Dáil Éireann díospóireacht -
Wednesday, 28 Feb 2001

Vol. 531 No. 4

Written Answers. - Care of the Elderly.

Alan M. Dukes

Ceist:

32 Mr. Dukes asked the Minister for Health and Children if he will ensure there is a more proactive approach by his Department and health boards to seek out elderly and vulnerable people, especially following the tragic deaths of four related women in Leixlip. [5498/01]

Minister for Health and Children (Mr. Martin)

The tragic deaths of the four women in Leixlip, County Kildare in June 2000 was one of the saddest events which our society has experienced in recent times. May I at the outset tender my deepest sympathy to the womens' relatives and to the people of Leixlip who have been affected by this sad event.

In 1988 the report entitled "The Years Ahead – A Policy for the Elderly" was published and among its recommendations it stated that health boards maintain registers of elderly people at medical or social risk in their areas. The health boards have informed my Department that public health nurses maintain lists of vulnerable older people in their areas; in addition some boards have developed strategies to identify older people at risk.

The public health nurse plays a vital role in a multi-disciplinary team based approach to the delivery of health services to vulnerable groups in the community, including the elderly and ill and dependent people. This role extends to assessment of need, provision of support and a range of nursing services in the home, co-ordination of services and collaboration with other health professionals, hospitals and voluntary organisations.

Vulnerable older people are brought to the attention of the public health nursing service through case finding/anticipatory care carried out by the public health nurse, through family members, concerned neighbours, through GPs, and in networking with voluntary agencies etc. Regular contact is maintained with these older people once identified, and arrangements are made by the public health nurse for any service that the person may need in accordance with a care plan in so far as the public health nurse is permitted to do so by the client involved. Health boards have acknowledged that care plans for vulnerable older people must take account of the wishes of the individual and their families or carers. It has to be recognised that whereas every effort may be made on the part of the health and community-voluntary services, each individual is entitled to his/her privacy and independence and a sensitive balance needs to be struck between the views of the client and carers in this context.

It is a matter of record that the financial investment which this Government has made in the area of services for older people, has increased very significantly. This investment has been targeted at both community based and residential services with the intention of ensuring a balance in development in line with long-standing policy.

In the report of the Commission on Nursing it was noted that the delivery of health services in the community is a complex and difficult task and that the significant social and other changes which have taken place impact upon the service and necessitate a more coherent and integrated structure for the delivery of nursing services in the community. Thus, the commission recommended that the Department of Health and Children prepare a revised statement on the role of public health nursing. The Department is about to undertake a review of community nursing services and this review should be completed in early 2002.