One of the more prominent proposals in the Budget is a pilot project under which elderly people on the waiting list for a government residential home would be granted a subsidy should they employ a carer to look after them in their own home. The subsidy would amount to 50 per cent of the minimum wage.
The idea is that 80 per cent of the elderly person’s pension, which is retained by the government when that person is living in one of its care facilities, would instead go towards paying the rest of the salary. The total subsidy allocated next year will be capped at €1 million, allowing about 200 pensioners to take advantage of the scheme. By doing so, they would forfeit their place on the waiting list.
From the perspective of public finances, this proposal appears to be a winner. Forking out half the salary of a live-in carer would cost the government less than a third of what it does to look after an elderly person in an institution. The scheme, if taken up by enough families, should start to make significant inroads in the 1,400-strong waiting list for residential places, a figure which is putting great pressure on government homes and is only expected to grow.
The project must be commended from a social point of view as well.It is part of the gradual movement away from institutionalised care towards care in the community. Some of the government’s other services already long in place, such as mealson wheels, should only make it easier to implement.
On the level of individual care in the field of geriatrics, there are some very sound reasons for strengthening this approach. As we age and draw closer to our inevitable death, we tend to derive more and more comfort and security from the people we love – family, friends, neighbours – and the items around us that we hold dear, which perhaps are imbued with our fondest memories and have come to symbolise our most cherished values.
Even as our bodies grow frailer, we may have established habits and routines that allow us to feel our lives still have meaning and purpose. Home is where the heart is and this is no truer than in the twilight of our lives.
So enabling as many elderly people as possible to go on living in theirown homes for as long as possible, instead of uprooting them to cold, alien surroundings, is the correct psychosocial approach and certainly the most compassionate.
In theory, the offer should be snapped up. It gives immediate family members an attractive middle way: respite from what sometimes turns into full-time care without the guilt of resorting to an institutional solution. There are already hundreds, if not thousands, of elderly people in Malta who employ live-in carers, many of them Filipinos, and demand for them runs high. The testing period will reveal whether there are enough qualified carers to go round. The fact that the certification course is only three months long may help to attract more locals to the job.
The scheme will need to be monitored closely to protect both the carer and cared-for from potential maltreatment or abuse. In the same way as standards are being set for residential homes, there will need to be some guidelines on the minimum level of care to be provided. At present, this area is unregulated.
This is a scheme that greatly deserves to succeed, giving our elderly a more dignified and life-affirming way to see out their remaining years.