Caít Keane (Fine Gael) | Oireachtas source

I welcome the motion put forward by Senator O'Donnell and compliment her on moving it. The discourse on older people and care of our elderly citizens is one of the most important discourses we can have, as is the management of our approach to the elderly, death, dying and bereavement, not only within our health services, but in society in general. This motion covers many of these areas and matters, not only for patients in the health system but for the whole system. Senator O'Donnell has encompassed many of the relevant areas in what one might say is a broad motion.

It has to be because people do not change because they are elderly or late in life.

Having a truly strategic approach to care of the elderly, not only those facing end of life, makes political and economic sense because death is something everybody will experience. We all have a vested interest in the subject. Some 27,000 people die in Ireland each year and up to 290,000 are newly bereaved. In anticipating and planning for the needs of the elderly, over-medicalisation is usually what we have to deal with in Ireland. When there was consultation in the Seanad, Nursing Homes Ireland had a good input and spoke about medicalisation. It has many facets, for example, preventing inappropriate emergency admissions, discharge from expensive care settings such as acute hospitals and providing care closer to home in line with the patient's preferences. It is easy to have over-medicalisation and the patient's preference sometimes do not come into it.

In 2011, there were 523,800 people or 11% of the population over the age of 65 years. By 2041, this percentage will have risen to 22%. It is vital, therefore, that we look at this issue in an all-encompassing manner. On my way here this morning I listened to a radio interview with a 98 year old woman who gave classes in knitting. Given the benefits the elderly bring to society and will bring in the future, we do not use them. Everybody has so much to offer, which is another facet at which we should be looking.

I note the contribution made by the voluntary and community sector. When representatives of Nursing Homes Ireland were here, they spoke about nurse training and how nurses over-medicalised in treating the elderly. As we all know, gerontology is distinct from geriatrics, the most universally acknowledged branch of medicine that deals with the diagnosis and treatment of disease, but I took to heart Nursing Homes Ireland's statement that nurses should receive more training in the field of gerontology and what the people wanted. In its submission it stated nurse training was lacking in assessment and care planning. This was through no fault of the nurses but the training provided. Nurses are ill-equipped to assess a person's psycho-social needs and include his or her personal preferences in care planning. Personal preferences are so important as one size does not fit all, be it in what the person wants in making a will, giving power of attorney to someone while he or she still can, all of the financial and legal matters that have to be dealt with and everything else that worries an older person. In that regard, he or she should have the facility to get advice on what he or she should be doing.

The range of issues which impact on bereavement is diverse, ranging from palliative care, counselling, social welfare payments following death to taxation on inheritance, the legal rules around capacity, public awareness and bereavement training. I acknowledge that 8,751 episodes of bereavement support were provided by the Department's bereavement support services in 2013. The Minister of State, Deputy Kathleen Lynch, is doing a lot in the Department to acknowledge the person-centred approach recommended, which is obvious in the various changes made in what she termed "other supports" provided and the linkages in the provision of advice on social protection and support from organisations such as the citizens information centres. I mentioned the voluntary sector, but there is also the Irish Hospice Foundation and the work the Minister of State is doing with it.