Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome the opportunity to speak on this important motion. I commend Deputy Mary Butler for bringing it forward. We will be fully supporting the proposal.

The provision of health and social care services for people with dementia has become an increasingly important issue. That is set to continue as a result of our ageing population, longer life expectancy and the expected trebling of the numbers of people with dementia in the coming years. Health and social care services do not match up with need and are often inconsistently provided, if at all. Of the 48,000 people living with dementia in this State, it is estimated that 63% of them reside in their own homes. The national dementia strategy acknowledges this and the fact that most people with dementia who live in their communities wish to continue to do so. This is not always possible. More must be done to ensure that every person with dementia who requires home care has access to dementia-specific care in his or her home. The Alzheimer Society of Ireland has been very active on the national dementia strategy and has requested that all parties commit to its implementation, an aim of which is to ensure that every person with dementia who requires home care has access to dementia-specific care in their own home. Sinn Féin fully endorses and supports this recommendation and is committed to the full implementation of the national dementia strategy. We are also of the strong belief that when implemented, preferably in full, there should be a follow-up strategy based on a review of the current strategy’s implementation and effectiveness.

The Government must improve investment in care. Carers need to be rewarded and given every support so they can help their loved ones stay in familiar surroundings, if it is their choice or the safest and most manageable option.

In our alternative budget proposals for 2017, we also identified housing adaptation as a critical area of importance for those with specific health needs. The existing local government adaptation grant schemes are chronically under funded. Therefore we committed to increasing the central funding of these grant schemes by 50% through the allocation of an additional €15.75 million, a measure which would especially benefit people with dementia and their carers. Additionally, we believe it is of critical importance to ensure that everyone with dementia has access to a timely diagnosis and appropriate post-diagnosis support including, but not limited to, a dementia adviser as a minimum standard of follow-up support. Adequate training must also be provided throughout the health and social care services for staff dealing with people with dementia.

I will revert to one of my initial points about our ageing population. Improved health and longevity should be seen as an opportunity as well as a challenge, with older people contributing to our society. The words of the democratic programme of the first Dáil Éireann resonate as loudly today as they did back then. We should be committed to the care and support of Ireland’s older people "who shall not be regarded as a burden, but rather entitled to the Nation‘s gratitude and consideration".

It is also important to speak about our older people in the context of this motion and their right to choose how best they will be supported as they age. The vast majority of older people prefer to live out their lives in their own homes if at all possible. Current Government policy is supposedly oriented in this direction but has failed in practice. Cuts to home help, home care, housing adaptation grants, carers’ supports and other services have resulted in more people than necessary going into long-term residential care. It has been estimated that possibly up to one third of people in nursing homes could be at home if adequate supports were provided. A greater emphasis on community-based care has the potential to reduce the number of older people requiring nursing home care.

While most care is provided for people living in their own homes, the bulk of State spending is on nursing homes. In 2015, €315 million was allocated for home help and home care, compared to €933 million for nursing home support. Home support services as part of a comprehensive programme of reform, with emphasis on the home and the community, must be introduced. The serious deterioration in the pay, terms and conditions of those workers and carers who provide care for older people at home, in the community and in residential settings must be addressed. Most older people who require care and assistance with daily living are looked after by unpaid family or friends in their homes. It is vital that the role of carers is fully recognised and that current State supports for carers are enhanced. Sinn Féin opposed the cut of €325 that was made by the Government to the respite care grant and provided for its restoration in each of our annual alternative budgets since. Respite care involves giving families and carers help in caring for their loved one for a short period. This care is provided by the HSE and by voluntary organisations. Current provision is far short of what is needed. Without adequate respite, family carers are themselves left more vulnerable to ill-health.

While the tendency in one's address of dementia is to focus on older people, there is also the sad reality of younger onset dementia. As the motion before us states, an estimated 4,000 people under the age of 65 are now affected. In that number, are people in their early to mid-50s, with all that represents for their loved ones. It is also appropriate to mention the key contribution of Atlantic Philanthropies whose generous support has helped to develop the national dementia strategy implementation plan including the establishment of the national dementia office. It is not just nice but right to thank Atlantic Philanthropies.

Special thanks are also due to the Alzheimer Society of Ireland and the many local ASI groups across the country. Founded in 1982, the Alzheimer Society of Ireland will celebrate 35 years of service and support for Alzheimer's disease sufferers, including those with dementia, in 2017, which is just around the corner. I wish to record my personal thanks, as I have done previously on the floor of the House, to the County Monaghan branch of the ASI, to Mae Murphy and all at the Drumkill day care centre in Threemilehouse in my county of Monaghan. My family will always appreciate the great work they do. I also record my admiration and great respect for all achieved to date by the County Cavan branch of ASI. Molaim iad uilig. Mar fhocal scor, cuirim fáilte arís roimh an rún seo. Is dócha go bhfeicfimid dul chun cinn mór i leith cúraim do dhaoine le néaltrú san am atá amach romhainn.

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