‘Our ageing population’

We need a system capable of supporting choice and adjusting to changing needs

Sir, – Simon Carswell’s timely article (“Our ageing population: Can the Irish system cater for healthcare complexities as we grow older?”, January 14th) on the challenges posed by an ageing society and economy provides useful context as we endure the “perfect storm” raging across many parts of the health and social care sector. Thankfully, the word “tsunami” was never used but there is a growing sense that there might be merit in having Met Éireann incorporate healthcare data into their evening forecasts on RTÉ such is the current level of linkage between meteorology and medicine.

A few points.

1) Your correspondent’s article pointed out that life expectancy in Ireland is now the highest in Europe. We must be doing something right somewhere.

2) The fact that circa 1,000 “beds” may be empty in nursing homes does not automatically mean that 1,000 older people currently in hospital should be in them or, indeed, want to be in them.

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3) Enterprising approaches to the management of resources and patients in hospitals in the southeast and elsewhere point to the potential to get things right, even in difficult circumstances.

4) The poor, sometimes awful, experiences of older people in acute hospitals clearly indicate a need for more rooms (with beds of course) in hospitals with all the necessary clinical and therapeutic supports. It also indicates a need for a wider spectrum of supports in the community.

The programme for government (2020) made a commitment to establish a Commission on Care and to introduce a regulated statutory scheme to support people to live in their own homes. The development of this statutory scheme must be informed by the views of older people and by decades of detailed policy development. It must be integrated with a reformed Nursing Home Support Scheme and allow older people a choice regarding how their support and care needs can be provided for. Some older people might prefer vouchers and to organise their own supports. Others might prefer to hire what they need through a trusted provider. Some will need support in organising their homecare involving family, friends or health or social care professionals in the process and some will need occasional or more prolonged care in a higher support environment; preferably in a high-support housing or nursing home organised on household lines. What is important is that any system developed is capable of supporting choice and adjusting to changing needs and that it does not become an opportunity for well-resourced organisations with strong compliance departments to offer a choiceless menu of the same thing provided by different brands.

Despite our sometimes low opinion of ourselves, Irish society has shown itself capable of developing and sustaining many significant organisations and movements which enrich social and cultural life and make an enormous contribution to the health and wellbeing of our people. Might it be too much to believe that it may yet be possible to develop a GAA for Care?

As for the Commission on Care, I look forward to an announcement from Met Éireann any day. – Yours, etc,

MERVYN TAYLOR,

Stillorgan,

Co Dublin.