Dáil debates

Thursday, 14 May 2015

Implementation of National Dementia Strategy: Statements (Resumed)


2:00 pm

Photo of Dan NevilleDan Neville (Limerick, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to this important debate. I welcome the Government’s launch of the national dementia strategy which is important to the many people who suffer from this difficult disease, a disease which is also difficult for their families. Families are often confused by it and the sufferer can also be upset. There is a fear factor around the whole area of dementia. We should endeavour to relieve this that by disseminating information on assistance.

I commend the Alzheimer Society of Ireland on its excellent work in assisting people who suffer from Alzheimer’s and their families. It works across the country in the heart of all communities providing dementia specific services and advocating for the rights and needs of all people living with dementia and their carers. Its vision is an Ireland where no one goes through dementia alone and where policies and services respond appropriately to the person with dementia and their carers at the times they need support.

I welcome the development of a national Alzheimer’s and other dementias strategy to increase awareness, ensure timely diagnosis and intervention and develop enhanced community-based services. The strategy sets out several principles to underpin the provision of care and supports for people with dementia.

These include taking account of dementia in the development and implementation of existing and future health policies, encouraging the participation of people with dementia in society and in their own communities as fully as possible for as long as possible, the prioritisation of end-of-life care in an appropriate setting for those with dementia, and appropriate training and supervision for all those caring for or providing services to people with dementia. In addition, the strategy directs resources to provide the best possible outcome for those with dementia and their families.

Dementia or old age should not control people's lives and rob them of what is so valuable to them, privacy and dignity. Central to the strategy announced by the Taoiseach, Tánaiste and Minister of State, Deputy Kathleen Lynch, last December is something that is characteristically taken away from people living with dementia - that is, awareness. We want to increase awareness of dementia in the community so that we can act faster and more smartly to ensure early diagnosis, treatment and all-important supports, particularly with community-based services.

It is estimated that there are approximately 50,000 people with dementia in Ireland today. These numbers are expected to increase to more than 140,000 by 2041 as the number of older people rises. I have also met some younger people with Alzheimer's, so it does not always respect age and consequently is not just an issue affecting the elderly.

The strategy emphasises that most people with dementia live in their own communities and can continue to live well and participate in those communities for longer than many people appreciate. The strategy distinguishes between those actions that can be progressed within existing resources and others to be addressed as more resources become available.

Those identified for first implementation include that clear responsibility for dementia will be assigned within the HSE. In this regard, a dedicated office of specialist services for older people has been established within the HSE to support the strategy's implementation. Clear descriptions of care pathways and better information and guidance on services will be made available to GPs, as well as to people with dementia, their families and carers.

A better understanding of dementia will be promoted, including modifiable risk factors. The strategy also promotes the use of existing resources to be reviewed to ensure that they are used in the best possible way. Research will be promoted to inform and design the delivery of dementia services in Ireland in order to be supported and given appropriate priority.

The term dementia was used for generations concerning memory loss, but it is not a specific disease itself. Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning. Dementia indicates problems with at least two brain functions, such as memory loss and impaired judgment or language, and the inability to perform some daily activities such as paying bills or becoming lost while driving.

Though memory loss generally occurs in dementia, memory loss alone does not mean that one has dementia. A certain extent of memory loss is a normal part of ageing. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of progressive dementia. Some causes of dementia may be reversible with treatment.

The common symptoms include declining memory loss. Short-term memory loss is the most common early symptom of dementia. People with ordinary forgetfulness can still remember other facts associated with the thing they have forgotten. For example, they may briefly forget the next door neighbour's name, but still know the person they are talking to is their next door neighbour. A person with dementia will not only forget the neighbour's name but also the context.

People with dementia often find it hard to complete familiar everyday tasks. For example, a person with dementia may not know how to get dressed or how to prepare a meal. Occasionally, everyone has trouble remembering the right word, but a person with dementia often forgets simple words or substitutes unusual words, thus making their speech or handwriting hard to understand.

We may sometimes forget what day it is or where we are going, but people with dementia can become lost in familiar places, such as the road where they live. They can forget where they are or how they got there and may not know how to return home. They may also confuse night and day. Those with dementia may dress inappropriately, wearing several layers on a warm day, or very few on a cold day. They may also find it difficult to follow conversations or keep up with paying their bills. Anyone can temporarily misplace his or her wallet or keys. A person with dementia, however, may put things in unusual places, such as an iron in the fridge or a wristwatch in a sugar bowl.

Everyone can become sad or moody from time to time. A person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. Alternatively, a person with dementia may show less emotion than is usual. A person with dementia may become suspicious, irritable, depressed, apathetic, anxious or agitated, especially in situations where memory problems are causing difficulties. At times, everyone can become tired of housework, business activities or social obligations but someone with dementia may become very passive, sitting in front of a television for hours or sleeping more than usual. They may also appear to lose interest in hobbies.

The Department of Health and the HSE have agreed a joint initiative with Atlantic Philanthropies to implement significant elements of the strategy proposed over the period 2014 to 2017. We look forward to the roll-out of the programme.

I congratulate the Minister of State once again for the work she is doing in all four areas within her remit. In this case, the work to provide services for the elderly is being undertaken in difficult circumstances. This is because the economy has put a lot of pressure on services to all areas.


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