IT CAN be very difficult for older people to get information on how to apply for the homecare packages introduced by Minister for Health Mary Harney in 2006 to assist older people live in their own homes, according to a report.
A review of the homecare package scheme by the National Economic and Social Forum says applicants often have to make a multitude of calls and be sent “from Billy to Jack” before they get information on whether they are entitled to help. For one person it took 18 telephone calls over 10 days to finally find the “right” person to talk to.
Furthermore the report, published today, finds that eligibility criteria for the scheme varies between different HSE areas, as do the amounts of funding which may be provided to successful applicants. It says the Dublin North Central area has a much higher proportion of homecare package funding per person over 65 years than other areas. Carlow/Kilkenny had lower than the national average proportions of home help hours and homecare package budgets per person over 65, while Dublin West had higher-than-average proportions of both.
Average amounts paid out a week under the packages varied from €71 to €400 in different regions. “This provides at best inconsistencies and at worst inequities in the amount of care which people can access through a home care package,” the report says.
Some €120 million was allocated to the scheme in 2008.
In addition there are different means tests and different medical assessments for the scheme in different areas. Sometimes there were double or even triple assessments of care needs.
The report says the reason for these inequalities and inconsistencies is that national guidelines on the how the scheme should operate were not put into action.
Concerns about lack of training and supervision, as well as a lack of Garda vetting of some people providing homecare services under the scheme, are raised in the report. It says this has potential to lead to elder abuse. It also says there are no set standards for the care being provided and little monitoring of outcomes.
A further complication is the fact that there are many organisations, including the HSE, private healthcare providers and voluntary home-help organisations, delivering homecare packages. “Instead, different provider groups appear to be defensive of their work practices and wary of each other.”
More than 100 submissions were made to the review group. Some pointed to the homecare support workers’ “lack of punctuality, irregular attendance and unwillingness to undertake some tasks” that were needed by the older person.
While many older people were positive about the packages, some also raised concerns about the lack of sufficient hours of care provided. Some said there was “the implied threat that if they complained about the insufficiency of hours that these would be further reduced”.
A homecare package can include nursing care, home help and/ or various therapies such as physiotherapy and occupational therapy. About 8,000 people were availing of them in December 2007.