Áine Brady (Kildare North, Fianna Fail)

Dementia is a most distressing condition, both for those suffering from it and their families. It presents a significant and growing challenge to health and social services.

Alzheimer's disease represents about 70% of the cases of dementia. People are living longer and, as a consequence, are more likely to develop some form of dementia. While dementia is not solely related to age, the prevalence is higher in older people and increases with age. It is estimated that approximately 5% of people over 65 years of age have some form of dementia, with this figure rising to 20% for people over 80 years of age. Research and published work on dementia have outlined the complexity and range of issues involved in its effective management. This work also emphasises the need for co-ordinated, multi-layered and well-resourced services which respond to the individual needs of people with dementia, and of those who care for them.

There is an intimate link in Government policy between the care of older people and that of people with dementia. It stresses the need to provide support in dignity and independence, through the provision of appropriate services to the people concerned and their carers. Recent years have seen dramatic changes in both the concept and practice of services for older people. Enormous strides have been made in developing a comprehensive, community-based service. This will continue to focus on helping people to remain in their own homes and communities.

There has been an unprecedented level of investment in this sector. The Government has provided over €200 million in additional funding for new service developments in recent years. This year, therefore, the Health Service Executive will invest in the region of €211 million for mainstream home help services and approximately €130 million for home care packages. This commits the executive to providing almost 12 million home help hours to over 54,000 people; to deliver home care packages to over 9,500 people at any one time or to some 13,000 clients over the course of the year; and to maintain over 21,000 day care or respite places, benefiting an estimated 80,000 people.

On 1 July 2009, the new regulatory regime for residential care settings for older people came into force. On that day the Health Information and Quality Authority, HIQA, commenced an independent system of registration and inspection of all nursing homes. The Health Act 2007 (Care and Welfare of Residents in Designated Centres) Regulations 2009 underpin the National Quality Standards for Residential Care Settings for Older People in Ireland.The standards include supplementary criteria for dementia specific residential care units which should be read in conjunction with the general standards. Since the commencement of the regulations the authority has inspected all designated centres for older people, some 600 centres and published approximately 550 inspection reports.

The demographic make-up of Irish society is changing. Our population is ageing. The number and proportion of people diagnosed with dementia can be expected to increase, and with it demand for services. In recognition of this, the Department of Health and Children has started the process of developing a policy on dementia that will support the delivery of long-term care services. The policy will be developed on the basis of the best evidence available from national and international sources.

One of the first issues to be addressed is the need for comprehensive data on the prevalence of dementia in Ireland, on dementia specific services and on demographic trends. Officials from the Department held discussions with relevant stakeholder groups and the Health Service Executive earlier this year on the first stage of the process. Arising out of these discussions an advisory committee was formed to oversee a project to provide a comprehensive research evidence base to inform the development of the policy. I expect this project to be completed and submitted in 2011. Following this, formal work on the national policy will commence.

In addition, the HSE is currently exploring the potential for changes in care pathways for people with dementia, and will make recommendations for the future provision of dementia care across all health and social services. An audit is under way within the HSE of the current specialist dementia care services available both in residential or hospital settings and community services and it is hoped to have it completed by the end of this year. This work will also feed into the overall dementia policy formulation.

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