Plans, not platitudes; action, not inertia

I HEARD it reported recently that Ireland is now known as "Retireland" - a good name, it would seem, for a country in which many people from overseas are choosing to live out their old age. But, perhaps, equally appropriate is that population projections confirmed by the Central Statistics Office remind us that we are going to have an ageing population in the years ahead of us, with a diminishing workforce. In 1991 the number of people aged 65 and over numbered 400,000; in 2021 that number will exceed 600,000.

In recognition of this fact, the Minister for Social Welfare was recently quoted as recommending that we put in place mechanisms to plan for old age. Certainly, our, current healthy economic situation does mean that now is an appropriate time to improve pension planning for the future. But besides ensuring that the issue of pensions provision becomes firmly placed on the agenda for discussion during the current round of talks for a new national agreement, what else does the Government propose to do? Proinsias De Rossa has said, on more than one occasion, that there is a clear need for interdepartmental communication and cross departmental co operation. Planning for the care of the elderly would be a good place to start. Here is a pressing instance of how the Departments of Health, Environment, Welfare and Justice must get together in order to develop effective policy for the care and well being of our elderly population over the next 25 years.

According to a recent report from the Economic and Social Research Institute, the average income of the elderly in 1995 amounted to only £95 per week, inclusive of State pension and, pension from a previous employer - hardly sufficient to maintain the standard of living for which one had worked and towards" which one had contributed all one's working life; and definitely insufficient to finance the additional costs of old age.

It is this age of dependency which needs to be funded and which needs to be planned for, or we run the risk of creating a new marginalised group in this already polarised society of ours - the poor and institutionalised old. We are not far removed from the situation in the US where the absence of places and the cost of those, places that are available, make it impossible for more people to get professional nursing home care. And how far removed are we from the situation in Japan, one of the richest countries in the world, where elderly people are starving to death because they have insufficient means and are too ashamed to ask for help?

In saying this, I am reminded of the establishment of our own Reach Out campaign, now four years old, which was started after an elderly man was discovered to have been dead in his house for about four years before he was found.

What is needed is forethought, vision, a bit of creativity and a lot of collaboration. The recent formation of the Irish Senior Citizens' Parliament, which will act as a co ordinating group for about one hundred bodies representing elderly and retired people is, indeed, a welcome initiative in this regard. The parliament has set itself the task of establishing links with Government and other State agencies and of making representations "which may improve the quality of life for senior citizens."

It is no surprise that as people get older, they become less able to live independently and become more dependent on their children, on their families, friends and neighbours, and on the services that are offered by local authorities, health boards, hospitals, nursing homes and the State. It is no surprise, and yet we refuse to plan for this eventuality. The Irish Registered Nursing Homes Association, for example, has drawn attention to the woeful underfunding of nursing home care. This lack of statutory responsibility has meant that the burden of shouldering the increased costs of institutional care falls on those who can least afford it: these elderly members of our society who need such care to maintain something resembling quality in their lives.

It is in such ways that this State has devalued and shown disrespect for both the concept and the reality, of old age. This Government has a stated commitment to justice. But what we need to see now are plans, not platitudes; action, not inertia. In the constant rush of everyday life, our old people, with their slowness and their stillness and their tendency to remember and to muse, are a valuable asset. We need our old people as much, if not more, than - they need us. We exclude them to - our own peril. We must harness their experience of living to force us to stop and think and recognise what is important in life.

And for those who read this and believe me sentimental, think again. The most striking demographic change that has occurred in Ireland in the last 10-15 years has been the increase in the number of middle aged people. We will be the ones contributing to the greatly enlarged elderly population of 2021. With careful planning now, therefore, we can avoid consigning our future elderly people - and that means many of us - to lives of poverty and misery.

SO what can we do? Well, we could start by developing innovative ways through which our elderly people can be cared for among their own families and neighbours, rather than being shunted off to big nursing homes or hospitals. We could examine the feasibility of old people attending day centres but living at home; or availing of respite in a community based centre when they, or their families need a break. And we could look at models of short, medium and long term nursing care which, in offering a blend of home life and professional care, will not only support the old person who needs looking after in the familiar environment of family, friends and neighbours, but which will also support the family which is struggling to meet the demands of modern life while still keeping the clan intact.

These are not radical suggestions. Indeed, as models of care in the community, they were pioneered and put in place in Kilkenny city and county by Bishop Peter Birch over 25 years ago and I have seen similar models, inspired by the informal network of the family and local community efforts, in place in other rural parts of Ireland since then. But all of them, as in the case of Kilkenny, are totally inadequately resourced by the State.

In one case, a community based day/respite/nursing centre is almost totally reliant on the voluntary services of family, friends, and the religious community, and the only State help was a contribution made by FAS and a tiny grant from the health board. These community based services will not come into existence, nor will they stay in existence without adequate funding by the State. The State funding required is minute compared to the cost of funding virtually any of the available alternatives.

It is on foot of such suggestions, and those many others coming from the myriad of local community groups and voluntary organisations working with the aged, that I would hope that Government departments can start to coordinate their own activities in such a way as to make good planning and implementation of plans in this area possible. The very least I would expect from our individual public representatives is that they look to their own and lobby government to enable and resource the local communities they serve, develop this and other innovative models of care. Let us value our old people. Let us not allow the creation of a society in which the words of W.B. Yeats could ring true: "That is no country for old men..."