Dáil debates

Thursday, 14 May 2015

Implementation of National Dementia Strategy: Statements (Resumed)


1:40 pm

Photo of Fergus O'DowdFergus O'Dowd (Louth, Fine Gael) | Oireachtas source

I welcome the new national dementia strategy announced by the Minister and I acknowledge her commitment to changing the way older people are looked after in our society. I recognise also that it has been put together initially in a very difficult economic climate and as things improve I hope and expect that the strategy will expand and there will be more funding available to look after our people.

We have a large number of people who will have dementia in the future. At the moment 12% of our population are over 65 and, by the year 2046, 25% - that is one in every four - will be over 65. Clearly, a significant number of these will have dementia issues, whether it is in the initial stages or longer-term. The number of people with dementia will double over the next 30 years. Internationally, in 2010 there were 36 million people with dementia but by 2030 the world estimate is 66 million. It is a huge problem that has a personal, emotional, financial and social impact on all of us and on all society. We need to change many things in our country to deal with it. When I meet people with dementia, in many cases I find families or individuals who are invisible, isolated in their community and socially excluded.

Their families are worn out and strained, and are working 24-7 to look after them. The lack of care the community is offering them in their homes has a major negative impact.

Some two weeks ago I met a lady in her mid 70s who is dealing with her husband, who is in his 80s. He is doubly incontinent and suffers from serious dementia, and she was offered a princely amount of 18 minutes of home care help per day, one and a half hours per week. It is a disgrace and I condemn the policies that do not provide adequate home care to people who need it. There have been cuts and we have been through a very difficult time, however we must prioritise home care packages. The lady's house was in a state of bedlam and was in bits. Her life had been shattered and she had no help, nothing at all. I was shocked and dismayed. I will give another example of a daughter who is looking after her mother who is suffering from dementia. Her father, who is in his mid 70s, is also very unwell with a heart condition. The lady, God bless her, is very active in her dementia state and is up and down the stairs all night repeatedly. Both these carers are at their wits' end.

People in Alzheimer's care centres say they do not have enough money. In Dundalk, the budget has been reduced by 5% and this has a major negative impact on the people who are entitled to the care but do not receive it. The same applies in Drogheda, where the members of the Drogheda Alzheimer Society are at their wits' end trying to provide better services for an increasing number of people.

How do we change the situation? While the dementia strategy is one way of starting it, there is a more fundamental principle, which the Oireachtas should establish, namely, an entitlement to home care and home help by statute, which does not exist. We should have legislation that guarantees that people are entitled to the care, just as much as they are entitled to benefit from the fair deal if they need to go into long-term care. We have got it the wrong way around. We are spending billions of euro on putting people into nursing homes, while many of them should not go there until they reach a much higher stage of dependency, but do so because of the lack of community supports. That is wrong. The lady who is trying to look after her husband told me she would have to put him into a nursing home, although she did not want to do so. She just needs help to look after the person she loved and who loved her all her life.

We need to change the way we address this. We need much more home support and to use modern technology. In the Great Northern Haven apartments in Dundalk, there is an experiment whereby older people live in the apartments and have technology that notifies a carer, who is attending 24-7, if they get up at night or leave a window open or a tap on. When they wake up in the morning they can use a laptop or iPad to communicate with a health care worker and verify that they have taken their medication. We need to change our local authority houses to use more technology to provide support to keep people in their homes.

The public health nurse is the real hero of our society. In every case I encounter, the public health nurse is the first person who helped the person, as best they could. Good care costs a lot of money. The policy in Norway is to make the most of the good days. We can make the most of the good days for our people who suffer from dementia by keeping them happy at home for as long as we can. The last place they should go is a nursing home. They should go there only when all other home care supports have been exhausted or failed. We need a bill of rights for our elderly identifying the promises we will fulfil in looking after them. There are plenty of examples from states around the world available on the Internet. If people have statutory entitlement to community care, a bill of rights identifying how older people are treated and protocols in place for them, it will change the way things happen.

I had a meeting with the Alzheimer Society of Ireland in Our Lady of Lourdes Hospital, Drogheda regarding putting protocols in place for people who are suffering from dementia and who are admitted to an acute hospital. Such a person needs to be looked after specially and staff need to know how to treat them, given that many of them cannot talk or express what they feel or they are confused. We need these protocols in place now on a national basis. We received attention from the very top of the HSE. The quality of care for people suffering from dementia in some of our institutions is disgraceful. I have here dozens of complaints made to HIQA regarding the quality of care of people suffering from dementia. In many cases, there are not enough staff on duty to look after them. In some cases, sadly, they are treated disgracefully. I am waiting for a Bill of mine to come up in the lottery for debate on a Friday sitting. As backbencher, one hopes to make the lottery. My Bill will change the 2007 Act by giving statutory powers to HIQA to go into a home immediately to investigate a complaint that a person suffering from dementia is being assaulted. This cannot happen under the current legislation.

I spent the past few hours, with the assistance of the Minister's office, dealing with a family whose family member died in disgraceful circumstances in a HSE institution. The patient did not have dementia as such. The family complained to HIQA that they were unhappy with the care their relative was receiving. Nothing happened, and he subsequently died in disgraceful, shameful circumstances. I acknowledge the Department's commitment to get to the bottom of it.

This is just the beginning of the debate and I welcome the initiation of the strategy. However, we are not at the races if we do not look after people in their communities and homes and invest much more money in it. I accept that the degree of care the people need is a very complex issue. This week, the country is examining how we treat our people when they come into the world, and the tragic circumstances of the deaths of many babies, six or seven, in Portlaoise. We are also considering the appalling and disgraceful treatment of people suffering from dementia and how it can change. The two debates are equally important and, hopefully, they will get equal time and attention from the House and the Government.


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