Demand for homecare is growing rapidly as outlined in the ERSI’s 2017 report. They expect the demand for homecare to increase by well over 50% to the year 2030. However even this is an under estimation as the ERSI calculations are based mainly on demographics and as such don’t take into account the large increase in demand from increasing numbers of disabled people.

With the sector struggling to meet existing demand, the expectation is that we will be facing a severe shortage of carers in the coming years unless some pretty radical changes are brought in.

Despite their critical importance to the health of our older and disabled population, the vast majority of our carers are living from week to week on low wages and with no guarantee of what their next wage slip will look like.

The jobs themselves are incredibly tough and with the very poor employment conditions, it means that there is a huge turnover of staff, probably in the region of 40%. Many of them leave for other sectors like retail, hospitality and fast food, which in themselves aren’t the most attractive jobs.

Caring is the lowest rung on the ladder in our health sector despite the fact that it is carers who spend the most time with clients and patients. It is also carers who very often are the biggest source of patient satisfaction and it is carers who are on the frontline addressing the very significant problem of loneliness.

Are we missing something here? Surely, we need to be concentrating on how we can convert caring into a respected well-paid job that ensures we all will have the support we need in our later years? We need to concentrate on converting this network into a professional resource that can play a much wider role in the healthcare continuum?

Home care also needs to move away from been seen as just a poor relative to acute care and seen more as being fundamental to improving the quality of life of the people who receive it. For this to happen the profile of the sector needs rise and we need to look at incorporating more long term care into health care teams.

I suspect that improving caring as a career could in fact improve the quality and efficiency of our whole health system and probably make our health budget go further! Indeed looking at savings with a wider lens, in the US its estimated that employers are losing $33 billion each year due to employees care giving responsibilities!

Ignoring and not investing in long term community care is short sighted. If carers were trained to do more actions like recognising and reporting on patient’s health problems, tracking medication and doctor appointments and offering advice on healthier living, we could make significant savings in health budgets.

Many carers are capable of doing so much more and expanding their role is one sure way of making caring a more attractive career.

Imagine carers trained to help manage chronic conditions such as diabetes and obesity. Carers being able to help manage hospital discharges and follow up with G.P.s. Bridging that gap between G.P.s and patients and thereby improving rates of vaccination, the management of high blood pressure or general healthy behaviours, could result in huge savings for our health budgets. Because of the time they spend with patients, no one is better placed to help with the management of chronic diseases.

Changing how community care works and giving more responsibility to better trained and better paid carers won’t be easy. There will be resistance because of risk aversion by the HSE. There will be the initial cost of higher paid carers and there will be resistance from nurses and other professionals of carers encroaching on their territory.

At Home Care Direct we are taking the first steps towards making caring a more attractive carer and allowing carers take on more responsibility and therefore play a more important role. We are enabling them earn significantly more than within traditional home care structures and we see the knock on effect this has on the quality of provision.

We have a vision of highly trained regional teams of carers working for themselves in self supporting local groups. Carers being empowered to provide highly personalised care in their own communities and being coordinated by a regional clinical professional rather than being hemmed in, in bureaucratic and costly corporate structures.

We feel the local element is vital to foster and leverage more community spirit of self-help and self-reliance. We see on a daily basis, there are lots of capable carers being frustrated by archaic systems and processes, who want and are capable of contributing so much more.

There are other initiatives like the Burtzog movement where community health professionals are let get on with providing care and support to communities as they see fit rather than under a bureaucratic sclerotic system.

We also have recently seen the first carer coop set up in Dublin to provide home care which is giving carers new opportunities within the sector.

We need to work out how to leverage this fantastic network of carers with a high level of contact with vulnerable people in our society, so that we can reduce pressures on our acute system but also to build a self-help attitude in those communities where the carers live. The bottom line is we can’t afford to lose quality people to the likes of McDonalds when there is such important social care work to be done in communities all over the country.