The crisis in elderly homecare
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Why is Ireland’s ageing population creating pressure on home‑care services?
Now, Ireland's population is aging rapidly, with more than one million people expected to be over sixty five by twenty thirty. At the same time, there are concerns about the capacity of the home care system to allow older people to remain living independently. The government is developing a statutory home support scheme. Well, the National Women's Council has warned that the existing system is fragmented and under resourced. Joining me now is Dr. Suzanne Crow, intensive care consultant in CHI in Cromlin. Suzanne, good morning to you.
Good morning, David.
You've written about this issue in the past. Uh how close are we to a crisis in home care? Are we already in a crisis in home care?
Well we're in an interesting situation and I wouldn't like to use the word crisis because I think it does make people frightened.
What is the ‘critical bottleneck’ in home‑care packages and why aren’t carers available?
Um what we have is we have a really critical bottleneck. Um it's actually not to do with funding, interestingly. Uh the state has actually allocated a huge budget for home care. The main difficulty is is that many of the home care packages messages that people are assessed for actually are not staffed because there's no available carers in your in your local area. So you might actually be assessed in Dublin and get care quite quickly, but there is huge deserts of carers out in the west and the south west where people are waiting months for staffing and and that's cutting causing a big strain on families.
Yeah, so the National Women's Council is talking about a postcode lottery, so that sounds exactly uh to the point that you're you're making there. And a lot of a lot of older people want to stay in their homes, understandably. Uh what does that shortage mean for them?
Well, it means that they they struggle to stay at home and they're at risk of falls because of lack of care in the home and la lack of maybe support with taking medication safely. And as a result, lots of older people may end up in the acute hospital system and that causes problems because the longer you're in hospital as an older person, you become quite deconditioned. conditioned and it's difficult to actually go back home then.
How does the shortage of home‑care staff increase falls, hospital admissions and nursing‑home moves?
So unfortunately, not having care in the home on a kind of a fairly timely and sufficient basis means that carers can become really burnt out and older adults may actually be forced into a nursing home when that isn't quite what they needed.
Yeah, and um the other issue I suppose is continuity of care, which is really, really important as well, isn't it?
It is. And I mean that's one of the issues with um home care. It's it's often perceived as being it's it's quite l poorly paid, it's very gendered and it means that you get really transient care uh in the home and that's very unsettling. I mean, I don't think any of us would like to be cared by for by a different person each day, but it's particularly uh the case if you have somebody who's, you know, cognition is is is already in trouble. Uh one I mean one of the things, one of the reasons why out uh in in more rural regions it's a problem is not only is the work poorly paid, but it's also people don't get uh additional uh payment for travelling or for for driving different places. And so y that mean if you're spending thirty or forty minutes driving from one client to another and you're not getting paid for that.
you're not you're just not gonna be as as likely to take up that job.
Right.
Um
and obviously the demographics uh are slightly worrying in the in this uh situation because as a as a population we are getting older quite f quite fast.
Why is continuity of care difficult in home‑care and how does low pay affect caregiver turnover?
We are and and you know, this is a good thing. Well indeed a bad thing. Um and I suppose it's one of my one of the reasons why I'm interested in in home care is We have we have an increasing number of older people who are going to require home care, but we actually also have an increasing number of children and young people who require um home support as well, because we have children and young people who are living with really complex medical conditions, some of them dependent on technology, and they require home support.
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Chapters
6 chapters
1
Why is Ireland’s ageing population creating pressure on home‑care services?
0:00–0:46
2
What is the ‘critical bottleneck’ in home‑care packages and why aren’t carers available?
0:46–2:14
3
How does the shortage of home‑care staff increase falls, hospital admissions and nursing‑home moves?
2:14–3:47
4
Why is continuity of care difficult in home‑care and how does low pay affect caregiver turnover?
3:47–5:09
5
What role do gender and travel‑time subsidies play in the home‑care workforce crisis?
5:09–6:33
6
What would a fully‑functioning statutory home‑support scheme look like and how could it fix regional gaps?
6:33–7:50
Speakers
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