Elderly care cash crisis

Growing uncertainty surrounding the future of at least three community nursing homes in Clare and the lack of adequate funding for home help has prompted claims that elderly care in the county could become a “ticking time bomb”.
Green Party Councillor Brian Meaney has warned the lack of proper supports for the elderly is a potential “time bomb” over the coming years unless proper resources are put in place.
His claim coincides with a warning from Fianna Fáil TD, Timmy Dooley that long stay residential facilities in Raheen, Ennistymon and Kilrush are facing possible downgrading, or closure in a worst case scenario, under radical proposals being considered by Health Minister James Reilly.
At a HSE Forum West meeting in Galway on Tuesday, Councillor Meaney said he is getting an increasing number of representations in recent weeks from people who are struggling to look after their elderly father or mother in their own home.
Following the dramatic decrease in the number are in long-stay residential care, Councillor Meaney has proposed that a new public/community model of care be introduced to alleviate hardship and allow the elderly to be treated with dignity.
He also suggested the HSE spearhead a new public/community partnership involving organisations such as ClareCare, Caring for Carers and other bodies to provide a meitheal system, where volunteers in the community, with the help of State agencies, would help with the care of elderly people in their own homes.
He urged the HSE to act as the co-ordinator to provide a new model of service that would be cost effective and help keep more elderly people in their own homes and out of hospitals and long-stay residential facilities.
Supporting the comments, Councillor Tom McNamara expressed concern that, following new regulations introduced on October 4, Fair Deal applicants will only be covered to enter a private nursing home once their application is processed, which has resulted in a large number of elderly people staying in acute hospitals.
Previously, an elderly person who entered a nursing home could receive back pay when their Fair Deal application was approved.
Councillor McNamara said more funding should be allowed for home help and the day care model such as the Kilmaley Day Centre, which is in his own area. The centre currently operates four days a week and caters for over 100 people. It gets a HSE annual grant of €157,000 and has an application for €1.8m in funding to build 12 more units in its complex.
In addition to increasing the days of operation from four to seven, Councillor McNamara said it is hoped to provide four new units for high dependency clients.
In a briefing for Oireachtas members this week, Dr Reilly warned that up to 43 community nursing home facilities throughout the country faced the prospect of substantial cutbacks in funding, which would threaten their viability unless he achieved substantial savings in the health service elsewhere.
Deputy Dooley urged Clare’s five other Oireachtas members to make a clear statement opposing any downgrading or closure of these vital facilities.
Considering the amount of money raised by community groups in East, West and North Clare, Deputy Dooley said any closure of these facilities would be totally unacceptable.
Last weekend, the Government was criticised by
thousands of protestors following the closure of a community nursing home in Abbeyleix.
John Hehir from Kilrush Community Hospital said the implementation of a new Government directive concerning the Fair Deal scheme is causing hardship for Clare families.
ClareCare general manager, Fiacra Hensey said there has never been enough funding for home help in the county. However, he stressed the home help scheme delivered by ClareCare is a very efficient model and involves a voluntary element as assistants often do extra work caring for a client without pay.
If community beds are closed in Clare, he warned it would put huge pressure on existing services and wondered where would these elderly patients be accommodated.
“I am concerned about the future provision of elderly care in the county if major cuts are introduced. I regularly discuss these concerns with local HSE colleagues who are equally concerned. Decisions are not being made locally but are being directed from the Government.
“We have to accept the same level of funding is not there. If community beds have to be closed at least 20% of the savings will have to be invested in community services. It costs roughly the same amount of money to keep between five and seven people in the community compared with one in long term residential care,” he said.

Commenting on the new model proposed by Councillor Meaney, Mr Hensey said there has been great co-operation between the State and voluntary sector delivering the existing home help service.
A Mid-West HSE spokesman stated, “Many interesting ideas were advanced by members at the Regional Health Forum and we are always willing to discuss them in the context of available finance”.
Deputy Michael McNamara confirmed he would be opposed to any reduction of long-stay elderly care facilities in Clare. Stressing no final decision has been taken concerning this issue, he accused Deputy Dooley of “playing politics” with healthcare provision. “I will be doing my utmost to protect services in all community hospitals. Deputy Dooley is well aware of difficulties in the health service considering he was part of the Government, which presided over the country since 2002 until the General Election.”
Senator Tony Mulcahy said he would be opposed to any reductions in long stay residential facilities unless appropriate alternative facilities are provided in the local community.
He acknowledged the most cost effective way of providing long-stay care is to support people in their own homes with proper home care packages but also admitted that some people with high dependency needs have to be cared for in a residential facility.
Deputy Pat Breen acknowledged that Minister Reilly outlined his concerns for the health services going forward, but noted no individual hospitals were named and no decisions have been made.