“There are no carers in the rural parts of Cork” is how one senior nurse summed up the homecare crisis — as the number of older people in need continues to rise.
The shortage can lead to patients even in their 90s being unable to be discharged from hospital because they are waiting for a carer to be found, even if their medical treatment is finished.
The carer shortage is reflected nationwide, with HSE figures showing by the end of March that over 4,800 older people were waiting for a carer after they were approved for help.
HSE Southwest ran another recruitment campaign for home support jobs this summer across Cork and Kerry. It offered salaries of €35,434 to €44,539 and paid travel time.
Delays caused by these shortages are now such a concern that Mercy University Hospital in Cork is offering up to four weeks homecare provided by staff for their patients.
They link in with the HSE and the idea is this service fills the gap until a longer-term plan is made.
It is only the second hospital in Ireland doing this, with the system piloted by Beaumont Hospital in Dublin.
Demand has been high, with 180 referrals since February 2024 and a business plan now submitted for expansion.
The nurse manager in charge, Eileen Kenny, explained it also helps keep beds open in the hospital.
Patients are assessed for their home support needs, and she said: “If no one can provide it locally or the private providers can’t take it on, they are referred to me.”
They work with the family, describing the system as “a bridging service”.
She said: “We give the assurance we will stay in situ until the public package is available.”
They cover Cork City and areas such as around Bandon, Youghal, or Millstreet. She said:
In the city, the packages come up very fast because there are more carers available in the city.
“But there are a lot of black areas in the surrounding areas that we could have a patient for longer than anticipated in some of those areas because there are no carers in the rural parts of Cork.”
Ms Kenny has seen team members go to Youghal in the morning “and they may have to come back to Cork and do another patient at lunchtime and maybe head down to Youghal again for the evening call”.
“Otherwise that patient would be sitting in an acute hospital bed,” she said. “We’ve taken patients in their 90s as well, people are living longer now so we’ve had a good few patients in their 90s.”
The hospital is also seeing benefits, Ms Kenny added: “It’s freeing up beds, which is freeing up spaces in the emergency department and freeing up spaces for booked surgery patients to come in.”
These booked or elective patients are often cancelled when hospitals have a surge of emergency care.
The service started with two healthcare assistants and now has three.
“The next plan is to expand it to increase the number of [healthcare assistants] so we can take more complex patients,” she said.
“The business case has been submitted and there is nothing approved there yet.”