Jennifer Horgan: The betrayal of Ireland’s elderly is happening in plain sight

Michael D Higgins’ poetry forces us to confront Ireland’s failures in caring for its elderly, both within families and at State level

 President Michael D Higgins with Sabina Higgins alongside the National Symphony Orchestra Ireland for ‘Against All Certainty: A Celebration of Michael D. Higgins’ at the National Concert Hall. Picture: Mark Stedman

Joni Mitchell had it right — you really don’t know what you got ‘til it’s gone. Or in this case until it’s almost gone.

The loss of Michael D Higgins as our poet president of Ireland is a considerable one, as is the loss of his wife, Sabina — Ireland’s philosophical first lady.

As president, Higgins was equally willing to criticise as to cheer. He was absolute in his devotion to Ireland; unwavering in his protection of its constitution; able to hold complexity too — precious these days when the online world longs to sort us all into neat little goodie and baddie piles, positioned on either the ‘right’ or ‘wrong’ side of history.

There are many examples of his ability to manage complexity, but I’m thinking particularly of the 2014 Water Services Bill, which he passed despite huge pressure and protestations from the public to slow it down.

Higgins had the option to consult with a deliberative body known as the Council of State which could have led to the bill being sent to the Supreme court, delaying it further, and pleasing an enraged public. Perhaps against his own personal convictions, he declared that there was nothing unconstitutional in the bill and so he signed it.

More recently, last week marked the release of his poetry album — a collection of ten poems read by Higgins with soundscapes created by Myles O’Reilly. They’re mesmeric and weighty; I’d recommend you have a listen. I’m particularly drawn to one poem called 'The Betrayal', originally published in 1990 by Salmon Press.

In it we meet Higgins’ father as an old man who is “seriously ill.” He is entering a facility of some kind, called ‘St Joseph’s,’ about which Higgins is scathing, writing “you had been moved/ to where those dying too slowly/were sent,/ a poorhouse, no longer known by that name.”

It’s an interesting comparison — a care facility and a poor house, those bleakly regarded institutions that closed in the 1920s. I visited one in Portumna last weekend, a place poet Noelle Lynskey describes as a “winter of flagstone.” Higgins is damning of himself in his poem too, admitting he felt relief to watch his aged, sick father being wheeled down a corridor, “confused, without a backward glance.”

He goes off to catch a lift to Galway, his load lightened, “away from the trouble” of his father’s “cantankerous old age.” He casts a ferocious eye on de Valera in particular. When his father smashes an attendant’s glasses, his son is asked to pay for them.

“It was 1964, just after optical benefit/ was rejected by de Valera for poorer classes/ in his Republic, who could not afford,/ as he did/ to travel to Zurich/ for their regular tests and their/rimless glasses.” Betrayal by family and betrayal by State. It is the story of Higgins’ past, but is it also the story of Ireland’s present?

Our personal betrayal of our elderly is obvious. Other commitments rarely allow us to care for elderly members of our own family. We don’t even have the conversation.

A giant swathe of our media is devoted to parenting children and although our record of protecting them is similarly stained, there is no comparable conversation around duties of care towards the elderly.

 Every week, radio slots and newspaper inches are given to help parents navigate schools, childcare and developmental milestones. Rarely do we address the reality that many people are juggling childcare and/or work alongside elderly care in the community. 

Where is the advice on that? Where is the national conversation about how best to cope?

More importantly, there is no moral consensus on our duty of care.

We don’t talk about it, question it even. To give just one example, is it morally acceptable for children to leave the country without consideration for their ageing parents? If there is only one adult child left in Ireland, or in the county, does it become their duty? How do we best negotiate these very real, deeply emotional challenges? I am not saying I have clear answers, but I’d welcome the discussion. What about a childless elderly person? Do adult nieces and nephews have a similar duty of care? When we have children, is part of the deal that they care for us in our old age? Should we prepare them for it?

It seems that we allow a moral looseness around the elderly. A ‘different strokes’ kind of attitude. It seems, dare I say it, that in some cases our children’s grandparents are viewed as essential childminders when fit and healthy, but not necessarily worthy of care themselves

Personal betrayal — similar to Michael D Higgins, heading off to Galway, leaving his father behind.

Then there is the institutional betrayal of our elderly — at State level.

Earlier this week we heard that there are huge numbers of elderly people going undiagnosed for serious health concerns. Following the release of a Tilda [The Irish Longitudinal Study on Ageing] report, the HSE admitted they are at “critical unmet need” levels.

We seem happy to treat old people at a distance, the report suggests, by simply not treating them enough. When we do treat them, we’re not giving them the wraparound care they need. One interesting finding is that falls have risen by 7% whilst the prescribing of medicines which increase the risk of falls also increased by 17%. The drugs are provided. The care is not.

Last month Age Action warned that the doubling of agency staff use for older people’s services by the HSE is a healthcare risk. Agency staff, sent into care settings or into elderly people’s homes, are potentially not trained adequately. Called on short notice, they cannot know the individual needs and preferences of the people in their care. We know from a report carried out by this paper that money paid to agencies in this sector almost doubled from €64.5m to €118.9m last year.

Then there is the standard of nursing homes to consider — never mind the cost of private options. None of us will soon forget the footage shot at two homes run by Emeis Ireland by RTÉ in June and the acute shortage of staff, training, and compassion recorded there.

I’m grateful to our president for raising this topic again through poetry because it’s an urgent one. Two-thirds of our public hospitals had unsafe levels of occupancy for the first half of 2025. Ireland has an ageing population, and with the number of older people in Ireland set to double over the next 25 years, it is only going to get more complicated.

Are we any better than the Ireland Higgins describes in his poem, set in the 1960s? Might we be worse?

 Whatever the answer, Higgins’ line strikes a chord: “In the dining room of St Joseph’s/the potatoes were left in the middle of the table, in a dish, toward which/you and many other Republicans/stretched feeble hands that shook.” I see them so clearly.

We will soon have a new president; time moves on, things change. It’s on us to notice what isn’t changing, at least not fast enough.