Widespread confusion over care for the elderly


Questions on care for the elederly

Q. Who is entitled to a public nursing home bed?

A. In theory, all older people are entitled to public beds where the only contribution required of most residents is that they hand over their pension.

In practice, however, there are not enough beds available to meet demand and there are no uniform rules on who may secure a place.

Q. What do health authorities assess when judging a person's eligibility for a public bed?

A. Assessment procedures, based solely on a person's pension, are so loose that a well-off person with a substantial amount of property can get a public bed before a needier individual.

In general, however, most older people secure public nursing homes or State-run long-stay places after an assessment by a GP or referral from an acute hospital.

Q. How does the subvention scheme for private beds operate?

A. The level of State subvention, which is means-tested, ranges from €114.30 a week to €190.50, nowhere near the full cost of nursing home care, say support groups.

There is no consistent or transparent policy among the health boards about means testing and the disposal of assets when it comes to paying for care in the private sector.

More than half of all nursing home residents receive a subvention payment. However, the arbitrary nature of how it is paid is illustrated by the contrasting proportion of people who receive the subsidy from health board to health board. A recently published survey found that 66 per cent of patients in the Western Health Board were in receipt of subvention, compared to 44 per cent in the Southern Health Board.

Q. Under what circumstances may subvention be refused?

A. A health board may refuse to pay any subvention if a person's assets, excluding the house, are greater than €25,395.76, or if the principal residence is valued at €95,230 or more and is not occupied by anyone else.

Q. What changes is the Government making to the subvention scheme?

A. The Minister with responsibility for older people, Mr Ivor Callely, said he agreed there was "total unfairness" in the application of the subvention scheme and says he is in the process of making changes to the system.

The Government is alarmed at the cost to the State of subvention which has soared from £15 million in 1994 to €115 million last year.

Q. The Government is making changes to the use of contract beds. How significant is this?

A. Contract beds are public beds in private nursing homes, paid for by the State. The Government suspects that many well-off people are being give these contracted beds and will cut back on new contract beds from the start of next month.