TCD International Conference on Home Care for Older People

Posted on: 13 March 2007

“There is currently no legislative framework for the regulation or inspection of home care for older people in Ireland. If regulations are not introduced soon, similar scandals and abuses which have occurred in the nursing home sector may arise in the home care for Ireland’s older people,” warned the Director of Trinity College’s Social Policy and Ageing Research Centre, Dr Virpi Timonen¹ at the TCD international conference on home care for older people on March 12th last.

“There is a disparity in the extent to which persons cared for in their own homes and persons cared for in nursing homes are protected by legislation, standards, monitoring and inspections. Home care for older people in Ireland needs to be taken seriously and prioritised by policy makers,” said Dr Timonen.

In the case of Ireland there are currently three sectors involved in the provision of home care – public, non-profit and private sectors. There is currently no register of care workers in this country, and minimum training requirements for home care workers are nowhere defined. Garda or other background checks are not mandatory. “There are no recommendations, let alone regulations, regarding staff to supervisor ratios. Collection of feedback from care users is up to individual provider organisations. The proposed nursing homes inspectorate does not seem to extend to home care. This is paradoxical in the face of the stated policy ambition to ensure that older persons can stay in their own home for as long as possible,” continued Dr Timonen.

“The media spotlight has been turned on nursing home care that has resulted in the Health Bill 2006 which is currently before the Dáil. It is imperative, however, to introduce legislation which will cover both institutional and home care,” continued Dr Timonen.

The older person’s own home, as opposed to an institution, is universally advocated as the preferred location for those with care needs. The TCD international conference, Home Care for Ageing Populations, International Comparisons of Domiciliary Care Policies for Older People, has been organised to look at other international models in relation to home care and the policies that underlie these different models. In Denmark for example, it is now prohibited to build any more nursing homes, home care is available free of charge for all older people, and 25 % of all persons aged 65 or older are in receipt of home care supports. “This is in contrast to the probably optimistic official estimate of 5 % in Ireland,” commented Dr Timonen. The conference heard presentations on the Danish, UK, German and Californian models. These international comparisons highlighted policies which research has shown have had adverse as well as beneficial consequences.

Presentations were given by an 88-year-old person in receipt of a range of home care services, the CEO of Our Lady’s Hospice, Mo Flynn and academics from the US, UK, Germany and Denmark, including Prof Hildegard Theobald, University of Vechta, Prof Andrew Schlarlach, University of California, Prof Caroline Glendinning, University of York and Dr Tine Rostgaard, Danish National Institute of Social.

1. The Social Policy and Ageing Research Centre (SPARC) which forms part of Trinity College’s School of Social Work and Social Policy was established in 2005 with the view to generating fresh, rigorous thinking on social policy as it relates to the ageing population in Ireland and internationally. The Centre draws on policy and practice in Ireland and abroad to generate insights into ways in which social policies can better serve older people.

Its director, Dr Virpi Timonen, is author of the Centre’s first report, No Place like Home, which was published last September, in which she focused on home care as its subject, interviewing 125 individuals involved in financing and delivery of home care for older people in the greater Dublin area.

TCD's dr timonen, prof gilligan, international speakers: prof theobald, prof glendinning, prof scharlach, dr rostgaard