Issues

Together with thousands of older people around the country Older & Bolder campaigned for the right to age well at home to be made a reality and resisted the cuts to home help and home care packages. Activists used this campaign leaflet (PDF) and the points outlined below to frame their interaction with politicians.

See us as active managers of our own health

Older & Bolder rejects images of older people as passive consumers of health care. We know that most older people take proactive steps to maximise good mental and physical health, and strive to stay socially engaged. Many older people also play an active role in supporting others’ well-being through caring for their spouses, relatives and friends.

• The planning and delivery of supports and services must recognise and support the active role older people play in maximising their own well-being and independence within periods of good and poor health.

Make Community Care effective

Government policy and planning recognises the need to move towards a primary health care model where health services (GP, Local Health Nurse, Physiotherapist, Chiropodist etc) link-up effectively at a local level and where community and hospital services work together efficiently. However, in most villages and towns in Ireland this is not a reality.

• Those of us with multiple chronic conditions should be supported to manage our own health locally. Diagnosis and management of conditions such as dementia, stroke, falls, incontinence, bone health and immobility should be available in the community.  
• Community care services, though patchy, are vital and existing levels of service must be retained. These budgets are under threat; they must be protected against cuts and safeguarded from pressures in other parts of the health system.
• We need an audit of community care services for older people so that we can map the services that are available, identify the deficits and plan effectively for the future. The HSE’s existing HealthStat system should be developed to provide this much needed information

Recognise that health is more than medicine alone

While placing a strong value on good GP, primary care and hospital services, the older people we talk to share a broad understanding about what is needed to age well at home.

Accessible local transport, a secure income and involvement in vibrant community and voluntary groups are all identified as essential to good health and well-being at home.  

• To ensure ageing well at home is a real option we must protect the State Pension and related supports; retain opportunities to participate with community groups and further develop accessible local transport.

Clarify the right to supports in the home

Older people who need and receive community care (e.g. Home Help, respite, Home Care Packages, hospice home care services) value this support enormously. 

However, access is discretionary, unequal and problematic. The root of this issue is the lack of legislation to underpin access to these services.  Since access is discretionary, it is extremely difficult for individuals, families and carers to get information and reliable access at critical points e.g. discharge from hospital, onset of disability, diagnosis of long-term or life-limiting illness. 

• Older & Bolder stands with the Ombudsman who observes that “people do not know where they stand in terms of their entitlements and in terms of the HSE's obligations to provide services” . Older & Bolder calls for the development of long-promised legislation to establish a clear right to community care. This will finally provide clarity and security to individuals and families for whom this is currently causing unnecessary anxiety.
• Community care supports (e.g. Home Help, respite, Home Care Packages) should have a central, not peripheral, role in health service planning and delivery. Older & Bolder are calling on the Government to widen the discussion on plans for Universal Health Care beyond GP and hospital services alone to incorporate community care too.

Make Positive Ageing happen

Supporting people to age well at home requires the right kind of planning, information and supports. The discussion and thinking has been done around the National Positive Ageing Strategy and Older & Bolder has outlined to decision makers the 10 commitments that must be upheld in the strategy if Ireland is to be a better place to grow older.

• We are now looking to the Government to publish a comprehensive and effective strategy that addresses, with ambition, the key issues concerning growing older in Ireland.

Beyond the home

A majority of older people live at home and the focus of MAKE HOME WORK is on realising the right to age well at home.  However, there are circumstances where individuals need access to high quality care in other settings e.g. hospice, dementia specific and residential care. 

Whatever the setting, people want to live in a place that ‘feels like home’ and our system of health and community care is not complete until those needs are met. 

• Specifically we call on the Government to honour its commitment in the Programme for Government to review the Fair Deal system of financing nursing home care and to plan for an effective system of community and residential care for older people.