Elderly should pay share of care costs, report says


A report to Government will recommend that older people availing of long-term care make a substantial contribution towards the cost involved. Martin Wall reports.

One of the options outlined in the report is that equity be released on people's homes to pay their contribution towards care costs, The Irish Times has learned.

With the number of people aged over 65 set to double between now and 2036, it warns of the huge increasing burden on the State.

The inter-departmental report, which is due to go before the Cabinet in January, forecasts that total spending, both public and private, on residential care for those aged 65 and over will increase from €900 million this year to to €6.8 billion in 2051.

It says "a substantial level of co-payment will be central to a sustainable approach to financing long-term care" into the future. It suggests the State could ask people to contribute up to 80 per cent towards the cost of care.

The proposal is contained in a report from an inter-departmental committee chaired by the Department of the Taoiseach. It was established a year ago by the Tánaiste and Minister for Health, Mary Harney, and the Minister for Social and Family Affairs, Séamus Brennan, to identify policy options for a sustainable system of long-term care. It includes representatives of the Departments of the Taoiseach, Health, Social and Family Affairs and Finance.

The report notes that the value of housing stock owned by people aged 65 and over is estimated at between €70-€85 billion.

"Given that the average length of stay in residential care for people entering over 65 years is two years for men and three years for women, it is reasonable to conclude that there is considerable scope for people receiving care to fund their contribution from these assets without fully depleting the value of those assets," it says.

The report says the number of people aged over 65 here will rise from 463,000 presently to over 1.1 million in 2036. Over this period the number of people aged over 85 will triple, to over 155,000, while by 2056 the old-age dependency ratio will reach 59 per cent.

It proposes that the amount to be paid by the individual should be determined by a new standardised financial assessment which would take account of private earnings as well as "imputed income" from assets including their primary residence. Such a financial assessment "should be indifferent as to whether care is provided in a public or private facility", it suggests.

The inter-departmental group accepts it may be difficult for some people to meet the co-payment from housing assets and in particular from current income, and suggests an equity release mechanism would be needed. However, it warns that a number of significant policy, legal and design issues, including the role of the State in relation to products of this type offered by the private sector, should be explored before schemes of this nature could be introduced.

The report says the provision of services to meet the long-term care needs of older people will have "substantial financial costs" in the years ahead.

It proposes that a central principle of policy should be to support older people to remain in the community. It recommends that as an initial measure to allow further work on long-term programmes to take place, that the Government provides additional home-support packages in 2006 and 2007.

"These packages should comprise services such as public health nurse, daycare, occupational therapy, physiotherapy, homehelp services and respite care, whether drawn from the existing pool of services or any additional resources which might be put in place. If appropriate, they should also take account of requirements for specialist equipment or adaptions to the house and the availability of sheltered housing options."