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- Home care- what are your options?
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Some older people with sight loss may find that they need help with certain household tasks, like preparing meals, cooking or cleaning. Help at home is available both publicly and privately and here, we go through what is available and how to apply for it.
The Health Service Executive (HSE) offers a home help service, which is administered either through your local public health nurse, or through a hospital social worker, for those who are coming out of hospital. If you think you need help at home and make a request to your public health nurse, he/she will conduct an assessment with you in your home and recommend how much and what type of assistance you might benefit from.
The service is generally free to medical card holders, although people may be asked to make a contribution to the cost of the service. The HSE is not limited in the categories of people they can assist at home. However, the priorities are normally to provide a service to older people, families with small children where a parent has died or is seriously ill and people with disabilities.
The home help is expected to provide a set number of hours assistance each day or each week. The precise arrangements can usually be agreed between you and the HSE. The sort of work that a home help is normally required to do includes light cleaning, possibly some shopping and cooking and laundry but it depends on your individual needs. Home helps are not expected to provide nursing or medical care.
In making your application for home care it can be useful to include a letter from your GP to support your claim, as well as a letter from other family members, if appropriate. Before making a recommendation, the public health nurse will consider your support system, looking at who is around you who may be able to provide assistance and what financial resources are available.
Each HSE area has a budget to manage home care in that area for the year. The Government is committed to enabling people to remain at home and so provided €20 million additional funding nationally for home care in 2010. In spite of this, Danny Cahill, NCBI’s regional manager for the North West region, has seen hours being cut for some service users in his area.
“We have seen hours cut for some people. In Donegal the services are stretched because, while our budgets are high, the population is rural and ageing and so demand for care within the community is high, even though the service is not limited to older people with disabilities. Families are often left to take on the responsibilities themselves, but that is not always possible. Even if you live with family, they may be out at work all day and the older person can feel very isolated. Home care is a vital service and one that can make the difference between people being able to stay at home and going into full time care,” according to Danny.
“It can take a lot to persuade someone to consider home help. They may be nervous about having someone in their home, for example, or about other people finding out that they require extra help at home. Our community resource workers can talk to people about what home help entails and can help them make an application to the public health nurse. A lot of the time the contact and the company is as important as the work the home help does around the house,” explains Danny.
With the growth in demand for home help, there has been an increase in the number of private agencies offering home care, with agencies offering anything from a half an hour per week to full-time 24-hour care. The Irish Private Healthcare Association is an alliance of various private home care companies which is lobbying to create standards for the provision of home care, an area which is currently unregulated.
According to Julie Roberts of Comfort Keepers, a private home care agency, standards and monitoring are areas of concern for all those involved in home help. “We are pushing for regulation of the sector at the moment. Standards should include some kind of monitoring, such as a tele-monitoring system where the home help would phone in when they arrive and when they are leaving the person’s home. It may also include spot checks, internal monitoring by the agency and also external monitoring.”
Julie also outlined things that people can look for when choosing a home care provider. “The first important thing would be to make sure that the carer has been vetted by the agency or the HSE and that they have Garda clearance, which everyone working in this area should have. You should also look at what experience they have and what training they have undertaken. For example, manual handling is compulsory. Another consideration would be what monitoring the agency undertakes, whether they do spot checks and what the feedback or complaints procedure is,” explains Julie.
There is also tax relief available for anyone who pays for home care – up to 41%, depending on the level of tax paid. If the person who is availing of the care is not eligible to apply for tax relief, a relative can arrange to apply for it instead.
How to apply for home help
You can talk to your NCBI community resource worker about any difficulties you are having. They can help you make an application to your local public health nurse for home care. Community resource workers can be contacted on 1850 33 43 53. Alternatively you can apply directly to your public health nurse at your local health centre.