Protecting the aged in nursing home care

No justification for charging people for services they are incapable of using

The more vulnerable you are, the more likely you are to be mistreated. This pattern of abuse crosses boundaries of age, disability and poverty and requires a fundamental change in public and official thinking. When incidents of exploitation are exposed, particularly within health-related settings, there is a dismayed “we didn’t know” reaction before normal services resume. It is not good enough.

The latest controversy, relating to charging residents for unused social services in private nursing homes, has been revealed by Age Action Ireland. It carries echoes of illegal charges imposed in public nursing homes from the last decade. Up to 5,000 people who are physically incapable of participating in a variety of add-on social activities are currently required to pay for them. Some nursing homes charge for incontinence pads, although this cost is covered by the HSE. Such charges are in addition to property-related and other deductions provided for under the so-called Fair Deal scheme. A government review of the Fair Deal scheme, two years ago, recommended a ban on additional charges. Nothing was done. As a consequence, long-term residential care has become unaffordable for some people.

Nursing Homes Ireland makes the point that their members are obliged by the HSE to provide social activities for residents, to ensure they remain active within a stimulating environment, and they have little option but to pass on the cost. That may be so, but there can be no justification for charging physically unwell individuals for services they are incapable of using.

The Fair Deal scheme and the gradual withdrawal by the State from the provision of public nursing home places have cut exchequer costs. A similar process may be under way involving home care packages. Keeping people in their homes has long been official policy as a cheaper, more acceptable alternative to residential care. But a review of the scheme is now under way. It would be perverse if vulnerable citizens were to be penalised for saving the State money by choosing, with limited assistance, to remain in their own homes.