Introduction:
Carers provide an essential service, both to the people they care for and also to society as a whole. The care that family and other carers provide involves looking after the needs of people with a wide range of dependencies and issues, including older people. There are a variety of services and financial entitlements available for carers, while some of these are provided by the HSE others are provided by other statutory agencies such as the Department of Social and Family Affairs as well as voluntary and private agencies, all play an important role in providing information, support and services for carers. According to the 2006 census, there were over 161,000 carers in Ireland.
People in a caring role will have regular contact with the HSE, as an essential service provider of services like home help service, public health nursing, or occupational therapy service. As a carer you will have contact with a number of Health Care Professionals.
Tips for effective communication with Health Care Professionals include:
- Knowing who the health professional is, write down information such as names, organizations, titles and roles
- Take someone with you to appointments
- Make a list of questions
- Keep a diary of the persons problems or symptoms
- Ask for information to be written down, particularly about diagnosis or medications
- Ask your doctor for any printed material on support available or additional information on the cared for persons condition.
Community Services
The Health Service Executive has responsibility for the delivery of public health community and home care supports at local level in Ireland. One of the major challenges for the HSE is to support and develop community services which can help and support, both those people who are dependent at home, and also the family and informal carers who look after them. Public health nurses provide an essential link for carers particularly around referrals to other therapies and home care supports.
Public Health Nurses
Public Health Nurses provide free nursing care to Medical Card holders although the service is not exclusive to Medical Card holders. Public heath nursing services are also free to all people aged over 65 and to those with a long term illness.
Public Health Nurses can provide the following services:
- Home help for practical assistance with homemaking duties
- Home care, including help with dressing, feeding and other personal care
- Liaison service - for further care which may be needed at home after hospital
- Home visits, including practical advice on care techniques
- Referral for carer training - lifting, handling and strategies for coping
- Advice and assistance on continence management
- Referral to day care, respite, meals on wheels and other local services
- Advice on women’s health issues - breast care and cervical smear testing
- Information on local carer support groups including The Carers Association
- Respite care, usually for a week or two, at local residential care
Other HSE supports include:
- Physiotherapy services
- Occupational therapy
- Chiropody
- Speech and language therapy
- Social workers
- Psychological services
Home Help Service
The home help service, which is recognised both in Ireland and internationally as a vital component of community care, has received significantly increased funding over the last number of years. Currently, over 55,000 people living in the community benefit from a home help service on a weekly basis. Carers can find out more about this service from their local public health nurse or local health office.
Home care packages
A home care package is an individualized package of community based services and supports provided to enable people, assessed as needing such supports, to return home from an acute hospital or to prevent admission to an acute hospital or long term residential care. Home Care Packages comprise services and supports such as community health nursing, therapy services, home help services and access to both day and respite care. Home care packages are of their nature flexible and are tailored to the individual and changing needs of the recipient, taking account of his or her particular circumstances and the presence or otherwise of a carer. For further information on Home Care Packages contact your local health office or public health nurse.
The HSE has also developed and expanded day centres and respite services. Respite services are recognized as hugely important for carers as it offers an opportunity of a break from the stresses of caring.
Carers of people with Dementia
All people with dementia will need help from other people at some point. In most cases a family member meets this need, taking responsibility for the care and support of the person with dementia. Carers themselves often need help from others too. Family and friends are an important source of support, as are formal day-care services, home care/home support services, carer support groups and respite care. Family and care givers often have to make major changes to their lives to care for and support a person with dementia. The first step is to learn as much as you can about the condition and to consider and make plans for the future.
Caring for a family member or friend can be emotionally draining and wearing. When so much energy is going in to caring for someone else, it is so easy to neglect your own needs. It is vital to look after your own health and well-being and maintain hobbies and interests. This can help to lessen stress and help you to cope with the daily challenges you face. Click here for more information on Dementia and Alzheimer’s disease.
Ward of Court
If a person with substantial assets becomes incapable of managing their own affairs due to dementia, family may apply through a solicitor to have the person made a ward of court. If there is no family sometimes the HSE makes the application. A committee (one or more people, usually the family) is appointed by the Court to manage their affairs. The person then becomes a ward of court. All applications are processed through The Wards of Court Office (Telephone: +353 1 872 5555). This office publishes an explanatory booklet and approximately 30% of all applications involve people with dementia.
Training for Carers
There are a number of voluntary organisations providing information, advice and support for Carers in Ireland. Education and training contribute to easing the burden at home as well as establishing, maintaining and improving standards of care.
The HSE as well as voluntary agencies supported by the HSE can provide training for carers; voluntary agencies such as Caring for Carers and The Carers Association are both national voluntary organisations for carers in the home. They provide national certified training courses such as “Care in the Home” for carers and people working in the caring profession. This course covers practical caring skills such as feeding, washing, dressing and personal skills such as communication stress management and coping skills.
Other courses can include:
- Caring for Children with Special Needs
- Occupational First Aid
- Carers Support Programme
- Entitlement for Carers
- Patient Handling Course
Medication
There are two types of medication, those that require a prescription that you take to your chemist, and those that do not which can be bought over the counter.
Here are some questions you or the person being cared for may want to ask their doctor or chemist about their medication:
- What is the name of the medication and what is it for?
- Are there any possible side effects?
- What should I do if there are any side effects?
- How long will I need to take this medication for?
- Will this medication affect any of my other medical problems?
- What should I do if I forget to take my medication?
- Will this medicine interfere with any others that I take?
- Is there anything I should avoid while taking this medication – such as alcohol, cigarettes, driving?
- Check that you are taking the lowest possible effective dose of medication.
If the person being cared for is taking more than one type of medication, it can become confusing knowing when to take each one. The local pharmacist will be able to help you with this by dividing up the week’s medication so it is easier to monitor the dosage. You can also buy a daily tablet box to remind you of what needs to be taken and when. Click here for more information on Drugs and Medicines.
Financial Assistance
Carers Allowance
Carer’s Allowance is administered by the Department of Social and Family Affairs to people who are looking after someone who is in need of support because of age, physical or learning disability or illness, including mental illness. Carer’s Allowance is a means tested payment, it is mainly aimed at carers on low incomes who usually live with and look after certain people who need full-time care and attention. If you are caring for more then one person you may be entitled to an additional 50% of the maximum rate of carer’s allowance. Click here for more information on Carer’s Allowance.
Respite Care Grant
The Respite Care Grant is a cash payment made to carers and is operated by the Department of Social and Family Affairs. The grant may be used to pay for respite care for the person you are caring for however, it is not necessary to do so. Carers can use this grant in whatever way they choose. The grant is paid by the Department of Social and Family Affairs in June of each year. In previous years it has been paid to those in receipt of Carer’s Allowance, Carer’s Benefit, Constant Attendance Allowance or Prescribed Relative’s Allowance. However, since June 2005 you do not have to be receiving a payment for caring in order to qualify for the Respite Care Grant. Click here for more information on Respite Care Grant.
Supplementary Welfare Allowance
Supplementary welfare allowance is a scheme administered by Community Welfare Officers in the HSE on behalf of the Department of Social and Family Affairs. People with low incomes may qualify for an exceptional needs payment which is a single payment to help meet essential, once off, exceptional costs which the person could not reasonably be expected to meet out of their weekly income. For example, the payments can be made for special clothing for a person who has a serious illness or costs in relation to funerals. Community welfare officers also administer a Back to School Clothing and Footwear Allowance from June to September each year as part of the Supplementary Allowance Scheme. Click here for more information on Community Welfare Services.
Money Advise Budgeting Service (MABS)
MABS is a free and confidential service for people in Ireland with debt problems and money management problems. There are 52 MABS offices in Ireland, staffed by trained Money Advisers who can help you deal with your debts and make out a budget. Money advisers can examine your income to make sure you are not missing out on any of your entitlements, contact your creditors on your behalf with offers of payment if you are not able to do it yourself and help you decide on the best way to make the payments. For more information on this service contact helpline@mabs.ie or telephone: 1890 283 438 (9am – 8pm Monday – Friday).
Hospital Charges
Everyone living in Ireland and certain visitors to Ireland are entitled to a range of health services either free of charge or at reduced cost. If you need to attend a public hospital or stay overnight in hospital as a public patient, you may be liable for Hospital Charges. Medical card holders and certain other groups do not have to pay hospital charges.
There are three possible types of hospital charges, which include:
- Out-patient/accident and emergency/casualty services in public hospital charges
- Daily in-patient/day service charges
- Long-term stay charges
All citizens are entitled to in-patient and out-patient services in a public hospital, regardless of their means. Click here for more information on Hospital Charges.
Medical Cards
If you hold a medical card, you do not have to pay public hospital charges. People aged 70 years and over and ordinarily resident in Ireland are automatically entitled to a full medical card.
If you are a Medical Card holder, you are entitled to a range of free health services, including:
· Hospital care
· Medicines
· Treatment by your family doctor
· Technical aids and appliances
The HSE has discretion in granting a Medical Card and can take into account individual circumstances, such as heavy medical expense or the cost of your rent or mortgage. Click here for more information on Medical Cards.
Drug Payment Scheme
Under the Drug Payment Scheme an individual or family pays the first €90 per month of the cost of prescribed medicines. To apply, you will need to fill out a registration form which is available from your chemist or from your Local Health Office. Click here for more information on the Drugs Payment Scheme.
Long Term Illness Card
People with certain long-term illnesses or disabilities may apply to join the Long Term Illness Scheme and will be supplied with a Long Term Illness book. This book allows the person to get drugs, medicines, and medical and surgical appliances directly related to the treatment of your illness, free of charge. It does not depend on their income or other circumstances and is separate from the Medical Card Scheme and the GP Visit Card Scheme. People who already have been given a Medical Card do not need to apply for a Long Term Illness book. Click here for more information on Long Term Illness Scheme.
Nursing Home Subvention
The Nursing Home Subvention Scheme is a grant towards the cost of care in a private nursing home. Subvention may be granted following a medical assessment of your need for nursing home care and a means test of your income. Click here for more information on Nursing Home Subvention Scheme.
Bereavement Grant
The Bereavement Grant administered by the Department of Social and Family Affairs is a once-off payment to help with funeral costs. Eligibility is usually based on PRSI contributions and is not related to ability to pay for the funeral. The grant is also paid on the death of a person who has been getting a contributory pension or on the death of their spouse, partner or someone for whom the contributory pensioner would have been getting an Increase for a Qualified Adult. Click here for more information on Bereavement Grants.
Bereavement Counselling
Everyone experiences loss during life. However, for carers many of the changes and losses experienced come quickly and can lead to feelings of grief. Other people may understand that you feel grief for the person who has died but they may not realise that you can also feel the loss of not being a carer anymore. Bereavement counseling offers the opportunity to explore, understand and work through feelings of grief. Although everyone's personal reaction to a bereavement is different, most people experience some of the following emotional responses when someone close to them dies such as disbelief, shock, anger, sadness, relief, guilt, depression, anxiety, despair, longing and loneliness. Carer support groups can also offer different types of support. Your general practitioner or local health office can provide advice on supports available in your area. Click here for information available on Bereavement Counseling.
Other relevant contacts or links include:
HSE National Information Line
Monday to Saturday, 8am-8pm
Call Save: 1850 24 1850
Email: info@hse.ie
The Carers’ Association
Freephone 1800 240 724
Monday to Friday, 9am – 5.30pm
Email: nationalcareline@carersireland.com
Website: www.carersireland.com
Caring for Carers Ireland
Telephone: 065 6866515
Monday to Friday 9.30am to 5.00pm
Email: caringforcarers@eircom.net
Citizen’s Information Centres
LoCall: 1890 777 121
Monday to Friday, 9am-9pm
Website: www.citizensinformation.ie
Citizens Information provides comprehensive information on all aspects of Public Services and entitlements for citizens in Ireland and is based on a personal approach to the presentation and delivery of information on public services and the social and civil rights of everyone in Ireland. Citizens Information is also available by calling in person to a Citizens Information Centre near you. This is a free and confidential service.
The Alzheimer Society of Ireland
National Helpline Freephone 1800 341 341
Monday to Friday, 10am – 4pm
Email: info@alzheimer.ie
Website: www.alzheimer.ie
Irish Hospice Foundation
4th Floor
Morrison Chambers
32 Nassau Street
Dublin2
Ireland
Tel: +353 (0)1 6793188
Website www.hospice-foundation.ie
Email:info@hospice-foundation.ie
Money Advice Budgeting Service (MABS)
Helpline number: 1890 283 438 (9am – 8pm Monday – Friday)
Email: helpline@mabs.ie
Senior Helpline
LoCall: 1850 440 444
Seven days a week, 10am-1pm and 7-10pm
AWARE
Helpline: 1890 303 302
Seven days a week, 10am–10pm
Email: info@aware.ie
Website: www.aware.ie
Active Retirement Ireland
Tel: 01-6792142
Email: fara@eircom.net
Address: Shamrock Chambers, 1-2 Eustace Street, Dublin 2
Active Retirement Ireland is the largest national network of local and community based voluntary groups involving older people in Ireland. We believe that getting older is not a barrier to continuing to enjoy life, maintaining dignity and independence, making new friendships, acquiring new skills, sharing experiences and contributing to the community. Joining your local active retirement association is one of the best ways of achieving these aims.
Last updated on: 22 / 10 / 2009