How eldercare has evolved in Ireland over time.
Historically Irish mothers lived with “the son and the daughter in law”. My paternal grandmother lived with my aunt and uncle on the farm until she died in 1977. My maternal grandmother Granny M. lived until 2006 which was amost thirty years after my other Granny died and obviously a lot changed in Ireland socially and economically during that period.
After her husband died Granny M. lived on her own for over twenty years in a house a few miles away from the farm which was then owned by her son. The adult children, all seven of them helped to care for her in Granny’s house but they did not live with her. They also paid a lady for a few hours home help. My Granny was 90 years old when she died at home and fortunately she did not have major health complications. How many people die at home now? One can only imagine that most people die in hospital. For more on this see the TILDA report May, P., Mc G, P., Normand, C. (2017) The end of life experience of older adults in Ireland 46% died in hospital, 27% at home, 11% in the hospice and 10% in nursing homes.
According to the TILDA report the causes of death in Ireland are cancer (38%) Cardiovascular (31%), respiratory disease (12%), severe infectious disease (7%) and other (1o%). There are slight discrepancies with the Department of Health Statistics 2017 because the TILDA study draws from older people living in the community rather than the community at large.
The other question people might ask is how long illhealth and disability lasts – according to the above report 33% were ill for more than one year, 17% suffered for 6-12 months, 21% for 1-6 months and 15% of people died suddenly. Of course these figures are given in retrospect and if you have an elderly relative it is impossible to predict how long they will survive.
In this particular study 18% of older adults stayed in a nursing home for approximately 60 days, 12% spent time in a hospice and 8% stayed in another’s home, 19% received home helap and 9% had a personal care attendant. It was reported that 15%-30% of people who wanted to access public home help services were unable to do so.
According to the TILDA study the average cost of eldercare in the last year of life was €47,479. This was made up of formal care including hospital costs at 58% and informal care amounted to 42% of the average costs.
We are now in 2021 and fifteen years after my first Granny died eldercare in Ireland is totally different. The HSE provides only limited homecare and many private homecare are operating in our communities. The social context is totally different – fewer people live on farms and they do not live with their inlaws. But perhaps the biggest change is the fact that more women are working outside the home. It is not that long since married women were prevented from working by the marriage bar which was not removed until 1973. Traditionally women provided a lot of the care to older relatives but nowadays they are not in a position to do that. So we can see how the system of eldercare has evolved in Ireland…
Another consideration is the fact that people are living much longer with more complex health conditions. The incidence of dementia increases with advancing age , see Pierce, M., Cahill, S., O’Shea, E. (2014) Prevalence and Projections of Dementia in Ireland 2011-2046. The report estimates the future using projections from the Central Statistics Office and fertility and migration patterns are guidelines only. The age categories start with the grouping 30years to 59 years (early onset) and after that 60-64 years, 65-69 years, up to 90-94 years and 95 years plus. The report projects that the number of people with dementia is expected to double from approximately 47,000 2011 to around 94,000 in 2031.
Cardiovascular disease is a big threat to older people and one of the reasons for this is changes to diet. The diet that my grandmother had and what my parents ate was likely far more healthy than the food we eat today which is heavily influenced by an increase in advertising.
The world has speeded up and Ireland has become a markedly different place in the last forty years since we joined the European Union (formerly the European Economic Community). Our whole society is altered we can see how times have changed in relation to eldercare in Ireland and will continue to change in the future.
If you would like to speak with Emer Lavin about your eldercare concerns please go to www.emerlavineldercare.ie to book a consultation.