Madam, - Your Editorial (Dec 4th) regarding impending changes to the nursing home charges makes the same omission as much of the media coverage over the last number of years by focusing solely on the elderly when in fact there are many thousands of disabled adults of all ages who are currently paying these charges.
The decision, by the Minister, Mary Harney, to include the disabled in the Health (Charges for In-Patient Services) Regulations Bill 2005, was ill-considered at best and simply malicious and cruel at worst. Disabled adults living in residential settings, who are simply seeking to live as independently as possible, will over the course of their lifetimes pay any times over the amounts that the elderly will have to pay.
Yet they have been completely sidelined in the debate on this issue.
Perhaps it is because we all expect to be elderly one day while we are not similarly committed to issues affecting the disabled.
One of the most stressful aspects for parents of someone with a disability is the ever-present thought of what will happen when you're gone. People rightly have an expectation that when they're gone their community will care for their offspring and the State, which is the community writ large and the mechanism for expressing that care, will do what needs to be done.
Brian Cowen's first budget promised much to the disabled and seemed a positive sign that the issue of treating people with disabilities fairly, and supporting those organisations that work in the area, was now to be completely part of the mainstream of Irish political life. Sadly all that effort has been undermined by the Minister for Health's mean clawback.
I would ask that in seeking to make alterations to the nursing charge Bill, the Minister should take this opportunity to rectify her mistake, and treat those with disabilities as equals by excluding them from all such charges while under the age of 65. - Yours, etc,
DANIEL K SULLIVAN, Corbally, Limerick.
Madam, - Most of the debate regarding the proposed "Fair Deal on Residential Nursing Home Care" has focused on the issue of finances and inheritance tax but the Alzheimer Society of Ireland feels that wider consideration is also needed in addressing this complex issue.
Dementia is a serious health issue in Ireland affecting up to 50 per cent of those in nursing home care. It is a progressive, degenerative brain disease that impacts on people uniquely, creating distinct needs that change over time. Any proposed scheme for residential care must be dementia-proofed for it to work and be truly equitable.
Ongoing and dementia-specific assessment of the person, their condition and their care support network is essential in determining whether or not residential care is appropriate or necessary for the person at a given time.
Adequate levels of dementia-specific nursing homes - offering an appropriate environment, adequate levels of trained staff, and a person-centred philosophy of care - are critical for people with Alzheimer's/dementia but are not yet a reality.
The present system for accessing and paying for residential care is inequitable and unsatisfactory. Fundamental restructuring is vital.
Change is happening, but the policy, procedures and places necessary to achieve a fair deal for people with dementia are not in situ.
The principal structures and mechanisms of "Fair Deal"- eg, the HIQA care standards - are not all functioning yet; and much of the operational detail of the scheme is still unknown, making it difficult to assess its impact for those living with this devastating condition.
Addressing the needs and protecting the rights, entitlements and dignity of vulnerable people - particularly those with dementia and their carers - must be central to any restructuring activity. The Alzheimer Society is encouraged by the Government's decision to delay progress of the "Fair Deal" legislation and their commitment to consultation. Our most vulnerable must be heard, understood and responded to if we are to fulfil any promise of a fair deal for all. - Yours, etc,
Dr NIALL TIERNEY, Chairman, The Alzheimer Society of Ireland, 43 Northumberland Avenue, Dún Laoghaire.