The government last year “purchased” 298 beds in the private sector to address a growing waiting list of elderly people who seek to enter homes specifically catering to their needs, the Ministry of Health and Active Ageing told The Malta Independent on Sunday.

This year, this number of “purchased” beds has already reached 167, as the government has a dedicated budget of €72m to “significantly strengthen” its capability to help those in need of residential care.

The ministry was replying to questions by this newspaper after information received that waiting lists for elderly people seeking space in care homes, along with a general shortage of nurses in the country, is creating difficult situations for care workers as well as nurses who are overburdened by their tasks.

Sources said that this situation significantly impacted both the elderly residents and the quality of care they received, as well as the availability of care workers and nurses responsible for their well-being within the home.

Contacted about this, Nationalist Party spokesperson for the elderly Paula Mifsud Bonnici said that “not having immediate access to nursing homes, a lot of elderly persons are experiencing social isolation, neglect and abuse”, not to mention the distress caused for their loved ones.

For its part, the Malta Union of Midwives and Nurses said that “[it] always stresses the importance that the job of a nurse cannot be done by a care worker. First of all it is against the law, and secondly, the safe practice of the clients will be seriously jeopardised”.

The government waiting list, last checked in a parliamentary question in May 2023, was 1,556 and apparently increasing, Mifsud Bonnici said.

So, the only other options available are to remain at home and be a strain on the partner or other members of the family, which many elderly people seek to avoid; go directly to a luxurious care home with no waiting list but which charge exorbitant prices or seek to obtain some help via a list of services that are offered by the government, such as home help care.

Mifsud Bonnici said that the high costs of expensive nursing homes place a “significant” financial burden on the elderly and their loved ones. She said that not only are such homes inaccessible to families who do not have the means to pay for them, but also exacerbate already-existing inequalities in access to long-term care of good quality. 

A difference also exists between the beds provided by Active Ageing and Community Care Department and those provided by the Health Services Department, Mifsud Bonnici said. The Active Ageing and Community Care Department requires that an elderly resident pay up to 60% of their income when entering a residential home, while the Health Services Department demands a resident to pay up to 80% of their income, she said.

Mifsud Bonnici questioned this injustice and insisted that “all elderly people should have access to the same support and services they need to age with the same dignity and comfort independently of their wealth or lack of it”.

Returning to the question of nursing shortages, the MUMN said that government care homes, which have their “best visibility”, are staffed “considerably well” since any nurses taking leave or sick leave are promptly replaced by nurses from a private contractor, funded by the government.

Mifsud Bonnici said that she had encountered situations in which due to nurse or carer shortage, among other adverse situations, the service is focused on operating in an “uncostly manner” as opposed to catering to the dignity and respect of the elderly. Honing in on the use of nurses or carers for catering services, Mifsud Bonnici said that food quality is a common complaint and sometimes doesn’t even cater to the nutritional value or dietary requirements of the patient.

These increased workloads and decreased job satisfaction caused by the shortage of carers and nurses all contributes to the level of care received by the elderly, Mifsud Bonnici said.

In response to this, when contacted, the ministry said that to enhance the assessment process a novel “multi-domain assessment tool” was recently introduced at St Vincent de Paul Residence designed to differentiate between individuals who genuinely need residential care and those who can be “adequately supported” within the community through services offered.

In doing so, we aim to ensure that resources are allocated efficiently, “maximising support for those most in need”, the ministry said. The ministry went on to say that the government is also working on three residential homes: the Floriana Home is being renovated, while a tender for the Cospicua Home was published in the last weeks and a new call for tenders for a home in Msida is in the pipeline.

The ministry said that this is to ensure that the elderly people who require moving into residential care homes are offered the “best service in the environment they deserve”.

The Older Persons Standards Authority (OPSA) stands to regulate and monitor government, church and private homes within the parameters of the set standards, the ministry said.

From January up to March, 254 inspections were carried out and following the visits, the OPSA issued 272 recommendations concerning administration, service, physical environment, food and staff, the ministry said.

With regards to the workload on nurses and carers, the ministry said that within government-run care homes, “there is no indication that duties intended for nurses are being performed by carers”. Furthermore, the ministry said that the government is working actively to incentivise individuals to pursue careers in nursing.

The ministry went on to cite a recent agreement with the MUMN that “underscores the government's commitment to this endeavour, as it includes a range of efforts and incentives aimed at attracting and retaining talented professionals in the nursing profession”.