Dáil debates

Thursday, 14 May 2015

National Dementia Strategy Implementation: Statements


11:30 am

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

Over the years, there has been great progress in the prevention, medication and treatment of many physical and mental illnesses. However, two illnesses - motor neuron disease and dementia including Alzheimer's disease - have not shared in this, and they present great challenges. Alzheimer's disease is the most common form of dementia. Like motor neuron disease, it is progressive and irreversible, although we hope that we will see progress on this. It means a loss of intellectual function, chronic memory loss, language deterioration and personality change. Like many others here, I have experienced it in my family. I know exactly what the four aspects I mentioned mean, an I have vivid memories of my aunt, who suffered from them, and my uncle and the immediate family who were caring for her.

The number of people living with dementia has been estimated variously at 38,000, 42,000 and 47,000. It is scary that the female sufferers outnumber the male by two to one. A vast majority of sufferers are cared for at home by a family member. All too often, we see the most difficult cases, and it is reassuring to know that many people suffering from dementia continue to live well, socialise and be involved in their communities. At events organised by the Alzheimer Society of Ireland, it is reassuring to hear people with Alzheimer's disease or some form of dementia speaking of their illness and living with it. A year or two ago, I listened to Helen Rochford Brennan from Tubbercurry talking about how she was living with dementia and making the very poignant point that memories are precious and are lost to Alzheimer's disease every day.

I acknowledge the work of the Alzheimer Society, particularly the cafés. I have been to two in Dublin Central, one on the Navan Road and the other in Clareville, Glasnevin, and have seen the benefit for the carers. The society also provides social clubs and dementia advisers. I am sure others received the letter about the scheme to support national organisations. In June last year, the Alzheimer Society was one of 23 disability organisations which lost funding. Because of intense lobbying, a bridging scheme was put in place until the end of this June, which is approaching quickly. On another occasion here, I referred to the need for intellectual disability nurses to be available at accident and emergency departments for those who present with intellectual difficulties including autism, Asperger's syndrome, dementia and Alzheimer's disease. At the best of times, accident and emergency is a very difficult and disturbing place, and it must be a nightmare for people with intellectual difficulties unless there is support for them.

Ireland must up the tempo, given that many European countries, including Britain and France, are ahead of us. A year ago, David Cameron said he was making dementia a priority and allocated €300 million for research. We are told that Alzheimer's disease will reach epidemic proportions within 40 years unless new therapies can be developed. Professor Brian Lawlor, consultant psychiatrist, recently told a conference of the need to increase awareness of the illness and for more research on the cause, care and cure. Otherwise, we will have a global health crisis. We need to know more about how to delay the onset and progress of the illness. We are told keeping brain, body and heart healthy and active can help to reduce the development of dementia. There is a role for medication in delaying the progression of the illness and early detection is vital. In my family, early detection and medication was immensely beneficial and prevented the onslaught of the illness, although there were many difficulties with the memory loss.

It is alarming that 25% of carers are elderly, 75% are under financial strain and many find caring for somebody who suffers from Alzheimer's disease or dementia overwhelming at times. This is where the vital respite care comes in. I have met carers who found interaction with the HSE to be a frustrating, box-ticking exercise, for example watching television was ticked off as activity. To spend six hours watching television is not an activity. Others have found their engagement with the HSE much more positive.

VHI cover for Alzheimer related illnesses, or the lack thereof, has been brought to my attention. Sufferers are generally of advanced years and, in the majority of cases, have been paying for health cover for 40 or 50 years and have probably never made a claim. At the point in their lives when they need it, they discover the exclusion of Alzheimer's disease. Surely this is age discrimination. Health insurance is a public policy matter and is subject to Government influence in general. Given that the Minister for Health appoints the directors of the VHI, the Department of Health should have an input on this aspect.

The home care package is much more appropriate than admitting people too early into residential care. We accept the need for mental stimulation, which slows the rate of deterioration. In the majority of cases, the best place for a person is at home in familiar surroundings. I have read the criticism of the strategy's narrow focus, that it will benefit 500 particular families, and the Minister of State can take us up on this. We know how many families need support. The publication of the strategy is very welcome and the Alzheimer Society has been watching for it for a long time. The question is what will happen in 2018.

Obesity, smoking and lack of exercise are recognised as risk factors for Alzheimer's disease, and we are very conscious of those issues. There is a need for joined-up thinking with the other Departments which are involved with each of the risk factors, particularly for people at a certain age. As the Minister said, we could paper the walls of many buildings with the many strategy and policy documents, and implementation is the most important aspect. The monitoring group, and the fact that it will not wait three years but will examine the issue in a year's time, is to be welcomed. I am particularly happy that the group includes a person who is living with dementia and one of that person's carers.


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