Caring for our elders - Elderly care regulation is a necessity

The Law Reform Commission has today published recommendations for the Health Information and Quality Authority (HIQA) to be given additional powers of regulation and inspection in order to ensure proper standards in the care of elderly and vulnerable people at home.

HIQA already monitors standards in private and public residential institutions.

Rather than having older people go into full-time residential care, the Government has been encouraging them to live at home as long as practically possible. Those that need some outside help from carers ought to be protected by the enforcement of proper standards.

A number of commercial companies have sprung up offering professional home help and homecare packages. But the Law Reform Commission warns that “there is an absence of regulatory structure for the delivery of professional care in the home”.

Little over a year ago, RTÉ’s Prime Time Investigates uncovered not only poor standards and sloppy practices but also shocking evidence of neglect and even abuse among care workers entrusted with looking after some 65,000 older people. Charities such as Age Action and the Home Care Association, which represents a number of home care companies, have been calling for regulation in this sector.

The issue is becoming all the more important as the age profile of our population rises. Family sizes have been going down and people are now living longer. The percentage of people over the age of 65 has increased in every census since 1961, and it is expected to double from the current 11.4% to 22.4% within the next 30 years.

The existing high level of emigration could also have a serious demographic impact. With more people expected to live into their late eighties, they will inevitably need some level of assistance in their later years at least. The age profile of the population could turn into a social time bomb if the issue is not addressed properly.

The Law Reform Commission’s recommendations should therefore be warmly welcomed. The proposed legislation would bring all health carers — whether employed by the HSE, nursing homes, or simply privately employed— under the watch of HIQA. This should apply to anyone — other than the family at home — providing such care for people whether because of age, chronic illness, disability or rehabilitation following an accident.

We are already experiencing the catastrophic consequences of light-touch regulation in the economy, and, as a society, we also now know the horrors that developed as a result of the lack of proper regulations in our orphanages and industrial schools over decades. It would be an outrageous and damning indictment of our system of government — and, indeed, of ourselves as a people for tolerating it — if we go on to make similar mistakes with the elderly.