Ageing population and inadequate services leading to healthcare timebomb, report warns

The number of people aged over 65 in Ireland will increase from 629,800 in 2016 to 1.6m by 2051
Ageing population and inadequate services leading to healthcare timebomb, report warns

An increasing ageing population will put added strain on the health service, the report has warned. File Picture: PA

Ireland is heading for a healthcare timebomb, with a new report saying the country has a rapidly ageing population at a time when services for the elderly are inadequate, under-resourced and in some cases, ill-suited.

The report Mental Health Services for Older People, was written by Dr Susan Finnerty, inspector of mental health services for the Mental Health Commission, and describes Covid-19 as a "perfect storm" in which elderly people already under-served by existing healthcare structures now face heightened risk from the disease.

The report highlights population projections showing that the number of people aged 65 years and over will increase from 629,800 in 2016 to almost 1.6 million by 2051, which in turn will lead to increased pressure on the health system. About 15% of adults aged 60 and above suffer from a mental illness, and physical illness is also more common.

According to the report, that illustrates the need for an integrated health system – something that is currently not in place.

"Despite the increasing elderly population, we are currently not providing a nationwide, comprehensive mental health service for older people," it said. "We have highly-trained and committed specialist clinicians, yet we have only 66% of the recommended number of specialist teams, which themselves are only staffed at an overall level of 54%.

"Day hospitals assist in maintaining people living at home while providing assessment and treatment, but there are only 0.26 day hospital places per 10,000 population over 65. 

Lack of community supports, such as respite care and home care packages, increase the probability of dependence on costly residential care.

"There are 1.2 dedicated acute mental health beds for older people per 100,000, compared with six per 100,000 in England and 9.7 in Northern Ireland."

It also said the delivery of in-patient mental health care to older people in general adult mental health units, rather than in dedicated units, "constitutes a risk to their safety and does not meet their therapeutic needs".

When it comes to the percentage of Community Mental Health Services for Older People teams, it is as low as 31% of recommended staffing levels in the Cork and Kerry area.

"In Ireland, there are not enough MHSOP teams to meet demand at the present," it said.

The report said the threat posed by Covid-19 meant the elderly must be provided with more single-room accommodation in residential and acute mental health care settings, with adequately staffed community teams and other supports provided to enable them to stay at home as long as possible.

 It calls for a single integrated system of needs assessment and service provision that aims to promote alignment and collaboration between the care sectors. Dr Finnerty said: "Older people’s mental health is an increasingly important area of public policy that does not get the attention it deserves. The levels of unmet mental health needs amongst older people are extremely high and improving current services is necessary."

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