The country's largest dementia-specific nursing home may have to close down due to a lack of funding.

St Joseph's Shankill in Dublin is currently home to 60 people with dementia. It also provides two respite beds and 120 daycare places per week.

However according to the home, it will be forced to stop providing these vital daycare services from January 2020. Furthermore, the entire facility faces having to be gradually wound down unless proper funding is supplied.

St Joseph's is a private not-for-profit nursing home that is owned and managed by Saint John of God Hospital. In recent months, hospital management and board members have been engaging with the National Treatment Purchase Fund (NTPF) and the Department of Health on the need for a significant increase to both inpatient and daycare reimbursement payments.

The nursing home has been experiencing annual deficits of €1 million per year since 2012. Saint John of God Hospital has been covering this €7 million financial shortfall from its own resources during this time. A further subvention of €1.2 million will be required to offset the 2019 deficit.

The hospital insists that this is not a sustainable or fair way to fund services that are so vital for people affected by dementia.

"People living with dementia have very different needs to elderly people living in care facilities without dementia. We deliver intensive person-centred, dementia-specific care every day to the 60 people that live in St Joseph's and to the people who utilise our 120 daycare places and two respite beds each week.

"Dementia care is an end-of-life palliative process and we simply cannot continue to offer this specialist long-term care based on the current funding model applied by the NTPF and the HSE. We are paid at considerably lower rates than equivalent public facilities and no account is taken of the added costs associated with meeting the high dependency needs of the people we care for," explained the hospital's CEO, Emma Balmaine.

She noted that most residential places in St Joseph's are funded by the NTPF rate of the Fair Deal scheme, however she insisted that this rate is "insufficient".

"It does not take account of the dementia-specific and palliative care needs of these residents who have a terminal diagnosis. Added to that, the daycare rate, which is set by the HSE, has not been increased since 2006, and just last month we were informed that there is still no funding available, despite our warning of potential cessation of the service," Ms Balmaine said.

She warned that the nursing home "has endured such significant shortfalls since 2012", that it must now consider winding down its service.

"This would be devastating for the people who live here, their families who depend on this vitally important service, as well as our highly dedicated staff and volunteers. We dearly hope it won't come to this, but we are now obliged to make our service users, staff and volunteers aware of the very challenging financial scenario we all now face," Ms Balmaine added.

The nursing home currently employs 100 staff and also has 100 dedicated volunteers.