of the community and voluntary sector, and is based on keeping as many people as home as we can.”

People growing older isn’t the problem, she says. It’s about keeping people healthy and more mobile for longer.

“There’s no doubt that we can manage. Other countries in more challenging situations are doing so. It’s just time that we started properly planning, rolled our sleeves up and prepared for the future.”

THIS IS IRELAND

WHAT IT SAID ABOUT OVER-65S

565,393 (11.7%)Proportion of over-65s in Ireland.

136,295 (28%)Number/proportion of over-65s who live alone.

49.4%Total dependency ratio (the sum of people outside working age, both old and young).