More than half of nursing home residents could live at home if they were provided with enough support, according to a new study of social workers.

The report, compiled by a number of care groups, points to a lack of home help services as the major hurdle facing elderly people who would prefer to remain at home.

Waiting lists and service inconsistencies between different geographic areas were among the problems cited by social workers interviewed as part of the research.

“Often the situation is that you are waiting for someone to die to access hours,” one participant said.

Others cited difficulties in applying for home help hours for their clients. 

One social worker said they needed to make three calls to a public health nurse and write a three-page report to request one hour a hour. They said they needed to make their case “sound really bad”, and that it felt “like begging”.

In the end, a home help co-ordinator allocated three quarters of an hour per week.

Participants also reported that most older people they worked with did not want to go into long-term residential care. 

"I could count on one hand the number of people who want to be in the facility," one person said. "Many people eventually accept their situation – they see it as having no other choice."

The Irish Association of Social Workers, Age Action and the Alzheimer Society of Ireland - which compiled the report along with UCD academics - said the system is “disorganised, fragmented and underfunded”.

John Brennan of the Irish Association of Social Workers said: “All of the evidence and the feedback from the social workers that spoke to us confirm that older people, including those with dementia, want to stay at home as long as possible.

“Many of these people could be at home, where they want to be, where their families want them to be and where government policy says they should be, but we are simply not providing the supports they need."

Speaking on Newstalk Breakfast, he stressed that the state relies to a great degree on family carers.

"We had one instance of an 84-year-old woman, and her 82-year-old sister, who were living together.

"The 82-year-old was looking after the 84-year-old but they weren’t getting a service because there was a family carer there.”

Geographical disparities

The report also highlighted that each of the nine community health organisations (CHOs) has its own system for providing home care services and its own criteria for deciding what older people are entitled to.

Emer Begley of the Alzheimer Society of Ireland explained: “You might be able to get a home help in one place but be refused 10 miles down the road because you’re the other side of line on a HSE map, even though your circumstances are exactly the same."

Even when older people do get access to services, many home helps are not allowed to carry out simple domestic tasks such as cooking, she added.

Dr Marita O’Brien of Age Action said: “It has been government policy since the 1960s to support older people to stay at home as long as possible but this simply isn’t happening.

“Right now, the priority must be increased investment in community care services and putting in place a transparent, nationwide, system to provide home care.

“This requires ring-fenced, centralised, annual budgets. Need, not your address, should be used to allocate care services."

The authors of the report are calling for immediate investment and reform of community care services, and a fairer way of allocating home help.

The study was based on a nationwide survey of social workers working with older people, including people living with dementia.