Dr. Caitríona Crowe:

Turning to Senator Burke's question, the difference between men and women is that women generally live longer. Men may have more risk factors, but it is women's longevity that has that figure so high.

The implementation element is important. The strategy's monitoring group will monitor the implementation. We have a large job to do there. Professor O'Shea and I are members of the group. We in Ireland are good at strategising, but we are not always good at implementing. That is our greatest job. At least this kind of approach can be implemented and copied everywhere. We are not precious about it. We can give everything to everyone. People have been coming to look at and find out about what we are doing. We are more than happy to help other groups to set up. They do not have to do all of the ground work; we have done that and found models that work.

Turning to Deputy McLellan, a single point of contact is important. As to the eight areas that will get intensive home care packages, those packages are in a novice state. They are concerned with getting people out of acute hospitals and back home. We have received funding from Genio for three packages outside of the eight. They are cumbersome to put in place and there is a great deal of paperwork, but they could be useful in time. There is no single point of contact yet, but each of the three other Genio projects that Deputy Mitchell O'Connor mentioned has a single point of contact.

We have not set up any sheltered accommodation as part of the project, but there is a small amount of it in south Tipperary and some people with dementia live there as part of our normal practice. We have not done anything differently in that regard.

Delaying dementia is important. This is something that we all need to think about. Four treatments for dementia came out between 1997 and 2002, but there has been no new treatment for it since. What has come out is evidence to the effect that, if one manages one's vascular risk factors, which we should all manage anyway for healthy hearts and brains, one can delay the onset of dementia.

That is part of the heart strategy. It is part of the Healthy Ireland strategy. We need to emphasise that and let that word go out. We were always afraid of dementia but at one time TB was not talked about. People never talked about cancer, HIV and AIDS. Those are now talked about. There is no stigma surrounding them. We need to talk about dementia in the same way as something that one can do something about. That is not to say that plenty of people who got it went on to live healthy lives. Therefore, it is not the only risk factor. If we, as individuals, can do anything, we would be happy to do so, but also acting as part of a wider community can help.

Deputy Neville spoke of the wandering and the simple contact by telephone, and I appreciate that. It is often other families who come up with those kind of solutions. We found that in the project. We have spaces where families can tell each other and give advice.

In response to Deputy Fitzpatrick on the question of dementia and Alzheimer's, it is common for people not to understand the difference. People say to us they do not mind if they have dementia as long as it is not Alzheimer's. Dementia is the umbrella term and Alzheimer's is the commonest type, but there are approximately 50 different types of dementia. People use the terms interchangeably and the Alzheimer Society of Ireland does not restrict itself to Alzheimer's but covers every dementia. The terms are used interchangeably but Alzheimer's is the commonest type of dementia.

Dementia is different to normal ageing. People think it is normal ageing and want to say that there is nothing wrong but it is different. The outcomes for the person are very different. We all are losing brain cells all the time, probably from our 20s, but that is not dementia. Dementia is not normal aging. As anyone who has been involved with it will know, there is a difference qualitatively in terms of the experience.

In the general hospitals, there are three big Genio projects. The Genio Trust, the funder of our projects, combines Atlantic Philanthropies and government funding through the HSE. There are three big Genio projects going on in acute hospitals over three years to improve the dementia care pathway through acute hospitals. These are in Blanchardstown, St. James's and the Mercy in Cork. Those are trying to correct the care pathway because general hospitals are terrible places if one has dementia. Patients get very confused and agitated. The projects are trying to smooth out and improve such issues as training, understanding and the environment so that the patient has a quicker trajectory and gets out quicker.

With our project we found it has spilled into the general hospital and one of the general hospital wards has made itself dementia friendly. Tesco has even set up fund-raising for us using its tokens to make the ward dementia friendly. It has been done out of donations with no new funding. The ward has been reoriented, painted in dementia-friendly colours and uses signage and trained the staff. We found with our project we can get patients out of hospital quicker because we can put in support workers to get them home, and that is a much better outcome. Those with dementia do badly in acute care. They have longer lengths of stay suffer higher forms of morbidity and greater mortality and are more likely to end up in long-term care.

I think I have answered my questions.