A study carried out by the Irish Centre for Social Gerontology has found that the provision of home support services for older Travellers and older homeless adults must be considered as a fundamental right, promoted as a viable and accessible support for these groups, regardless of their housing circumstances and where they live. The findings were reported at the launch of research findings yesterday, held as a part of the Irish Gerontological Society’s webinar series on Marginalised Ageing and Inclusive Systems.
There are currently efforts to improve the design and quality of home care services for older people in Ireland, with the aim of enshrining the rights to, and regulation for, these services within legislation (i.e. Professional Home Care Bill 2020). There is a critical need to ensure any new home care reforms are accessible and relevant to the most marginalised of older populations. Older members of the Traveller community and older people who have experienced homelessness are two such groups, who are more likely to encounter health inequalities, poor health outcomes, and challenges in accessing care services.
The study aimed to capture older Travellers’ and older homeless adults’ perspectives on and preferences for home care, and in doing so to use their lived experiences to improve policy and practice in the area. Highlighting a range of barriers in accessing home support services, the study shows the potential for these groups to fall through the cracks in Ireland’s long-term and community care system. Barriers can include communication and cultural issues, eligibility criteria (where older members of these communities requiring these services are not always aged 65 years), willingness to accept care, the suitability of environments for receiving care, and, more broadly, discrimination and stigma,
The research which was conducted by NUI Galway’s Irish Centre for Social Gerontology in conjunction with co-investigators from NUI Galway, Queen’s University Belfast, Newcastle University and University of Limerick.
Speaking at the event, Professor Kieran Walsh, Director of the Irish Centre for Social Gerontology and lead investigator, said: “There are a number of critical gaps evident in the care for older Travellers and older homeless adults, and in part, these stem from the structural disadvantages that both groups encounter in our communities, and society.
“While the gaps are reinforced by our failure to properly account for the needs of these populations in care provision, they impact not only individual older people, but also put significant pressure on families, charity organisations and primary and community care providers working with the groups.”
Dr Bridin Carroll, a member of the research team, said: “The findings show that without the significant cross-sector efforts, particularly at grass-roots level, and the resilience of many older Traveller and older homeless individuals themselves, the welfare of these populations would be even more at risk. But this situation is really not sustainable.
‘The research highlights that home care for these groups requires sensitivity to people’s individual circumstances, and the sorts of social exclusions they have faced. To secure better health outcomes for these populations, the research calls for home supports that are flexible, well-communicated, free of stigmatisation and discrimination, and that target both the instrumental provision of care and the enablement of individuals.’
Putting forward 20 recommendations for policy and practice on home care, the research calls for public, private and voluntary long-term care providers to develop care and support protocols targeting marginalised and diverse older populations, including older Travellers and older people who have experienced homelessness.
Professor Walsh concluded: “It is difficult to talk about the situation of older Travellers and older homeless adults without acknowledging the massive deprivation of rights with respect to adequate housing, health, and equality of treatment that has been experienced by these populations. Without these efforts to ensure that future care provision is relevant to the situations of older Travellers and older homeless adults, and help to address some of these deprivations, we run the risk of further exacerbating inequalities for these growing sections of our ageing society.
To read three briefing papers on the project, and for more information on the study visit: https://icsg.ie/our-projects/otoh/.
This study was conducted in collaboration with the HSE National Social Inclusion Office, Safety-Net Primary Care, Galway Traveller Movement, Age and Opportunity, Community Healthcare Organisation 8, and Pavee Point. It was funded by the HSE, Department of Health, and Atlantic Philanthropies, through the Healthy and Positive Ageing Initiative (HaPAI) partnership [HAPAI/2017/KW].