Noel Mulvihill, the HSE’s National Director Services For Older Persons this week was interviewed by the Irish Time’s health supplement, Health Plus. In the interview he spoke about the key improvements brought about recently by the HSE including the Fair Deal Scheme, the introduction of an inspection regime by the Health Information and Quality Authority and the development of integrated services across Ireland.

He also spoke about the importance of lessening the need of residential care and expanding in turn home care services. He spoke about the need to ensure correct standards within home care and to make sure that access to the service is available in a consistent manner across the country.

Numerous international surveys have shown that the vast majority of people want to stay living independently in their own homes for as long as possible. Home care enables them to do this and it is generally recognised that staying in familiar surroundings in beneficial to healthy ageing.

There is of course in addition a strong economic reason to develop the home care sector in Ireland as it is much more cost efficient than long term residential care or stays in acute hospital beds.

Home Help

The recent publicity around cuts to disability services has brought to light some of the inefficiencies involved in delivering these services which in all probability exist in delivering similar services to other sectors such as children and the elderly.

The HSE delivers a lot of its care services through “not for profit” organisations which it funds partially or wholly with very significant amounts of money. It is vitally important that a proper supervision and cost analysis of these funds is carried out to ensure that the funds are efficiently spent and that the maximum percentage is funnelled towards the provision of frontline services rather than unnecessary administration and management services.

Presently in the disability sector over 200 organisations are providing services. This means an awful lot of doubled up administration costs that could otherwise be going directly to frontline services.

Some organisations have very top heavy organisational structures with several regional chiefs and their attendant bodies.

Where organisation providing care and support are getting state funding it is very often in the absence of detailed service provision agreements. The putting in place of these service agreements would be one way to get better value for money in conjunction with proper regular tendering between services providers and avoiding long term agreements. This would ensure competition between service providers.

The Minister is making headway with these type of issues but a lot more work needs to be done to ensure in these times of economic hardship that there is minimum disruption to frontline services.

Home Care

Alzheimer’s behaviour will often test the limits of your patience. The same question asked over and over again. Refusals, excuses, reluctance, testiness, anger, insults can often emerge when things are rushed and not timed just so. As adults, we’re used to making accomodations to other adults, letting someone in first on the elevator, opening a door when it looks like someone else is in a rush, etc. In other words, we’re always looking out for others, we get used to that, and expect it in return. But those with Alzheimer’s are returning to their own world, a world that centers around them. With kids, it was cute — but with an adult, well…that’s where the patience comes in. You’ll have to say the same phrase over and over a few times. You’ll have to adjust your statement until you find one that gets them to do what they need to do, like change for bed, take a shower, eat more meat, or maybe get up and move around. You’ll have to do things in slow motion, even though a hundred other things are pressing to be done around the house. No caregiver get’s this patience out of virtue, most just use patience to survive the day. A person with Alzheimer’s doesn’t mean to be so slow and un-abled, remind yourself it’s Alzheimer’s and remember they once were able to do it on their own.

It’s important as well that the caregiver gets respite care on a regular basis to ensure that they dont suffer burnout. With regular respite care you can make sure that you are always giving the level of care your oved one deserves.

Alzheimer’s Care