Thomas Pringle (Donegal, Independent) | Oireachtas source

A strange anomaly is occurring in funding for home help packages. Funding for home care packages for people with dementia fell by €11 million in the four years up to 2015 while nursing home care investment rose by €84 million. Simultaneously, we saw the number of home-help hours being significantly reduced. Furthermore, according to Age Action, in 2013, out of a total budget of €1.39 billion, 72% was spent on the nursing homes support scheme, which supports over 22,000 elderly people - approximately 4% of the population aged 65 and over - while only 14% of this was spent on home-help services with 9% spent on home care packages.

Age Action has noted an overall trend in the admissions policies of nursing homes, which have increased the number of low to medium-dependency people being admitted while lowering the number of high-dependency residents. This is placing the greater burden of dealing with high-dependency people on community and public facilities. We are always treated to nursing home providers' complaints about the cost of care in the community sector but this is mainly because it has higher-dependency patients. According to a report compiled by the Alzheimer Society of Ireland, Age Action and a number of other groups, more than half of older people could remain in their own homes instead going into long-term care if more home-support services were available. That same report also confirms that multiples of resources are being invested in long-term care instead of community-based care despite the fact that Government policy is supposedly to support people to remain at home. As it stands, Ireland places 35% more of its senior population in institutional care than the EU average. This is proof that the Government is pushing towards the privatisation model of care and allowing nursing homes to dominate the sector. I am happy to say that Donegal has the highest number of elderly people being cared for at home in the country. I think this is due to how well our community hospitals are connected with Letterkenny University Hospital and how elderly patients are transitioned out of community hospitals and prepared to go back home again. It is also due to the fact that families want to care for elderly parents, aunts and uncles at home for as long as possible. However, we are not making it any easier for them. There seems to be an attitude within the health service that because someone has dementia, he or she may not be as important as somebody with normal mental capacity. We see treatment delayed and GPs not responding to people with dementia. These families save the State hundreds of millions of euro every year by keeping their loved ones at home in the surroundings with which they are familiar, going all out to care for them and organising their entire lives around looking after their elderly loved ones. However, they do not get the support they deserve from the HSE and the health service. There should be a recognition that supporting people at home saves the State money in the long term.

In respect of people with intellectual disabilities, I know of one woman with an intellectual disability who lives in supported community housing and who has early-onset dementia at 47 years of age. The HSE is trying to move that person into a nursing home away from surroundings in which she has lived for over 20 years and a community in which she has been supported. The HSE wants to get her into the nursing homes support scheme and out of intellectual disabilities care because she has early-onset dementia. This will do nothing for her quality of life. This is the core of it. We must recognise that people with dementia are every bit as valuable as everybody else in their communities and that they and their families need to be supported to keep them in the settings in which they are most comfortable and with which they are most familiar, thus saving the State money. It is hard to believe that this Government, which has been so obsessed with saving peanuts in many cases over the years, does not see the value of keeping people at home and the savings to which this can give rise. Perhaps that has something to do with the privatised model of nursing home care we have in this country.

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