Ireland’s older population have just had the worst three years in living memory. About nine-in-10 of the more than 7,500 people to succumb fatally to the Covid19 pandemic were older people. While the majority of deaths occurred in hospital, one-third occurred among nursing home residents. Nursing homes bore the brunt of the pandemic. The Covid19 pandemic should have represented a defining moment to provide a new focus on older people’s wellbeing and on their care. But, as the recent closure of multiple nursing homes confirms, a deficit in policy and resourcing is leading to an emergency within older person and broader health and social care.
Nursing home closures are heartbreaking for residents, families, staff and owners. It should not be lost upon us, that nursing homes are indeed the residents’ homes. While the closures have grabbed the attention and caused considerable angst within affected communities, regrettably there should be no surprise that it is happening. The warning bells have been sounding for years, with the closures a manifestation of the failure by the State regarding the policy it applies to resourcing nursing home resident care.
A crisis and crossroads now presents as a result of this for care of the older person in Ireland. Ten nursing homes providing care to about 400 people have closed or announced they will be closing their doors this year to date, resulting in the loss of approximately 500 jobs. Their closures follow a trend whereby 29 homes ceased providing care between 2018 and 2021. Nursing homes have closed due to the failure by the State to ensure that fees encompass the reality of resident care costs.
Nursing home care operates within a unique funding environment. Fees are set by the State through the National Treatment Purchase Fund (NTPF) under the Fair Deal scheme. Geography and historic pricing arrangements supersede resident care needs in determining fees. A chasm exists between fees payable under the scheme’s budget for private and voluntary nursing home residents and those within Health Service Executive-run homes. The Department of Health’s Value for Money Review report, published last December, found HSE nursing homes were provided with fees that were, on average, over €600 per resident, per week, more.