John Halligan (Waterford, Independent) | Oireachtas source

Ireland currently has a ratio of six people to every older person. By 2045, that ratio will be three to one. To give just one example of life-changing conditions that affect the elderly, the number of dementia sufferers in Ireland is expected to almost triple to 140,000 in the next 25 years.

Instead of putting into practice current policy, which according to the public service reform plan, pledges to "enable people to age with confidence, security and dignity in their home and communities for as long as possible", the Government has hacked away at services for older people since the recession began, to the tune of hundreds of millions of euro. This includes cuts to staff in hospitals and health centres, cuts in medical cards and the abolition of the telephone allowance. The number of home help hours has been reduced from 11.9 million in 2009 to 10.3 million in 2015 and provision of this service remains largely based on geography and available resources. I have seen the result time and again in the cases being handled in my office and know that where a person lives is a huge deciding factor in successfully securing home help hours. There was a high profile case in Waterford some time ago of an elderly lady whose breakfast and lunch were delivered at the same time because of the distance to where she lived and the lack of available carers to come to help her out. How undignified is that?

Furthermore, spending on the housing adaptation grant, housing aid for older people and the mobility aids grant, all invaluable in helping elderly and disabled people to continue living at home, have almost halved in recent years. Behind these facts and figures are real people being deprived of their dignity. By the end of this year, Government figures provided to me by the Department estimate that the nursing home support scheme will support just under 24,000 people in public and private nursing homes. Elderly advocate groups, however, believe one third of older people living in nursing homes could live at home, with the right supports. This is what we should be doing, as Deputy Tom Fleming said in his opening statement.

At any given time it is estimated that at least 700 older people are occupying beds in hospitals while they wait to access a bed under this scheme. These patients, who are deemed "fit" for discharge, are often unhelpfully referred to as "bed blockers" in hospitals that are struggling to cope with huge backlogs. The price of a bed in an acute hospital is €850 per night. They would give anything to be able to sleep in their own beds but the supports are simply not there to allow them independently to do so.

Staff in nursing homes have told me that, after spending many weeks stuck mainly in a bed or chair in an acute hospital, elderly patients are often unable to walk by the time they get their places in nursing homes. At the root of this complete waste of public resources and unnecessary suffering by already frail elderly people is this Government's and the last Government's failure to plan for our aging population. Figures based on Department of Health records suggest that 35% of elderly people in long-term beds have "low to medium" support needs. It is the absence of proper supports in their community that is forcing many of these people into long-term nursing home care at an annual cost of €50,000 each to the State. It is estimated that nursing home care is three times more expensive than home help. Economically, the way we care for our elderly does not make sense.

Unless we change our approach and put in place statutory entitlement to home care for the elderly, as there is for nursing home support, the number of older people in nursing homes who could be supported to live at home will increase. Already, since 2003, there has been a 49% cent increase in the number of private nursing home beds. That is incredible. There is no doubt that if proper primary care supports were in place in the community, including home helps, home care packages, public health nurses, occupational therapists, day care centres and meals on wheels, many of these people would opt to return home. There is no question about that. The Government's approach is at variance with the stated policy of enabling people to "age with confidence, security and dignity in their home and communities for as long as possible". Economically, and to treat people with dignity, the policy needs to be dramatically changed over the next few years based on the statistics coming from the Government and the Health Service Executive.

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