Moving to a nursing home

As people get older, the issue of care becomes important. While many elderly people can remain in their own homes, for others this is not an option and they may have to move from their homes into long-term care.

How do you choose a nursing home?

All nursing homes in Ireland – public, voluntary and private – are registered and inspected by the Health Information and Quality Authority (HIQA).

HIQA has a checklist for choosing a nursing home, whether it be public, voluntary or private. They also have a tool to help you locate a nursing home in your area. Nursing Homes Ireland also has some information on choosing the right nursing home and some useful contacts and resources.

Public nursing homes are run by the Health Service Executive (HSE). Voluntary homes include those run by charities or religious orders. Private nursing homes are run by commercial businesses.

What is the Nursing Homes Support Scheme?

The Nursing Homes Support Scheme (also known as ‘Fair Deal Scheme’), provides financial support to people who need long-term nursing home care. It is managed by the HSE.

Under the Fair Deal Scheme, you make a contribution towards the cost of your care and the State pays the balance. The scheme covers approved private nursing homes, voluntary nursing homes and public nursing homes.

It covers long-term care only. It does not cover short-term care such as respite, convalescence or day care. The Department of Health has stated that this includes:

• Bed and board
• Nursing and personal care appropriate to the needs of the person
• Laundry service
• Basic aids and appliances necessary to assist a person with daily activities

Your eligibility for other schemes, such as the Drugs Payment Scheme and Medical Card, are not affected by the Fair Deal Scheme.

How do you apply for the Fair Deal Scheme?

Anyone who is ordinarily a resident of the State (i.e. living here for at least one year) is eligible for the scheme. You can apply to your local Nursing Home Support Office on the standard application form. The application process involves both a financial and care needs assessment. The financial assessment looks at how much your contribution will be based on your income and assets. You will contribute:

• 80% of your income
• 7.5% of the value of any assets per year

The first €36,000 (€72,000 for a couple) is not counted in the financial assessment. This is known as State Support.

Where your assets include land and property, the 7.5% contribution can be delayed and paid to Revenue upon your death, if you choose. The HSE will pay your contribution to the nursing home on your behalf. This is known as a Nursing Home Loan.

If you own your home and are renting it out, you can apply to pay only 40% of this towards your nursing care. Read more about renting your home, on HSE.ie.

To find about more about the Nursing Home Loan, take a look at the Department of Health’s FAQs on the Nursing Home Support Scheme.

The HSE provides each approved applicant with a list of all approved nursing homes. Legislation states that the choice of nursing home is the decision of the applicant and/or their family. You can choose any home on the list subject to the following two conditions:

• The home must be able to cater for your needs
• The home must have an available place

Once your home is confirmed, you will pay your contribution and the HSE will pay the balance to the nursing home.

How do you manage your money in long-term care?

When going into a nursing home or long-term care it is also worth thinking about access to your money and how you will manage your finances.

You should consider whether you need another person to be able to access your accounts in the event that you are unable to. When choosing this person, ensure you choose someone you trust and consider putting limits on when and/or how they can withdraw money.

You can also make legal arrangements and appoint a power of attorney. This is a document in which you authorise another person to act for you in certain matters, according to the terms set out. A power of attorney can be specific (limited to particular purpose – for example, selling your property), or it can be general (allowing the person to do almost everything that you could do yourself). More information on the power of attorney is available on the Citizens Information Board’s website.

If you become incapable of managing your affairs due to mental incapacity, you may be made a Ward of Court. There are a number of different procedures for this, depending on the circumstances. More information can be found on the Citizens Information Board’s website.

What are your rights?

Before you go into residential care, a contract of care is agreed between you, or a family member acting on your behalf, and the nursing home. This sets out the terms and conditions of your care and must include details of the services to be provided and the fees to be paid. This is an important document and it should be carefully considered before it is signed. If you are not happy with the service you or your family member is receiving, you should firstly compare what you are getting to what you have signed up to in the contract of care.

How can you complain about a nursing home?

By law, care providers must have procedures in place for handling complaints and provide information on how you can make a complaint. If you are not satisfied with the response from your nursing home, you can contact HIQA to report your concerns.

You can contact the Ombudsman with complaints about publicly-run homes. Since August 2015, you can also complain to the Ombudsman about private nursing homes. Further information on how to complain to the Ombudsman about privately-run nursing homes can be found here.

If you have any questions about your rights as a consumer, we are here to help. You can contact us here.