Key Points

In Government, the Social Democrats will: - Appoint a Commissioner for Ageing and Older Persons. - Introduce a statutory right to homecare to support people to remain in their own homes. - Invest to reduce and eliminate homecare waiting lists, and develop step- down facilities. - Link the State Pension to at least 34 per cent of the average wage. - Use other welfare payments and schemes, including the Living Alone Increase, Fuel Allowance, Household Benefits Package, and Free Travel to ensure that older people can have a decent standard of living in Ireland. - Invest in a variety of age-appropriate older persons’ housing. - Increase funding to the suite of housing grants for older people and people with a disability: The Housing Adaptation Grant; the Mobility Aid grant; and the Housing Aid for Older Persons grant. - Introduce replacement schemes for the Motorised Transport Grant and Mobility Allowance based on assessment of individual needs. - Increase funding to create additional accessibility on public transport, including at train and DART stations, more accessible buses, and other measures. - Prohibit the ‘digital only’ provision of publicly funded services, including services that impose obstacles or disincentives to accessing offline options. - Implement the National Dementia Strategy, and provide additional funding for dementia and Alzheimer’s services and for palliative care. - Invest in neurological services, and roll-out of chronic care programmes such as for arthritis and heart disease. - Reduce prescription charges for patients. - Invest in a range of activities, and social and cultural outlets, for older people.

Introduction

The Social Democrats want to build a society where we can all feel confident about our futures as we grow older, and we are proposing a number of measures to make this goal a reality. Over the coming decades, the make-up of Ireland’s population will change considerably. We often talk about the needs of Ireland’s ageing population as if it represents a change in demographics to be considered for the distant future. In fact, our population has already gotten considerably older in recent years, and will continue to do so. In 2011, people aged 65+ in Ireland made up just over 11 per cent of the total population. By 2041, the population aged 65+ is projected at almost 1.4 million, or more than 22 per cent. In addition, the number of people aged 80 and over is projected to increase from around 130,000 to approximately 458,000 between 2011 and 2041; an increase of 250 per cent. Older people are not a homogenous group and every individual’s experience of ageing will be different. Most older people will live full and independent lives. However, some are more likely to experience challenges relating to health, income, housing, transport, work, digital communications, and more besides. It is important to have policies in place to deal with each area. Equally, it is important to have a structure in place to ensure policy takes account of the needs of older people, and allows their voices to be heard in reviewing the adequacy of policy, legislation and services affecting older persons. The appointment of a Commissioner for Ageing and Older Persons would provide the oversight currently lacking to drive a rights-based approach to ageing policy and services.

A Commissioner for Ageing and Older Persons

Surveys taken by a number of Age Sector NGOs suggest that many older people feel ignored, sidelined, and misunderstood by the State, and express fears and anxieties about an uncertain future. The appointment of a Commissioner for Ageing and Older Persons would provide the oversight currently lacking to drive a rights-based approach to ageing policy and services. Such an office already exists both in Northern Ireland and Wales. Among the functions of a Commissioner for Ageing and Older Persons would be: - To examine systemic issues affecting older people, including by funding research and analysis to fill gaps where there is inadequate evidence to inform public policy. - Holding Government and public bodies to account by monitoring policy implementation and practice. - Reviewing the adequacy of policy, legislation and services affecting older persons; and - Advising Government on matters concerning older people. A Commissioner for Ageing and Older People would safeguard and protect the interests and well-being of older people and an ageing population in Ireland. They would champion the mainstreaming of ageing across Government strategies and plans. The Commissioner for Ageing and Older People would provide an independent voice with the ability and capacity to engage with all relevant Government departments. They would also support a coordinated approach to the implementation of strategies and actions relevant to the needs and rights of older people, importantly taking a role independent of any one government department.

Health and Social Care

One of the most basic functions of a republic is to put in place the necessary services to keep people well and treat them when they are sick. As Irish citizens, it’s not too much to expect decent healthcare. Yet the sad reality is that we cannot depend on our public health service, and it has been broken for some time. The current system is far too hospital-dependent, with much of the care that could take place in local health centres happening in acute hospitals, where care is more expensive and waiting times are longer. The different parts of the system don’t work well together, creating huge gaps and inefficiencies. And there is too little accountability for managers, senior medics, and ministers. Recent decades have seen the increased privatisation of many aspects of health and social care. While contracting out what are typically public services, or relying on the market to deliver them, is often thought to result in efficiencies, the reality is that the increased outsourcing of services – especially in the health and care sectors – is leading to a growing public capacity-deficit. The Sláintecare report was agreed by an all-party committee and launched in May 2017, based on proposals from the Social Democrats, for the development of a national public health service, available to everyone. The Social Democrats are proud to have led the way to agreement between all the political parties on the way forward for our health services. For the first time, a change of government shouldn’t mean changing the vision and direction for the health service, allowing for long term strategic planning for health needs. Much more needs to be done to fully implement Sláintecare and to feel the full benefits of synergies offered by the plan. Ireland’s healthcare system remains fragmented, often difficult to navigate and with long waiting lists. We have seen specialist services turning patients away due to overwhelm, the shutting down of services including mental health services in rural areas, and the continued emigration of health care practitioners (HCPs) seeking better working conditions, pay, and opportunities. Ordinary people pay a high price for these failures, especially our most vulnerable, including the elderly and people who live with disability and chronic illness. There is no excuse for this, now that a plan exists to change it.

Sláintecare will mean: - Free and comprehensive health services in our communities. - Investment in, and development of, GP and Primary Care. - Quicker access to public hospitals. - Community care teams for older people and those with mental health and addiction needs. - Diagnostics like x-rays and scans provided locally. - Thousands more healthcare workers including doctors, nurses, and therapists. - An increase in hospital bed capacity and an end to the trolley crisis. - A system that champions early intervention and illness prevention. - Strong systems of collaboration between overlapping departments. - Addressing weaknesses in the existing systems to support HCPs and protect patients, such as emergency and acute hospital discharge communications and plans. When Sláintecare is implemented, we will finally have a health system that is comparable to other European countries, based on need, not on ability to pay.

Other health measures we will take in government include:

• Implementing the National Dementia Strategy, improving homecare and community supports for people with dementia, and integrating dementia into the Chronic Disease Management Programme.
• Providing additional funding for dementia and Alzheimer’s services and for palliative care.
• Investing in neurological services.
• Rolling-out chronic care programmes such as for arthritis and heart disease.
• Expanding Old Age Psychiatry.
• Reducing prescription charges for patients.

Mental Health

Mental health difficulties among older people are under-recognised both by the medical profession and by older people themselves, according to TILDA research, and loneliness can be a huge problem for older people. The Mental Health Commission reported on challenges in mental health services for older people in 2020, noting that no CHO region was meeting the recommended number of dedicated acute mental health beds for older people. A Vision for Change recommended that there should be eight acute beds for older people per 30,000 population. By this metric, 205 acute beds for older people are required, but there are just 63 dedicated beds for older people nationwide. Loneliness and depression are closely linked, and loneliness leads to outcomes like increased risk of dementia, early mortality, and cardiovascular illness. Though research suggest that loneliness has as severe an impact on our health as smoking, it has not received the same public health response. In Government, the Social Democrats will: - Increase the number of acute mental health beds available for people aged 65 and older. - Implement the Model of Care for Specialist Mental Health Services for Older People. - Complete the action plan to combat loneliness and social isolation, and then fund and implement it.

A Statutory Right to Homecare

Residential care is rarely anyone’s first choice. Most older people would prefer to stay in their homes, and the State should support that. Not only is remaining in the home and community associated with better health outcomes, but older people also deserve a meaningful choice in how and where they choose to live. For too long older people have been funnelled into nursing homecare, in the absence of adequate support for them to stay at home. This system does not serve the interests of many older people. Instead, it seems set up to serve the commercial interests of the sector, which is increasingly financed by international investors. Since the onset of Covid-19, this Government has accepted the need for a new model of care, but it hasn’t moved much beyond statements of intent and aspirations. It’s now eight years since the then-Minister for Health, Simon Harris, committed to a statutory right to homecare. Since then, every target for the introduction of such a right has been missed, and now it appears that that commitment has all but been abandoned. This Government has settled for just regulating the homecare sector. While this is an important aspect of the broader reform programme, it’s a far cry from providing a radically different model of care. In Government, the Social Democrats will: - Introduce a statutory right to homecare to support people to remain in their own homes and provide a budget for a person-centred homecare scheme with equality of access and availability across the country. This scheme will provide equitable access to high-quality, regulated homecare. - We will also invest to reduce and eliminate homecare waiting lists, and develop step-down facilities. This is a vital aspect of ensuring patients’ needs are met and maximising hospital efficiency. At any given time, there are hundreds of people in hospital who are ready to be discharged if the necessary homecare support was available.

A Caring Society

Social care in Ireland has been progressively privatised. Employees within the sector deal with precarious working terms and occasionally other forms of exploitation. We now have a largely unregulated homecare industry and the legislation required to regulate the sector and provide for a statutory right to homecare has been beset by delays, while this Government has completely reneged on its commitment to introduce a statutory right to homecare, missing each target for delivery. Investment in universal social care services is vital to ensure older people and disabled people have the necessary supports to reduce dependence on family and friends and to maintain a private life with dignity. The European Commission has noted Ireland’s over-reliance on institutional care while homecare – which is a key part of long-term care services in many other EU Member States and is more efficient and appropriate for addressing much of our care need – has been historically underprovided. An increase in investment in social care is needed. In Government, the Social Democrats will: - Introduce a statutory right to homecare to support people to remain in their own homes (see previous page). - Conduct a review of the privatisation of elder care, and the market structure for those already privatised. - Begin a process of creating parity of treatment for staff delivering services in HSE-funded organisations. oThese Community and Voluntary organisations are experiencing an escalating crisis in staffing. Service delivery is being jeopardised as a result of challenges around staff recruitment and retention. oThis is mainly due to the disparity in pay and conditions between Section 39 organisation staff and their public sector counterparts, which we will seek to close. - Reduce and eliminate homecare waiting lists through investment in homecare packages and stepdown facilities.

oThis is a vital aspect of ensuring patients’ needs are met, and maximising hospital efficiency: oAt any given time there are hundreds of people in hospital who are ready to be discharged if the necessary homecare support or stepdown services were available. - End the ‘3-day rule’ in part time jobseekers’ payment to benefit homecare workers. - Ensure homecare workers receive a real living wage. - Re-examine the Critical Skills list for visas to ensure as much as possible is being done to allow skilled workers for the sector to be found. - Introduce and enact robust adult safeguarding legislation. oThe current legislative and regulatory framework is fragmented and limited. It does not adequately protect many adults at risk of abuse or provide effective powers to investigate potential risk settings such as private nursing homes.

Income Security

We must do more to ensure that people can have confidence about the income they will receive at retirement, whether this is a pension payable from the State or a pension through a savings arrangement. There have been several commitments to benchmark the State Pension, made in the Roadmap for Social Inclusion 2020-2025 and the Roadmap for Pensions Reform 2018-2023, but to date there has been little progress. Older persons with the lowest incomes (the bottom 30 per cent) rely on social protection for more than 90 per cent of their income. Even the top 30 per cent gets between 18 and 48 per cent of their income from welfare, so for almost everyone, the State Pension makes up a really significant part of their income. Implementing pension benchmarking is an opportunity for Government to make a real and long-term impact on the lives of the elderly today and to lift many older people out of poverty. As the cost of living continues to increase, older people’s incomes must be protected and benchmarked to keep up with the rest of society. In Government, the Social Democrats will: - End the auction politics on pensions by linking the State Pension to at least 34 per cent of the average wage. - Conduct a review of the Total Contributions Approach (TCA) for calculating state pension eligibility, including on the implications for pensioner poverty, with a view to making adjustments to the design, including: oCreating bands, similar to the Yearly Averaging system, so TCA calculations are not strictly pro-rata. oReducing the number of years of PRSI contributions necessary to achieve the maximum pension. - Introduce a Cost of Disability Payment. - Use other welfare payments and schemes, including the Living Alone Increase, Fuel Allowance, Household Benefits Package, and Free Travel to ensure that older people can have a decent standard of living in Ireland.

Protecting Private Pensions

Workers are entitled to know that they will have security in their old age, and that they will not have the pensions they have worked for stripped away unfairly or due to discrimination. We will legislate, as is the norm in other EU countries, to prevent employers who have the financial resources to meet the commitments in their pension schemes from simply walking away from those benefit promises.

Improving Accessibility

One difficulty experienced by many elderly people is simply accessing the benefits they are entitled to in the first place. Large parts of the social protection system are not designed with accessibility for older people in mind. In fact, the system often throws up barriers to people trying to access support. The range of supports available from the Department of Social Protection and other Departments all require different forms, some have means tests and some don’t, and the means eligibility varies, with some applicable at different ages. Applications must often be sent to many different organisations and Government departments. This complexity often prevents older people from accessing supports they are eligible for. It most severely impacts older people with lower literacy and numeracy skills, including online literacy, as often the default procedure is to direct them to a website for information. In Government, the Social Democrats will: - Create a more streamlined approach for accessing and applying for pensions and other entitlements, in accessible formats both online and offline. - Aim to develop simplified eligibility criteria and administrative requirements across the entitlements, as far as possible.

Older People’s Housing

Most older people wish to remain living in their communities. However, there often comes a point when many find their homes are no longer suitable for their needs, yet there are no alternative options for them within the local area. As a result, it is not uncommon for older couples or single people to continue living in three- or four-bedroom houses (or larger). If Government and local authorities provided better housing options to older people, they could continue living independently for longer, enjoy better health, and stay in local communities among friends and family. We have a range of proposals to provide these options.

Designated housing for older people

Designated developments for older people could be built on many of the small infill sites in our cities and towns, while new estates should have a mix that includes older people’s homes. This would enable people to move to more suitable, affordable accommodation within the same neighbourhood, or even the same estate. There are some models of dedicated housing schemes in Ireland, but there is no standard, consistent model in place. This contrasts with Germany, where housing estates designate 10 per cent of their stock for older people, which makes it easy for so-called ‘empty-nesters’ to downsize within their own estates. Close to a third of older people would feel positively about moving if it better suited their needs. Purpose-built, designated homes would address mobility challenges and safety concerns, as well as enable longer independent living and better social inclusion. We will meet the clear demand by introducing such a designation for purpose- built homes for older people by reforming the planning law to ensure that older persons’ housing is provided as part of all new developments and improve the supply of privately built step-down housing.

Renewed Step-Down Housing Scheme

The models for both sheltered housing and the Financial Contribution Scheme already exist in Ireland. Both have the added advantage of freeing up family homes for county council use, which could be refurbished and let to families on the housing waiting lists. We would make greater use of the Older Persons Housing Financial Contribution Scheme so that older people who want step-down housing in a sheltered housing setting can do so.

Accessible Homes

Funding for Housing Adaptation Grants is far too low. Funding for 13,000 housing grants for older people and people with disabilities was allocated in 2024; fewer than the 13,588 grants in 2010, when the population of people aged 65+ was around two thirds of what it is now. The impact of the shortfall in funding for these grants is severe. Delays in accessing grants prevents timely hospital discharge for older people, prevents them from ageing comfortably at home, and can prevent them accessing basic necessities like accessible washing facilities. In Government, the Social Democrats will: - Increase funding to the suite of housing grants for older people and people with a disability: The Housing Adaptation Grant; the Mobility Aid grant; and the Housing Aid for Older Persons grant. - Ensure funding levels take account of the increased cost of construction. - Set a minimum of 7 per cent of social housing to meet universal design standards. - Ensure that every social housing pipeline project demonstrates at Capital Appraisal Stage the inclusion of a minimum target of fully wheelchair- accessible housing with higher percentages applying for areas of higher need.

Supporting Older People with a Disability

The majority of people with a disability acquire it over the course of their lifetime. In fact by the age of 85, a majority of people will have some form of disability. In Government, the Social Democrats will: - Use a rights-based approach to disability, recognising the role of Disabled Persons Organisations, or DPOs. - Prioritise the implementation of the United Nations Convention on the Rights of People with Disabilities. - Invest in inclusion, guided by the findings of the Disability Capacity Review, to put the sector on a sustainable financial footing. - Make multi-annual funding from government the norm for the disability sector. - Implement a weekly Cost of Disability payment to reflect that disabled people have a higher cost of living as a result of their disability. - Insist on a full Minister for Disability at cabinet. - Implement, enact and commence key legislation and strategies to promote and protect the rights, quality of life, and independence of disabled people. - Introduce replacement schemes for the Motorised Transport Grant and Mobility Allowance based on assessment of individual needs. - Increase funding to create additional accessibility on public transport, including at train and DART stations, more accessible buses, and other measures.

Transport

One of the starkest differences between Ireland and other European countries is our poor public transport system. One of the greatest problems with the system is its poor level of accessibility. This must change. Public transport is a public good. The Social Democrats aim to keep it that way. In government we will oppose attempts to further privatise the public transport system. We will also insist on high-standard services from all operators. Public bus routes can only be sustained if they provide a reliable service that people can depend on. There must be a vast improvement in the area of accessibility for older people and people with disabilities. We will strengthen accountability by requiring public transport providers to account for local services and targets at monthly council meetings. Local Link is vital for rural Ireland. It helps alleviate rural and urban isolation for older members of our communities, who may no longer be able to drive themselves. Current funding is completely insufficient to develop a strong and reliable Local Link network. The Social Democrats would immediately double funding for Rural Link and seek to improve this over time. In Government, the Social Democrats will: - Commit to developing major National Development Plan transport projects, including MetroLink, expansions of the DART and Luas, and the Cork Commuter Rail project, as well as Bus Connects in our five major cities. - Create a new National Transport Policing Unit to police mainland rail services, Luas, DART and Bus services and stations. - Ring-fence funding for the purchase of new buses to expand capacity on Ireland’s public transport network. - Double funding to the Rural Transport Programme and to Local Link to increase availability, provide further local and circular routes servicing towns and villages. - Treat public transport as a public good, opposing the increased privatisation of services.

Digital Rights

The Government’s Roadmap for Digital Inclusion recognises that older persons are less engaged with digital technologies, and that there are multiple barriers to digital inclusion, including access, affordability and ability. Covid lockdowns accelerated the digitalisation of Irish society, which has worsened social exclusion for the many older persons who are not using the internet or who lack basic digital skills. Both private and public services are increasingly moving online, leaving many members of our society behind. To avoid digital exclusion, people must often take risks with their personal data, or rely on others who are more digitally literate. For many older people, this, at best, reduces their autonomy and at its most dangerous leaves them exposed to abuse and exploitation. While the State declares that public services should be ‘digital first, not digital only’, examples of publicly funded services being exclusively available online, include local property tax payments, passport renewal, and bookings for national car tests, as well as various public consultations. Work needs to be done to improve older persons’ digital skills and access, as well as to protect high-quality offline services of which they can avail. In Government, the Social Democrats will: - Prohibit the ‘digital only’ provision of publicly funded services, including services that impose obstacles or disincentives to accessing offline options. - Give the Commissioner for Ageing and Older Persons a role in enforcing this prohibition. - Ensure public services are designed to assist those who have literacy and/or numeracy difficulties, which often lie behind digital exclusion. oThis should also apply to essential services in the private sector, such as mainstream banking, and to private or voluntary bodies supported by state grants. - Oblige all publicly funded services to deliver a minimum level of offline customer service.

Loneliness, Recreation and Wellbeing

Data from ALONE, the organisation for older people, shows that many of the people they work with have little or no social outlet and are hugely isolated. Some older people are continuing to isolate themselves, in part due to lingering fears and anxiety relating to the pandemic. Cost of living increases are also having an impact on their ability to socialise. Some day-centre facilities and social activities have never fully returned, post-pandemic. Studies have linked loneliness to depression and mental health difficulties, and also to diseases such as Parkinson’s, diabetes, cancer, stroke, and even early death. Increased health risks add costs to the State as a result of increased pressure on health services. In Government, the Social Democrats will: - Complete the action plan on loneliness and social isolation, then fund and implement it in full. This action plan was committed to by the Department of Health under the Roadmap for Social Inclusion, Healthy Ireland Strategic Plan, and other Government strategy documents, but has not been completed. Sport is fundamentally embedded in our culture. However, participation levels have declined in recent years. The Social Democrats primary objective is to maximise participation levels in sport and less formal recreation. We believe the success of sports policy should not be measured in gold medals but instead by the percentage of the population who are out and active in their local communities. This is key not only for keeping people active, but also in the fight against obesity, the sustainment of communities, the integration of people from diverse backgrounds, and the promotion of strong mental well-being. We have a particular desire to improve participation levels among groups who do not generally have high participation rates, including older people and people with disabilities. In Government, the Social Democrats will: - To use participation levels as the main driver of funding and strategy in sports policy. This means funding will be geared towards participation more than any other criteria. - Extra funding for initiatives aimed at cohorts with high drop-out rates or low participation rates including older people and people with disabilities.