I welcome the Minister of State to the House.
European Year of Older People and Solidarity between Generations: Motion.
I move:
That Seanad Éireann commends the Government and the Minister for Health for the manner in which the activities organised to mark 1993: The Year of the Elderly and Solidarity between Generations contributed to the outstanding success of the Year in this country.
It gives me great pleasure to congratulate the Minister for Health and the various initiatives which have taken place during 1993 in the context of the European Year of Older People and Solidarity between Generations.
Designating 1993 as the European Year of Older People and Solidarity between Generations, the Council of Europe had the following objectives: (1) to help to implement the social dimension of the Internal Market and to bring to public notice the challenges resulting from the ageing of the population; (2) to promote and reflect the discussion on the types of change required in order to deal with current demographic developments; (3) to prepare the general public for the implementation of these changes; and (4) to make it easier for the elderly to identify with the process of community integration.
It is fitting that this motion to pay tribute to the Government is before the House on the day the Year is being would up in Brussels. The Minister for Health is there today. He can be proud of the work that was done given that the Government provided £4 million to implement the nursing homes Act. The Government also made £0.5 million available to the various projects that were organised and 5,000 events took place throughout Ireland. That gives an indication of the amount of work done.
I have long been a proponent of the value which can be obtained from the special events organised during a special year, such as this year, provided the Government, relevant Ministers, Departments and other agencies take an approach which is open-minded, enthusiastic and innovative. In 1981, the International Year of the Disabled, I was chairman of the North-Western Health Board, I took a positive stand to highlight the year when I drove a pony and trap from Donegal to Dublin. I attended a number of functions on the way and collected quite a lot of money.
It was a good pony.
It was very good. At the last minute when things went wrong, it was bought from under a gypsy's cart.
They know their business.
That year highlighted many problems. Initiatives mooted and debates and discussions helped to promote a process of change which occurred in subsequent years. The special year provided the framework and the opportunity to focus minds on the needs of people in that sector.
So it has been in 1993 when services where provided for older people. I am convinced that the year has provided an opportunity to identify initiatives, activities and projects to improve the quality of service and the care of the elderly generally. That has been case in the North-Western Health Board region where the chief executive officer established an advisory committee in July 1991 to identify areas and advise on how the quality and range of services for the elderly in the board's region could be improved. Work was undertaken on a number of initiatives, including All Ages Together, a project of education and work which aimed to facilitate the development of attitudes and of mutual respect and understanding between persons of all ages.
This was important because that was the way it used to be, but the supermarket syndrome crept in; every group was in separate boxes, like on supermarket shelves. There was tots, tiny tots, teenagers, over 25s, under 25s, over 50s, under 50s, senior citizens and, eventually, the geriatrics. This year helped to bring all those people together and create a great spirit of community activity among all ages.
A second project aimed to reduce the risk of exploitation of older persons, particularly in relation to their property, contracts, wills, etc. This project, through the involvement of senior Department of Social Welfare officers from the regional advisory committee in the north-west, received a huge impetus when the Minister for Social Welfare accepted the concept and in November in Sligo launched an advisory booklet for the elderly. This was important because we all know that many old people had been coaxed and cajoled, and very often gave up their property and then found themselves dependent on the health board or some other State body to look after them. This project created an awareness of how they could and should handle such situations.
Other work initiated included pilot work on personal care arrangements and befriending schemes. This was highly successful. It encouraged younger people and neighbours to visit elderly people. Perhaps in some cases older people did not want people calling on them, but when they kept calling, they broke down that barrier and eventually established a line of communication. That is important in this day and age with so many old people being attacked in their homes. It is great that they know there is someone they can call, and who calls on them regularly. This is creating a community effort to ensure they are safe.
Others events included exhibitions of equipment for older people and their careers, which took place in Sligo and Letterkenny, and a major international conference in Sligo on 12 and 13 May, entitled "Some Forgotten People" focused on the needs of the elderly in long stay hospitals. All these activities contributed significantly towards formulating debate and discussion and imparting information on the needs of the elderly in our community. That excellent conference made people think. I have no doubt that the work carried out there, and all the other events, will gain momentum and make things much better for the elderly as the years pass. In overall terms it is important that the opportunity provided by designating a special year is seized by the relevant and appropriate agencies as a chance to review and to innovate in the service areas.
I mentioned the nursing homes Act at the outset and there was some talk recently about nursing homes. Whether we like it, many elderly people are getting special care in those homes. They now know there is an Act in place which ensures that they cannot be put into a little back room and left unattended. Now the health board can examine these homes which must have reached certain standards. The nursing homes Act was very good and the fact that the Government made £4 million available to implement it was even better.
I wish to focus on a small country townland, two miles west of my home in north Sligo, which is a good example of how a concept developed in the EC corridors of power can impact positively on a local area. The health and day centre at Carrigans in north Sligo provides the usual range of services which one might get in any health or day centre in any health board area. The day centre service, which is organised by the North-Western Health Board and supported by an active local voluntary committee, was the national award winner in the inter-generational category.
This organisation took the initiative in 1993 and organised and assessed entrants in various categories. The award has given a morale boost to those who gave time voluntarily, like so many others in our society to provide for those with special needs, in this instance, their elderly neighbours. What was achieved will be copied by other health care centres throughout the country. The Government can look back with pride and joy on the work which has been done. It highlighted the need for young and old people to come together to care for the elderly and to make the winter years of their lives a happy time.
I second the motion.
I welcome the Minister to the House and I welcome the opportunity to speak this evening. Some of the matters mentioned by Senator Farrell are relevant and I pay tribute to voluntary committees who give their time to senior citizens.
There are areas where the State has a direct input in caring for senior citizens, and housing is one such area. I am disappointed with the progress made by this and the last Government in that regard. I have been a member of a local authority for 15 years and for five of those years a major housing programme was undertaken. Housing schemes were started in every town and village in County Longford and housing for the elderly was included in most of those schemes. Giving the elderly proper accommodation was a major step forward in caring for them. They were accommodated in towns and villages where facilities were available and where they felt secure. I ask the Minister and the Government to direct extra money to housing for the elderly. If the Government wants to make an impact in caring and support for the elderly, it should provide housing in villages and towns throughout the country.
In recent years senior citizens have been subjected to violent attacks. Members who canvassed during last year's general election will know that many doors were not opened at night. How many senior citizens stood behind their doors and asked in a shaky voice: "Who is there?" and when a door was opened, it was done with a shaky hand. This says a lot about the type of society which has developed here. There is no quick answer to this problem.
The Minister for Justice, Deputy Geoghegan-Quinn, was in the House this afternoon and I did not have the opportunity to speak on the Criminal Justice (Public Order) Bill. As far as I am concerned, there is little wanting in the laws of the land, but there is a lot wanting in public order and this or any other Government must face its responsibility in this regard. The people, particularly senior citizens, deserve to live without fear of attack. Order has broken down, although I understand why the Government, the Minister for Justice and the gardaí do not want to say this has happened. God fearing, hard working people who reared families and paid taxes are now prisoners of fear in their homes. That is how elderly people live in this country.
I will now refer to nursing homes. Changes have taken place and legislation in that area is welcome. As a Member of the other House, I spoke on the nursing home Bill. I believed the Government had not placed sufficient emphasis on nursing homes. The elderly have three options. The first is to take care of themselves with the help of family and friends. The carers' allowance which is supposed to help is a bottle of smoke. It does not serve its purpose, although it serves the purpose of politicians to talk about it. Some people still have not received this allowance and until it is the scheme will not be administered properly.
Second, elderly people may go into nursing homes. I believe health boards are now preparing to carry out investigations as to the means of patients in nursing homes. This will put another burden on senior citizens. Third, the eldfor erly may go into hospitals run by health boards. However, it is difficult to get into these hospitals. Often senior citizens are sent home, thus adding stress to the situation.
A committee or a section of a Department to deal with care for the elderly and to co-ordinate different Departments must be set-up because at present the elderly are getting the run around, being sent from the Department of Health to the Department of Social Welfare and the Department of Justice. A committee or departmental section should deal with the care of the elderly. Our party has moved a motion for a carer's charter to ensure appropriate assistance for dependent relatives and guarantee institutionalised care where families can no longer cope.
Demographic projections reveal that by the year 2006 the number of people over the age of 75 will have risen to 164,000 from the present level of 150,000. This increase poses a huge problem for policy makers and must be treated as an emergency. There is no point in bringing in schemes like the carer's allowance which is good in theory but does not work in practice.
This year's nursing home regulations were of little benefit to moderate and middle income families' many of whom are spending up to 50 per cent of their resources on nursing home care. There should be a broadening of eligibility conditions and a widening of the means test. That is an important area. Many institutions are understaffed and under-resourced. While those who run nursing homes are, in most cases, doing their best, it is a move in the right direction to have regulations and more responsibility for the health boards, backed by funding. While nursing homes must make a profit to survive, they provide good employment and so it is in the State's interest to make sure the homes receive proper support. They are providing a social service as well as taking the burden off the State which cannot provide the required beds and nursing care within its own institutions. The State must take the matter seriously and, instead of a more stringent means test, take the opposite approach.
Nursing homes take enormous pressure off families by caring for relatives who can no longer stay at home. In the past it was the sign of a more caring society that the elderly were put in nursing homes rather than being forgotten about in other institutions which we do not have to name here. With a little extra care, those who prefer to stay at home should be able to do so rather than being put in these institutions. It is up to the State to provide proper housing and facilities for our senior citizens who can look after themselves. More financial aid from the State should be spent on those in nursing homes. The situation of those living at home but requiring care must be examined.
I welcome the Minister to the House for the debate on this motion. I commend the Government and the Minister for Health on the manner in which the activities of the year of the elderly have been carried out. Last year the Council of Ministers of the European Communities designated 1993 as European Year of Older People — the culmination of the Community's programme for the elderly which was adopted as a result of the European social charter. The main purpose was to heighten society's awareness of older people as well as the challenges resulting from present and future demographic developments and the consequence of an ageing population for all EU policies. The year in Ireland was organised by a national co-ordinating committee established by the Minister for Health with representatives of the social partners, statutory and voluntary agencies caring for the elderly. This committee adopted a number of care themes for the year including the positive contributions of older people, past, present and future.
Life styles have changed to a great degree when one looks at how older people were looked after in the past. They were kept at home and those who became ill went into hospital. People were not as concerned to send older people to geriatric hospitals then as they are now. With life styles changing as they are, do people really want the elderly at home any more? They have their own lives to lead as well as their families to look after and people sometimes feel that looking after older people is a problem because of the time constraints involved. Elderly people living together with the young can be beneficial to both age groups. Young people can make the elderly feel young while old people, in turn, can tell the young what things were like in times gone by. That is an education in itself. Those are the areas we must examine with a view to putting moneys into helping the aged.
A sum of £400,000 was made available this year to the national co-ordinating committee to cover the operational costs of European Year of Older People. This included grants for a public awareness campaign featuring various events, projects and awards. As Senator Farrell said, over 5,000 events took place and the committee approved grants to 170 groups and organisations, most of which were voluntary. One must congratulate those voluntary groups for the help they give to the elderly.
The year stimulated many groups to examine the issues of ageing. Conferences were held on the following subjects: the implications for those providing services to the aged mentally handicapped population; the care of the elderly in long-stay hospitals and homes; and the need to expand dementia services. All these areas were examined, and rightly so, because of the changing situation. The conferences examined how best our general hospitals could respond to the needs of a growing elderly population. It is timely to do something about this issue because, since we are all getting older, we may be the beneficiaries at the end of the day.
Many older people, especially in rural areas, now live in isolation with no one to look after them. It is not much of a life to sit at a turf fire eating spuds and salt. They cannot all be put in psychiatric institutions, nursing homes or geriatric homes. Efforts should be made to care for them in the community. This should be the responsibility of carers, community psychiatric nurses, public health nurses and district nurses. Such people do tremendous work and have done so over the years. Although their salaries have improved, many carers are not as well paid as they should be. There was greater communication with older people in the past. The withdrawl of postmen from rural communities was detrimental because it removed the only contact many older people had with society. One has to feel extremely sorry for those who have been attacked and robbed. This is very unpleasant and probably drives many of them to an early grave.
Senator Belton mentioned housing. I am delighted with the increase in housing starts for the elderly. I congratulate the Minister, Deputy Stagg for his work in the provision of such housing. Long may it continue and may more houses be provided.
Society is changing. Fewer old people are being cared for in their own homes or in the homes of relatives than in previous years. Many of them, therefore, need institutional care. Many old people have stayed in psychiatric hospitals over the years but should never have been there. Where can mentally handicapped people go when they become old and difficult to look after. Moneys which have been provided, while greatly appreciated, are probably insufficient to care for such people in future years.
There has been a big increase in dependency on nursing homes. When the nursing homes Act was passed, I looked at the relevant figures. There are over 300 private nursing homes with a capacity for 5,500 beds. Whether one agrees or disagrees with people being taken out of hospitals, psychiatric homes or geriatric homes to be put into nursing homes, it sometimes seems like renting out elderly people so that others can make money. I am not fully in favour of the present position. There are 60 voluntary nursing homes with about 3,500 beds. Thus, there is a total of about 9,000 nursing home beds. There are 87 health board geriatric hospitals and welfare homes with a total of about 10,000 long stay beds. Almost half of the 19,000 or so long stay beds are provided by private and voluntary nursing homes. The number of private nursing homes is continually increasing. It increased from 262 in 1988 to 323 in 1991. The number of voluntary homes will probably remain static or reduce in years to come due to the decline of religious orders.
The elderly must be provided for and services should be available to help them, whether they are in institutions or homes. If they are in homes, extra occupational therapy should be provided for them. There has been a decline in such therapy in recent years and therapists have been withdrawn from psychiatric units. This area should be developed to give elderly people a feeling of worth, enable them to adapt to programmes or work which may be suitable for them and contribute to their happiness. Behavioural therapy is used to help people with specific problems. Many psychiatric nurses in the community are very well trained in this therapy and can help old people with problems. We should work as hard as possible to provide the correct help for people with problems.
Community psychiatric day centres are being provided in hostels because of the scaling down of psychiatric hospitals. I did not agree with this scaling down because I felt people who had been institutionalised for 30 or 40 years were being put into a community for which they were not prepared. This move helped many of them but did not benefit others. I welcome the community-based day centres and hostel facilities. Many people have attended them, accompanied by nursing staff. These services have worked extremely well and are an area in which the elderly have been better catered for than they were in the past. However, there could be major improvements in some areas. I welcome the motion and commend the Minister and the Government for their policy in relation to it.
Is the Government, by this motion, seeking congratulations or wishing to give the impression it deserves credit for its work for the elderly? I am aware of what has happened over the years in relation to this group in society. Senator Maloney referred to areas about which I am always concerned. There has been a large increase in the number of nursing homes. I am unhappy with the present trend towards private nursing home care. Unfortunately, many people are put into such homes. We should look at how other countries treat their elders. It is sad that nobody, irrespective of what part of society they are from, seems to take responsibility any more for caring for old people. No Government should seek recognition or compliments for improving services for the elderly. Nobody can say old people are better off now than they were 15 or 20 years ago. To put it bluntly, they are stashed in small rooms, some of which I have seen.
I understand the problems of those who care for elderly relatives. It is a sad reflection on the Oireachtas that it is doing everything but trying to keep the elderly at home. Some 1,500 home carers are paid to look after the elderly. Have we any idea what it is like for people, who have reared families or lost them through emigration, to be on their own and unable to look after themselves? We are providing for situations whereby such people are stashed away. We have a duty to prevent this. Anybody who says this no longer happens should explain what has been done to prevent it. I want a completely different situation to exist.
I am not a well travelled man but we should learn from other countries. In Portugal, which is not as developed as Ireland, the elderly are looked after well. They are recognised by people as being their elders and leaders and most importantly, they are not described as old. Why do we not treat our elderly in a similar way? I say we should but people cannot because they do not have the means to look after them or to get somebody else to do it. For example, the mother or father of a family of four could be unwell or have Alzheimer's disease. This is happening in many homes and it is not easy for these families to cope. I can describe extremely sad cases and the people involved do not receive any benefit. It is better for four or five of the family to contribute £20 or £30 each a week, put the parent in a nursing home and visit them once a month rather than the family look after them. The spouse may even be deterred from visiting.
Senator Maloney made several points about the closure of psychiatric homes. We have sent people into the community who cannot cater for themselves. He admitted that is happening. This motion should not have been put down this early in the Government's term. I compliment anybody who will give any benefit to the less well off, but I did not see anything spectacular happening during the year of the elderly. I would like somebody here to point out what happened or what extra benefits the elderly received. Is it not a fact that more private nursing homes are being built? Is it not a fact that county and city councils are putting up signs for nursing homes but not for beaches? That is a sad reflection on this society, which I resent.
I want every possible benefit given to people, one way or another, to assist them to keep their elderly relatives at home. I am not saying that benefits should necessarily be given to everybody. They should be given, for example, to a person who is earning £15,000 a year gross and has an 82-year-old senile father living at home. The daughter-in-law may not want to look after the father. If benefits were given, somebody could look after the father within the community without putting him in a public or private nursing home.
One must never take away from a person what they have. A nurse being interviewed for a job is always asked what the first priority is, and the answer is the patient. Here we are talking about patients, whether they are physically fully fit, half fit or otherwise.
I see ways around this problem but, unfortunately, I do not hear anybody saying they are going to do anything. Why do we not assist people who want to build a granny flat? If it costs £5,000 we should give them £2,000 towards the cost. Would that not be better than putting a person in a nursing home? It would cost £700 a week to put them in a public hospital. Should we not avail of every possible opportunity to help people? What is wrong with giving people tax relief to look after their relatives or to pay somebody else to do it? Is that not what job sharing is about? Is that not a service area where jobs could be created?
All parties are in favour of assisting people who want to return to work after having children by providing an extra allowance for a child carer. There is nothing wrong with that. What is wrong with giving allowances for looking after our elders? They are our own and did not come from another planet. We should not get rid of them because suddenly they are awkward, cannot do something for themselves or shows signs of senility.
It is most unfair of the Government to table this motion so early in its term. It should not insult the intelligence of anybody on this side of the House by trying to give the impression that everything is fine, when the opposite is the case. With all due respect to everybody here, the situation is going to get worse. It is now a question of having to look after oneself.
Is anybody here prepared to tell me that some provision will be made in the next budget for people caring for their elders, for example, a £1,000 a year tax free allowance? That is not a large amount of money. However, it is a start and says to people that we want them to do this. Will the Minister in charge say to the health boards that people cannot be brought into hospital if there are not enough geriatric beds? Doctors are tormented every day by people looking for geriatric beds.
If one asks a doctor what is wrong with a geriatric patient he will often reply that the patient is not sick but just old, which is sad. This happens because people want to get rid of their elderly relatives. I believe we should offer people £1,000 a year to care for their elderly relatives. It would cost £770 a week to keep them in a regional hospital, so the £1,000 would be recouped within nine and a half days. The person might live for another few years.
The Government should not insult my intelligence by putting this motion before the House when nothing has been done about the situation. It is most unfair to this House. People are looking for glory which they do not deserve.
I welcome the Minister of State to the House. I have already seconded the motion. I wish to comment on Senator Cregan's contribution. I appreciate and can agree with much that he said. However, the basis of the motion is that this House should debate and compliment the activities of the Government and the Minister——
The motion refers to "the outstanding success".
——to coincide with the European year of the elderly. Everything is not rosy in the garden and everything which is necessary for the care of the elderly has not been implemented. That will never happen because care of the disadvantaged — the elderly, handicapped and so on — will always be an ongoing process. However, with regard to the elderly, I must compliment the Government and the Minister on the financial backing for the nursing home Act, which was an important development.
The care of the elderly is not just a matter for nursing homes or is not any one section. It can be divided into three categories. I have no doubt that the first choice of any elderly person would be to be cared for in their own house by their family. Unfortunately, and the Government has little say in this, people are not as forthcoming in that area as they were in the past. Sacrifices to look after the elderly are not made as readily as they were. An incentive should be given for care of the elderly in their own home. An extension or variation of the guidelines for the carer's allowance would be a help in this regard and I hope it will be considered in the future. It is important to identify what I believe is the first wish of the elderly, that is to be cared for in their own homes by their own families. Our first aid should be in that direction and I hope it can develop over time.
The second area which it is appropriate to address is the care the State provides. We are often inclined to downgrade State care and imply that it is somehow of a lower standard than other forms of care. I would like to place on record my total disagreement with that. The people who work in our welfare homes, county homes and other institutions, whether in the Alzheimer units or geriatric units, provide excellent care. Those units are not run on a profit and loss basis. They are run on the basis of economy and good husbandry. People are never left short of anything just because the budget is a little short. The standard of State care is very high and this level must be maintained. Full professional care is provided.
Nursing homes have become extremely popular. Approximately 50 per cent of the beds provided in the State are under the nursing home heading. State beds account for approximately 10,000 out of 19,000 beds which leaves 9,000 provided by the private and voluntary nursing home organisations. It was of vital importance that the nursing home Bill was enacted because controls and checks and balances were certainly necessary.
Private health care must at all times be under the jurisdiction and control of the health institutions, the Department of Health and the health boards. They provide excellent care. Some people choose to be cared for in private nursing homes but those private nursing homes by and large cannot exist without State aid. Most people cannot take a bed in those nursing homes without subvention from a health board or the Department.
Pay them to enable them to stay at home.
Those are the three areas of care that can be provided. There are many things which can be done to help, particularly in the area of home care. There are a number of opportunities available to the local authorities and the Government. The construction of dwellings for elderly persons by the local authority or through a joint project involving a voluntary group, the local authority and the Department can be a most important cog in the wheel of care for the elderly. Where those houses are integrated with other housing developments in a community a balance is struck.
There is a need for balance between care for the elderly at home, in the State sector and in the private sector. The construction of dwellings for the elderly is one option but it is not the only one. Extensions can be built on to houses; Senator Cregan mentioned granny flats. Essential repair grants and housing aid for the elderly are available through the health board. These opportunities could be expanded to provide care for the elderly.
The provision of day care facilities provides a backup for people being looked after at home. The elderly can be taken by minibus to a day care centre for a number of hours during the day where they can involve themselves in various activities and meet other people of their own age. They can discuss and debate issues that are important to them and be back home with their families that night.
This debate could go on and I would like to have three times the amount of time. I hope we will return to it at another stage. The debate on the elderly has to continue. I spoke recently in another forum about the vast number of people who will come on stream to be cared for as elderly. Senator Cregan identified one group, those who are now elderly and were cared for in institutions to date. There are also many mentally handicapped people who are being cared for in facilities provided in joint operations between Departments and mental handicap associations. At some stage, a Minister for Health and a Government will have to make provision for them.
This is an ongoing debate but it is appropriate that we commend the Minister and the Government on identifying with the European year of the elderly. They identified a number of measures that involve activities for the elderly. Extension and development right through the services will be necessary. I commend the motion to the House.
I am pleased to address the Seanad. My colleague Deputy Howlin, the Minister for Health, has asked me to convey his apologies for his absence. He cannot be here due to his commitment to the European year. He is in Brussels at the closing event of European Year of Older People and Solidarity between Generations organised by the Belgian presidency of the European Union.
The European Community designated this year to honour its older citizens, focus on the challenges and opportunities of an ageing Europe and reinforce links between the generations. This special year had its origins in the European Parliament. Some MEPs, the Irish members being prominent amongst them, became aware of the need to plan for the growing elderly population in the Community. They persuaded the European Commission to propose a three year programme for the elderly.
In November 1990 the European Council of Ministers launched a Programme of Community Actions for the Elderly 1991-1993. The objective of the programme is to encourage the transfer of knowledge, ideas and experience on aging between member states. This is being done through studies and research, conferences and seminars, networks of innovative projects and awareness raising campaigns. The designation of 1993 as the European Year of Older People and Solidarity between Generations marks the culmination of this programme. During this year the Community and member states have tried to heighten awareness of the position of the elderly and of the challenge which an aging population holds for society.
The European Union is aging. There are more than 60 million people aged 60 or over in the Union, representing just under 1 in 5 of the population. By the year 2020, older people will comprise more than one quarter of the population. These demographic trends have major implications for member states, including Ireland, although the proportion of older people in our population is lower than in other member states. In Ireland the over 65s represent 11.43 per cent of the population overall. The percentage of over 65s in other member states ranges from 12.8 per cent for the Netherlands to 15.6 per cent for the United Kingdom.
Our older population is growing rapidly. More people are living longer. The CSO has estimated that those over 65 in the year 2021 will comprise over 16 per cent of the population. The number of people over 65 in the same year will be 553,000 or 150,000 more than recorded in the 1991 census. It is because of the fundamental shift in demography that is taking place in all member states that the European Union, in co-operation with member states, designated the year as European Year of Older People and Solidarity between Generations.
It is gratifying to see that so much has been done in this country to highlight the position of older people and to promote and encourage inter-generational solidarity. In each member state a national co-ordinating committee was established to ensure the success of the year throughout the Union. The co-ordinating committee in this country is representative of the social partners, the trade unions, the employers, the farming community, voluntary bodies providing services for the elderly and statutory bodies with responsibility for services for the elderly. It is chaired by Mr. Larry Tuomey, former chairman of the National Council for the Elderly. The co-ordinator of the year is Ms Catherine Rose who reports to the co-ordinating committee.
As a mark of support for the objectives of the European year, the Minister, Deputy Howlin, who had the lead role at Government for the year, made £440,000 available to the national co-ordinating committee to fund its programme of promotion and sponsorship of activities to celebrate the year. The themes the co-ordinating committee promoted included the positive contribution which older people make to society, all ages working and playing together, and meeting the challenge of older age.
The European year is an occasion to remind ourselves about the positive contribution older people make to politics, literature, music, amateur drama, voluntary work, community development and family life. Despite this contribution, many people still have negative attitudes to old age and older people. It is not always appreciated that over 80 per cent of elderly people are healthy, active and leading independent lives. The age and opportunity organisation, funded from the Health Vote, has established a nationwide network to promote positive attitudes to aging and to highlight the positive contribution of older people to society. A sign of the times is that more and more older people are joining organisations which focus on issues and interests of older people. These include the Federation of Active Retirement Associations, the National Federation of Pensioners' Associations and the Irish Association of Older People and Age Action Ireland.
Although the rate of participation of older people in groups involved in charitable works, education, the arts, the environment, human rights and consumer affairs is estimated to be as high as that of younger people, there is scope for greater involvement of elderly people in shaping every aspect of society. The European year has helped to focus attention on the role older people play in our society and the potential for developing that contribution in the years ahead.
Many people have difficulty with the subtitle of the European Year, Solidarity between Generations. The concept of linking the generations together is a simple one and it is an idea which has really caught the imagination. The 1993 committee has been surprised and delighted by the variety of projects and events involving the young, middle aged and older people that have taken place throughout the country during the year. The findings of a Eurobarometer survey on attitudes to aging and older people published earlier this year are interesting in this context. The survey indicates that the Europeans hold elderly people in high esteem and believe that national governments and the European Union as a whole should do every thing possible to promote their welfare.
These findings point to a very powerful inter generational solidarity between young and old which provides hope for the future. It is especially pleasing that in terms of respect for older people, Ireland came top of the league of member states. Economists sometimes portray old age as a burden on the younger generation because of the taxes and social security contributions which must be paid by those in employment to fund pensions and health care for older citizens. Of course there are economic and financial consequences of everyone living longer, but each generation in their active years must accept a responsibility towards the support of the elderly so that when they in turn grow old, younger people will support them.
The elderly have much to give to the younger generations, gifts which may never be quantified on a slide rule or calculator. How can wisdom, spirit, experience and stamina be measured? We know the influence grandparents have on the upbringing of children, should the latter be lucky enough to know them. Rooted in the memory, the young person's values and beliefs will always reflect the moral influence of the older generation.
Many Senators will also be aware of the successful Mentor schemes where retired people with particular skills offer their assistance to new and expanding firms. There is scope for the broadening of opportunities for people with skills and expertise acquired over a lifetime to give tuition and advice to the younger generation in developing our economy and reducing our high levels of unemployment.
One of the greatest achievements of western society in this century has been the opportunity provided to a majority of citizens to live to old age. While recognising that increased longevity usually brings more active years of life, plans must also be formulated to meet the needs of the more dependent elderly. The Minister for Health is very fortunate to have the National Council for the Elderly as an advisory body. Without the council, very few of the research projects, reports and seminars on a whole range of important topics pertaining to the elderly would have been undertaken. These reports have been very useful to the Department in determining policy and priorities for the elderly and in informing a wider public of the challenges of aging and an aging population.
The council has highlighted, through its work, issues relating to the elderly which previously received scant attention. For example, the report on the role of carers of elderly people had a tremendous effect on focusing public attention on the needs of this neglected group. The council's work on nursing home care, housing for the elderly and co-ordination of services for the elderly has made a major contribution to thinking on these issues and to clarifying the issues to be tackled. To mark the year the council held a successful conference on measures to promote the health and autonomy of older people in conjunction with the launch of the report of the same title. Two publications, "In Due Season" and "Bearing Fruit" which were recently circulated to schools for use with primary and secondary pupils will help create more positive attitudes to older people and ageing.
I have already mentioned that life expectancy is growing. Naturally, there will be economic and social consequences of living longer. In the health services we have a particular responsibility to study the implications of an ageing population because illness increases with age and older people tend to avail of a share of health services which is disproportionate to the size of the elderly population. The good news is that most older people are in good health and are participating actively in the social and economic life of their communities. It would also appear that the proportion of health care consumed by elderly people in the 1970s was about four times as high as for persons under 65 years of age and this declined slightly during the 1980s despite the rapid increase in the number of older people. This suggests that financing health care for the elderly may not be as great a problem as suggested some years ago.
I would like to take this opportunity to thank the 1993 committee, chaired by Mr. Larry Tuomey, for the role it has played in stimulating action and provoking reflection. Thanks to the work of its members, the co-ordinator, Ms Catherine Rose and the co-operation of many statutory and voluntary bodies involved with older people, attention has focused in an unprecedented way on the ageing and the needs and concerns of older people. The 1993 committee has built on the work of many organisations over the past decade who have helped change attitudes and policies toward older people. The year has also helped many in this country to realise that their work is part of a much wider European movement and that while we have much to learn from our fellow member states we also have much to offer.
In quantitative terms the committee has approved grants to 170 groups and organisations, mostly voluntary, which have organised events to celebrate the aims and spirit of the year. Over 5,000 events were organised as part of the year in villages, towns and cities throughout the country. The year has stimulated many groups to examine the issue of ageing for the clients with which they work. Conferences have been held on the implications for service providers of an ageing mental handicap population; on the care of the elderly in long stay hospitals and homes; on the need to expand dementia services; on how best our general hospitals should respond to the needs of our growing elderly population; on measures to promote the health and autonomy of older people; on combating age discrimination, to name but a few. The year has also helped to strengthen links between older people in both parts of this island and between organisations working on their behalf. These links, I believe, will be one of the lasting benefits of the year. The exchange visits by groups of older people, the "come and go" week which encouraged older people to travel North and South and the participation in conferences and workshops on issues relating to older people have helped to remove barriers and build friendships.
The Government has also been concerned this year with the question of how one organises health care most effectively for the growing elderly population. One of the most vulnerable groups in our society is the dependent elderly. The Minister for Health was pleased as part of the Government's contribution to the European Year for Older People to bring the Health (Nursing Homes) Act, 1990, into effect on 1 September last. I understand that this country is the only member state of the European Union to implement new legislation in favour of older people during this European year of the elderly. The Health (Nursing Homes) Act has two principal objectives. First, it aims to ensure that all nursing homes which care for the dependent elderly of the country have a high standard of accommodation and care. Second, it will assist financially dependent persons who need nursing home care and who cannot afford to pay nursing home fees. The implementation of the Act is also another important step in honouring the commitments of the Programme for a Partnership Government.
Under the Health (Nursing Homes) Act all nursing homes which care for dependent persons are obliged to register with a health board. Before placing a nursing home on the register the health board will inspect the home to ensure that it conforms with the required standards of staffing, accommodation and design. Registration will help to ensure that high standards of nursing care will be the norm in every nursing home. Under the new legislation a dependent person requiring nursing care but who cannot afford to pay the full costs of care in a home can apply to a health board for a subvention payment toward the cost of care. Each case will be assessed by the health board and it is my hope that the new subvention scheme will ensure that those most in need will benefit most from the new scheme. The new Act is a major step forward in ensuring that dependent elderly persons in this country will be well cared for which is an aspiration appropriate to the European year.
In drafting the new legislation extensive consultation took place with the Irish Private Nursing Homes Association, the Federation of Catholic Voluntary Nursing Homes, the Council of Homes and the Jewish Home. I would like to pay tribute to the constructive role played by these organisations in the negotiations which took place before the Act was commenced. Private and voluntary homes have fulfilled an important role in providing high quality care for our dependent elderly population. The nursing homes legislation will strengthen the bonds of partnership between public health services and private nursing homes so that by working together they can provide the best care and facilities for the elderly who need residential care.
Today in Brussels the Belgian presidency hosted a ceremony to mark the end of the European Year of Older People and Solidarity Between Generations. At that ceremony a declaration of principles agreed by the member states was published. The declaration commits the member states to recognise in their legislation and policies the full citizenship of the elderly in freedom and with equal rights and obligations in all areas of life of the community. The member states commit themselves to promote the integration of the elderly in the life of the community, thereby, acting to counter social exclusion, isolation and discrimination. They are to pursue policies based on the principle of solidarity between generations. The declaration calls on member states to guarantee the elderly the right to minimum resources, access to social protection and to an income at the end of their working lives which will maintain their standard of living. Governments are asked to encourage a flexible housing policy to provide care and services to support the autonomy and well being of older people, to examine the extent to which differential treatment in employment based on age is justified and to promote the full involvement of the elderly in the life of the community. In the declaration the Commission commits itself to making medium term proposals in 1994 for increased Community support for member state policies which continue to contribute towards the achievement of the objectives of the European year.
I would like to express the Government's commitment to support actions in favour of older people at European level and the declaration of principles in favour of the elderly which marks the end of the European year. The Government is happy to endorse the principles in the declaration and looks forward to the medium term proposals of the Commission in 1994 for continued action in favour of older people. The end of the European year will be celebrated in this country at a ceremony in the National Concert Hall which the President, Mrs. Mary Robinson, will attend. Representatives of participating groups from all over the country will attend. The celebration will be intergenerational both on the stage and in the audience. It will, I am sure, be a fitting conclusion to what has been a most successful year.
I thank the Senators who put down this motion for giving me the opportunity to place on the record of the House my appreciation and that of my colleague, the Minister for Health, of the hard work of many people who made this year so outstanding. I have no doubt that the achievements of this year will be long lasting and will lead to more positive attitudes to the elderly and growing old and to better services for the dependent elderly.
We all have an interest in ensuring that we grow old in a society that respects its older citizens and supports them when they can no longer support themselves.
It is a pity the Minister for Health is not here to hear the lavish praise for him from the Fianna Fáil benches. It seems that the party has no Minister of its own to praise in the Seanad during Private Members' Business.
We are a generous party. We give praise where it is due.
The last motion the party had down was in praise of another Labour Minister. The party certainly will not put down a motion praising the Minister for Agriculture after GATT and when the farmers of this country are finished with him. There certainly will not be a motion praising the Minister for the Environment when the Estimates are released. The Environment budget is well trimmed at no loss to the Labour Ministers, if my sources are correct.
This motion states:
Seanad Éireann commends the Government and the Minister for Health for the manner in which the activities organised to mark 1993: The Year of the Elderly and Solidarity between Generations contributed to the outstanding success of the year in this country.
Members on the Government side of the House are praising the Minister but taking praise from where it is due. That credit should go to the members of committees and we should not take from the very fine work those people have done. All the voluntary organisations throughout the country have done great service for the elderly and we should not diminish their role and work in society.
I wish to draw attention to the County Mayo general hospital in Castlebar where 34 beds in the female surgical ward and 12 beds in the gynaecology ward have been closed. While on the one hand we are commending the Government for what it has done for the elderly, on the other hand what is happening in Castlebar is ridiculous to say the least.
The Senator should elaborate.
The Western Health Board decided, on instructions from the Minister for Health, to close down ward D which has 34 beds. There is no female surgical bed in Castlebar hospital.
An Leas-Chathaoirleach
While I appreciate the point being made by the Senator, which I am sure is relevant to Castlebar, it is not relevant to the motion.
Senator Roche asked me to elaborate.
An Leas-Chathaoirleach
I ask the Senator to speak to the motion.
I would like the message to get through to the Minister for Health. In Castlebar we are not happy with what is happening.
An Leas-Chathaoirleach
I got that impression yesterday evening. I ask the Senator to speak to the motion before the House.
I am speaking about the elderly. We should not take from what the voluntary committees have done throughout the country. I believe this motion seeks to diminish the work of the voluntary groups. A Leas-Chathaoirligh, if you would allow me two minutes in relation to Castlebar general hospital where 19 nurses have been made redundant before Christmas——
An Leas-Chathaoirleach
Senator, we cannot discuss Castlebar general hospital now.
The elderly patients——
An Leas-Chathaoirleach
We are addressing a different subject and I ask the Senator to stick to that.
Put down a motion on the Adjournment.
The beds in Castlebar for the elderly are taken over for surgical cases. What is happening is ridiculous, to say the least. I am sorry that I must persist in this way. We are seeking only £40,000 to keep this ward open. I plead with the Minister this evening——
An Leas-Chathaoirleach
The Senator will have to use a different opportunity to raise this issue.
When looking at the report of the National Council of the Aged I noticed that reports on the elderly always deal with problems. We have a multiplicity of reports in the library dealing with various problems of the elderly. This is an extraordinarily narrow perspective from which to look at the issue of the elderly because, as Senator Cregan said, we are all getting older. We should not look at the "problem" of age or the "problem" of the elderly. We should celebrate age. Senator Cregan mentioned other societies where the elders are considered the leaders and the repositories of knowledge, information and culture. In Ireland we did that until very recently. We no longer do it. Senator Cregan made the point that we are impoverished as a society because we no longer respect, cherish or honour the elderly and the resource they represent.
I wish to concentrate on the elderly as a resource. It is true that Irish life has changed dramatically in the current generation. Increasingly the typical Irish family is a nuclear family consisting of the husband, wife and 2.4 children. The extended family of the mother, father, children, grandparents, aunts and uncles is a thing of the past. I can understand the reasons for the passing of the multi-generational family. However, its passing represents a tragic departure and a cultural loss. The end of this year, in which the special relationship between generations is celebrated, should be a time for looking forward and not looking back.
At the outset I said that the elderly are a resource. There is a vital role in the modern nuclear family society for men and women who have decided to retire from active employment and for those who have become elderly. We should examine the extent to which we can extend the role of the elderly in our society. The Minister of State mentioned the scheme whereby retired business people employ their experience in assisting young industry to grow. That is an ideal utilisation of the resource of the elderly in society.
Active elderly people should also be involved in a wider range of community activity than is currently the case. They should be involved not just in some form of therapeutic activity but be actively involved. A carpenter, for example, who is retired after 30 or 40 years may have slowed down but he will not have lost his skills. A woman who has been involved in the caring professions over a lifetime will not have lost her skills simply because she has moved out of her wage earning role. The challenge is to try and work out appropriate roles and mechanisms to make greater use of the knowledge and skill base of elders than we do at present.
I do not accept the notion that when one reaches the chronological age of 60 or 65 one should automatically retire. I believe that individuals have different retirement ages. The idea of retirement should be examined and there should be far more flexibility in that regard than there is at present. In some professions — teaching, for example — people burn out much earlier than they do in other professions. Perhaps we should recognise that fact and give them the opportunity to change profession. Perhaps we should give them the opportunity to retire early in order to build up new skills or to open new career prospects.
I have mentioned schools and education. The elderly could play a remarkable role in our schools. As the nuclear family is now the norm as opposed to the traditional multi-generational family, older people, retired people and those who have an extraordinary repository of folklore, knowledge and local history should be involved in the schools. They should help children who are slow learners and excite the interests of the children in their own society.
One of my children was fortunate to go to a small school in Greystones, County Wicklow, many years ago. One of the exciting aspects of the school he attended was that the teacher invited older people to talk about the town and the area 40, 50 or 60 years ago. I remember the wideeyed excitement of the young child when we went for a walk and he told me that Mr. Y had told him about the big flood. I thought this was enriching for the young person and a good use of the skill, knowledge and historical base which is locked in the heads of the elderly.
I agree with Senator Cregan that we should explore this role. Teachers have no need to resent older people being brought into the schools to share their knowledge and experience with the younger generation. This would help to bridge the gap.
The elderly could play a greater role in nursing care. We have nursing homes, but we need a structure to involve elderly people in professional visiting and to use their knowledge to help those who are incapacitated. Nursing care and the incapacitated elderly have been mentioned by a number of contributors, but I am not in sympathy with many of the statements made. Inevitably, contributors turned their attention to nursing homes and decried the fact that they spring up in society. I understand the point being made, but I also understand the counterpoint which can be made. It was said that the elderly are "stashed" in nursing homes, but I am sure this phrase was not intended in a cruel way. In recent times a speaker in the other House referred to nursing homes in less acceptable terms.
The elderly who are incapacitated should be kept in the family environment whenever possible. I remember my mother nursing her elderly mother who had suffered a series of strokes and was cruelly incapacitated for 16 years. It was ideal in many ways because we, as young people, benefited. The burden fell on the female member of the house, therefore I am not sure she benefited.
Although men decide the ideal solution regarding home care, they do not carry its burden. The burden of home care always falls on women. One does not see men queuing to empty bed pans and wash dirty sheets. In Ireland this role is regarded as unique to women. When a family faces a crisis with an incapacitated relative, and when it is decided that home care is the ideal solution, the woman assumes the burden. We must agree this is not acceptable.
I recall a case — and I am not being controversial — where a woman called to one of my clinics in Bray, County Wicklow. She had cared for her father-in-law, who suffered from Alzheimer's Disease, for almost ten years. When she visited me, I realised she was at the end of her tether. She had willingly welcomed her father-in-law into her house when he first became sick with this disease. She had small children at that time, but she made space available for that person. When the time came for the other members of the family to play their roles, many reasons were given as to why the father-in-law should not be moved to their homes. As it happened, the man's children were all male and it was the daughter-in-law who carried the burden. This happens too often in Irish society. When this lady suggested that her father-in-law should be sent to a respite bed in an excellent compassionate institution, St. Colman's, all hell broke loose. When the family realised I was helping her to get a respite bed, I also felt the anger and I had serious and angry visits from them. I suggested that the people who felt strongly about this should make a bedroom available in their homes for the man, but once again they could not.
Home care is the best solution, but we must acknowledge that the infrastructure, the respite care places, the home help and the pay for carers is not available. As I said, I had personal experience of this for 16 years through my mother. I saw love in a practical sense, but I also saw the burden. If we as a society have a model of home care, we must accept its costs. The males in our society must recognise that they too have a part to play in the implementation of the model solution.
The best way to make a male pay is to charge him.
I welcome the Minister of State at the Department of Agriculture, Food and Forestry, Deputy O'Shea, to the House and I listened attentively to what he said about the European Year of the Elderly. People have always been able to look after the elderly in Ireland. Senator Roche who told us how his mother looked after his grandmother for 16 years. I was honoured as a son to look after my father at home, with the rest of my family, for six months before he died. We also kept my uncle, who was a bachelor, at home rather than sending him to a nursing home. The women looked after the washing, etc., but the men also played their parts in cleaning and turning him.
There are many ways we can help the elderly and we must not be found wanting when the time arises. I do not apologise to anyone for criticising the present position. I was one of the first people in this country involved in the building of old people's homes, without a grant from the State. In 1979 four old people's homes were built in my village from community funds; no one gave us money. We brought families from the countryside into these new homes and we supervised them. When these people passed away, more families from the countryside, who were living in bad conditions, were taken in. I am glad a housing programme has been implemented there and that communities may now avail of 90 per cent grants. Greater consideration should be given to housing the elderly because many of them are living in remote areas and in bad conditions. They would be better off in towns and villages where they would be close to churches and people could visit them.
It is difficult to get money to look after old people and those living alone, although the amount required is small. A person looking after a sick relative is not allowed to draw any State aid. That is why these people are put into homes. This is wrong and it should be changed. We should look at life 20 or 30 years ago when there was an old person in every home and they were cared for by the family. In modern times, with the increase in the number of nursing homes, people believe these homes can provide all the facilities to care for the old. However, the elderly wish to stay at home because they believe their families will provide better care than any institution. This is not right because the institutions with which I have worked over the years have been well run and the people in them well cared for.
To make it easier for families with elderly relatives some kind of funding should be available, and these people could be kept at home in their own environment. If we put an elderly person into an institution, the cost factor should be examined because this puts the burden back on the State. By contrast, those looking after the elderly at home are doing so at minimal cost to the State. If, for example, in the morning all the people who are cared for in family homes were placed in institutions, I do not believe the country could afford to keep them. Extra revenue should be made available for home carers; only a relatively small amount of revenue would be required.
As a country we have always been proud of our elderly. They built our country. We should look after these people; they expect nothing less. One of these days we will be old people, and we will be looking to the next generation to care for us. When we get old all we can expect is the same respect we gave old people. If we cannot give them the care and attention they need, how can we expect the next generation to look after us?
I welcome the debate and I welcome the Minister to the House.
The motion was worthwhile in highlighting what is needed to help the elderly. This issue has always been a problem, as illustrated by the lines from Robert Burns's poem, "Man Was Made To Mourn":
Look not alone on youthful Prime,
And manhood's active might;
Man then is useful to his kind,
Supported is his right.
But see him on the edge of life,
With cares and Sorrows worn,
Then Age and Want, oh! ill-matched pair!
Show Man was made to mourn.
Down the centuries, as one got old, old people were left to mourn.
In days gone by there was the extended family and there was no such concept as the two householders working. However, today it takes two pay packets to keep a house and when old people become incontinent, feeble and unable to look after themselves, they cannot be left on their own and it is not easy for people with young families to care for them.
The health boards are doing a good job. They provide community care, public health nurses, home help, housing for the elderly and so on. There is much being done in this area and the debate in the House tonight has further highlighted the need to look after old people.
I agree with Senator Cregan's remarks on care for the elderly. Some old people are put into homes who could be kept at home while some are kept at home at great sacrifice by those caring for them. However, some have to go into care. We should be aware that there are dedicated people providing these services. Nursing is more than a profession, it is a vocation and requires a great deal of dedication. No money would pay for the work they do; they do a wonderful job.
There are old people, some of whom I know, who like to be independent. They prefer to make arrangements for their old age. In my own county, I have seen husbands and wives take a suite in a nursing home, using the dining room for their meals. They have their independence and they are not a burden on their families.
I was impressed with Senator Roche's remarks on education. They brought me back to my school years. When I was in second or third class, there was a lesson in the school book where a rich man met an old man sitting on a pile of stones, breaking them. He was getting approximately two shillings a week for this job. The rich man asked the old man how he managed. The old man replied that he managed to keep a wife, a couple of children and to pay an old debt. The rich man asked as to the nature of the old debt and the old man replied that when he was young and feeble his father and mother looked after him. He said that today they are old and feeble and he must look after them.
There is no lesson like that in the school books today. We have moved from the concept of caring from childhood. Such concepts make memories. Those stories had a moral, something to remember through life. Today our school books contain airy fairy material which does not prepare us for life.
As other Members remarked, we are an again community. We will all become old. I hope existing services as well as the work undertaken by the Government, the health boards and voluntary workers. In this context one group not mentioned was the team behind "Live at Three" with Mr. Derek Davis. Mr. Davis is doing much for the elderly, giving them encouragement and providing a good, entertaining programme for them.
This has been a successful year. I believe that we have highlighted a problem. When was the last time we had a two hour discussion on the elderly? I do not believe there ever was such a discussion. This House has made history in so far as this is the first time we have discussed the elderly, the most important group in our community, for two hours.
I believe the international year of the elderly will be as successful as the International Year of the Disabled, which continues to have an effect. The international year of the elderly has brought youth and age together, it has pulled communities together and got people working together. The foundations will ensure a more successful and happier life for old people.
I thank the Minister for his coming here this evening and the Minister of State, Deputy Fitzgerald for her attendance earlier. I regret the Minister for Health was not in attendance, although I am pleased he was in Brussels today for this historic occasion.
Question put and agreed to.
When is it proposed to sit again?
At 10.30 a.m. on Thursday, 9 December 1993.
Sitting suspended at 8 p.m. and resumed at 8.30 p.m.