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YESTERDAY SAW THE publication of a large scale study focusing on the lived experiences of older people in Ireland’s nursing homes.
It found overwhelmingly that Ireland’s older generation wants to be more involved in the decision-making around where and how they spend their final years. The options for most, however, are limited according to those who work with, care for and represent them – and money is one of the key barriers.
Many will opt into the HSE’s Fair Deal scheme, which requires the person to hand over 80% of their income to cover a nursing home placement for the rest of their lives.
Sean Moynihan, CEO of Alone – an organisation which supports older people who remain in their own homes – commented that “in no other part of the healthcare system would a person have to contribute that much”.
You’re giving up a percentage of your housing and your pension income. You’ve paid tax, you’ve lived this long and now that you need support you’re going to have to pay for it. Some people see a pension as a social welfare payment, but if you are to get the full contributory pension of €232 per week you have to have 40 years of stamps. We have to ask ourselves: ‘What will we want for our parents? What will we want in place for ourselves?’
There has been discussion about cutting the contribution to 70% of the person’s income and while Moynihan said this would certainly be welcome, it would not make a substantial difference to residents’ finances.
“It would just give them more access to comfort money so they can buy a present for the grandchildren or so they have enough money to buy a paper, it would just allow them to do things for a bit of self-dignity.”
Moynihan said that for many older people, the option of remaining in their own homes is just not there as the basic supports are not available for them. He said the government needs to look not just at improving the nursing home experience, but at facilitating people who could live happily in their own homes with just a little help.
His organisation is also promoting the concept of ‘housing with supports’, which would involve specialised individual units supported by care staff for older people who have greater needs.
Nursing home fees
In 2012, the HSE commissioned a review of the Fair Deal scheme which was published two years ago. Since then it has been considering the various options outlined in this review and stakeholders are eagerly awaiting reforms.
The HSE told TheJournal.ie that the waiting time for the scheme is currently no greater than four weeks and this is representative of all counties. Though this has fallen significantly in recent years, the same issues remain with waiting times.
Age Action head of advocacy and communications Justin Moran said: “While people are waiting they could be in an acute hospital in which case there is a cost to the exchequer – the bed can’t be freed up because the support isn’t there. People could be at home and family could be required to get home help or family members may need to take time off work.
“That’s during the intervening period when they are trying to find a home that has a vacancy and also that they can afford. Some families are priced out of nursing homes because of additional charges.
“We have social workers who work with older people telling us, in one case a family was looking for a home in south Dublin or Wicklow and with additional charges of €85 a week they simply can’t afford it. Another client went on the public nursing home bed – and they’re quite rare – because again they can’t afford the charges,” he said.
There is a perception that once you go into a nursing home and you’ve made your contribution then you’re taken care of, but that only covers bed and board.
The most common services nursing homes charge for are social activities.
“That’s not necessarily inappropriate, but there can be very little transparency in the charges. So we had a case earlier in the year where it was €100 for social charges and that increased to €200 and it wasn’t clear why.
“We have heard examples of people charged for incontinence pads or for chiropody visits. One in particular that we’d be concerned and frustrated about is people with medical cards being charged for doctor visits because the nursing home has had a GP come in. Now that’s illegal, but we have heard of that happening.”
Ireland’s ageing population
Speaking to TheJournal.ie, Tadhg Daly, CEO of Nursing Homes Ireland, said his organisation was also concerned about the current delay in the government’s review process.
“In tandem with that we have the issue around housing, around farming assets, resident contributions. What I’m concerned about is dealing with those issues in isolation as it does a disservice to the scheme. You need to look at it in the round. Any changes in terms of amending or adjusting should be done as a totality, as a package.”
Any reform package, Daly said, needs to focus on the issue of funding to ensure there is “an appropriate number of locations and types of care facilities” into the future.
“We have an ageing population, that’s no surprise to anyone. Sometimes it’s portrayed as a tsunami or a ticking timebomb and that’s unhelpful. We should celebrate the fact that people are living longer, but by the same token, because of that we need to put structures in place. It’s not just about beds in buildings, it’s about staff, about training, about workforce.
“The age profile now is 85 plus, dependency is at maximum. People are coming to nursing homes later and that has implications for staff numbers and the cost of operation.”
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A tragic story that I remember well. Heartache for the families to hear that had safety procedure been adhered to and more up to date equipment used, then loss of lives could have been prevented.
While there is no fine or penalty appropriate enough, the fines imposed are now having to be paid by a government funded body, so the council will have to tighten up their expenditure for a few years to cover that. So who is really being penalised here…??? How about pointing the finger at specific individuals who’s job it was to make sure the rules were adhered to. Why are these people being protected by the umbrella of basic politics again. Utterly crazy
Accountability within the establishment! I’m not putting money on that one.
In the public service the reason nobody is responsible for anything is because unions will use the victimisation card anytime an individual is asked to be held to account with the threat of strike, everyone is responsible,therefore nobody is liable,it stifles transparency and accountability and should not be tolerated in a democratic country.
‘Call Vetting’ Is the real emergency in the Irish Fire Services.
There is a saying that ‘timing is everything’ and nowhere is this truer than when it comes to the response of the emergency services to a 999 call. And few people understand the importance of time better than the men and women of the fire services who know all too well that when emergencies happen, and lives and safety are on the line, then minutes, and seconds count.
Imagine then the concern and frustration of fire and emergency service personnel throughout the country when they know that increasingly emergency 999 calls are subject to ‘Call Vetting’ by Chief Fire Officers who decide if an emergency call warrants the turn out of the fire service or not – and that these ‘Call Vetting’ decisions are being made in the interests of cost savings.
‘Call Vetting’ in its simplest is where a broader spectrum of calls are seeing a delayed response or no response at all from the Fire Service – it is a means of implementing tighter financial control on the provision of a vital public service.
Fire fighters as highly trained professionals regularly ask themselves – did we respond adequately to that emergency ?, could we have done more or better?, did we do everything possible in responding to the 999 emergency? It is part of our professional training to do so.
However, increasingly the concern of fire-fighters is that ‘Call Vetting’ as dictated to by the need to save money, is resulting in a delayed or indeed no response at all from the fire services, and that the public and communities throughout the country can no longer rely on the fire services to respond to emergencies.
We know that in certain regions of the country, Fire Control 999/112 control rooms on the instructions of Chief Fire Officers are requesting Gardai or HSE Ambulance service to check out incidents to see if Fire Service is required before the Fire Engines are mobilised. In effect this is a post code lottery that decides a response from the Fire Service!!
IFESA identified the use of ‘Call Vetting’ by Fire Officers and its negative impact on response times over a year ago. The National Ambulance Service denied that the practice was in place but last month it was reported that the National Ambulance Service (NAS) and the National Directorate for Fire and Emergency Management were in talks to try to reach agreement to allow the ambulance service request fire fighter assistance without being billed.
This report confirms the evidence that IFESA had compiled on the growing reliance and a more rigid interpretation of ‘Call Vetting’ of emergency 999 calls as a cost saving measure. Sadly and with reluctance IFESA have had to warn that the use of ‘Call Vetting’ is a disaster waiting to happen.
It is also blatantly obvious that using ‘Call Vetting’ as a crude mechanism of implementing more cutbacks in the Fire & Rescue service is a ‘false economy’ that makes short term savings at the expense of much bigger long term costs for the HSE and other agencies in the long run.
All the evidence (and indeed common sense ) shows that early intervention by fire and emergency ambulance services in certain medical emergencies cuts down on long term costs to the HSE and other services.
The public’s right to a full fire service is further threatened by the policy of inter-agency billing between the Gardaí, HSE and the fire and ambulance service, that is where the fire service charge the Gardai and HSE for a turn out at emergencies. This is a further pressure from management to justify why the fire service has been called to assist the public.
It is IFESA’s strong view that there should be No inter agency billing of emergency services.
It is time for the public and local public representatives to ‘Wake Up’ to the practice of ‘Call Vetting’ and the threat that it poses to the public and property, through the non-attendance of the fire services at emergency situations for cost cutting reasons.
For the public access to 999 emergency responses is a ‘safety net’ that provides protection and peace of mind. ‘Call Vetting’ removes that safety net and is increasing the risks to the public throughout the country.
A number if things amaze me about this case:
Why was the case taken against the Council as a corporate body only and not jointly with the people who had a duty of care to the Firemen?
Six years is a long time for the case to proceed? Why did it take so long?
The fine is approx 10% of what they could have been fined per charge? They were found guilty on three charges so the total fine could have been €9m. In the case of Nolan Transport, where two people died as the result of an accident, the company was fined €1m. So why the difference? Yes the cases are different but ultimately two died in each incident.
The Council initially pleaded not guilty to the four charges. The trial started and the Firemen’s families and colleagues had to relive the awful tragedy. On day four after some negotiations, they changed their plea to one of guilty but just for three charges. Why was the fourth charge dropped? Usually in a trial where the charged party forces a trial and later changes their plea, the trial judge usually “punishes” them for this; but not in this case. Why?
No Marty,At the time of the investigation a number of people had been arrested in connection with the deaths, including senior officials within the Wicklow fire service and the county manager Mr. Sheehy who is the ‘head’ of the fire service.The Chief Fire officer in charge at the time has retired since and of some officials have been promoted I believe.
Its incredible that fire services are run by county councils. A full review is required to nationalise this.
Another complete failure of public services with no accountability. Hogans reforms are completely wrong. Town councils should be left reporting to 4 or 5 regional councils.
The amount of the fine was irrelevant. The fact people weren’t held accountable was wrong.
A terrible tragedy for these men and their families.
The people in charge when this was allowed to happen. Have any of them quit their positions.
It seems incredible that emergency services would send out a scout to the scene of a fire/accident to make a further assessment of emergency personnel requirements to deal with the situation before actually sending help. We are told of the “Golden hour” for accident victims and how outcomes are affected by rapid response so obviously this time frame is not relevant in Ireland. I shudder to think I could be standing at my bedroom window while my house is on fire, waiting to be rescued and I notice someone watching me , using their mobile phone to advise how many should come……send them all..it’s an emergency , a fire doubles in size every minute.In relation to the two fire fighters who lost their lives, my heartfelt condolences to their families and colleagues in the fire services and shame on those in Wicklow Co. Council for their failures in policy which contributed to these deaths, financial considerations should never come before safety especially when we call our “999″ crews out.
There seems to be no accountability when it comes to government bodies etc,In a previous life working as a operations manager I had a duty of care for all of my employees.
This included making sure that all employees had up to date training,safety wear and that equipment and vehicles used had DOE etc.
Now if an accident or incident occurred while an employee was driving a vehicle,Which was not road worthy I could be dealing with the RSA for non road worthy vehicle.
The HSA for not providing a safe place for my employees to carry out their work etc,And I would be up in court on various charges along with the company.
It seems to be that if you are a manager or officer in certain public bodies and fcuk up,You are not accountable to anyone unlike the private sector.
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