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Active nursing homes closed to house refugees? What are our priorities?

Last August, it was reported that Junior Minister Mary Butler, who has special responsibility for older people, had to hold an “emergency meeting” with her Department officials because private nursing homes were closing in order to switch to accommodating Ukrainian refugees.

The Minister’s local radio station, WLR reported that the Junior Minister was concerned that this was happening “even where the nursing home [was] a viable business”.

“I have seen it across the country,” said Minister Mary Butler, “that some providers are opting to de-register their nursing homes and to take in displaced people as another alternative.

Butler’s concerns then became a national story.

Speaking on RTÉ’s Morning Ireland, the Minister said she “was aware that eight nursing homes have closed in the last three months”. The station reported:

She added that in the last two weeks, four nursing homes have deregistered their provision of care for older people.

Ms Butler said that she has been made aware that there are some instances where these nursing home operators have “changed their business model to provide care to other vulnerable cohorts of society”.

However, Nursing Homes Ireland said they were “disappointed” at her comments – claiming that “nursing homes are closing because they are being forced to close”.

The Minister then moved to prevent the care facilities being used to house refugees, and and public attention regarding accommodation for migrants and refugees moved elsewhere, but now the repurposing of nursing homes may be coming to the forefront once more.

We now know that 11 active nursing homes in Ireland were converted into accommodation for refugees in just a few short months and that this was why Minister Butler was so concerned.

She said the ban was necessary because the payments being made available to provide refugee accommodation might be an incentive for nursing homes to close.

There was a need to “avoid unintentionally incentivising active nursing homes to leave the market”, she said. Clearly that was the case, if 11 active nursing homes had already opted to become asylum centres within a few months.

The revelation should force us, as a society, to think long and hard about where our priorities lie. Are we more concerned with virtue-signalling to the world on immigration, or with putting the care of our elderly – and our most vulnerable – people first?

The foolish decision by the government to say Ireland could take an unlimited number of Ukrainian refugees, while simultaneously sending a message to the rest of the world that our doors were open to all other migrants claiming they needed protection, dealt another blow to the already-in-crisis housing and health services in this country.

But while we’re now accustomed to seeing the government turning the country inside out to scramble enough beds for new arrivals, there has been very little discussion on how the these policies impact those who are most in need of nursing care.

Nursing Homes Ireland says that the situation had already been deteriorating for years, and that the government has persistently short-changed private nursing homes – paying them 60% less, they say, on average per resident than what is paid to public homes.

They say that the Fair Deal subsidy is not meeting the rising costs of providing care and that the government is dragging its heels as private nursing homes go to the wall, with many unable to meet script HIQA requirements without support from the State.

But while most nursing homes are run by decent people, who provide compassionate care, its also undeniable that some operators seem to fall far short of what’s expected.

Take the profoundly shocking case of Ultan Meehan, who had dementia, and whose facial wound became so septic that it was infested by maggots. This horrific neglect happened in a private nursing home in Co Meath.

His distraught wife said that her efforts to have the harrowing circumstances of his death fully investigated came to naught. She and her husband were failed both by the private sector and by the state.

Some operators, it could be argued, are motivated primarily by their profit margins – and if they are incentivised to switch to accommodating refugees rather than caring for older people, then they will argue that makes good business sense.

We’ve seen this elsewhere as well. Those who own the biggest hotels in towns like Killarney are putting other businesses such as small restaurants and cafés at risk when they close their doors to trade and switch to housing migrants and refugees.

But when the government is splashing around hundreds of millions on providing housing for newcomers to the country, then the most hard-nosed operators will simply see changing their business model as an opportunity to make hay while the sun shines.

It is almost unbelievable then, to have read this week that the ban on nursing homes switching to operating as refugee accommodation centres is now being reviewed.

Butler now says: “Given the changing situation with regard to accommodation for people under temporary protection, the Department of Health will review this policy before the end of April”.

This is incredible. Have we lost any sense at all of putting our own people first – or even making our most vulnerable people a priority. It would be a catastrophe if more nursing homes were “incentivised” to close their doors to elderly people who may have nowhere else to go.

That would be a truly appalling vista. Communities around the country have repeatedly expressed concern that the needs of Irish homeless people are being subjugated in the current chaos around housing and immigration. But making elderly people effectively homeless or turfing them out of nursing homes would be a scandal of enormous proportions.

Ireland, just like the rest of Europe has an aging population, and the demand for nursing home spaces is therefore increasing rapidly.

Despite all the guff about helping older people remain in their homes or with family, the truth is that the state, in its usual haphazard way, offers very little real support to make that happen.

Care Champions, who have done trojan work in speaking for older people who suffered disproportionally and often needlessly in the Covid crisis, called on the government to do more for those most in need of best-quality care.
“The reality is when a person lives in a nursing home, they and their family choose the home due to its location, near or in their local community and close by so that easier access for family members or spouses who are often in walking distance to the home. Residents have also built relationships and are familiar in their home,” Majella Beattie told me.
She said families have reported “cognitive deterioration and stress caused to older people and families and especially to people with dementia”  when nursing homes closed.
“Residents & families pay enormous money to live in the home, which one would expect is the residents final home. It calls into question the lack of regulations and oversight of older persons care and calls for total reform,” she said.
It also calls into question, in my opinion, the priorities of our government. It is unconscionable that vulnerable older people, who contributed so much to Ireland, would be shunted aside because nursing homes are being offered financial incentives to house migrants and refugees instead. That would be a step too far.
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