Dáil debates

Thursday, 14 May 2015

National Dementia Strategy Implementation: Statements


11:10 am

Photo of Colm KeaveneyColm Keaveney (Galway East, Fianna Fail) | Oireachtas source

I am grateful for the opportunity to make a statement on the national dementia strategy.

Dementia is a deeply distressing condition, both for those suffering from it and for their families. It presents a significant and growing challenge for the Government, the State and health and social services. As our population ages, the number of people with dementia increase and in response to ongoing calls for action, late last year the Government published its first national dementia strategy. Fianna Fáil welcomes that strategy as it has the potential to change people's lives and help those vulnerable to dementia. For the strategy to become a reality, it must be implemented and must be positioned at the centre of politics and of how we approach our health service.

Fianna Fáil welcomed the publication of the national dementia strategy in 2014 and is committed to supporting and helping the implementation of that policy. The Department of Health is to conduct a mid-term review of progress in 2016 and we support the call for the findings from this midterm review to be utilised to develop a revised dementia plan. Such a revised plan must address the gaps in the current strategy, specifically, the needs of people with younger onset dementia. The revised plan must ensure it addresses the commitment to remove age discrimination as a barrier to accessing the health system. The strategy purports to be for everyone with dementia, but in its detail highlights services which will not apply to those under the age of 65 who suffer early onset dementia. Similarly, there has been little focus on residential care A recent report from Trinity College Dublin and St. James's Hospital found that only 11% of long-term residential care homes have dedicated dementia units. It is also important that we give priority to new social and community approach to how we handle dementia and to the development of a dementia friendly community.

There are just under 50,000 people currently living with dementia in Ireland. The majority of people living with dementia are women , approximately 30,000 and just under 20,000 are men. If current trends continue, this number is expected to rise to just under 70,000 by 2021 and to 132,000 by 2041. An estimated 3,583 people - 8.6% of people with dementia - have early onset dementia, and most of these are men. These figures do not include an additional circa 700 people who have Alzheimer type dementia associated with Down's syndrome. Approximately 4,000 new cases of dementia arise in Ireland every year. Local health office areas in the HSE west have the highest prevalence rates of the nine areas estimated. Roscommon has the highest share of people with dementia, at 1.4%.

The major increase in numbers of people with dementia in this country is likely to occur after the year 2020, with the numbers growing to between 141,000 and 147,000 by 2041. It is estimated that the overall cost of dementia in Ireland will be in the region of €1.69 billion per annum. Some 48% of these costs are attributable to the opportunity cost of informal, mostly family support, care to those living with dementia in the community. A further 43% of costs are accounted for by residential long-stay care, while formal health and social care services contribute to only 9% of the total costs of dementia. A significant proportion of people with dementia are aged under 65. It is estimated there are approximately 4,000 of these, many of whom are in their 30s or 40s. There are 50,000 family carers in Ireland providing care to someone with dementia.

I acknowledge the dedication, commitment and work of the Alzheimer Society of Ireland. The society makes the important point that the majority of people with dementia, over 63%, live in the community and wish to continue living in the community as a first option. It points out that research has found that the two strongest predictors of admission to care homes are whether the older person has dementia and whether or not the family is in a position to cope and care for the onset of dementia. The society has found that dementia-specific home care is a critical component to ensuring that people with dementia can live in the community. It is important this House takes every stop possible to ensure people with dementia can remain in their homes.

Experts in the field of dementia have also pointed out that the right information, support, resources and investment can help families with a member with dementia. Timely diagnosis is identified internationally as best practice. However, we have a shocking rate of identifying dementia and much dementia remains undiagnosed until at quite a late stage. As the Alzheimer Society of Ireland has pointed out, without diagnosis people cannot get the information they need, cannot access the services to which they are entitled and cannot make a decision as a family about the future in respect to the dementia. Community based dementia advisers are critical for early intervention and for helping promote the dementia awareness required in communities. This is critical in regard to how this House and society approach the onset of dementia. Since the middle of last year, the Alzheimer Society of Ireland has funded seven dementia advisers to cover specific parts of the country. However, this is not enough. We need to see a greater investment and a better network set up across the country.

It is important that dementia friendly community initiatives are developed across all communities. I welcome the fact that in my home county of Galway, the Galway City dementia friendly initiative will see the development of key local agencies that will implement a programme of training and awareness raising actions at local level and of an initiative that will ensure we have timely claiming of supports across the community. The initiative will provide dementia awareness training that can be rolled out across communities. These communities will have support from resource centres, active age groups and various other community groups. The dementia friendly initiative provides a new layer of support. The type of supports dementia friends will provide will include supports that will ensure people with dementia get involved in community activities and organisations. We as a society have a responsibility to take on ownership and awareness of such initiatives.

Fianna Fáil is alarmed by the findings reported that only 11% of long-term residential care homes have dedicated dementia units. The research on this area highlights the fact that at least six counties have no dementia provision whatsoever and that there are capacity issues in many of the units that cater for people with dementia. The private sector provides the majority of residential support services. This leaves thousands of dementia patients and their families with no option but to seek care in our hospitals. This is inappropriate. It is unacceptable that we rely heavily on our acute setting. Dementia is an issue that will escalate as time goes on, because people are living longer. The problem already exists and it is clear it will grow.

I was saddened by the fact the Government did not see fit to send a representative to the WHO ministerial conference on dementia. For the first time, last March health Ministers from across the world gathered in Geneva to share policies and best practice on dealing with the increasing prevalence of dementia in our aging population. Ireland lost out significantly by failing to send a single representative to this gathering which addressed this important issue.

The fact that the Minister, Deputy Leo Varadkar, did not think it important enough to attend or to send a Government representative exposes the Government's priority in this area.

A recent Sunday Independentarticle on 15 May confirmed that just one in 60 families would win with the State's new dementia strategy. We do not have enough focused funding in this area. I encourage the Minister to secure additional resources to roll out a more comprehensive community infrastructure in this area. The burden of dementia is deeply distressing for those who are suffering with it and their families. It presents a significant and growing challenge for the health system which will require best practice in terms of social and public policies and must be underpinned by resources.


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