Wednesday, 23 September 2015
Topical Issue Debate
Mental Health Services
On Monday this week, World Alzheimer's Day, the world united in the fight to raise dementia awareness and make a difference for the 46 million people worldwide who suffer from dementia. Unfortunately, we all know someone who suffers from dementia and the debilitating life impact it can have not only on a person but on loved ones and friends. In 2012, the World Health Organization stated that dementia is the biggest social issue facing the world today and in Ireland, as in the rest of the world, the prevalence of dementia is rising. Currently, there are 48,000 people with dementia in Ireland and this number is expected to treble in a generation. This is not a goal we want to reach, which is why I am urging the Minister to address brain health and dementia prevention. We must tackle this issue head on, and I would like to see the national dementia strategy for 2014 implemented.
If we could delay the onset of dementia for two years, it would result in a massive 20% decrease in prevalence. A report published recently and commissioned by the Alzheimer's Society of Ireland and authored by the Institute of Public Health in Ireland revealed that if key risk factors for dementia, such as low levels of education and unhealthy lifestyles, had been addressed through public policy initiatives, there could be a reduction of more than 1,000 in the number of people living with dementia in Ireland today. The study highlights seven modifiable risk factors, including low education, diabetes, smoking, depression, physical inactivity, mid-life obesity and high blood pressure. These are all risk factors that can be addressed, modified and avoided in many cases.
I work very closely with the Alzheimer's Society of Ireland in Blackrock and I wish to emphasise the simple concept of brain health it has proposed to me. This concept can be used to inform Government policies geared at minimising early school leaving and promoting a healthy lifestyle which it believes could prove significant in reducing dementia risk in the population. We could and should seriously consider the integration of dementia awareness into national public health programmes. We must fight the growing prevalence of this condition. Next year alone, 4,000 people - or 11 people per day - will develop dementia. This is alarming, as the average annual cost per person with dementia in Ireland is estimated at €40,500, with the economic cost of the illness was estimated at €1.7 billion in 2010. The concept of brain health is a new theme but it is effectively cost-neutral, as it is simply about incorporating messages into existing public health policies and promotions. As a member of the Committee on Health and Children, I fully recognise the challenges we face in tackling the risk factors alone, such as obesity and smoking. That is not reason enough not to consider how we can integrate brain health and dementia awareness into our existing public health policies. It can and should be done.
I thank Deputy Mitchell O’Connor for raising the issue of dementia and Alzheimer's disease. I am taking the debate this afternoon on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who is abroad on Government business.
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 in Ireland increases. For this reason, in December 2014 the Government launched the Irish national dementia strategy. This delivered on a commitment in the programme for Government and set down a number of 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 people with dementia to participate in society and in their communities as fully as possible for as long as they can, and prioritising end-of-life care for those with dementia and providing it in the most appropriate setting. All those caring for or providing services to people with dementia should be appropriately trained and supervised and resources should be directed to provide the best possible outcome for those with dementia and for their families and carers.
The initial emphasis was on doing things better within existing resources. A welcome boost has since been provided by Atlantic Philanthropies which, along with my Department and the HSE, has agreed a joint initiative to implement key elements of the strategy to 2017. This national dementia strategy implementation programme will represent a combined investment of €27.5 million, with Atlantic Philanthropies contributing €12 million and the HSE contributing €15.5 million. This programme will promote a greater focus on the timely diagnosis of dementia and the value of early intervention along with the long-term objective of making people in Ireland generally more aware and understanding of the needs of people with dementia and of the contribution those with dementia continue to make to our society.
The initiative includes the following key elements. One is a programme of intensive home supports and home care packages for people with dementia while another is the provision of additional dementia-specific resources for GPs, who are the initial point of contact with the health service for those with dementia. This resource material will include training materials and guidance on local services and contact points that are relevant. The GP programme is being led by Dr. Tony Foley in Kinsale and training will be delivered in the nine community health organisations. A further element is to raise public awareness and promote a better understanding of dementia and its prevention, address stigma and promote the inclusion and involvement in society of those with dementia. Measures will be implemented by the HSE to support the work of Healthy Ireland by highlighting the modifiable lifestyle and cardiovascular risk factors that can beneficially impact on risk and time of onset of dementia, and by implementing the national physical activity plan, which will encourage the population to be more physically active.
The HSE is developing a dementia-friendly Ireland campaign, which will aim to promote simple preventative measures for everyone in society by improving understanding of dementia and its causes. Clear responsibility has been assigned within the HSE, where a dedicated office has been established to lead the implementation of the strategy. The consolidation of functions that were previously dispersed will have a very significant effect in generating and maintaining momentum and driving change. We are still in the early stages of implementation but the national dementia strategy is a clear indication by the Government of the importance it attaches to the condition, its prevention and our commitment to ensuring those with dementia can live well for as long as possible.
I am glad the Minister mentioned intensive home support packages today. I also want to recognise the extremely difficult and hard work that a carer for a person with Alzheimer's disease must do. The majority of people with dementia - 63% - live at home in the community. Most are cared for by a family member, with approximately 50,000 dementia family carers in Ireland. Often, that family carer is an elderly spouse or partner who may be in their 80s. Carers must watch their own husbands, wives and partners change before their eyes.
They are helpless in so many ways and struggle every day to make sure their loved ones are comfortable and safe as Alzheimer's takes its terrifying grip on their personality and memory. I must also mention the Living Well with Dementia initiative, which has been running in Stillorgan and Blackrock for the past three years. There are also a number of other organisations throughout the country. This initiative provides amazing supports to people with dementia and their families so that they can continue to live at home. Living at home in a familiar environment plays a vital role in slowing down the progression of dementia. It is for both the person suffering with Alzheimer's and the carer that we must do something. We must address dementia prevention and awareness and make sure carers are supported.
I concur with all the remarks made by Deputy Mitchell O'Connor and thank her in particular for her interest in this very important issue at the time of World Alzheimer's Day. I assure her of the Government's interest in the issue.