Support and Services for Caring for Older People

Are you caring for an older person or friend?

‘A family carer is described as someone who is providing an ongoing significant level of care to a person who is in need of care in the home due to illness or disability or frailty.’ The care that family and other carers provide involves looking after the needs of people with a wide range of dependencies across all age groups. The support from the carer enables the persons they are caring for remain at home for as long as safe and practical.  

This page provides information on services and supports for older people aged over 65 and their carers.  Check the Carers Support section for more general information.

How Health Services are Organised
The HSE delivers health services through six Hospital Groups and nine community health areas called Community Healthcare Organisations (CHO) across the country.

Acute Hospital Services
Our hospitals provide planned and emergency inpatient care, emergency department, maternity care, outpatient and diagnostic services.  Some acute hospitals provide day hospital services which are generally Consultant led and provide a full medical service. Referral to this service is through your GP.  If a patient is being discharged from an acute hospital the staff there will speak to the appropriate community staff to organise care following discharge. Family carers and relatives may be involved in the discharge process with agreement of the patient.

Community Services
The Community Healthcare Organisations (CHO) support people who are dependant at home. The CHO also provides support to family carers and informal carers. The Primary Care Teams provide core support services including Family Doctor, Public Health Nurses, Physiotherapists, Occupational Therapists, Speech and Language Therapists.  Older Persons Services provide home support such as home help, homecare packages, daycare, meals on wheels and residential services including long stay care, respite care and short stay care.

To access community health services the first point of contact is usually with your GP or through your local Primary Care Team (PCT) including the Public Health Nursing service who can be contacted through your local health centre. Find your local services

How to Access Services
A care needs assessment identifies an individuals dependencies and care needs to ensure that appropriate care is provided in the most appropriate setting. A health professional will assess a person’s ability to look after themselves safely; for example; personal hygiene, movement / mobility, continence management, preparing meals and essential environmental care/ cleaning and caring for their home.  Following this assessment a Care Plan will be prepared showing the care that will be provided to meet the identified care needs and all the actions to be undertaken by relevant services and care staff involved. This may be at home or in a residential home.

The Home Care Plan will include ‘formal care’ provided by the HSE, private or voluntary organisations and the ‘informal care’ provided by carers, family and friends.  It takes account of the older person’s opinions and wishes and where appropriate and with the older persons agreement the views of the carer will also be considered.

Under the HIQA National Standards for Residential Care Setting for Older People in Ireland for each resident must have a Residents Care Plan (Standard 11). The plan must be started within 48 hours of admission and is developed in consultation with the older person and the relevant health professionals in the nursing home. 

Your local health office or Public Health Nurse can help you to access community services in your area.

Home Support Service
There are currently, over 47,000 people benefiting from a home help service and approximately 15,000 people are in receipt of a home care package. Find out more about home care packages

Home Help Service
The HSE home help service provides personal care and or essential domestic care to dependant people to support them to live at home.  Your local health office or Public Health Nurse can help you to access community services in your area.

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 can include services and supports such as public health nursing, therapy services such as physiotherapy, occupational therapy, home help services and access to both day and respite care. Find out more about Home Care Packages

Day Care
The HSE also directly provides and funds voluntary organisations to provide day care and meals on wheels services services. The type of day service provided varies with  some providing a more social element which may offer personal care such as showering, chiropody; while other services are nurse led and provide a nursing service as well as social activities.  Some day care centres are targeted at specific conditions such as alzheimers / dementia.  Your local health office or Public Health Nurse can help you to access community services in your area.

Respite services 
Respite services both in the home and in nursing homes are recognized as hugely important for carers as they offer an opportunity to take a break from the stresses of caring. Your primary care team/ public health nursing service can help you to access respite services in your area. Find out about the government Carer's Support Grant (formerly called Respite Care Grant) 

Residential Services
The HSE is committed to supporting older people to stay at home for as long as it is safe and practical. Residential care in Ireland is provided through public (HSE) homes, private and voluntary Organisations. In the event that residential care is required the HSE has a scheme to part fund nursing home care. Find out more about the Nursing Home Support Scheme. Or content your local health office or Public Health Nurse to access community services in your area.

Choosing a Residential Home
If you are considering a residential home you may find it helpful to view the latest inspection reports for the nursing home you are considering on www.hiqa.ie  A list of nursing homes in Ireland and information on key steps to consider before choosing a home is available on www.myhomefromhome.ie. This is a collaboration between HSE, Third Age and Nursing Home Ireland.

Health Information and Quality Authority (HIQA)
HIQA is the Government appointed organisation to register and inspect residential services and monitor their compliance with the National Quality Standards for Residential Care Settings for Older People in Ireland.021 240 9300 info@hiqa.ie www.hiqa.ie

Caring for someone with Dementia 
Caring for someone with Dementia can bring its own unique challenges and care requirements.  If you are caring for someone with dementia and would like further information on the condition and supports available see Dementia and Alzheimer’s disease.

Safeguarding Vulnerable Adults
Each Community Healthcare Organisation has a Safeguarding and Protection Team for vulnerable adults so if you have any concerns about abuse and or neglect of a vulnerable older person please contact your health professional or the Safeguarding and Protection Team.  If you have any concerns about the welfare of a child or young person please contact TUSLA The Child and Family Agency www.tusla.ie

Tips for Effective Communication with Health Care Professionals
People in a caring role usually have regular contact with health professionals in the HSE and other health providers.
To get the best out of your visit or appointment with a health professional we recommend 

  • Knowing the health professionals looking after your family member. Write down this information such as name, contact details, organisations, titles and role.
  • If you have a large Family, agree who will be the main contact person communicating with the health professionals.
  • Go with your Family member to appointments, where possible and with their consent.
  • If you are attending an appointment on behalf of your family member, take someone with you to the appointment, especially if you are concerned about the information to be shared.
  • Make a list of questions you want answers to.
  • Keep a diary of your Family members problems or symptoms and any concerns that you have.
  • Ask for information to be written down, particularly about diagnosis or medications.

Your Health and Wellbeing
Being a carer can be challenging emotionally and physically. It's really important that you look after your self both physically and mentally. It is important to maintain social relationships and activities as much as possible. Find out more about Caring for yourself.

Training for Carers
Relevant education and training may help you to care for yourself and family member more effectively and safely.  It's important to learn how to care more effectively and safely. The HSE as well as voluntary agencies supported by the HSE can provide training for carers for example;

Family Carers of Ireland (formerly Carers Association & Caring for Carers) The national voluntary organisation for carers in the home provides a range of training.

Alzheimer’s Society of Ireland provides training courses to suit the family carer.  

Your local health office or Public Health Nurse can help you to access community services in your area.

Finance and Benefits
There are some government financial schemes for carers such as the Carers Allowance, Carer's Support Grant (formerly called Respite Care Grant) 
Learn more about medical cards and other benefits and schemes administered by the HSE.

Ward of Court
If a person with substantial assets is unable to manage their own affairs due to mental incapacity, an application can be made 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 the affairs of the Ward. The person then becomes a Ward of Court. All applications are processed through The Wards of Court Office (01 888 6189). Approximately 30% of all applications to the court involve people with dementia.  Learn more about Wards of Court

The Ward Of Court process will be replaced by the Assisted Decision Making Act later in 2016. 

Assisted Decision Making (Capacity) Act 2015

The Assisted Decision Making (Capacity) Act was passed by the Oireachtas in December 2015.  It will come into effect in 2016. This Act applies to everyone and has relevance for all health and social care services.

The Key features of the Assisted Decision Making (Capacity) Act are:

  • It applies to everyone and to all health and social care settings.
  • It provides for the individual’s right of autonomy and self-determination to be respected through an Enduring Power of Attorney and an Advance Healthcare Directive – made when a person has capacity to come into effect when they may lack decision-making capacity.
  • It provides for legally recognised decision-makers to support a person maximise their decision making powers.
  • It places a legal requirement on service providers to comprehensively enable a person make a decision through the provision of a range of supports and information appropriate to their condition.
  • It abolishes the Wards of Court system. 
  • It provides for a review of all existing wards to either discharge them fully or to transition those who still need assistance to the new structure.
  • It repeals the Lunacy regulations governing the Ward of Court system.
  • It establishes a Decision Support Service with clearly defined functions which will include the promotion of public awareness relating to the exercise of capacity by persons who may require assistance in exercising their capacity. 
  • The Director of the Decision Support Service will have the power to investigate complaints in relation to any action by a decision-maker in relation to their functions as such decision-maker.

For further information see  Citizens Information - Incapacity or get legal advice.

Bereavement Counseling
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.

Check out the voluntary organisations providing helplines, supports and services for older people and their carers.