Improving Quality of Life for Older People in Long-Stay Care ...

2.3 Policy for Long-Stay Care in IrelandThe Health (Homes for Incapacitated Persons) Act, 1964, was the first formalrecognition by the State of private nursing homes. This Act provided for the 1966Regulations which set minimum standards for care, accommodation and food, aswell as inspections in private nursing homes. The report by the Inter-DepartmentalCommittee on the Care of the Aged, published in 1968, was the first explicit reportoutlining a policy for older people in Ireland. The report made several recommendationsconcerning long-stay care for older people. One of the main recommendations ofthe committee was the replacement of the old county home structure by geriatrichospitals and welfare homes. The former would cater specifically for older peoplein need of constant nursing care while the latter would meet the needs of olderpeople requiring residential care for other reasons, for example frailty or the inabilityto live alone at home.The Care of the Aged report was concerned primarily with the provision of carefor older people in public long-stay care and makes no reference to quality of lifein relation to older people in Ireland. The emphasis on care was probably due tothe underdeveloped nature of care services for older people in Ireland at the time.It appears that the lack of reference to quality of life was due to the fact that theterm ‘quality of life’ was not yet in common usage by health professionals or bypolicy-makers working in the area of health and social care.43The next major benchmark for policy on older people was the report of theWorking Party on Services for the Elderly, The Years Ahead: A Policy for the Elderly(Department of Health, 1988). This document remains the official policy frameworkon services for older people (Mangan, 2003). The main recommendations of TheYears Ahead report were as follows:Existing geriatric hospitals/homes, long-stay district hospitals and welfarehomes should be developed, where appropriate, as community hospitals.The proposed community hospitals should provide a wide range of servicesfor older people and their carers including assessment and rehabilitation,convalescent care, respite care, facilities for nursing older people whocannot be cared for at home, and information, advice and support for carersof older people at home.The Health (Homes for Incapacitated Persons) Act, 1964, should be amendedto include nursing homes run by voluntary bodies and to provide for a licensingsystem for all nursing homes.