Residential Care Policies for Elderly Persons with Disability

This report focuses on elderly individuals with intellectual disability under residential care setting in Ireland. It also provides an insight to the history of elderly care taken in the nursing homes in Ireland, Canada and United Kingdom.

Running head: RESEDENTIAL CARE FOR ELDERLY PERSONS WITH DIABILITY
RESEDENTIAL CARE POLICIES FOR ELDERLY PERSONS WITH DIABILITY
Name of the Student
Name of the university
Author’s note

1RESEDENTIAL CARE FOR ELDERLY PERSONS WITH DIABILITY
Introduction
The number of elderly people with intellectual disability has increased considerably. As
one ages the functional deficient generally decreases with the age. People having intellectual
disability often have to confront with dependency and functioning impairment related to chronic
situation, especially the ones who are residing away from home in residential care facility. This
report aims to focus on the elderly individuals with intellectual disability under residential care
setting in Ireland. It also provides an insight to the history of elderly care taken in the nursing
homes in Ireland, Canada and United Kingdom.
History and development of residential facility for the intellectually challenged elderly
In the late 1970, in spite of the national community care policy for the elderly and the
disabled which emphasized on the fact that older disabled people should be kept at home, a
possibility was noticed in the income support system for meeting the majority of the person's
cost if they are shifted to a residential care setting (Cooney, 2012). There was an escalation in the
social security costs spend on residential care settings. This paved the way for a burgeoning
private sector expansion of the residential care homes that were often run as small businesses.
For example it was quite natural to find a local builder adapting properties for becoming care
homes which were afterwards managed by his spouse and staffed by the family members. Thus
became a very flourishing business.
In the era of 1800 and 1900, there had been an epidemic of Asylums in Ireland, as at one
point about 20,000 people in the institution were being treated for mental illness; most of them

2RESEDENTIAL CARE FOR ELDERLY PERSONS WITH DIABILITY
were older adults (Cooney, 2012). According to the published history of Ireland, it was actually
not an epidemic of mental illness; instead there was a combination of social, political and other
factors that lead to such a higher number of people. According to Cooney, (2012) early
residential care and the asylums were more like prisons than a proper residential care. Formal
domiciliary care has come as a solution to the challenges in providing care to the ageing
population of Ireland. Previously there was a lack of community care for the elderly. It is
asserted frequently that home care is the most preferred choice of care for the elderly. But
according to the researches, equal proportions of elderly find informal care acceptable.
Previously most of the care provided to the people was mainly based on home care. One of the
earlier policy documents meant for the intellectually disabled older individual stressed on the
desirability of domiciliary care from the perspective of the well being of an older person and
from the cost perspective (Cotter et al. 2012). Although nursing had existed since the
development of early human beings, it was not before Florence Nightingale that nursing became
a profession. The nursing profession had diversified its sector leading to specialization in many
fields, which is represented by the division of Irish professional register of nursing maintained by
the regulatory board of Ireland, An Bord Altranais (ABA). Historically, the elderly people
having intellectual disability were institutionalized with people who are poor, infirm,
unemployed and mentally instable. Institutionalized care was predominant from 1700s. At that
time the untrained members of the religious order constituted the major work force of the
asylums and the hospitals. Provisions for the people having intellectual disability started by the
end of the nineteenth century and the services were structurised concretely to meet the needs of
the people. The concepts of typical nursing homes moved above a custodial approach of care and
emphasized more on a holistic view of elderly people who are intellectually challenged and that

3RESEDENTIAL CARE FOR ELDERLY PERSONS WITH DIABILITY
focused on their need and education. The nurses working came from psychiatric and general
background and they started employing illness oriented initiatives for the caring of those elderly
who were not ill and have intellectual disability (Cotter et al. 2012). The intellectual disability
nursing in Ireland for the elderly was in the late 1940s.
Current provisions in the area
The health services executive of Ireland offers a wide range of services for older
individuals in Ireland. Local support can also be obtained from agencies like Department of
social protection, Local authorities and certain voluntary organizations. The role of the
residential care homes is to provide a family style care for the elderly people who do not have a
positive health. Intellectually challenged people needs both medical care and also responds better
to social and family care model. The residential care homes help the intellectually challenged
elderly people to remain in a society, where they can interact with their type of people and thus
increase the scope to socialize, thus enhancing their mental and social well being. Cotter et al.
(2012) will provide medical monitoring apart from the stay. The residential facility has trained
health care professionals, Health care volunteers and entrepreneurs that can offer help to the frail
intellectually challenged elderly persons to maintain their quality of life. It should be
remembered that elderly persons are affectionate hungry. Approximately 6% of the older people
seek help from residential care facility. Because of the difference in the life expectancy rates the
majority of the older intellectually challenged people receiving residential care facilities are
women.
Eldercare in Ireland is mainly a combination of private and public provisions, a large
proportion of which is given by private individuals within a family (Cotter et al. 2012). The Irish

4RESEDENTIAL CARE FOR ELDERLY PERSONS WITH DIABILITY
system of health care had to depend heavily on unpaid care, most of which is offered by the
women (Doody et al. 2013). Locally, the important source of help to the older people came from
women having extended family structures. At the local level the most important support to the
older people increases and those who are dependant becomes a higher population of the people.
The residential care homes for the older adults in England were registered with the care quality
commission that provides a number of residential care beds. The Canada community residential
care sector encompasses a range of living options for elderly people with different needs. With
varying terminologies across the country, residential care facilities can include the lodges,
assisted residency, and supportive housing and care homes for long term. The community
integrated care in UK provides specialist residential care to the people with age related health
care needs and dementia for leading a happy and full lives. The community integrated care
provide spacious bedroom, trained staff, meals , specialist furnishings and the facilities, engaging
various activities programs, regular access to proper doctors. It also communicates with the local
community to provide care to the elderly with intellectual disability (Doody et al. 2013).
Legislative framework and policy provisions
A number of standards acts are there for the care and the regulation of older persons in
voluntary, public and private residential care setting. The national Quality Standards for
Residential settings, the health act 2007, the health Information and the quality Authority
(HIQA) was established as a part of the Health act 2007 (Walsh and Shutes 2013). They are
responsible for setting variable standards for the health and social services. They undertake
registration and the inspection of the public. They provided charitable and the private residential
service for the older people (Szebehely and Trydegård 2012). This involves following up of the
information, frequent visits to the residential homes by the officers for ensuring a good quality of

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life for the elderly persons with intellectual disability. Inclusion Ireland is a National association
for providing support to persons with intellectual disability. Their main vision is to engage the
intellectually challenged elderly to participate in their community with equal rights as citizens
and for living their life of their choice to the fullest (Dalton and Sweeney 2013). The UN
convention on the rights of Persons with disability (CRPD) is an important agreement that has
been signed by Ireland, which focuses on elderly people having intellectual disability residing
under a residential care.
Reflection
Social care professionals provide support, advocacy and care to those people who are the
vulnerable class of the society, including the people with disabilities. Teamwork and group
project are an integral part of the social care professionals as they have to access a large number
of people and communities. With the projects and the presentations I have achieved skills and
expertise that is required to become a social care worker. We often have to work with children
and families at risk, people suffering from addiction issues, asylum seekers and elderly people.
The project and the presentation had allowed us to focus and develop our knowledge regarding
the residential care, the disability and the society based services. The project and the presentation
have helped to examine the nature of the recent theories and practices of social work. It is
necessary for us to look at the profession as a whole. The study had helped us to understand that
social forces impacting a large number of people recognized by their influence over some people
have been seen by other people one at a time. It has helped me to develop a habit of going deep
inside the matter instead of just providing help to the needy. Furthermore the group presentation
and the project have helped me and my peers to understand about the importance of the
collaborative practice in social work. It has helped me to avoid every conflict of interests that

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normally arises in any team work. I am bestowed with the art of bringing about better social
adjustments in the social relationships of human beings.
A critical reflection can be made by following the UNSTAR model of reflection.
UN (Intellectual understanding)-
Projects and presentations in social care can be useful in developing the intellectual
understanding among the groups and the partners. Being a part of a team had helped me to
develop the interpersonal skills such as listening, speaking as well as the team working skills like
leadership and motivating the other members. This project and presentation has helped me to
understand the history of nursing care in Ireland, how the elderly with intellectual disability were
taken care off. It also provided evidence to the role of religion and the involvement of the
religious workers in the workforce development of the asylums and the hospitals. Team work
can be defined as the method of working in a group collaboratively to achieve a complete goal.
The team work and the projects could help us to gain knowledge about the differential elderly
care settings in different parts of the world. In my presentation and project I have worked with
the juvenile prisoners and have tried to address their grievances and understand their cognitive
behavior.
Situation
We have often come across the many vulnerable classes of the society such as persons
with physical disabilities, psychotic and mentally challenged people, elderly persons, women and
children at risk, sex workers and juvenile prisoners. Reflecting on situations we have come
across a project that requires to be dealt with juvenile prisoners. While working on the project

7RESEDENTIAL CARE FOR ELDERLY PERSONS WITH DIABILITY
and the presentation. We could learn about the history of the detained youths, the harsh
conditions and the overcrowding in the detention facilities after being arrested and also while
awaiting legal action. The team also required to conduct interviews with staffs or even with the
juvenile members. The whole set up needed a collaborative approach from setting up of the
presentation to gathering of information, which is only possible being part of a team.
Actions
As a part of the team, I have visited the Juvenile homes, gathered relevant information,
has taken a note of their current conditions. Being a part of a team I have understood how a large
task can be accomplished by distributing the work load among the different members. I have also
brainstormed through several databases to search for the relevant information. Surveys and
questionnaires were made suitable to their age. We also conducted a one- on one interview with
the staffs in order to understand the behavioral and the cognitive status of the captives.
Result
The outcome of the project was that it helped us to understand the underlying reason behind the
conditions of the juvenile prisoners, their grievances, mentality and the reasons for the
behavioral pattern. The presentation and the project had enough rationale for the scope of this
project in future. It helps us to understand the importance of strength based approach over deficit
based approach while dealing with the juvenile prisoners.

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References
Cooney, A., 2012. ‘Finding home’: a grounded theory on how older people ‘find home’in long‐
term care settings. International Journal of Older People Nursing, 7(3), pp.188-199.
Cotter, M., Donlon, S., Roche, F., Byrne, H. and Fitzpatrick, F., 2012. Healthcare-associated
infection in Irish long-term care facilities: results from the First National Prevalence Study.
Journal of Hospital Infection, 80(3), pp.212-216.
Dalton, C. and Sweeney, J., 2013. Communication supports in residential services for people
with an intellectual disability. British Journal of Learning Disabilities, 41(1), pp.22-30.
Doody, C.M., Markey, K. and Doody, O., 2013. Future need of ageing people with an
intellectual disability in the Republic of Ireland: lessons learned from the literature. British
Journal of Learning Disabilities, 41(1), pp.13-21.
Doody, O., Slevin, E. and Taggart, L., 2012. Intellectual disability nursing in Ireland: identifying
its development and future. Journal of Intellectual Disabilities, 16(1), pp.7-16.
Szebehely, M. and Trydegård, G.B., 2012. Home care for older people in Sweden: a universal
model in transition. Health & social care in the community, 20(3), pp.300-309.
Walsh, K. and Shutes, I., 2013. Care relationships, quality of care and migrant workers caring for
older people. Ageing & Society, 33(3), pp.393-420.