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Progress on efforts to implement a human-rights based approach to health and social care

Age Action welcomes today’s publication of the ‘Guidance on a Human Rights-based Approach in Health and Social Care Services’ published today by the Health Information and Quality Authority (HIQA) in conjunction with Safeguarding Ireland.

Age Action supports a rights-based approach which empowers people to know and claim their rights. If people know and claim their rights in how they decide what health and social care services they wish to receive, this will in turn impact the quality of health and social care services as providers will be held to account to higher standards of person-centred care.

In addition to existing HIQA standards, today’s publication is a welcome resource to assist both service users and staff and organisations working with adults across health and social care services to understand how human rights principles apply in health and social care services on a day-to-day basis.

We are pleased to see that the publication includes discussion on the complex situations that occur in practice where many factors need to be considered, such as balancing an individual’s will and preferences, and – at times – competing human rights. We hope to see a better understanding across health and social care services of how to uphold human rights, and better guidance for staff in practice in overcoming the challenges that arise when the organisational protocols are seemingly at odds with a rights-based approach e.g. options for transgender people in single sex residential units.

Age Action remains disappointed that significant legislative and policy gaps continue to exist in the area. While enacted, the new Assisted Decision Making (Capacity) Act 2015 will not be commenced until Q4 2020. Key elements which should be fast-tracked for commencement include: Arrangements for the making of Enduring Powers of Attorney; a legal framework for Advance Healthcare Directives. In addition, related legislation on the deprivation of liberty - which will provide safeguards for people living in or going to live in residential settings – has also seen delays in its progress into law.

An Adult Safeguarding Bill has been in development since 2017 to replace or cover out of date or non-existent legislation in the area. When underpinned by a regulatory framework for adult safeguarding, this will provide for the protection of at risk adults and statutory powers to ensure adherence.

The expedition of these legislative and resulting policy changes will ensure that rights, freedoms and dignity of people are promoted and protected.

ENDS

 

Did Budget 2020 Take Steps Towards a Fairer Society for an Ageing Population?

 

The Government's Budget 2020 choices did not include measures to address the inequalities faced by older people living in Ireland who are family members and contributors to our communities. Budget 2020 did not offer the majority of older people the support they need to meet the rising cost of living that is anticipated by the impacts of Brexit and it did not offer a concrete plan to support us to age in place.

 

Equality for older people requires the re-distribution of resources; power and influence; status and standing; and respect.  While the Government has increased some secondary benefits with the view to targeting people in the most vulnerable situations, which is a sensible approach, it has to be acknowledged that if people had adequate income to meet the true cost of ageing, they would be able to have choice over how to spend their money to best meet their specific needs.

The net affect of Budget 2020 on the income of older person headed households is;

  • Those under 80 and living with another person are €1.08 better off per week following Budget 2020 and have seen a weekly increase of €11.68 since 2009

 

  • For those under 80 and living alone, they are €6.08 better off per week following Budget 2020, and have seen a weekly increase of €20.48 on 2009 income

 

  • For those over 80 and living with another person, their weekly income has risen by €1.08 in Budget 2020, and €11.68 since 2009

 

  • For those over 80 and living alone, they are better off by €6.08 per week following Budget 2020, and €20.48 since 2009.

 

Some people who are over 80 are people in the most vulnerable situations in our society with no capacity to increase their income while dealing with the increasing cost of ageing. A person over 80, not living alone, received €1.08 per week to cope with Brexit, the carbon tax increase and the rising cost of living in 2020. It is on the backs of these people that our economy has been built: these are the same women and men who lived through the Marriage Bar, shouldered several recessions and are now dealing with the accumulated disadvantages. In working for equality, it is critical that we focus on equality of outcomes not just equality of opportunity.

AGE ACTION CRITICISES GOVERNMENT FOR BEING CONTENT TO KEEP OLDER PEOPLE HOVERING ON POVERTY LINE

AGE ACTION CRITICISES GOVERNMENT FOR BEING CONTENT TO KEEP OLDER PEOPLE HOVERING ON POVERTY LINE

Failure to increase pensions contradicts Government’s commitments under National Pensions Framework

Reducing tax breaks for private pensions could have allowed Government to tackle significant income inequality among older people

Age Action CEO, Paddy Connolly, says that older people will be disappointed but probably not surprised by the Government’s failure to increase the Old Age Pension for 2020. Mr Connolly said that the tone of the Government’s message to older people in the lead up to the Budget has been that they shouldn’t expect much by way of income improvements. However, Paddy Connolly welcomed the Budget measures to tackle income inequalities in childhood which he said would help protect against the accumulation of disadvantage later in life for future generations of older people.

“The Government’s own National Pensions Framework committed it to benchmarking the State Pension at 35% of average weekly earnings. In order to move the current pension payment towards the delivery of that target, Age Action called on the Government to increase the weekly pension payment by €9.

“What’s most disappointing is that this increase was eminently achievable – at no extra cost to the State – by reducing the tax breaks on private pensions to 33%, as proposed by the National Pensions Framework. Reducing these tax breaks would not alone provide the funds for significant increases for all pensioners, it would also help to reduce the massive income inequality that exists amongst older people,” Paddy Connolly said.

Mr Connolly welcomed the increase in the Living Alone Allowance, rise in the Medical Card income thresholds for over 70s as well as increases in some secondary benefits but questioned whether older people would see any real net benefit in their pockets particularly because of rising fuel prices. He also challenged the Government to commission research on the cost of ageing to establish the true costs of growing old in Ireland.

Paddy Connolly welcomed the commitment to increase spending on home support provision and called on the Government to expedite home care legislation.

“The vast majority of older people wish to spend their later years in their own home, close to family and community, and not to be forced into nursing homes due to a shortage of home care packages. In this context, we welcome the Government’s commitment to provide an additional one million hours for home care. However, it’s vital that the promise of home care legislation by 2021 is delivered upon,” Age Action’s Paddy Connolly concluded.

ENDS

The Home Care Coalition seeks €110m funding for Home Supports ahead of Budget 2020

 

Coalition urges action in report ‘Experiences from the Grassroots’, as waiting list for Home Supports Service increases to 7,348 people

The Home Care Coalition, a group of 22 charities and not-for-profit organisations of which Age Action is a member, released a report highlighting the challenges faced by older people and people with disabilities when accessing essential home care services on 4 October. The Coalition is seeking an investment of €110 million in Budget 2020 to provide the necessary levels of support for people who are already receiving home support services and to meet the growing demand for new home care packages, with recent reports indicating that the waiting list has increased to 7,346 people.

The report, ‘Experiences from the Grassroots’, highlights experiences of delayed discharges and lengthy waiting lists seen by member organisations, including cases of older people and people with life-limiting illnesses remaining in hospitals for months longer than medically necessary due to lack of home care supports. This is despite reports that priority for home supports is being given to people in acute hospitals to enable them to be discharged, as a shortage of home supports services directly contributes to a lack of available hospital beds.

The Coalition highlights that although there have been numerous reassurances that access to home care has not been frozen, this is not reflective of their experiences on the ground, with one organisation highlighting a case in which the family of an older woman were told not to bother applying home care as they would not get it due to the length of the waiting list, and another being told in number of regions they were not allowed to use the word ‘embargo’.
Members of the Coalition range from NGOs working with older people and people with disabilities and long-term illnesses, to organisations working directly with carers, to groups working in the primary care sector.

“It is unacceptable that no action is being taken as we simply watch the waiting list for home supports continue to rise,” said a spokesperson for the Coalition, ALONE CEO Seán Moynihan. “We have seen in recent weeks that there was a record number of delayed discharges this summer when 769 people remained in hospitals nationwide who did not need to be there, many of whom were waiting for step down support services. Meanwhile we know that in some areas there is simply no funding for new home supports packages. Explanations that the HSE do not want to overrun their budget are simply not good enough when there are thousands of people on waiting lists unable to access the services they need.”

As well as challenges in accessing home supports, the Coalition note that the service itself is under-resourced and that issues remain with the quality of the service provided. Issues faced by the older people and people with disabilities when accessing home care services include insufficient staff training, under-resourcing of home care staff, insufficient standards and quality systems, inadequate safeguarding and monitoring, and inconsistencies across areas in terms of prioritisation, access and assessment processes.  

The underresourcing of the home supports service affects more than the person who needs home care; it impacts their families, home care workers, and the health system at large. The lack of clarity regarding the legal obligation of the State to provide care to older people and people with disabilities, as well as a lack of qualified home care workers, has put pressure on family members to take on the role of carer. Home care workers themselves are overstretched, while family carers find the services available inadequate to meet their needs.

It is vital that the budget for the Home Supports Service is increased in line with demand by €110 million this year. We recognise that the Department of Health is working on a new statutory scheme for home care which the Coalition is contributing to, and we hope that the new scheme will solve some of the challenges that people who are in need are experiencing every day with the home supports service. The scheme will represent a vital part of Sláintecare and we support its implementation. However, older people, people with disabilities, and their families, can’t put care off until the new scheme is introduced.

 

On United Nations International Day of Older Persons Age Action CEO writes Society Must Collectively Tackle Inequality Facing Older People

Writing in the Irish Examiner on International Day of Older Persons, Paddy Connolly says we need to challenge our view of ageing and overcome the structural barriers to equality for all ages 

ONE of the clearest signs of how much progress we’ve made as a society since Independence is the massive increase in life expectancy. In 1916, average life expectancy was 53 years, now, more than 100 years later, average life expectancy has increased by almost 30 years to 81.61 years — a tremendous achievement.

To reap the benefits of this demographic bounty, we, as a society, need to challenge our view of ageing and overcome the structural barriers to equality for all ages.

To continue reading the op-ed visit Irish Examiner here 

A Fair Society for All? Listening to the Voices of Older People

Often, inequalities experienced by older people reflect an accumulated disadvantage which can be as a result of factors such as socio-economic status, health, gender, location. How existing inequalities impact on us as we age is something we in Age Action explored through a panel discussion 10 September – A Fair Society For All? Listening to the Voice of Older People – in Croke Park, on the occasion of the Annual General Meeting 2019.

An audience of over 160 people, including members of Age Action and people working in the ageing sector, joined the conversatoin which included a panel disucssion moderated by the CEO Paddy Connolly. The discussion centred on a discussion paper, Equality for All - Older People for Equality, published by Age Action in advance.The  panel set the scene with inputs from Michael Taft, Economist and political economy columnist, Colette Bennett, Policy Analyst Social Justice Ireland, Deirdre Garvey, CEO The Wheel, Ailbhe Smith, Co-Director of Together for Yes.

Home care needs immediate injection of ring-fenced funding of €110 million.

During 2019, over 53,000 people will receive home support services, to a total of 18.2m hours, an increase of 800,000 hours on the 2018 outturn but this is not adequate to meet the needs of people. It is now harder for over 65 year olds to access home care than it was in 2008. There are waiting lists over three months and recent figures show over 6,000 people assessed as in need of home care waiting for an initial service. Less hours per week are being spread more thinly per client with an increase in the provision of 30 minute slots of care. The current funding of home support services by the Government is inadequate and does not reflect the unmet need because people who are waiting for their first assessment are not counted. Without access to home care supports some older people are not realising their rights to housing and adequate healthcare. As a result some people are remaining in acute hospital settings or have no choice but to move to residential care settings, undermining their human right to live with dignity and independence. Age Action believes that home care supports are invaluable to help older people maintain their independence and delay or avoid long hospital stays. It is unacceptable that older people in vulnerable situations, and in particular those with low incomes, are left without needed supports due to HSE budget restrictions. Currently people who cannot access the rationed resources have to pay, if they can afford it, for private care; this is not an acceptable situation. A statutory homecare scheme, which would provide a legislative basis for equitable access to home supports across the country, is not planned until 2021. Age Action believes that a universal home care scheme is a public good and is the collective social responsibility of Government. Age Action believes that we should 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.  The absence of adequate home supports means that many people are unable to age in place. Despite the fact that it is stated Government policy (e.g. National Positive Ageing Stragetgy, Rebuilding Ireland), Government planning is inadequate at providing services to keep older people in their communities, out of nursing homes, and living with dignity and independence.ENDS

World Refugee Day

 Today, June 20th is World Refugee Day. The number of people fleeing war, persecution and conflict exceeded 70 million in 2018. This is the highest level that UNHCR, the UN Refugee Agency, has seen in its almost 70 years. Data from UNHCR’s annual Global Trends report, released this week shows that almost 70.8 million people are now forcibly displaced. To put this in perspective, this is double the level of 20 years ago, 2.3 million more than a year ago, and corresponds to a population between that of Thailand and Turkey.   Today, older refugees make up some 8.5 per cent of the overall population of concern to UNHCR, and by 2050 more of the world will be over 60 than under 12. Older refugees experience an additional burden due to their age and associated conditions. In a report published by the Centre for Policy on Ageing and Age UK, they identified that “the main issues facing older refugees and asylum seekers are low income, the language barrier, the risk of loneliness and a lack of social networks, and possibly a loss of social status”.  Reduced mobility and a high number of chronic medical conditions also greatly impact the life of an older refugee, as adequate and culturally appropriate healthcare is often difficult to access. As well, throughout their time in refugee shelters, older refugees are also more likely to experience social disintegration, the impact of negative social selection and chronic dependency on the resources of refugee shelters. According to the International Federation on Ageing “The contributions of older refugees can have far-reaching impacts on the preservation of the cultures and traditions of disposed and displaced people. The wisdom and experiences of older refugees must be harnessed through formal and informal leadership roles, to improve the welfare of all refugees”. Marion MacGregor, writing for InfoMigrants says “Older refugees can be seen as an asset, rather than simply requiring special care. In many families, it falls to them to look after children so that their parents can work….. Older people are transmitters of culture, skills and crafts that are important in preserving traditions of displaced people. The resilience of older people can help to strengthen communities and they can contribute to positive and peace-building interactions with the local host communities.”    

Age Action Welcomes the launch of the Housing Options for our Ageing Population Policy Statement

Responding to today’s launch of the Housing Options for our Ageing Population Policy Statement, Paddy Connolly, CEO of Age Action, Ireland’s leading advocacy organisation  said;

“This is a welcome joint initiative by the Department of Housing, Planning and Local Government and the Department of Health because it begins to address the needs of our ageing population in terms of ageing in place.  The commitment to provide real choice to people through a catalogue of housing with supports is welcome, especially the recognition that an ageing population has diverse needs.”

He continued “Age Action believes that we should 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. The wider support needs of people as we age was to be addressed through the National Positive Ageing Strategy which was published in 2013 and is yet to be implemented.”

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