Home Care Policy Proposals from Home Instead

Over 50% of Home Instead clients of provided HSE funded home support services in Co. Waterford receive visits no longer than 30 minutes from their CAREGiver, compared to less than 2% in Dublin. Whilst the average HSE funded home support service delivered by Home Instead is 10 hours per week, this varies from 16 hours in South Dublin, 13 hours in Cork to less than 7 hours per week in Sligo and Mayo.

Such inequality in HSE funded home support for older people has significant consequences for individuals and their families. In 2023, the Alzheimer’s Society of Ireland published research on the experiences of people living with dementia in Ireland which starkly described the challenges people with dementia currently face accessing home care. In the research it stated that "Accessing home care was highlighted as a particular struggle, especially as respondents don’t receive the number of hours they need. This causes stress and frustration, leading many carers to seek out additional home care through private providers. Of the 236 people who are in receipt of home care, 63% have experienced a delay or a reduction in the delivery of home support hours or a home support package due to a shortage of home care workers. Some carers said that they are considering long-term care options due to a lack of services, even though their preference is to support the person with dementia living at home. The full document can be viewed on Alzheimer.ie.

Home Instead draws on our experience of delivering HSE funded and private home support in Ireland in our newly published position paper. Whilst the current inequities in HSE funded home support services are glaring, what is less understood are the decisions required to remedy this situation. If a fair deal scheme for home care is the answer, any Government progressing this will need to decide what home support includes, and how this is defined by budget, by scope of service or both.

Some of these questions may be answered by the newly constituted Commission on Care for Older Persons, which formally commences in early 2024. However, social care services are required by people of all ages, and it is critical that both the Department of Health and the Department of Children, Equality, Disability etc work in tandem on social care reform to deliver home care services suitable for all, rather than continue current practices of delivering different services to people, depending on whether you are under or over 65 years of age.