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Irish Times
14 hours ago
- Health
- Irish Times
Letters to the Editor, June 20th: Older people and language, loving your neighbour, misery and Gen Z
Sir, – A narrative of protecting our vulnerable 'elderly' has emerged following the recent RTÉ Investigates programme on the horrific treatment of older persons in nursing homes. Listening to the various debates, one is struck by the importance of language and the messaging that it conveys in the public discourse. Organisations such as the Irish Gerontological Society (IGS), devoted to the study of ageing, prohibit the use of the term 'elderly' in their publications due to negative connotations associated with dependency. Terms such as 'older persons', 'older people' or 'older adults' are encouraged by organisations such as Age Action, and Alone who seek to empower older persons and combat ageism. READ MORE Considering later life through the lens of the citizenship frames 'older persons' as citizens and rights holders, with the right to have their holistic needs met in whatever setting they may be residing. Furthermore, the lens of citizenship advocates an analysis of how policies and social structures affect our older citizens, and can challenge ageism which impacts upon the rights of older persons to participate fully in society. – Yours, etc, Dr JENNIFER ALLEN, Senior social worker, Mental Health Service for Older Persons, St Vincent's University Hospital, Dublin. Sir, – In light of the disturbing findings revealed by RTÉ Investigates into the treatment of residents in some Irish nursing homes – particularly Beneavin Manor, Glasnevin and The Residence, Portlaoise – I feel compelled to share a contrasting experience. My 90-year-old mother is supported at home by a home care team. They are men and women from all over the world, and their presence brings her joy, comfort, and dignity. When one of her regular carers recently moved on, she was genuinely sad to see him go – a testament to the meaningful relationships built through consistent, person-centred care. Just this week, with some additional private hours topping up her HSE allocation, the team supported my mum to leave the house for the first time since March. She went to the hairdresser – for a perm! That small act was transformative – restoring her sense of self, and later that day, we learned she will be discharged from palliative care. This is what good care looks like. As a country, we are reeling from yet another scandal in institutional care. But we must also look to the models that are working – those rooted in respect, continuity, and human connection. Home care, when properly resourced and delivered by skilled, valued workers, can change lives. It can restore dignity. It can offer hope. We need strong oversight in nursing homes, but we also need investment and policy reform that empowers people to stay in their own homes for as long as possible – safely, and on their own terms. – Yours, etc, KATHLEEN McLOUGHLIN, Roscrea, Co Tipperary. Key observation Sir, – Reading Ray Burke's Irishman's Diary (June 18th) reminded me of a story of a local character in Athy years ago, who on seeing the fire brigade flying by with sirens blaring was heard to say: 'It's not my house anyway, I have the key in my pocket.' – Yours, etc, NUALA QUINN, Carlow. Loving God and your neighbours Sir, – As someone who has served for over 30 years until my recent retirement as a rector in the Diocese of Down and Dromore, I find Bishop David McClay's statement to the clergy and people of Down and Dromore saddening (' Bishop criticises Christ Church invite to speak at Pride service ,' June 18th). He does not speak for me, or for many members of his diocese. Many committed Christians will find what he says distressing, even hurtful. Of course, the bishop speaks for many Christians, and the issues surrounding human sexuality are currently a cause of much division and pain. People of deep faith and real integrity are on both 'sides' of the debate. I find it difficult to understand why he, and many others, place such emphasis on those few (almost certainly less than 10) scriptural passages that either disapprove of, or condemn, same-sex relationships, while ignoring passages that prohibit wearing clothes of two different types of material, cross-breeding domestic animals or planting two kinds of seed in the same field (Leviticus 19:19). If there are gradations of authority, why this one? But to me the clinching argument is this: over the centuries, and even today, gay people have been made to feel rejected, misunderstood, hurt and isolated, unable to express themselves. The church, along with society as a whole, has been complicit in this. Many have been driven to despair, even suicide. Church condemnation of same-sex relationships causes great pain to many and gives permission to an unacceptable homophobia. I know that this is not Bishop McClay's intention, but it happens. To me the call to love our neighbour demands that I do not take positions that make others feel less than worthy. Love is the supreme command – love God and neighbour as we love ourselves. That trumps any legalistic prohibitions. Let us celebrate same-sex love just as we celebrate heterosexual love. Let us affirm those who are different, those we may not understand. That is part of love, the supreme command. – Yours , etc, Rev Canon TIMOTHY KINAHAN, Northern Ireland. Trinity College and Israel Sir, – Dr David Landy states that academic freedom was 'an important consideration in the Trinity debate' that resulted in the university's decision on June to cut ties with Israeli universities (' Why academic institutions are cutting ties with Israel ,' June 19th). But there has been no debate in Trinity. The college board voted to accept the internal taskforce recommendations before referring the report for further consideration to relevant college committees in line with the terms under which the taskforce was established. Indeed, the taskforce report has not been published, so most of the faculty have been unable to scrutinise it or understand how the board came to its decision. The principle of academic freedom has been shredded by the board's decision. Academic freedom is not compatible with an institutional ban on co-operation with colleagues in Israeli universities and research units. Academic freedom gives Dr Landy the choice to personally cut ties with colleagues in Israel or any other country he chooses, but that freedom is no longer available to Trinity academics who wish to continue contacts with colleagues in Israel. As Israel is an associate country to the European Union's research and innovation funding programmes, Trinity academics are now unable to apply for EU funding for research projects which include Israeli colleagues. As an illustration, one such current project is working on a novel, off-the-shelf delivery system for mRNA-based nanomedicines to improve diagnostic and therapeutic options for cancer and cardiovascular disease. Researchers from Trinity and the University of Tel Aviv are working on this project together with colleagues from the Netherlands, Canada, France, Hungary, Sweden, Spain, Norway and Belgium. Trinity researchers are also working on trials whose objective is to improve outcomes for people with autistic spectrum disorders via a global clinical trial. Researchers from Trinity and the Israeli pharmaceutical firm Teva are two of 63 European and US participants including hospitals, universities, patient groups, pharma companies and not-for-profit organisations. While these projects will continue, Trinity academics are now locked out of all such research consortia. Years of academic endeavour will now go to waste and millions of euro of funding will be lost. Dr Landy claims that Trinity's boycott of Israel is not anti-Semitic. However, while Trinity singles out Israel alone – the only Jewish state on earth, home to half the population of the world's Jews – but maintains ties with other countries with well-documented human rights and international law violations, the charge of institutional anti-Semitism and racism is unavoidable. – Yours, etc, JANE MAHONY, PhD, TCD, Dublin 6. Misery and Gen Z Sir, – The Oxford Dictionaries define Generation Z as 'the group of people who were born between the late 1990s and the early 2010s who are regarded as being very familiar with the internet'. Finn McRedmond writes that 'it's no surprise that Gen Z are miserable' (June 19th ). Perhaps spending less time with the internet and the phone might bring less misery. – Yours, etc, PATRICK O'BYRNE, Dublin 7. Missing out on transition year Sir, – What a great idea to have a national plan to target educational disadvantage. I note the Minister for Education, Helen McEntee, plans to particularly tackle high levels of absenteeism in disadvantaged and special education settings. I wonder does always excluding children in special schools from transition year, thus missing an entire year of education that over 80 per cent of their developing peers receive, represent State-endorsed absenteeism? Transition year is never offered in any special school in the State as per Government policy or never has been in the 40 years since its inception. If Ms McEntee's genuine priority is to really target educational disadvantage, it might be useful to finally lift this rock? – Yours, etc, CAROLINE FARRELL, Dublin 3. Debating security and the EU Sir,– In the Letters page (June 17th), Senator Tom Clonan, John O'Riordan and Fintan Lane comment in different ways on Ireland's potential contribution to debates on European security and global order. Ireland has a solemn duty to speak truth to power within the EU, said Clonan. The EU should 'negotiate directly with Russia to find conditions for an immediate ceasefire and an enduring solution to the Russian-Ukrainian war', said O'Riordan. 'Instead of decoupling Irish Army deployment abroad from the UN,' the Government should argue 'for deeper reform within the UN and a greater role for the General Assembly', said Lane. Pope Leo XIV states that 'the temptation to have recourse to powerful and sophisticated weapons needs to be rejected'. From this perspective, there is a scenario that draws together the thinking of Clonan, O' Riordan, and Lane. If a mission linked to the Organisation for Security and Cooperation in Europe (OSCE) monitors a future line of contact in eastern Ukraine, as happened under the Minsk agreements, a reimagined OSCE can recover the role it played in the former Helsinki process as a space for deliberation about the future. The defining goals of a new Helsinki-style dialogue can be summed up in three points: (i) recognition of the European Union as the anchor of a wider European zone of peace and economic cooperation; (ii) avoiding economic and cultural 'zero-sum games' in eastern Europe, the Caucasus, and other parts of the region: and (iii) a renewed commitment, based on the Helsinki principles, to enshrine cooperative economic relationships as a core value in international relations, and in this way to bring the European and global agendas together. In becoming the advocate and anchor of a wider European zone of peace and economic cooperation, the European Union can discover a new energy and sense of purpose. In the absence of some new departure in diplomacy, we are likely to see a hardening of the 'unquestioned assumptions and myths' referred to in Clonan's letter. In Germany, the UK, and elsewhere, the proposition that the arms industry and the arms trade are the key to 'future-proofing' the economy is mingled, not quite coherently, with arguments based on considerations of military security. A recent article by the president of the European Central Bank asserts that 'joint financing of public goods, like defence, could create more safe assets'. Christine Lagarde associates the supposed benefits of manufacturing weapons of greater and greater lethality with a further centralisation of power within the EU: 'more qualified majority voting in critical areas would enable Europe to speak with one voice.' The forthcoming international conference on financing for development in Seville will give us an indication of the extent to which the temptation to pursue growth and innovation through the arms industry is accompanied by reductions in development assistance and a loss of interest in the sustainable development goals (SDGs) and international financial reform. This year, for the 50th anniversary of the Helsinki Final Act, the chair-in-office of the OSCE is Finland. In 2026, it will be Switzerland. Is it unthinkable that in a spirit of solemn duty, as evoked by Clonan, Ireland could take on this burden in 2027 or 2028? We would bring to the table the values of the Good Friday agreement and Irish Aid, our peacekeeping tradition and our military neutrality, our standing as an EU member state with close links with the US, and our role in co-facilitating the negotiation of the SDGs. EU founding father Robert Schuman believed that 'the peace of the world cannot be maintained without creative efforts commensurate with the scale of the threat'. For him, the European project stood for the economics of solidarity at home and abroad. The Schuman Declaration emphasises Europe's responsibility to Africa. Let Schuman be the north star of the project I have in mind. – Yours, etc, PHILIP McDONAGH, Adjunct professor, Faculty of Humanities and Social Sciences, Dublin City University. Visiting other countries Sir, – Dennis Fitzgerald suggests in his letter (June 18th) that, given the current state of the world, we might do well to visit Australia – a safe and friendly destination, with only the occasional jellyfish or mushroom to worry about. It's a tempting thought. But I wonder if we are not long past the time when choosing a holiday should simply be a matter of personal taste, budget and travel brochures? Flying halfway around the planet for a bit of sunshine and sightseeing is hard to square with the knowledge that the very act of doing so helps fuel the fire – quite literally – that is making many parts of the world increasingly uninhabitable. This isn't a question of blame, but of awareness. Perhaps instead of encouraging long-haul leisure travel, we should be asking how to make it feel less normal – and a bit less easy to justify – in a time of planetary crisis. There are worse things than jellyfish. One of them is pretending there is no climate emergency. – Yours, etc, JAMES CANDON , Brussels, Belgium.
Forbes
17 hours ago
- Health
- Forbes
What The Senate Budget Bill Would Mean For Older Adults
WASHINGTON, DC - MARCH 14: Senate Finance Committee Chairman Mike Crapo (R-ID) is seen before Dr. ... More Mehmet Oz arrives for his confirmation hearing to lead the U.S. Centers for Medicare and Medicaid Services (CMS). (Photo by Craig Hudson for The Washington Post via Getty Images) The Senate's draft budget bill would cut Medicaid for older adults and people with disabilities even more deeply than the House version. It would scrap a Biden-era minimum staffing rule for nursing homes. And, at the same time, it drops a House proposal to increase tax-free savings that higher-income households could use to buy long-term care insurance or pay caregiving costs. The overall measure, approved by the Senate Finance Committee and likely to reach the Senate floor sometime next week, would cut taxes by trillions of dollars over the next decade and cut spending, though by significantly less. The Congressional Budget Office has not yet calculated the costs of the package. It also is possible Senate GOP leaders will revise the bill before it reaches the Senate floor. However, the current version would make substantial changes to programs affecting older adults, especially those on Medicaid. While Medicaid is widely considered to be a program for poor families, more than half of its benefits go to older adults and younger people with disabilities. About 7.2 million seniors and 4.8 million younger people with disabilities are enrolled in both Medicaid and Medicare. The Senate bill mimics the House measure by limiting the ability of states to tax Medicaid providers, such as hospitals and nursing homes, but it is even more aggressive. Those complex provider taxes make it possible for states to pay providers more and effectively bill most of the additional costs to the federal government, which pays for about 70 percent of the program on average. The House bill would cap these taxes at current levels. The Senate plan would require states to lower their taxes for most providers, though they still could tax nursing homes at the higher levels. The provider tax limits would apply only to the 40 states and the District of Columbia that expanded Medicaid under the Affordable Care Act. Critics call provider taxes a financial gimmick that allows states to boost federal payments for the program. However, the real-world impact would be less federal funding for state Medicaid programs. And that would force states to either cut Medicaid benefits, limit program eligibility, or raise taxes to fill the federal hole. It also likely would result in states scaling back their home and community-based benefits, which are optional under the law, and shift more people to nursing home care, which is required. Like the House version, the Senate bill also would require Medicaid recipients to work. It exempts older adults and people with disabilities from having to work. But it could require some family members who are unable to work because of their caregiving responsibilities to choose between assisting a loved one and losing their own Medicaid benefits. The House bill appears to exempt family members caring for children and younger people with disabilities, but it is not clear whether it protects those staying home to assist frail parents or spouses. The Senate bill is ambiguous in a different way. It would exempt people from the Medicaid work requirement if they are a 'parent, guardian, caretaker relative, or family care giver (as defined in section 2 of the RAISE Family Caregivers Act) of a dependent child 14 years of age and under or a disabled individual.' And what does the RAISE Act say? 'The term 'family caregiver' means an adult family member or other individual who has a significant relationship with, and who provides a broad range of assistance to, an individual with a chronic or other health condition, disability, or functional limitation.' What does that mean? Well, nobody really knows. What does 'significant relationship' mean? What is a 'broad range of assistance?' What happens if two Medicaid recipients are caring for a parent? Which is exempt from the work requirement? Presumably, somebody at the Department of Health and Human Services eventually would have to write regulations to clarify it all. But that could take months, at the very least, especially since the Trump Administration fired so many HHS staffers earlier this year. The Senate bill also adopts many of the House's additional paperwork requirements for those applying for Medicaid or trying to keep benefits. It would block a Biden Administration rule that makes it easier to enroll in Medicare Savings Programs, which allow Medicaid to cover Medicare premiums and cost sharing. Without MSPs, low-income Medicare beneficiaries would have to pick up those costs themselves or buy costly Medicare Supplement (Medigap) insurance. The Senate bill also would effectively scrap Biden rules that would require nursing homes to maintain a minimum level of staff, including aides and Registered Nurses. Nursing homes are fighting those rules in court but a congressional repeal of the regulations would make the legal battle unnecessary. Finally, the Senate bill excludes a change in the House bill that could benefit higher-income people who want to put money away for long-term care. The House version would double the maximum contributions to employer-based Health Savings Accounts, but the Senate measure currently has no provision. The House and Senate are operating on a self-imposed July 4 deadline for passing this huge fiscal bill. It will be important to keep an eye on what happens over the next couple of weeks.
Irish Times
2 days ago
- Health
- Irish Times
‘Nuclear option' to close nursing homes must be used, says Taoiseach
The 'nuclear option' to close nursing homes for significant failings 'has to be on the table', Taoiseach Micheál Martin has said, describing it as a 'fundamental power' of the Health Information and Quality Authority (Hiqa), the monitoring body. Mr Martin told the Dáil it was up to the Health Service Executive 'to resolve the consequential crisis that occurs when a decision to close is made. 'But we shouldn't baulk from that decision because of that.' He was responding to Sinn Féin leader Mary Lou McDonald and Labour leader Ivana Bacik, who highlighted what they said was a lack of power at Hiqa. READ MORE Wednesday's debate followed the publication of Hiqa's interim report on the Emeis Ireland nursing homes – Beneavin Manor in Dublin and The Residence in Portlaoise on Tuesday night. Both featured in the recent RTÉ Investigates programme. Mr Martin said there were some 'very disturbing clear facts' in the report, citing the non-adherence to fire regulations. 'Now, to me, that's a red alarm,' he said, adding that when fundamental issues like the health and safety of residents are at stake, then closure is an option. [ Taoiseach Micheál Martin's Cork office vandalised amid 'personal threats' Opens in new window ] Ms McDonald said it was clear Emeis did not fear Hiqa. 'Quite frankly, they didn't give a toss about regulations or inspections,' she said. 'Little wonder, because Hiqa's hands are tied behind its back. They don't have the legal power to impose fines. The corporate entities that own these nursing homes are out of their reach. And Hiqa badly needs new powers'. She asked how it took an RTÉ programme to expose a scandal when the report showed there were 198 allegations of abuse at a single nursing home. Opposition smells blood in the water over RPZ changes Listen | 35:51 The Dublin Central TD said 20 years ago, 30 per cent of nursing homes were in private hands but that had since risen to 80 per cent. During testy exchanges, Mr Martin said Hiqa's powers had been broadened since 2017 and stressed that 'if there is a series of noncompliance as seems to be the case in respect of the interim report of Hiqa', the option of closure 'should be on the table'. Ms McDonald said the culture of abuse 'was obviously endemic, hard-wired into the operation of the homes, and went on for a very long time'. Ms Bacik said trust in the model of private and for-profit nursing home care 'has been shattered' since the RTÉ programme and that 'faith in the system of inspections has also been greatly damaged', requiring Government action. [ Ireland's EuroMillions winner bought their €250 million winning ticket in Munster Opens in new window ] The presentations of Hiqa's chief executive and inspectors at Wednesday morning's Oireachtas health committee had raised more questions than answers, she argued, claiming the chief inspector had been 'frankly evasive' when asked about reports of abuse in a third nursing home. Mr Martin said the power to cancel nursing home registrations existed and that it had been used in eight cases last year. 'It can and has happened,' he said.
Irish Times
2 days ago
- Health
- Irish Times
Minister ‘has concerns' over nursing-home sector's increasing privatisation
Minister of State for older people Kieran O'Donnell said he has 'concerns' about the increasing privatisation of the nursing home sector, particularly in light of recent allegations of elder abuse and neglect at two centres. The Minister appeared before the Oireachtas health committee on Wednesday, after a programme by RTÉ Investigates highlighted instances of alleged abuse at Beneavin House, Dublin, and The Residence, Portlaoise. Both homes are run by Emeis, the largest provider of private nursing home beds in the State. The programme included footage of frail, older people, some of whom had dementia, allegedly being manhandled, 'forced' down into chairs, being left in chairs for hours, being left in incontinence pads for so long their clothes were soaked and being ignored when they pleaded for help to go to the toilet. Speaking to politicians, Mr O'Donnell said some 75 per cent of nursing homes in Ireland are privately run, adding: 'I would have concerns around the growth in the groups area.' READ MORE The Minister said the department commissioned a European body to look at the increased group ownership of nursing homes, and the potential risks of this both financially and in the case of quality of care. That report is due in September, he said, adding it will be 'considered greatly'. The Minister also revealed his officials have informed him of 'notifiable incidents' in two other nursing homes, one of which involved the gardaí. 'They were very serious incidents,' he said. In light of the issues highlighted in the Emeis-run homes, the Minister said it is his hope to bring forward safeguarding legislation 'as a matter of urgency'. Speaking at the same meeting, the Health Information and Quality Authority (Hiqa), which regulates the nursing home sector, said it has a number of levers to ensure compliance with the regulations, with the cancellation of a registration being a 'nuclear option'. Last year, the HSE took over six nursing homes that were operated by private entities. Furthermore, the regulator said 95 homes have additional conditions attached to their registration as of June 5th. These conditions can relate to a number of things, including staffing levels, specific care procedures or the number of residents a centre can accommodate. It added that due to the 'changing landscape' of increased corporatisation, there is a need to change the regulatory framework. Angela Fitzgerald, chief executive of Hiqa, said under the current system the body can only direct individual providers to do something and it does not have 'powers' to direct corporate companies. 'We work on the basis of co-operation,' she said, calling for Hiqa's regulatory powers to be increased in this area. In a statement following the broadcast, Emeis Ireland apologised 'unequivocally' to all residents and their families. 'We recognise and deeply regret the breach of trust that has occurred in relation to the service standards we promise, and for any failure to uphold the dignity of some residents at all times,' the company said. A report by Hiqa on Emeis-run nursing homes is due by the end of this week.
BreakingNews.ie
2 days ago
- Health
- BreakingNews.ie
Hiqa asks RTÉ for all nursing home documentary footage
RTÉ has said it will not hand over non-broadcast footage to The Health Information and Quality Authority (Hiqa) without a statutory obligation or legal order. Hiqa said it has asked the national broadcaster to provide all footage it captured in the making of an RTÉ Investigates documentary into standards of care at two nursing homes. Advertisement The programme highlighted serious issues at two centres – The Residence Portlaoise and Beneavin Manor in Glasnevin, Dublin – which have been acknowledged as 'wholly unjustifiable' by Emeis Ireland. Hiqa, which is responsible for inspecting nursing homes, said it had notified gardai about its concerns arising from the programme. The authority's chief executive, Angela Fitzgerald, told the Health Committee on Wednesday: 'We've also asked RTÉ to give us all of the footage because they have, maybe, more information than we currently have. 'We also need to be able to see it, because we need to make sure that every resident, not just the ones that were on the screen, are safe. Advertisement 'And they have agreed to cooperate with us and hopefully they will be able to provide the information we need.' In her written submission to the same committee, Ms Fitzgerald said that RTÉ director general Kevin Bakhurst confirmed that the broadcaster 'will assist us in whatever way they can'. Asked about the comments, a spokeswoman for RTÉ confirmed it was engaging with Hiqa – which is due to request a meeting with the documentary team. However, she said: 'Any assistance provided by RTÉ will be referenced by our own guidelines, safeguards, protocols and procedures. Advertisement 'RTÉ does not hand non-broadcast footage to third parties without a statutory obligation or legal order.' She added: 'Hiqa have now confirmed they have referred incidents evidenced in the RTÉ programme to An Garda Síochána.'
