Reader ResponseI refer to the piece by Ali Bracken in the Health Supplement on June 7th entitled "Company brings care to elderly in comfort of their own homes" and take issue with the statement contained therein that the majority of people in nursing homes do not need full time care.
That statement is completely untrue and shows that the person making that comment does not understand the care needs of the highly dependent elderly. The residents of nursing homes are there because they require 24-hour supervision and care and for no other reason. Under the proposal by HISC it would cost €162,000 per annum to provide 24-hour basic care support based on its average hourly cost quoted. This excludes the cost of providing food for the carers, 24-hour heating bills, the purchase of specialized equipment and general household expenses. This is four times what it currently costs per annum to have a person cared for in a nursing home and would fail to address the complex needs of nursing home residents because of the lack of professional nursing staff.
The type of basic care service proposed to be offered by HISC, which incidentally is widely available already in Ireland, is suitable for the elderly in the very early stages of dependency where visits by carers can certainly improve the quality of life of the older person. The statistic quoted from the experience of HISC's franchiser in the US makes my point that the benefit of the service is at the low dependency level - the average hours of care per elderly client per week is 15 hours provided over five days. I am afraid that visits of three hours per day by a carer would be totally inadequate to meet the requirements of the vast majority of long stay residents of nursing homes who may be incontinent, be suffering from an advanced stage of dementia, may be prescribed a complex drug regime over a 12/24-hour cycle, be in need of PEG feeding, may have wounds that require constant dressing changes, may be on oxygen or inhalers or using catheters or may require the administration of subcutaneous fluid. The care provider also needs to be competent to recognize the onset of infections and mini strokes. These services require 24-care giving and also qualified nursing input. The proposal by HISC does not address any of these needs.
The federation is supportive of and has called for a comprehensive community care programme. While the services that HISC is proposing and that many other entities are already providing are a part of it, it goes far beyond that with the need for adequate community nursing, rehabilitation services such as physiotherapy, speech and occupational therapy, chiropody care and social activities. The critical component is funding. People who can afford to pay for nursing home care would have been able to avail of these services while still in the community because they could afford them, but those who cannot afford them have a poorer quality of life and are unable to fulfil their potential for independent living.
This issue needs to be addressed by Government without delay. We as a society owe this to our elderly population.
Yours,
Pat Durcan
Chairman - Federation of
Irish Nursing Homes
patdurcan@eircom.net
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