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Your Later Life 2024

Patient-centred home services keep older adults living independently longer

Shona Rusk

Manager of Services for Older Persons, HSE

Services are being provided to support older people to live well at home and reduce the requirement for long-term residential care.


The Health and Safety Executive (HSE) Older Persons Services is dedicated to providing equal access to integrated services for older adults, helping them stay in their own homes for as long as possible.

Home support for older people

A wide range of services are provided including home support, day care and additional community support to assist with managing care at local level and support transition from hospitals back to the community.

Shona Rusk, Manager of Services for Older Persons in Dublin North City and West, along with her team, plays a key role in supporting our local acute hospital colleagues in managing patient flow.

Rusk advises: “Established discharge pathways and excellent working relationships between Older Persons Services and the acute hospitals ensure there are no untimely delays in discharging patients. Home support in our catchment area is provided by over 30 agencies currently approved under a National Tender Arrangement, which supports our older persons’ timely discharge back to their home environment.”

Home monitoring pilot programme

The Older Persons Services has successfully piloted a new initiative called ‘Discharge to Assess’ (D2A) across three of its network areas (Cabra, Ballymun and North Inner City) in partnership with the Mater Hospital. “D2A is an alternative discharge pathway where a patient is assessed in their own home for support, resulting in a more person-centred allocation,” explains Rusk.

“We have a dedicated team of carers that provides and monitors the older person’s care needs at home for an initial period of time. They support the older person in their transition to their permanent home care provider. We hope to expand D2A to the remaining Community Healthcare Network areas and Connolly Hospital over the coming winter.” Rusk also coordinates the provision of Day Care Services, Meals on Wheels and Respite services to support older people, their families and carers in the local area.

Long-term care placement review

When community support is no longer sufficient to enable older persons to remain at home, there may be a requirement for long-term residential care. Rusk chairs the Local Placement Forum, which reviews applications for long-term residential care. The purpose of the forum is to determine if the care needs of applicants can only be met in a residential setting. The forum has representatives from both community and acute hospital settings. The number of older people in our community continues to grow with ever-increasing demands for services. 

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