Caring for older people: Figures show we must do much more

This society’s capacity to turn a blind eye to difficult, sometimes criminal situations is well documented. 

Another report into a strand of this shameful, culturally embedded neglect was detailed yesterday when the Interim Report of the Mother and Baby Homes Commission was released.

These reports, the last more chastening than the first, invariably lead to declarations that these abuses cannot recur.

Despite those heartfelt, presumably sincere reactions can we say the abuses documented, or variations of them in different settings, are part of our history rather than our present?

Probably not.

Can we say that some older people living alone and in need of moderate support today cannot be as abandoned as some of their peers who, 50 years ago, were incarcerated in mother-and-baby homes?

Certainly not.

The report published yesterday by the Health Research Board into how we care for older, possibly vulnerable people, shows we have a distance to go before we can say we have learnt and acted on, the grim lessons of our collaborative past.

That report also details an underfunded, sometimes dangerously unsupervised system of care for older people. That system is not fit for purpose today much less for the future anticipated by demographers.

In just 14 years time there will be nearly one million people over 65 in Ireland, almost a doubling — an increase of 85% — on last year’s figure. These are not new figures and 2031 is not too far away, but the report details how far we have to go before an effective and equitable funding system might be in place.

We seem, once again, to be sleep-walking towards an entirely predictable situation where tens of thousands of older people may not get the care and attention any decent society would be proud to provide. That this inevitability will hit this society at the very moment our well-documented pensions’ crisis is expected to peak adds to the real urgency around the issue.

The Fair Deal scheme can make nursing home care affordable for those with some assets but, as everyone either dies young or gets old, some way will have to be found to fund a universal scheme.

The report considered how four countries — Germany, the Netherlands, Sweden, and Scotland — deal with this issue. In the Netherlands and Germany a mandatory, long-term insurance scheme is in place but in a society where a minority refuses to pay for water that idea might be a harder sell than a rational person who can add might expect.

It seems inevitable that individuals or families will pay more, one way or another, for home care or residential care. This will represent a shift in responsibility from the State back to individuals or families which might not be an entirely bad thing, especially in a society that argues that families are its bedrock.

It is easy to to be critical of the weaknesses in the system and how very hard it seems to reform it but it is a thankless, difficult task in a society where delusion about services is so active. Because of that it must be hoped this project survives the next election whenever it may be.

However, it does seem a mandatory and universal pension scheme for all citizens, incorporating home or residential support for dependent older people, might be the better long-term answer.