Addressing “The Healthy Ageing Conference”

ALICE LEAHY, the Director and Co-Founder of TRUST today (Thursday, 25 November, 2003) called for an end to aspects of official policy towards people who are homeless because it is having an especially harsh impact on the elderly who may find themselves on the street, when speaking at a conference organised by the National Council on Ageing And Older People.

Describing this policy as increasingly turning many of the elderly into outsiders as they are excluded from the life of the community ALICE LEAHY said: “The recent emphasis on moving people on and resettling them has caused distress and fear to many. Refusing to co-operate with at times questionable research or moving on to free up beds for the more needy are seen as uncooperative behaviour or worse and means they could virtually be excluded from any further help.”

“I would appeal that this conference does not lead to a rush to once again advocate research at enormous expense of this group of human beings as we have enough such documents gathering dusts in several government departments. What we should do is focus on the personal needs of each elderly person and not just see him or her as homeless but as a unique human being – the same as you or I.”

ALICE LEAHY went on:

“Our philosophy in TRUST is a simple one – we insist on treating people as people. No one should be dismissed as a statistic and forced to conform where that is not possible. Rather than creating boxes into which people can be consigned and often excluded because they are unable to fit into those categories we should adopt a people centred approach that seeks to create opportunities for everyone to realise their full potential regardless of age.”

“Conditions for the elderly who are homeless are becoming more and more difficult. A combination of a shortage of accommodation and reduced services has hit them hardest as they are a very vulnerable group within a highly disadvantaged sector. We must address the nature of homelessness as a form of social exclusion which is especially true amongst the elderly. Unless we create a welcoming and sensitive environment their poverty and exclusion will become more serious and many will continue to die alone and excluded.”

ALICE LEAHY also pointed out that in TRUST they meet on a daily basis 35-40 men and women on average with an age range from late teens to 88+. Some elderly people are proud and independent, know their rights and entitlements and are often fearful of hospital admission. Others encountered are often ill but with support at all levels can maintain their independence she said.

Alice Leahy also presented the following case studies as part of her address:

Age 78 from rural Ireland, first contact made 20 years ago after returning from U.K. having lived in boarding houses and worked hard on the buildings – only social activity attending mass and local pub. He kept in touch with home through his local newspaper which was posted in the way that some of you will remember folded neatly like a packet and string holding it in place – he still receives it. A physical assault in a hostel led to facial injuries and hospitalisation. This event led to his contact with services including our own service. He was a familiar sometimes described as lonely figure around the city. People befriended him and were concerned about his state – all now dead, he lives on. A new project set up some years ago was seen as being suitable for him, he was fearful to refuse, but we know his body language and intervened – this incident led to my being seen as not being progressive or worse. A new social worker in the hospital he attended dealt with someone he didn’t know and decided he should move back to his place of birth without consulting him again we had to intervene. He pleaded to be left in the hostel he calls home, he is known there, he has his own room, he can back a horse can go to mass to the church he knows and likes.

We give him a bath once a week and provide clothing, we see to his general welfare needs including contact with his family, hostel staff ensure he has his medication and he has respite care every 4/6 months. His quality of life may not be what those who don’t know him would recommend. He is contented – what is wrong with that?

When John was in his late 70’s, he decided to move to a hostel when living alone became difficult for him – he liked his independence. He felt his security was threatened and he was aware that nieces and nephews cared for him. Moving involved changing his address and all that that entails: changing his doctor, his post office where he received his Old Age Pension, and many other practicalities – including deciding what he could take with him.

He settled in, having the choice if he wanted to mix with other residents, or not. Technically, the hostel became his home – meals were cooked, laundry done and the only responsibility was to pay his weekly rent, which was subsidised by the Eastern Regional Health Authority.

After a number of years, his health deteriorated, his mobility became a problem, looking after his personal hygiene, walking to the local shops – even visiting his G.P., walking to the nearest toilet created problems, which led to soiled clothes and bed wetting.

We arranged chiropody, organised eye test and glasses. Weekly assisted baths ensured he maintained his appearance, skin was checked regularly especially for pressure sores. TRUST supplied changes of clothing when required. Income was insufficient to provide a change of clothes etc., it may have been necessary for him to attend a clothing centre to get same – he was a proud man, and would have preferred going to a shop, but this would have also proved difficult for him.

When his medical card ran out, he mislaid the notification, which requested a birth certificate for proof of age, even though he had had a card for years! To get same, involved calling to the Birth Registrations Office some miles away from the hostel, with no direct bus service.

All forms left in local welfare office were mislaid twice – his rapidly deteriorating health meant he could not walk up the hill to the office even though only 5 minutes away. A TRUST volunteer informed the office staff, who said they would phone him when the card was ready – he had no phone. Three visits, and numerous phone calls later, he got a medical card number. His GP had arranged a geriatric appointment at our request – hostel staff were using a wheel chair to take him to his GP.

Numerous appointments in Day Hospital followed – numerous tests were ordered. The procedure in OPD is not always patient friendly – a consultant says ‘ see you on 02/12’ – the patient is rarely told that it is necessary to go to appointment desk. On all his hospital and GP visits, TRUST staff or hostel staff escorted him. It was patently obvious the man was losing weight, was in severe pain, and needed care delivered by trained staff in a proper setting with at least some basic comforts.

Following a letter to the hospital consultant from TRUST, he was admitted to hospital, where staff visited him. There, he refused to let hospital staff bathe him. One afternoon, 3 weeks later, he was transferred to the Hospice – no one was informed – and he died less than a week later.

Involvement of TRUST staff at least meant that John was in comfortable surroundings. At times this perhaps is all we can do, but even that required enormous involvement, which could never be adequately described in current nursing literature / research.

87 this month. Farming background moved to Dublin, lived in a workman’s hostel (Iveagh) and worked as a night watchman until he retired. Continued to live in the hostel.

“In general I am fair enough for my age I have a little arthritis. A good while out of the country, Dublin is my home. I send Xmas cards to my cousins the only ones left, listen to radio especially the news, watch T.V. I read the papers and occasionally go to the Library”.

He feels independent where he lives “when I didn’t move earlier, why would I now”.

Maybe I should think of an old peoples home – how much would it cost.