Paul Hopkins: I'm fine... I can reach the shower head

I live alone, though the mother of my three adult children is never far away should I need her help. Our divorce was amicable, we're civil to each other. She was particularly good to me during the pandemic.

My eldest child lives 10 minutes away and is a mother to two of my four darling granddaughters. She is always there when I need her, despite her high-end, high-demanding career.

Health-wise, apart from one minor underlying issue, I am in fine fettle. That said, though, there is a big difference between being 60 and then being 70. Ageing is a bitch, believe me – my mobility and balance not being what it was once.

Out of the blue, my daughter said to me the other day: "Dad, can you reach the shower head?"

"Of course I can."

"Dad, do you maybe need a nurse to come in once a week," she then asked.

"For what?" I exclaimed. "I may be getting on but I'm not decrepit. Yet."

I mention all this because Junior Health Minister Kieran O'Donnell has said his "No 1 priority" is a Fair Deal-style scheme giving people a legal entitlement to home care. He also promises to provide a nationwide free DIY service by volunteers to do repair work in the homes of older people.

Mr O'Donnell points out that, while the Fair Deal Scheme provides a legal right to nursing home care, "there is no equivalent programme for home care". The Fine Gael minister says: ”I am aware that this has been a commitment made before, but I intend to be the minister to deliver on it. It is my No 1 priority."

A statutory home care scheme, guaranteeing people who are needs-assessed, would give a minimum level of hours to the individual and was recommended in the Sláintecare report in 2017 – but it has since been beset by delays.

According to a 2024 report by the Central Statistics Office (CSO), a quarter of our population aged 65 and over live alone, that's 189,574 souls. This figure rises to 44 per cent for those aged 85+, that is 30,072 people.

Alone and Social Justice Ireland believe that people should be supported to age well in the community, and that this should be the Government’s "over-arching policy goal" in the context of an ageing population. Housing and related supports are key challenges in achieving this goal. In a recent co-authored paper both organisations highlighted some of the key needs and challenges facing our ageing populating over the medium and long terms. Focusing on the central infrastructural issue of housing and related supports, they outlined a list of costed policy recommendations to be included in future Budgets.

However, with the minister's proposal, complexities emerge around cost, the availability of carers, what level of service would be provided, the regulation of providers and whether people must be means-tested and make a 'co-payment'.

The Fair Deal Scheme, introduced in 2009, involves a means test based on income and assets to determine a nursing home resident's contribution to the cost. Nursing-home care is much more expensive than home care, so any means test, if introduced, would be far less onerous.

According to the minister, home care is currently provided free, with no means test by the HSE, to more than 56,000 people a day and waiting lists have fallen from a high of 9,000 to around 4,700. People may have a service, but seek additional HSE-funded hours and many pay private companies out of their own pocket to top up their care.

In the last Budget, the previous Government allocated €120m to increase home supports from a target of 22.4 million hours last year to 24.3 million hours this year.

Mr O'Donnell says the new Government will also "roll out a care and repair scheme nationally so that small jobs that do not require a tradesperson can be carried out by a volunteer-led DIY service". This will help older people to maintain their homes and independence.

Age Action currently operates a similar Garda-vetted service and works with community groups across the country to deliver it.

I am not yet decrepit enough, nor would I meet the criteria, to warrant a visiting nurse and, anyway, I value my independence. But a DIY visitor sounds very appealing ... should it come to me being unable to reach the shower head.