In January, over 600 patients were left on trolleys in emergency departments in hospitals across Ireland waiting for beds. Unfortunately this is not a new epidemic, and a number of factors have been cited as the cause of Ireland’s health crisis: Lack of nurses, a surge in flu cases, and underinvestment.
The elderly continue to take up a significant number of beds in hospitals due to a lack of appropriate nursing homes or home-care packages. In 2009, then-Health Minister Mary Harney, announced the introduction of the “Fair Deal”scheme. The program was set up to provide financial support to people in need of nursing home care. Under the program, the applicant would contribute 80% of their disposable income, 7.5% of the value of their assets every year for 3 years (which can be paid after death), and the State would subsidise the rest.
The scheme has not worked.
The charity group ALONE noted that under the Fair Deal scheme there has been a 200% increase in the number of older people waiting for nursing home places. According to a report by BDO, commissioned by Nursing Homes Ireland, bed capacity within the nursing home sector is no longer keeping up with the increasing demand for long-term residential care, and the gap between demand and supply is rapidly increasing.
There has been no new constructions in the nursing home sector for years, leaving every patient to “compete” for beds in the already existing ones. This allows nursing homes to charge patients extortionate amounts for the use of their facilities. In 2014, the average weekly cost for a privately-ran nursing home was €890. Meanwhile, the ones that are ran by the HSE were charging €1,249 on average per week.
To put it simply, there is no more room in nursing homes.
No one would suggest a ‘standing room only’ policy on an aeroplane, even on buses the standing room only policy has a limit.
Therefore, the patients who find themselves in need of emergency care which could be dealt with in a nursing home facility, ultimately go to the hospital because either those kinds of agencies are non-existent in a patient’s area, or they’re full of patients already and usually include a long waiting list.
The elderly patients left in hospital are people who have worked, paid taxes, and are left to become a burden at the end of their lives. The hospital environment is not a safe one for the vulnerable, they are susceptible to further infections and could eventually die from the lack of appropriate care. According to the INMO, “The risk of cross infection is manifest and the stress for patients and staff who are at breaking point, is patently obvious.”
Elderly patients use acute hospital resources disproportionately. The introduction of intermediate care beds could reduce delays and patient cost dramatically. These beds could facilitate the elderly in rehabilitation before returning to their homes, or before entering a nursing care facility. They could also intervene before the health issues of the elderly patients deteriorate and therefore alleviate the pressure on the emergency departments.