Helping older people stay at home longer

Alone report suggests a better way and changes to the Fair Deal scheme

‘Why are we forcing older people out of their homes?” That provocative question is raised by Alone, a charity that helps older people in need.

It claims that one-third of older people in long- term care in nursing homes are actually well enough to live at home – provided they receive the necessary financial support and services to enable them do so. The charity, in launching its “Home First” campaign, has claimed that too many older people move into nursing homes too soon. The result is unsatisfactory, to put it mildly.

This State now has a far higher proportion of its elderly population living in long-term nursing homes than the European average. And a large minority of those are there simply because of the inadequacy of the home care services and support that the State offers.

Most people – including the Government and political parties – favour the idea of older people living at home, staying within their community as they age, and doing so for as long as possible. But the reality, as Alone points out, is very much at odds with that overall policy preference. And the reasons why, it is suggested, include cuts in home help funding, in housing adaption grants, and in the number of home care packages. These negative developments have accelerated the move from care in the home to nursing care in recent years, but as yet have prompted little public debate.

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Alone, in now raising the issue, aims to lead that debate and hopes to reverse that trend, by ensuring the Government reassesses its policy priorities in what is an important area of health- care. While the programme for government, the HSE Service Plan and the National Positive Ageing Strategy all offer nominal support for the general idea of older people ageing at home, nevertheless the financial means to achieve that end have simply not been provided.

Clearly it is time to look at some less expensive but more effective ways of supporting older people at home. And one proposal that ALONE chief executive Seán Moynihan has made, which is worth considering, is to reassess the economics of the Fair Deal scheme – where those in long-term nursing care make a contribution to their care, with the State paying the balance.

He has suggested a modification to the scheme to allow money be drawn down, and used for purchasing supports and services at home as an alternative to nursing home care. Alone says that more older people could be supported to live in the community, but that most are not now being given this option. Given the high cost of long-term nursing home care, the economics of the provision of services and financial support of those elderly well enough to remain at home deserves far closer scrutiny than it has so far received.