The realisation that an elderly relative can no longer be cared for properly at home can be a difficult time for both the individual involved and their families. Choosing the right nursing home can feel overwhelming but there is help available for families making the important decision, writes Grainne McGuinness.
The Health Information and Quality Authority (HIQA) is the authority responsible for nursing homes in Ireland and all of them, whether public, voluntary or private, are registered and inspected by them. Their Older Persons Register on www.hiqa.ie lists all providers and you can search by county to find a home in your area. You can click through to get detailed information on any home you are interested in. In addition to contact details you can find out the patient numbers and read recent HIQA reports on the home.
The Competition and Consumer Protection Commission (CCPC) strongly advise you visit any nursing home you are considering. HIQA have a list of helpful questions to ask, including whether residents have a choice of what and when to eat every day. Depending on the resident’s mobility, it may be important to find out how free they are to come and go.
Paying the high cost for long-term nursing home care is a huge concern for families and it is an area the state has addressed with the Nursing Homes Support Scheme, commonly known as the ‘Fair Deal’ Scheme. Managed by the HSE, under this scheme the resident makes a contribution towards the cost of care and the State pays the balance. Residents contribute up to 80% of their assessable income and 7.5% of the value of any assets per annum. The first €36,000 of assets (€72,000 for a couple) are not counted. Where assets include land and/or residential property in the State, the 7.5% contribution based on those assets can be deferred. This means it is not paid during the resident’s lifetime but it instead collected from their estate.
A person’s principal residence will only be included in the financial assessment for the first three years in care, capping the total liability at 22.5%.
Where one partner remains at home while the other enters longterm care the cap on the home is halved, to 11.25%. If a person seeking care does not own assets, their contribution will be based solely on 80% of their income. Find out more about the Scheme on www.hse.ie or by calling 1850 24 1850.
Because the Fair Deal Scheme only covers essential care, there are a number of extra services that the nursing home may provide but which the resident will have to pay for themselves. Recently Age Action said they had received reports of residents struggling to manage rising bill costs and offered advice on how to deal with the issue.
Before a resident enters a nursing home a contract of care should be agreed between them, or a family member acting on their behalf, and the home. This must include details of the services to be provided and the fees to be paid. If a resident feels they are paying more than was agreed they should ask for an itemised bill.
Remember that eligibility for the Medical Card is not affected by the Fair Deal scheme. If a resident has one they should not be charged by the home for doctor’s services or incontinence wear. The Drugs Payment Scheme also applies and should cap charges for approved prescribed drugs and medicines at €144 per month. If you would like further advice you can contact Age Action at 01-4756989 or email email@example.com.
If you or your relative are not happy with the care or feel it doesn’t match what was agreed, there are avenues of complaint available. Care providers must provide information on how you can make a complaint. If you are not satisfied with the response, you can then contact HIQA. You can also contact the Office of the Ombudsman with complaints about both publicly-run and private nursing homes. However, you must first have made a complaint through the nursing homes complaints process before the Ombudsman will look at it.
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