The content of the recently published Commission Report on the Leas Cross Nursnig Home reinforces the fears and anxieties of many older people, and indeed their off-spring. With an ageing population and the number of people aged 80+ in the Republic of Ireland expected to quadruple from 110,000 to about 440,000 by 2041, the future regulation of privately and publicly funded care systems should be paramount.

The report highlights the lack of  supervision and regulation by the Health Board and the HSE, and points out the gaps in training and management skills that enabled an abusive work culture to fester.

As Leas Cross Nursing Home service users increased from 6 to 96 over a 7 year period, staff numbers remained the same. This serious staffing deficit went unaddressed by State regulating bodies. It is argued that such sub-standard care provision can, in particular, act as a catalyst to the neglect of older people. While such inadequate numbers of staff were employed, the report also reveals that the home received over 7 million Euros of tax payer’s money for subventions and contract beds.

A recent paper by the School of Nursing, Midwifery & Health Systems at UCD, Elder abuse and neglect: the nurse’s responsibility in care of older people (2009), documents types of elder abuse and how and why abuse manages to exist at institutional level. Reasons include nurses viewing dealing with elder abuse as beyond their scope of practice, and as such don’t feel they hold the responsibility to take a leading role in addressing the abuse.  Other issues originate from ‘a fear of whistle-blowing’ and an ‘unspoken acceptance’ of inadequate care systems.

With one eye on future needs and the other on the McCarthy Report’s suggested review of homecare packages, (designed to reduce inappropriate placement of people in long-term care), the State’s strategic approach to providing care for an ageing population and planning for further pressures on care systems will play an important role for the future care of all of us!