A crisis looming for older people?

Presentation By Patricia Conboy, Director, Older & Bolder Friday, December 16, 2011 Buswells Hotel, Dublin

Welcome.  Thank you for coming.  My name is Patricia Conboy. I am the director of Older & Bolder, an alliance of 8 organisations in the age sector.  I am joined on the platform today by representatives of three of our member organisations : John Dunne, CEO, Carers Association; Anne Dempsey, Head of Communications, Third Age – Senior Help Line and Maurice O’Connell, CEO, Alzheimer Society of Ireland.  The chairman of the alliance is Mr. Tom O’Higgins and he has asked me to give an apology for his unavoidable absence this morning. Colleagues from the alliance are  also in the audience.

Older & Bolder called this press conference today because we are concerned that there is a crisis looming for older people.  We want to be responsible and to shout ‘stop’ before damage is done and before older people who are vulnerable suffer unnecessarily.  I will speak to you first and then each of my colleagues will make a contribution.

We in Older & Bolder are alarmed at proposed cuts to public nursing homes and the threat to community care services.  Our question is “What will happen to older people if we cut both public nursing homes and community care services ?”  Where and how are older people to live as they age ?  Make no mistake about it.  The price for cuts of this kind will be paid by two groups of older people : those who are in residential care because they are frail and vulnerable; and those living in communities who are at risk of losing their independence without support. 

Let’s just dwell on this point about unnecessarily losing independence for a minute.  We are talking about older people who are living at home and who can stay there and retain independence if they receive support at a point of illness or disability.  If they don’t receive support this group of older people will move into situations of unnecessary dependence. At its crudest, this will cost our health system more.  At a human level, it is almost unspeakable because it cuts across the heartfelt desire of adults to retain independence and control of our own lives – whatever our age or the circumstances of our lives.

Both before and after the Budget last week, we received many messages of concern from older people.  Here is just one :

 “My home help comes every day for one hour. I am 96 years old.  If I was to lose this service, I would not be able to live alone”.

Older & Bolder has two messages this morning.  The first is that we must protect the community care services that we already have in place.  Community care services are home help services, home care packages, respite and day care services.  These services are fundamental to ensuring that we MAKE HOME WORK so that older people can age well at home.   Just 3 % of the older population receive home help services.    It is a scarce resource allocated to vulnerable people who need support to remain living at home. Just €211 million out of a total HSE budget of €13.46 billion was allocated to home help services in 2011.  This allocation should not be cut in 2012.

The HSE itself has acknowledged that cuts to services such as home help and home care packages have negative consequences for the health service. They increase demand on hospitals and long-stay care or Fair Deal beds; increase the number of delayed discharges; lead to longer waiting lists; impact on A&E waiting times; and decrease older people’s ability to remain at home.

Our second message is directed to Ministers Reilly and Lynch.  The warning that public nursing homes with fewer than 50 beds are at risk of closure should be withdrawn pending the presentation of a national plan for nursing home care in Ireland.  Older & Bolder believes that  the 2007 Prospectus report on nursing home beds should be published so that a planned approach can be taken to the distribution of nursing home beds, the desirable level of public/voluntary nursing home beds, as well as the provision of therapies and other services. 

As well as residential care, many public nursing homes provide respite, step-down and palliative care services – all of which support care in the home which is more cost effective than residential care. When it comes to the possible closure of public nursing homes, we want to know what is going to happen to high dependency older people who can’t get a suitable private nursing home bed ?  What is going to happen to high dependency older people in private nursing homes if those nursing homes are under-funded  ? 

What we are talking about here is the planning of a service for the most vulnerable 5% of our older population who are in need of residential care.  We are also talking about the planning  of community care services that – as Older & Bolder’s MAKE HOME WORK campaign advocates – give people the right to age well at home. We must protect the services that can catch older people at a point of vulnerability : a point when they may lose independence and fall over the cliff and into unnecessary dependence.  None of us want to be there.

We invite Ministers Reilly and Lynch to speak directly with older people and their representatives.  We don’t have to have a crisis.  What we can have instead is an open discussion about planning the care and support of the more vulnerable older people in our society.  The Programme for Government has promised a review of  long-term care of older people.  Let’s have a review that involves older people and older people’s advocates.