Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I thank the panellists who have been here since this morning. We collectively apologise for all the delays today. I refer to the quote from the WHO which Ms Leonard cited which describes dementia as one of the most serious challenges facing the world today. I agree with that opinion and I know only too well the truth of it. I welcome all the delegates.

I do not have a raft of questions but one of the aspects that struck me with regard to the south Tipperary initiative is its simplicity. It is not complex and it is very straightforward, which is, perhaps, its strength. The critical aspect jumps off the paper but it also came across even stronger in the passion of each of the contributions. I apologise I did not hear all of Professor O'Shea's contribution as there was a vote in the Dáil. I refer in particular to Dr. Crowe's contribution. That passion, while it is not written into the text, just jumps out at me. I refer to such a critical component part in the success of the initiative which is the people; both they and the community have made this difference. I refer to the five steps of the Living Well programme or the building on those steps. The five areas are among the achievements of the past three years. Just two of the five areas, particularly, are directed to the dementia sufferer. The others are supportive of, or directly geared towards the wider family and then the community in turn, in terms of other supports, technological advances, dealing with the stigma, public knowledge, awareness, acceptance, all of those things. I ask the delegates to tell us a little bit about the clinical nurse specialist. I ask them to describe the factual position of the clinical nurse specialist - perhaps there are more than one - who is described in the contributions as the single point of contact for people with dementia.

My other question relates to the dementia support worker. I can readily identify with this role. I have had a recent experience within my extended family and friends of another case of dementia in the recent past and all that entails. I see how it can very much limit and arrest another's life because of the support requirements. I ask for more information about that role. How many dementia support workers are in the service in south Tipperary? With regard to the other areas I can readily understand and appreciate and I can apply them without any difficulty in my own community. I can see how we could all play a part. The clinical nurse specialist and the dementia support worker are more particular roles. Is there a training process for dementia support workers? What degree of preparation is involved? What is the personal profile of those who are support workers?

I refer to Ms Leonard's contribution and I ask Professor O'Shea to contribute as he thinks appropriate. I refer to the significant number of people with dementia under the age of 65. One particular case was represented in the audio-visual room only several months ago. He was a young man who could only be described as heroic, in my view, as he was looking after his mother who has dementia while still in her 50s. It can present even earlier than that. Are particular responses required for the younger age group as against dementia presenting in older life? Ms Leonard spoke about an estimated number of 4,000 people and that is not an insignificant number of people. This committee has addressed a raft of different rare diseases over the years that, in some cases, affect fewer than 100 people yet we are pressing, quite correctly, for specific supports and assistance. However, there is a particular cohort of younger people here and their needs may be slightly different, I would think, than those of the older cohort.

The investment of €30.2 million for dementia specialist intensive home care packages is one of the key component parts of the group's pre-budget submission. It proposes that this would extend beyond the eight pilot areas and to all local health organisations regionally. I ask the delegates to identify the eight pilot areas. I agree that receiving a service should not be dependent on where a person lives.

The people in south Tipperary will not be able to readily identify with what I am now going to say but I live four miles from the Border and I have lived there all my life, born and bred. Many in my home community, because of the absence of sufficient capacity within support structures and because of where they live, naturally gravitate towards the next little town or community and that might be in Tyrone or Fermanagh - I am thinking specifically of Tyrone and the Clogher valley. The fair deal support does not allow my neighbours, whose life gravitation has been to Clogher village, access to the use of that nursing home. There is a deficiency. We are talking about developing all-island solutions to health challenges and this is a very practical area. Fair deal should be available on the basis of the need of the individual as against the geographic location, not just of the individual, but of the service. I ask Ms Leonard to comment from the point of view of the Alzheimer Society of Ireland.