Survey highlights crisis in older person care that must be priority for Minister for Health


3 month+ waiting period for Fair Deal support brings pressures upon health services & families


The extent of care crisis in older person care because of inordinate delays in Nursing Home Support Scheme (Fair Deal) release of financial support is outlined today in a Nursing Homes Ireland survey of private and voluntary nursing homes.


The survey of 122 private and voluntary nursing homes has revealed a substantial crisis in the operation of Fair Deal, with older persons requiring the specialist and continuous care of nursing homes typically waiting beyond three months from application to funding drawdown. The survey reveals the inordinate delays are causing deterioration in older persons’ health and causing them and their relatives significant distress, worry and hardship. 


The survey conducted Thursday 3rd July – Monday 7th July extracted information in respect of typical waiting times for Fair Deal applications and impact inordinate delays are having upon older persons awaiting financial support.


Key findings emanating from the survey include:

  • 84.4% (103 nursing homes) were aware of a person/persons who have been Fair Deal approved but are awaiting the release of funding to support their care.
  • 96 nursing homes stated collectively they were aware of 364 successful Fair Deal applicants awaiting financial support – an average of 3.8 persons per nursing home.
  • Asked to advise of typical waiting times for Fair Deal support from initial application to funding release, over half of respondents – 51.6% (62 nursing homes) said waiting time is exceeding 10 weeks. Almost half – 48.1% (59 nursing homes) - said waiting time is three months (12 weeks) or beyond. *Waiting times advised of by survey participants exceed the 10 week funding approval waiting time Minister for Older People Kathleen Lynch informed Dáil Éireann in PQ on 1st July.
  • One Leinster nursing home said it is aware of 29 successful Fair Deal applicants awaiting financial support. A South nursing home said up to 20 persons are awaiting, and other individual nursing homes said they were aware of seven, eight and nine persons awaiting.

The survey participants, who were from counties across Ireland, advised:

  • Inordinate delays in receiving Fair Deal financial support are leading to extended, unnecessary stays in acute, district and community hospitals.
  • Persons are being readmitted to acute hospitals because delay in Fair Deal financial support is resulting in them being unable to avail of the continuous, specialist care provided in nursing homes. Families cannot provide the required care at home and older persons are consequently being readmitted to hospitals. Older persons and their families are aggrieved the delay in funding approval is limiting care options.
  • Persons have passed away while awaiting Fair Deal financial support.
  • Hospitals are coming under pressure because persons are availing of care within such settings due to inability to access nursing home care because of lengthy Fair Deal financial support delays
  • The inordinate delays are causing stress, distress and bringing significant cost pressures to bear upon families. Families are grouping together to pay for care. They are also trying to provide continuous care in a home setting while awaiting Fair Deal financial support to become available. Families are contacting nursing homes seeking to ascertain information re loved ones applications and asking if the process can be speeded up.
  • A West nursing home informed of a case whereby the family of a 92-year-old person with dementia who was Fair Deal approved opted to avail of HSE home help/private help to enable the person remain at home. When Fair Deal financial support was required to support the person to avail of nursing home care the family were informed a new application was required. The nursing home stated the 92-year-olds dementia condition would not improve and the family felt it was being penalised for opting to provide care at home for a full year, which resulted in State not incurring more cost arising from Fair Deal support for equivalent period.   
  • Nursing homes have beds available while nearby acute hospitals are under pressure due to older persons being delayed discharges because they are awaiting funding approval.
  • There is frustration at failure of health services to communicate reality of Fair Deal financial support delays.
  • A significant slowdown in the HSE assessment for persons applying for Fair Deal is being reported. 
  • Pressures are being brought to bear upon nursing homes as they are ‘holding’ beds while prospective residents await Fair Deal approval.
  • A voluntary nursing home has stated reduced occupancy has put enormous strain on its budget and could, potentially, put it out of business.

Tadhg Daly, NHI CEO stated: “The findings emanating from our survey highlight severe pressures and distress being brought to bear upon older persons and their relatives because of the delay in release of funding for Fair Deal. Nursing homes have informed us relatives are under significant pressure trying to provide continuous specialist care to meet relatives complex healthcare requirements. Older persons are remaining within acute hospitals for extended periods unnecessarily and being admitted to such settings because their complex care requirements cannot be met at home. The consequences of delays in release of Fair Deal funding have serious implications for wider health service. Nursing home care is care in the community that is provided by dedicated, specialist healthcare teams and failure to access it in a timely manner leads to older persons availing of care within acute hospital settings that is not specific to their requirements. It can lead to a deterioration in health.”


“The findings emanating from this survey outline there is a crisis in nursing home care that is going under the radar. The incumbent or incoming Minister for Health must address this as a priority. When Fair Deal 2014 budget was significantly cut we warned it would have very serious consequences for health and wellbeing of older persons and increase pressures upon acute hospital services. Our fears are being realised. We again reiterate our call for Department of Health to bring stakeholders around the table to ensure we address and plan for the significant growth for long-term residential care that is escalating with increase in numbers growing older.”


Tadhg Daly, NHI CEO is available for further interview. For further information contact Michael McGlynn, NHI Communications & Research Officer at 01 4292570 or 087 9082970.


Irish Examiner, 10th July 2014: Elderly 'die' waiting for care home cash, 9th July: Long waiting times for nursing home funding causing ‘distress and hardship’

Irish Independent, 10th July 2014: OAP's wait for beds 

Medical Independent, 11th July: NHI warns of 'present crisis' in older persons care, 17th July: 'Adding to chaos: Waiting times for nursing home funding double over three months

Sunday Independent, 27th July: Hellish wait for nursing home in Harney's 'Fair Deal'




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