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The cost of keeping elderly people in their own homes and away from acute hospitals and long-term nursing home care is being gradually shifted to the individuals and families concerned. It represents another instance of the State disengaging from its traditional role as the primary carer of elderly citizens and it is taking place without adequate public debate.
Demand for home support services, or home help as it used to be known, has been growing rapidly as the population ages. Operated by the HSE, it is a free service designed to support people with personal care and living requirements within their own homes and communities. As with nursing homes, service providers may be public or private. And where HSE-assessed supports fall short – as they frequently do – additional hours can be purchased privately.
At present, about 6,000 people are waiting to be provided with home support services. In some regions, applicants may have to wait until November before their needs are considered because of budgetary constraints. Home services are currently being provided to 53,000 individuals and State funding rose by €30 million this year.
Despite that, Minister of State for Older People Jim Daly admitted the Government was "struggling" to meet demand and raised the prospect of charging for services in future, along the lines of the Fair Deal nursing home scheme. There, people contribute 80 per cent of income and 7.5 per cent of their assets a year.
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The home help scheme was designed to save the State money by keeping elderly people out of acute hospitals and nursing home care. It does that. But Government parsimony threatens its success. Health officials view elderly people as a soft touch, as previously happened in nursing homes.
The commitment to a statutory home support service by 2021 sounds impressive and could encourage standardised care. But details have not been provided concerning charges or individual liabilities. This cannot become another money-gouging exercise.