Need help at home for yourself or a family member as you or they get older? What’s available, what’s free and what does private care cost?

The first thing you can consider – if the ageing person would like you to be their carer and if you are on a low income – is to apply for the carer’s allowance. However, to avail of this you can’t work outside your home for more than 15 hours a week. You get €204 per week maximum (under age 66) and €239 if you (the carer) are over 66.

Carer’s allowance is means-tested but €332.50 of your gross weekly income is disregarded if you are single, for example. A doctor would also have to agree that the person needs such care. You would also be entitled to a respite care grant of €1,375 each June – which can be used any way you wish – and some household benefits if you live with the person you are caring for. However, you don’t have to live in the same house as the person you care for.

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HOME HELP HOURS

Managing fairly okay and don’t need a carer as such but could do with a bit of extra help with daily tasks? If so, you could apply to the HSE for some home help hours. The HSE will provide these if you qualify and if funds are available. The service is generally free if you have a medical card.

If you need more help than this, you can apply for a home care package. This might be if you’d just come out of hospital, say, or your medical situation has deteriorated. This package may include additional home help, physiotherapy, chiropody, day care services and respite care. You don’t need a medical card to apply and it’s not means-tested, but again – the sticking point – HSE funds for this have to be available in your area. A care needs assessment (including a physical examination) will be done to confirm that you need support. If you are turned down for home help/care package but you still need it – and can afford it – you can employ a private care company.

WHAT TO CHECK FOR

Michael Harty, CEO of Home and Community Care Ireland (HCCI), says: “We would say that it’s better off starting early rather than later with home care, even having someone in one hour a week to start, because there is nothing more jarring than a person going from having nobody to having somebody there for six hours a day.

“Don’t wait until it gets critical. Our experience is that people see very quickly that home care improves their quality of life.”

Private home care offers companionship and personal care along with medication management and transportation to medical appointments if desired. It is usually sons or daughters rather than elderly parents who ring home care providers, he says.

As the sector is not regulated at present, you should research your private home care provider carefully, he says.

“You should make sure the provider has employer liability insurance in case the carer hurts themselves while working in your home. Also, you should expect the company to do a proper assessment, which will enable them to select the most appropriate carer available based on personality, logistics and skillset.”

Private care costs between €20 to €26 per hour. There is tax relief available on private home care costs at the funder’s marginal rate. There are now 25 to 30 private home care companies in Ireland, up from 10 in 2005. HCCI would like to play a more important role in the health sector, Michael says.

“What’s missing at the moment is client choice. We’d like the client to be able to choose the company that provides their home care through the HSE. Some of the Fair Deal scheme funding could be opened up for home care also, helping people to stay at home longer – something most want.”

‘You can feel very isolated as a carer’

Anne Kilduff-Lynam is a former nurse and farmer who has secondary-progressive MS herself but is also caring for her 85-year-old mother Rita.

Rita has early stage dementia and severe osteoporosis.

What is Anne’s experience of support as a carer?

“Mum gets a half hour home help from the HSE in the morning and evening to get her up and put her to bed every day. Two days a week she goes to St Joseph’s Day Care Centre in Trim from 11am to 3pm. She is showered once a week there. I take her to and from St Joseph’s myself. While I’m glad that she has this service, I’m hardly home before I have to go back again. If she was there until 4pm or 5pm it would be a huge help.”

Anne doesn’t qualify for carer’s allowance because the farm income is too high.

“I’m just over the limit so don’t qualify. I’m told that the respite grant can be given independently of the carer’s allowance so I am applying for that. It would be a help with heating the house for Mam. She is very immobile and needs the heating on all of the time.”

Anne would also like more regular visits from the public health nurse service.

“I haven’t seen a nurse since the bed sore my mother developed in hospital healed up. That’s a year ago now. It took four months of constant care to get it to heal, with the nurse coming out once a week and me doing the rest.”

Anne often has to get up in the night when her mother wakes.

“She pressed the panic button at 4am recently and was shouting at the responder to help her stop cattle. It sounds funny now but it wasn’t then. It can be so tiring. Sometimes she takes everything off and the bed would be wet. It’s worse than looking after a child really.”

Only for Carers Ireland, Anne wouldn’t have been aware of the supports available.

“It happens gradually and people don’t realise what you’re going through and you don’t know what supports are out there, especially if you’re not computer savvy – as many carers aren’t.

“Carers are so busy too. My mother isn’t ready for a nursing home yet as she is still manageable and the Fair Deal scheme is complicated.

“You can feel very isolated as a carer. I can’t go out socially unless I have someone to mind Mam. So often the emphasis is on the person being cared for even when carers may not actually be well themselves.”