Mr. Gerry Martin:

I am grateful for the opportunity to attend and to make a more detailed submission. As I represent the Alzheimer society, I will concentrate on people with dementia in connection with end of life. I will focus on four key points that summarise our submission.

Our key recommendation to the committee is to have dementia recognised in the first instance as a life-limiting condition in order that specific palliative care can be provided as part of dementia care following diagnosis to the end of life. Dementia is a life-limiting condition but often it is not recognised as such. End-of-life care and palliative interventions currently tend to focus on malignant diseases but we need specifically to include dementia as a life-limiting disease. End-of-life care for a person with dementia needs to be begin at the point of diagnosis. The trajectory of dementia is not a straight line similar to other diagnoses. It is complex and there is no cure for it. The journey begins at diagnosis, it continues and transitions to community services, possibly including an acute hospital admission, before long-term care and the onset of comorbidity. Too soon is never too soon in terms of planning for dementia and end of life.

To enable palliative interventions during the journey, we need to build capacity within current health care teams working with people with dementia. This would enable the 42,000 people in Ireland who currently live with dementia to live but also to die well. The number is projected to increase in less than 25 years, a relatively short period, to 140,000. We have the opportunity to prevent dementia and end-of-life care crises in Ireland.

We are working on the development of a national dementia strategy, which will be an important point in public policy. It is due for publication at the end of the year. It is critical in the context of this discussion that full policy recognition of dementia palliative care is contained within the strategy.