Nursing home care for elderly

Madam, - Dr Shaun O'Keeffe (Nov 11th) writes: "Older people are entitled to free in-patient care, including long-term care, subject…

Madam, - Dr Shaun O'Keeffe (Nov 11th) writes: "Older people are entitled to free in-patient care, including long-term care, subject only to a maximum maintenance charge equal to 80 per cent of their Old Age Pension".

Whilst this might be the general view the reality is that in some parts of the country there is no general public bed provision for the elderly. It is in effect a myth. For example in Limerick, where I work as a social worker in old-age psychiatry, the only public care provision for the elderly is in either an acute medical or psychiatric setting.

There is also a limited number of beds available for the elderly who do not have the means or the familial supports or have a history of vagrancy, for example, and are unable to afford private nursing home care. The forum which decides on whether or not you meet the criteria for eligibility for a long-term bed is known as the "Placement Panel". Needless to say, given the limited resources available, one's medical/psychiatric presentation or financial/social disposition needs to be very serious before any consideration is given to long-term public care. Your only other options are to be cared for at home by relatives or very expensive care in a privately run nursing home, albeit with the assistance of a means-tested State subvention.

In some regions the old health boards had contract beds. These were beds in private nursing homes reserved solely for public patients. There were also publicly run nursing homes, mainly located in the old Eastern Health Board region, but they are gradually being downgraded in the rush to privatisation. Therefore it is imperative that we debunk the myth of universal public bed provision for the aged in Ireland and focus instead on the morality of allowing market forces dictate the agenda of provision for our elderly. - Yours, etc,

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SEÁN WHELAN, Nenagh, Co Tipperary.