Dáil Éireann Debate, Thursday - 26 February 2026
454. Deputy John Brady asked the Minister for Children, Disability and Equality her plans and the timeline to phase out long-term care in a nursing home for younger people with disabilities; and if she will make a statement on the matter. [15701/26]
View answerThis Government acknowledges that a nursing home can be an appropriate care option where the person concerned has a clinically assessed complex medical and social care requirement that cannot be supported in the person’s home.
However, as identified in the Ombudsman Report “Wasted Lives: Time for a better future for younger people in Nursing Homes,” for the majority of people under the age of 65 nursing homes are not an appropriate placement and alternative, more sustainable supported living solutions are needed to give them greater independence and choice in their daily lives.
The Programme for Government commits to continue to work to end the practice of placing young people with disabilities in nursing homes. In recognition of this commitment In 2026, The HSE National Service Plan allocated a record €10m to the under 65s work programme. €8m of this funding will enable 45 people who are inappropriately placed in a nursing home to transition to more appropriate living arrangements.
The remaining €2m will provide Enhanced Quality of Life Supports (EQLS) to those who remain in nursing home settings. In addition, the U65 programme has also been awarded Dormant Account Funding for 2026 of €750k. This funding will be directed towards once off funding for EQLS.
EQLS are aimed at improving an individual’s quality of daily life in a nursing home, increasing social access and where appropriate, to support the pre-transition work, to help individuals prepare for a move back into the community.
Specifically, these EQLS supports range from iPads, Laptops, Audio Books & Head Phones, TV in own room, Motorised Wheelchairs, Mobility deceives, Communication devices, Exercise Bikes, PA (until year end), Therapeutic Supports, Allied supports e.g. Dentistry, Transport, Support Chairs etc.
Data from the HSE indicates that as of December 2025, there are 1,209 people under 65 in Nursing Homes, 14% of whom are under 50. As of December 2025, A total of 121 people have transitioned to homes of their choosing in the community since the start of the programme in 2021.
Additionally, over 300 individuals have received additional enhanced quality of life supports (EQLS), while they are currently continuing their placement in a Nursing Home.
Based on data from the U65 Operational Tracker, the majority of those continuing a Nursing Home placement due to their current personal will and preference (which Disability Services review regularly in recognition that will and preference may change with time).
A further cohort will remain due to their assessment of needs requirements. Such complex medical and social care needs may require intensive nursing and medical care that cannot be provided in a home setting or by family members.
Preventing entry to nursing home facilities requires a model of service that supports the changing needs of individuals and allows them to continue to live a life of their choosing in the community.
Therefore, the HSE along with Voluntary and Private organisations are providing a variety of supports to people with disabilities including Personal Assistants, peer supports, respite, day services, home supports, Advocacy and Digital and Assistive Technology. These supports are governed by a diverse range of health and social care policies and ongoing programmes and aim to enable young persons from entering nursing homes where possible.
The main source of admissions of people under the age of under 65 in to nursing homes is discharges from acute hospital settings where the individual has a complex medical need such as an acquired brain injury. HSE data shows the impact that wider policies have on the numbers of U65s in Nursing Homes, with particular focus on the Acute Hospital winter discharge programme and its sustained focus on increased discharge rates and turnaround times from Acute hospitals.
Due to the work of the Under 65s Integrated Steering Committee and project team, there is a greater awareness across HSE Acutes, Older Persons and Disability services of the need to prevent people under the age of 65 from being placed in Nursing Homes.
The National Clinical Programme for People with a Disability (NCPPD) is in the early stages of developing A Place to Call Home and its associated Guidance Notes - a rights-based model for all adults with a disability, supporting people of any age to live, age and thrive in their own communities. Together, this work will set out, in a clear and practical way, the full range of community-based alternatives to nursing home admission for people under 65.
Grounded in the Programme’s commitment to preventing unnecessary institutionalisation and enabling adults with a disability to exercise their right to live in the community rather than in long-term residential care, in accordance with their will and preference, the Programme is identifying the key supports, pathways and services required to uphold this right. This includes personalised supports, appropriate and accessible housing, enhanced home support, personal assistance, rehabilitation pathways and strengthened cross-sector collaboration — all central elements of the emerging model.
As the work progresses, the Programme will bring together research, data, stakeholder input and alignment with National reforms across health, disability, housing and social care to produce a clear, evidence-informed picture of the community options needed to ensure that adults with a disability can live independently and participate fully in society.
