Mary Butler (Waterford, Fianna Fail) | Oireachtas source

Gabhaim buíochas leis an gCathaoirleach Gníomhach and I congratulate her on taking the Chair. I also thank Senator Bacik for the constructive way in which she always raises these particular issues as they are very close to all of our hearts. I have just spent the last hour on a webinar with Irish Rural Link and a significant part of the conversation was spent discussing care of the elderly, meals on wheels, day care centres and active retirement groups which are hoping to restart. This is, therefore, a very timely Commencement matter.

As we are all aware, community services such as day care and respite play an important role in enabling older people to continue living in their communities and maintain their social connections. However, the introduction of physical distancing, isolation and restricted contact with loved ones has changed the usual dynamic of social interaction.

The HSE is working closely with providers and community staff to identify where service is most required and has been undertaking risk assessments of local services. This is to ensure, insofar as possible, that day care and respite services can resume in the context of Covid-19, having regard for public health advice. Services will resume when it is safe and all infection prevention and control measures and the requirements of physical distancing can be maintained to protect service users and staff and prevent any further spread of the virus. Unfortunately, I am not in a position to give a definitive timeline. When I was appointed to this role on 1 July our aim was to open these services in September and that is what we were working towards. The risk assessments were being undertaken in every community healthcare organisation, CHO. I was very hopeful at the time that we would be able to open them, even at a restricted level. Unfortunately, as we all know, the virus knows no boundaries and with the escalation again in the figures from the end of September into October, it has not been possible to do so.

Some day centres may not be suitable for reopening due to the constraints of their physical environment. It will be necessary to continue or expand alternative service delivery models. Some of the issues identified by the HSE include the sharing of facilities with other groups or clients and transportation of clients to day care centres where family members cannot assist. This has proven to be hugely problematic where some day care centres use small minibuses to move perhaps ten or 12 service users. The availability of isolation areas should a client or a member of staff become unwell is also an issue that has been identified.

The HSE has established a focus group to ensure day care centres continue to be prioritised and to develop a plan to assist service providers in having a suite of options available for the provision of day care and supports. This plan will be developed in line with the current Covid-19 roadmap.

Additional or new home support packages are being put in place for the most vulnerable clients, with the focus on both the carers and the persons who attend the day care services. A model of day care in the home is being finalised. Focused on individuals with dementia especially, this model is being reviewed with a view to transferring it to regular day care centres. The model will continue to develop even when day care centres reopen and will be based on the needs assessment and benefits for client and carers.

At present, the HSE is only allocating respite provision to clients most at risk of carer breakdown or an inappropriate admission to hospital. As the Senator will be aware, the whole premise of the winter plan is to try to keep older people at home as much as possible and avoid having to transfer them to acute hospitals. We are very conscious of those who are most at risk of inappropriate admission and respite occurs in such circumstances.