Services are being provided to support older people to live well at home and reduce the requirement for long-term residential care.

The Health and Safety Executive (HSE) Older Persons Services is dedicated to providing equal access to integrated services for older adults, helping them stay in their own homes for as long as possible.

Home support for older people

A wide range of services are provided including home support, day care and additional community support to assist with managing care at local level and support transition from hospitals back to the community.

Shona Rusk, Manager of Services for Older Persons in Dublin North City and West, along with her team, plays a key role in supporting our local acute hospital colleagues in managing patient flow.

Rusk advises: “Established discharge pathways and excellent working relationships between Older Persons Services and the acute hospitals ensure there are no untimely delays in discharging patients. Home support in our catchment area is provided by over 30 agencies currently approved under a National Tender Arrangement, which supports our older persons’ timely discharge back to their home environment.”

Home monitoring pilot programme

The Older Persons Services has successfully piloted a new initiative called ‘Discharge to Assess’ (D2A) across three of its network areas (Cabra, Ballymun and North Inner City) in partnership with the Mater Hospital. “D2A is an alternative discharge pathway where a patient is assessed in their own home for support, resulting in a more person-centred allocation,” explains Rusk.

“We have a dedicated team of carers that provides and monitors the older person’s care needs at home for an initial period of time. They support the older person in their transition to their permanent home care provider. We hope to expand D2A to the remaining Community Healthcare Network areas and Connolly Hospital over the coming winter.” Rusk also coordinates the provision of Day Care Services, Meals on Wheels and Respite services to support older people, their families and carers in the local area.

Long-term care placement review

When community support is no longer sufficient to enable older persons to remain at home, there may be a requirement for long-term residential care. Rusk chairs the Local Placement Forum, which reviews applications for long-term residential care. The purpose of the forum is to determine if the care needs of applicants can only be met in a residential setting. The forum has representatives from both community and acute hospital settings. The number of older people in our community continues to grow with ever-increasing demands for services. 

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The Healthy Age Friendly Homes Programme supports older people to remain in their homes where possible, prevents unnecessary hospital admissions and avoids early admission to residential care.

As the Minister for Mental Health and Older People and the daughter of an older but independent mother in her 80s, I am proud to have supported the Healthy Age Friendly Homes Programme from its pilot phase in 2021. This programme is a demonstration of this Government’s commitment to providing comprehensive care for older people.

Comprehensive support for older people

In 2019, Ireland was the first country to receive Age Friendly status by the World Health Organization (WHO). This is a testament to the social care model provided in Ireland to support older people. The Healthy Age Friendly Homes Programme, funded by Sláintecare in my Department, supplements this approach and was recognised again by the WHO as a best practice example of integrated care for older people. It positively impacts their health status, quality of life and functional ability.

We aim to enable older people to age well at home. The voices and choices of older people must be recognised, and the Healthy Age Friendly Homes Programme is a key initiative under our Sláintecare reform programme to help us achieve this.

This Government’s investment in older
persons services has seen a 30%
increase in funding since 2020.

Investment in health and social care

This Government’s investment in older persons services has seen a 30% increase in funding since 2020, reaching over €2.6 billion in 2024. This year, over 320 day centres are operating across the country, plus 53 dementia-specific day centres. Additionally, over 22 million hours of home support will be provided, and 3 million Meals On Wheels (MoW) will be delivered. MoW is more than a nutritious meal; it’s a social connection, knowing that someone will call to your home.

My department is implementing health reforms to ensure safe, timely and efficient care for everyone. We have established six HSE Health Regions to provide health and social care services. Despite progress made, challenges lie ahead. We are exploring new models of care and the principles of universal design for infrastructural development. The Healthy Age Friendly Homes programme is a strategic response.

I am grateful to all contributors to this programme, including the older people who participated in the pilot. I am pleased the programme is moving forward nationwide at pace. The success of the programme lies with the coordinators who devise and manage a support package for each person referred to the scheme — a person-centred approach.

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Parkinson’s disease (PD) is a progressive neurological disorder. It is the second most common neurological condition, after Alzheimer’s, but it is the fastest-growing neurological condition globally.¹

In Ireland, it is estimated that 18,000 people are living with PD. It is variable in its progression, meaning some people progress slower than others, and the symptoms can be effectively controlled with medication for many years.

Role of dopamine in Parkinson’s disease

PD is caused by a loss of a chemical called dopamine. We all lose some of this chemical as we get older. However, people with Parkinson’s lose this chemical at a faster rate than others. It is estimated that by the time symptoms are noticed, about 70% of dopamine has been lost.

Causes and risk factors

The exact cause of Parkinson’s is still not fully known. Current research suggests that genetic factors and environmental factors, such as the use of pesticides, may play a role in some of those affected.

Dopamine is a chemical responsible for
smooth movement and motor control.

Recognising the symptoms of Parkinson’s

Dopamine is a chemical responsible for smooth movement and motor control. As a result, widely recognised symptoms include tremors, which 70% of people experience, along with slowness in movement and issues with gait and mobility.

However, dopamine also plays a role in many other aspects, which, for many people with Parkinson’s, are the more troublesome and hidden symptoms. These may include issues with sleep; psychological symptoms (including anxiety and apathy); cognition changes, such as difficulty concentrating and multi-tasking; and bowel symptoms, such as constipation.

Raising awareness and supporting the community

From this arose our awareness campaign at Parkinson’s Ireland. The theme of the campaign stemmed from the awareness priorities identified by people with Parkinson’s, their families and care partners in a member survey and through the issues that were being brought to us on our support line.

We launched our first major awareness campaign, ‘Different for Everyone’, in April 2024 to represent and recognise the many symptoms that come with PD and how each individual experience with it is different.

Why awareness and education are important

To improve the wellbeing of someone with PD as they age, they must be aware of the many symptoms that come with PD and what can impact them. It is also important for care partners, loved ones and health professionals to be aware of the 40+ symptoms and how they can manifest themselves differently as the disease progresses.

Parkinson’s Ireland provides education to encourage self-management of the condition, helping people live well with Parkinson’s and supporting them throughout their journey.

[1] Dorsey ER, Sherer T, Okun MS, Bloem BR. The Emerging Evidence of the Parkinson Pandemic. J Parkinsons Dis. 2018;8(s1):S3-S8.

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Studies reveal a significant connection between hearing and cognitive health, suggesting good hearing supports healthy brain function. Take a proactive approach to your hearing care. Schedule a free hearing check today.

Many of us include regular visits to the dentist or opticians in our health agenda, but when was the last time you went for a hearing check?

Hearing loss linked to dementia risk

Dr Sabina Brennan, Scientific Representative at Hidden Hearing, says: “Age-related hearing loss is recognised as a major modifiable risk factor for dementia.” So, as we age, safeguarding hearing through early intervention and prevention is increasingly crucial.

Around 58% of men and 54% of women aged 75 and over in Ireland experience hearing loss. Yet, only 25% of adults are aware of the link between hearing loss and dementia.

Often, when we suffer from hearing loss our brains have to work harder to decipher sounds, leading to stress and mental fatigue.

Hearing interventions delay cognitive decline

A recent study suggests that the wearing of hearing aids may delay cognitive change in older adults who would otherwise be at increased risk of decline over three years. This further highlights the link between hearing loss and dementia. A third of adults over 65 have moderate hearing loss. However, age-related hearing loss is associated with an up to 40% faster rate of cognitive decline and reduced brain volume.

Book annual hearing tests

Addressing hearing loss with interventions like hearing aids and regular hearing assessments could counteract these effects and help maintain overall cognitive health. “Go headphone-free more often. Steer clear of loudspeakers and avoid exposure to loud noises or music. Get your hearing checked annually, and wear hearing aids if prescribed,” insists Dr Brennan.

Incorporating an annual hearing check into your health regime is a proactive prevention measure that will protect your hearing, reduce dementia risk and enhance your quality of life. Don’t wait until it’s too late — schedule your annual hearing check today, and protect your brain health.

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In Ireland, approximately 64,000 people are living with dementia, with Alzheimer’s disease being the most common form among the over 200 types of dementia.

Dementia is a physical illness characterised by damage to brain cells, affecting memory, cognition, communication and daily functioning.

Services designed for people with dementia

Receiving a dementia diagnosis can be an isolating experience, often leaving individuals and their families unsure of where to seek help. The Alzheimer Society of Ireland (The ASI) provides an array of services to support those living with dementia and their caregivers. These services includedaycare, daycare at home, dementia adviser services, cafes, support clubs, mobile information services, family carer training, social clubs and a national helpline.

National helpline for dementia

The ASI’s National Helpline is a confidential service offering information and support to people with dementia, their families, carers, individuals concerned about memory issues and professionals in the field. The Freephone number is available to callers within the Republic of Ireland and can be reached at 1800 341 341. The helpline operates Monday to Friday from 10 am to 5 pm and Saturdays from 10 am to 4 pm.

The helpline aims to provide accurate, current, accessible and relevant information as well as emotional support. It has achieved a quality standard from Helplines Partnership for the second time, underscoring its commitment to high-quality service delivery. Helpline advisers and trained volunteers can offer confidential advice on:

• Information about dementia and memory loss
• Different causes of dementia
• How a diagnosis is made
• Accessing services and supports
• Practical tips for daily living
• Legal and financial matters
• Emotional support and more

Online live chat service

For those who prefer online communication, a confidential live chat service is available at alzheimer.ie. The live chat operates Monday to Friday from 10 am to 11 am and 3 pm to 5 pm, as well as Saturday from 10 am to 1 pm.

This service provides the same level of support and information as the National Helpline, ensuring that help is accessible in a format that suits different needs. The Alzheimer Society of Ireland stands as a beacon of support and information for those navigating the challenges of dementia, offering vital resources to enhance quality of life and provide guidance through the journey.

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Pain in older people is very common and widely accepted as something to be expected and often regarded as ‘normal’ in later life.

For many people as they age– and particularly if they are living with chronic conditions like arthritis – learning to cope with pain can be challenging. However, lots of people have discovered that something can be done. While there are no easy answers, the ideas and suggestions here have been found to work. To appreciate how you experience pain, it is important to understand that everyone reacts to and manages pain differently, and how you deal with your pain can affect the way in which you feel it.

Changing gear by changing your mindset

A way to reduce your pain is to change gear by emphasising things like optimism, humour, a balanced diet, physical activity and enjoying a good social life. It can also include relaxation, medication and keeping pain in perspective. By doing these things, many people discover that they can feel good about themselves. The amount of time you spend consciously thinking about pain will influence how much pain you feel. If you get locked into thinking continuously about it, try to distract yourself by doing something you enjoy. Remember, pain is your body’s message to you to take appropriate action, and not necessarily to cease all activity.

Pain control methods

1. Respect pain. If you have increased pain that lasts for two hours after completing a task, do a little less next time, or go about it in a different way.
2. Avoid being in one position for too long and avoid postures that make you stiffer. Use equipment that reduces stress on joints and makes difficult tasks easier.
3. Control your weight. Extra weight puts extra stress on your weight-bearing joints, like your knees and hips.
4. Use your largest and strongest joints and muscles for daily tasks wherever possible, like using a bag with a shoulder strap rather than carrying the bag with your hands.
5. Try to balance rest with activity. Take breaks when you need them, but too much rest causes muscle stiffness.
6. Plan ahead, organise and simplify any tasks or chores you have to do.
7. Don’t be afraid to ask for help. Take responsibility for yourself and ask for assistance when you need it.

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Atrial fibrillation (AF) is the most commonly diagnosed disturbance of heart rhythm in adults. In AF, your heart beats in a disorganised, irregular and often rapid way which can lead to a range of symptoms and potential complications.

While Atrial fibrillation (AF) itself may not immediately be life-threatening, it can lead to a stroke or heart failure and so has potentially serious effects. AF is responsible for causing one third of strokes in Ireland each year.

One in four people will develop atrial fibrillation and it is estimated that over 33 million people globally have AF. This figure is projected to increase significantly with our ageing population.

What does the public know about AF?

Therefore, public education about AF is vital, as detection and treatment reduces the risk of stroke.

However, studies have shown that public awareness and knowledge of AF are poor. In a recent Irish study, it was found that overall awareness of AF in the population was low, with only 28% of those surveyed reporting they had heard of AF, and just over half of those correctly able to identify AF as an irregular heartbeat.

Following a short national billboard and radio campaign this marginally improved to 30% of people having heard of the condition, with only 35% able to describe it.

Just 28% people before and 22% after the national campaign knew AF was a risk factor for stroke. The nature of messaging and duration of such public awareness campaigns need greater examination if they are to be effective.

Gaps in patient knowledge of AF

Patient awareness of AF is also important to improve compliance with treatment and understanding of the potential associated complications. International studies suggest that even among patients with AF attending a specialist clinic, one third may not know they have the condition or understand what it means.

At Tallaght University Hospital, professionals at the specialist multidisciplinary AF clinic were disappointed that one in five patients were unaware of the term ‘atrial fibrillation’ although almost half had received education on AF and were returning to the clinic for the second time.

While 60% of all patients reported knowing what AF was, most could only describe it in a low level of detail and half did not identify AF as a risk factor for stroke.

How can AF education be improved?

Up to now, successful stroke awareness campaigns have centred mainly on recognition and response to common stroke symptoms. The concept of AF and its risk of stroke can be a more difficult one to explain to patients, and education may need to be more tailored.

A simple, useful analogy is the ‘faulty cement mixer’: the atrium fails to mix the blood correctly, causing ‘lumps’ (clots) to form in the ‘cement’ (blood) which if flowing out of the mixer and into the pump (ventricle of the heart) will be pumped down the ‘pipe-work’ causing blockage in the blood vessels.

Videos of AF are widely available on YouTube and may also be helpful, but their impact is unstudied and education may need to be more individualised and focused using validated questionnaires to decipher what the patient knows, before coming in for consultation, so specific gaps in knowledge can be addressed. Work is currently underway to produce a national educational tool to help patients understand AF. 

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At 84, you can be forgiven for slowing down a bit. Ronnie Delaney does all he can to make sure life doesn’t grind to a halt, however. With swimming now keeping him in shape – he urges people to find something they can still do to keep them improving and moving.

84 year-old Ronnie ‘Ron’ Delany – a poster boy of Irish athletics, since his 1500m Olympic Gold at the 1958 Melbourne Summer Games – strikes a balance that seldom few athletes manage. Delaney remains both humble and proud of what he’s achieved, in his long and varied life.

Since winning gold, the permeating pleasures in his life have been friendship, family and looking after his body. In short, Delaney is content with his lot – an outlook that is infectious to those lucky enough to meet him.  

Family and friends in later life

“I married a very lovely lady, Joan, who’s looked after me so wonderfully. Four beautiful children and eleven wonderful grandchildren followed. What has money or fame to do with anything when you have that?”

But as much as Ron’s everyday is enriched by the friends and family, great age does bring with it the inevitable realities of health issues and preparing to lose those around you.

Anyone out there struggling along, just get it checked out – there’s so much they can do for you now.

“I look around those I’ve come to know through running or business; we’re slowly popping off one by one – we’re in the departure lounge!”

His own health has been predominantly good. Indeed, he was 70 before having to admit defeat and give playing certain sports.

Health and fitness in later life

“Until I was about 70, I played regular tennis and squash. I also played golf – despite being no good at it. The ability to do those things does pass, but latterly I found swimming which is still a lifeblood to me today.”

The importance of taking responsibility for his own body is a priority for Delaney. Back in the day, he maintained his body as any athlete would – and continues to do so now.

“When I was 69, I got a pain in my groin playing tennis and thought ‘oh god I’ve tweaked my groin’. What actually was going on was degeneration in my hip and I had to eventually have it replaced.”

Swimming keeps him as strong and flexible as possible now. However, sometimes even Ronnie Delaney has to take a break. When his eyes started causing him some problems, he went to the doctor to get himself checked out.

“Anyone out there struggling along, just get it checked out”

“I’ve only just had a cataract operation last month! I almost forgot to tell you! I was getting blinded by car lights coming towards me and thought I’d better get it seen to. The specialist said ‘this is what you’ve got and we can sort it out’.”

“A week later it’s done. It’s brilliant, I can’t believe the difference in colour and my distance sight has improved massively. Anyone out there struggling along, just get it checked out – there’s so much they can do for you now.”

Looking after yourself and indeed knowing when a certain activity might be too much for you is key, according to Delaney. But maintaining movement and activity – just finding something that you can still do – is even more vital to staving off some of age’s less appealing declines.

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Why is atrial fibrillation important?

Atrial fibrillation (AF) is the most common abnormality of cardiac rhythm, affecting at least 3% of Irish adults over 60, and 6% over 70 years of age. The risk of developing AF is very much associated with age and the worldwide prevalence of AF has been rising. AF is a common condition of ageing.

Symptoms occur in less than half of those affected with AF, so you may not even know you have it. Some common symptoms of AF can be specific like palpitations (awareness of an excessively fast heartbeat) and shortness of breath/chest discomfort. Or, they may be less specific, more general symptoms such as dizziness, tiredness or feeling less energetic. However, AF may be completely silent until disaster strikes and a clot forms in the heart and travels to the brain, causing a stroke.

How is AF diagnosed?

AF is diagnosed by an electric tracing of the heart called an ECG. AF is often picked up and can be suspected if your pulse is irregular. This can be done by self-examination, visit www.irishheart.ie, which can show you how to do this. Your family doctor will check your pulse routinely if you are older or at risk of AF, and arrange an ECG if your pulse seems irregular. Many wearable applications (e.g ‘Apple Watch’). have cardiac monitoring capability that may alert the wearer to the possibility of AF, but the condition needs a reliable tracing to diagnose AF as other conditions may also cause an irregular pulse.

What causes AF and can I reduce my risk of developing AF?

AF is often an age-related phenomenon and there may be an increased risk or tendency to develop AF within families. Sometimes, AF is provoked by a serious infection such as a pneumonia, or toxic causes such as alcohol withdrawal and may resolve with treatment of the condition. In many cases, AF is paroxysmal or ‘intermittent’ and comes and goes, though the risk of stroke may be equally high even where the condition is intermittent.

High blood pressure, being overweight and overuse of alcohol are important, modifiable risk factors associated with the development of AF. Sometimes, a person may have an underlying cardiac condition, like a damaged heart valve, causing AF at a younger age. Occasionally, AF can be associated with other medical problems, like an overactive thyroid or underlying cancer. There is some evidence emerging that excessive and continuous strenuous exercise, for example doing repeated, vigorous endurance training may also predispose people to developing AF.

Knowing and ensuring your blood pressure is normal, reducing your alcohol intake and keeping your weight within healthy range can all help reduce your risk of developing AF in later life.

Can an AF stroke be treated?

Stroke due to AF can be treated, although it is often difficult as the clot blocking the blood vessel may be large or, alternatively, the clot may break up and go down several different smaller blood vessels at the same time, affecting multiple areas of the brain. The key to reducing the effect of an AF related stroke is speed. Once a stroke is suspected by sudden onset of Facial weakness (F), Arm or leg weakness (A), difficulty with Speech (S) then the Time (T) to act is now and ring 999 – FAST. Sudden loss of vision is another warning sign.

Reduce your risk of AF:

• Check and ensure your blood pressure is normal
• Avoid being overweight
• Avoid excessive alcohol

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While there is no specific age at which one is ‘old’ or ‘young’, it is a fact that populations are getting older. Ageing populations will influence health and social systems in multiple ways.

The emerging issues associated with population ageing impact health, economic and social systems in our own country. 

Ageing populations will influence social and health systems in multiple ways, including the need to increase spend and address management of chronic illness and disease.

In Ireland, recent CSO figures show that the percentage of the population aged over 65 will increase from 13.3% in 2016 to 18.1% by 2031 and 24.6% by 2051. It is predicted that those over the age of 65 in Ireland will reach one million by 2031 and those over 80 will increase by 270% by 2051.

An older population can bring challenges to the health system needed to support them

This significant change in ageing demographics is a global phenomenon. This success challenges us all, as these additional lifespan years are not always lived in good health.

Chronic conditions, such as heart disease, stroke, dementia, respiratory diseases, diabetes, cancer, Parkinson’s disease, osteoporosis, falls, and frailty are among the conditions affecting ageing populations. They are among the reasons a comprehensive public health action on ageing is urgently needed. 

We need a culture that upholds dignity, respect and compassion for each other over the course of our lives.

Working together is the key

Older people, policy makers, clinicians and health professionals must engage proactively in conversations around awareness, prevention, symptoms, solutions and treatments.

Interdisciplinary, cross-specialty, cross community engagement and collaboration are key in ensuring that society, health and social care services become and remain fit for purpose.

There are many examples of this excellence at work already in Ireland. The Royal College of Physicians of Ireland (through the clinical programmes, training and education), in conjunction with the HSE, play a critical role.

They provide the vision and clinical leadership for managing chronic diseases and ageing well, along with the many voluntary organisations like ALONE, the Alzheimer’s Society, the Irish Gerontological Society and the many other voluntary societies around our country. 

Innovations must translate to improvements for older people

We all live and work in a complex and changing world. Digital literacy has become a requirement for participation in most day to day activities. We must ensure that our online, digital, and cloud-dominated tech-world is accessible to all, not just the young.

Innovations in treatments and technologies – in particular in the growing field of gerontechnology – must be translated into improvements in the wellbeing, health and care of older people, and support for us all to age well at home.

We have a wonderful opportunity in Ireland to lead the charge and change in support for all us as we age. We all want to age well. As a country we must strive to become an Ireland that leads the world in becoming age-attuned, age-accommodating and age-friendly.

To do this we need a culture that upholds dignity, respect and compassion for each other over the course of our lives. We also need support to live well into old age, and timely access to supports if and when we need them.

While we each have a personal responsibility, there is also a shared societal and governmental policy responsibility. These are all interconnected. Progress cannot happen unless we all work together. 

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