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Disputes

What is the nursing home allowed to charge for?

One common source of frustration for people living in nursing homes or their families can be confusion about the additional charges put in place by nursing homes.

Nursing homes are allowed to charge for all therapeutic or recreational activities unless they are covered by the medical card. They are also allowed to charge for any personal services provided by the nursing home such as hair dressing, delivery of newspapers, etc.

HIQA Standards, published July 2016, require that the nursing home must agree a contract with the resident within one month of admission.

The nursing home’s management must communicate clearly with each resident, setting out the services that they receive and the required fees. You can only be charged for services as set out in the contract.   

 

What is the difference between a Care Plan and a Contract of Care?

There is a difference between the contact of care and the care plan.  The first is the legal document that outlines the legal relationship between whoever is responsible for paying the nursing home bill and the nursing home. 

It should record all charges that will be payable by the bill payer and all services that will be provided by the nursing home. The resident may have requirements that will be met by the HSE through the medical card scheme and these will not be listed in the contract of care. As was stated above there should be no additional charges levied by the nursing home outside of the contract.

The contract of care will include the care plan which is a comprehensive plan outlining how the individual care needs of the older person will be met.  

 

How do I ensure the property and finances of a resident are protected?

The HIQA standards state that every nursing home should have clear policies and procedure for managing a resident’s private property such as cash and jewellery. They also have a right to access items of personal property which should be kept secure either in a safe or in a secure locker or chest of drawers.   

Where an individual is no longer able to manage their own financial affairs, typically in relation to pensions and payment of nursing home bills, there should be an agent appointed to manage them on behalf of the resident. This person may be an employee of the nursing home or a representative of the resident.

The legal situation regarding guardianship and decision making is changing as new legislation is gradually being introduced and professional legal assistance should be sought if the older person’s capacity is being in doubt.  

 

How do I complain about something in a nursing home?

It is important if you have any concerns that you bring them to the attention of the management as soon as possible and there should be someone in the nursing home to whom these complaints can be made. Most disputes are solvable given good will on both sides.

If this proves unsatisfactory you can make a complaint to the Ombudsman's office and details of how to do so are availble on their website.

You can also call the Age Action information line on 01 475 6989 from Monday to Friday, between 9am and 1pm and 2pm and 5pm, or you can email us.

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Age Based Analysis of Mortgage Arrears Released for First Time

We welcome the publication, by the Irish Times, of data released for the first time by the Central Bank of Ireland that shows the number of people approaching, or already at retirement age, who are dealing wtih significant mortgage debt. The information gives a clearer picture of the worrying situation for Ireland’s ageing population. Simply, a lack of evidence exists on the cost of ageing with less complete data collected about us the older we become. As a result, crucial policy decisions are made without the availability of disaggregated and representative data which can result in discriminatory outcomes. We need an urgent rethinking of how we gather evidence and inform policy that meets the needs of a changing Ireland.

While there has been an assumption that older people close to, and in receipt of, the State pension are generally mortgage-free home owners, it is clear that this is no longer true with many still carrying large mortgages, in mortgage arrears or living in precarious private rentals with no security of tenure in older age. We should all have a choice to age in place which means the creation of age friendly environments, including the provision of support services locally, which enable people to remain in their own homes and in communities for longer; but the changing nature of homeownership, rising cost of living, and the lack of a coordinated policy response to the housing crisis means many people will be facing a very difficult situation in later life. 

Many older people live in the most vulnerable situations in our society. An increasing number are struggling to meet the rising cost of living – in particular costs around rent and mortgages - in the context of a State pension that sees many surviving on incomes only just above the poverty line. Latest CSO EU SILC figures show 1 in 10 older people at risk of poverty. New taxes, and rising prices in recent years have a greater impact on older people generally living on a fixed income with limited opportunities to improve their situation. Budget 2020 saw the income of older person headed households increase by €1.08 per week for those living with another person, and by €6.08 per week for those living alone in older age. It did not offer the majority of older people the support needed to meet the increasing costs of living and it did not offer a concrete plan to support us to age in place.

Ageist attitudes towards working later in life still exist, for example many older people have reported high levels of discrimination during recruitment. Discriminatory mandatory retirement clauses are still in place forcing people out of the workforce earlier than they may wish. These two things undermine people’s ability to continue working in later life whether by choice or necessity. In the context of a buoyant labour market, we urgently need a fundamental shift in how we view and support older workers.

An increasing number of older people are experiencing fear about retirement due to worries about income adequacy. Less than half of those working have a private or occupational pension to support them in later life. While Age Action welcomes the publication of the recent autoenrolment scheme by the Minister for Employment Affairs and Social Protection which will see increased pension coverage for more than an estimated half a million workers, the current design will further drive existing pension inequalities unless there is a targeted intervention to include people in low paid jobs, particularly women and long term unemployed.

Our economy has been built on the backs of those already in, and approaching, older age: these are the same women and men who lived through the Marriage Bar, shouldered several recessions and are now dealing with the accumulated disadvantages. Successive government policies have failed to adequately plan and provide for an ageing population which will ultimately impact on all of us throughout our lives.