Life for older people in care often 'fragmented' - report

The first of three reports from the commission on care for older people has found that their lived experience is often "fragmented" and "inconsistent".

The report examined the provision of health and social care services and supports for older people, including primary and community care, home support, supported living, residential care and dementia care.

It also examined the challenges of ageing with disabilities and the role of technology.

The report states that Ireland's population is living longer and the country's older population is expected to double over the next two decades.

The commission recommended that the narrative about care for older people needs to change from managing decline in favour of facilitating their ongoing enjoyment of life, allowing them to thrive and that their care should be seen in a more "positive light".

It stated that the future provision of care should help people to remain in their homes and amongst their families and communities for as long as possible.

While the report found that funding for home support has increased substantially in recent years, there are still several inconsistencies across the system.

Older people, focus groups and advocates in the sector reported that the jobs completed by carers do not always align with the actual needs of the people receiving care.

"Some of the older people who were in receipt of these packages described situations about the precise tasks being done for them were not necessarily the precise tasks that they wanted, and sometimes it might have been something small, like a bit of shopping or a bit of cleaning," explained Professor Alan Barrett who is chair of the commission.

The Government said that €1 billion will be spent on home support over the coming year.

"They [Commission] acknowledge the level of home support we're providing, but they want it more consistently provided around the country, and that's something we're working on," said Minister of State for Older People and Housing Kieran O'Donnell.

"When I look at home support, it's delivered both at public and private level, and some areas of the country there are literally waiting lists.

"My objective working with the HSE is to reduce the waiting times and provide that consistency of service," Minister O'Donnell added.

The report also found that the number of publicly funded care hours available is insufficient for many people and varies significantly across Ireland.

As a result, those who cannot afford to pay for additional care often experience unmet needs and other difficulties.

Discrimination identified in accessing services

Older adults also continue to face discrimination in accessing services because a narrative of ageism "continues to permeate the system".

"If you listen to the stories that people give about their experience of being in hospitals or care settings where they felt that their needs and their opinions and you know everything they were bringing were just not being valued or listened to in the way that they should be," Mr Barrett said.

In terms of long-term care, the current model was found to be not person-centred.

The report stated that a majority of older adults in nursing homes are there because of gaps in community supports rather than because institutional care is their preferred or most appropriate option.

The Government said that it is bringing forward an action plan under the new housing plan for the delivery of housing for older people across the public, private and rental sectors.

"We are looking at all the various services provided across all sectors to see how we can integrate it more and provide that level of service to allow older people to remain living in their homes in their own communities as long as they wish,'' said Minister O'Donnell.

While the commission acknowledged that there have been substantial improvements in dementia care over time, it stated that there needs to be a greater emphasis on reducing the incidence of dementia including the provision of new drug treatments that are being developed.

The Commission on Care for Older People was established by the Government in 2024 to examine how health and social care services and supports can best meet the needs of older people and develop a new framework for development.

The commission is supported by a reference group which includes members of the community and voluntary sector along with those with lived experience.

The commission said the recently published module 1 report provides the foundation for its next report, which will consider recommendations for the future care of older people in Ireland.

It will be published in the first half of 2027.