Jackie Cahill (Tipperary, Fianna Fail)
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I will make a point before I start and I intend no disrespect to the Minister of State who is here. I have looked for this Topical Issue matter on a couple of evenings and it has been selected for this evening. The Minister of State, Deputy Butler, has responsibility for the area that I wish to discuss and I am disappointed I was not informed by the Ceann Comhairle's office that she was not available. The Minister of State is hard-working and this is in no way a criticism of my party colleague. She has been very helpful to me on a number of issues and I have been discussing the issue of dementia care with the her. We all wait for our slots in Topical Issue debates and it would be only proper and courteous that if the Minister with responsibility for that area is not available, we be told in order that we can wait for a time slot when that Minister is available. It is no disrespect to the Ministers of State who are present but Deputy Butler is the Minister of State with responsibility for dementia care. She is developing a new strategy for dementia care and it is to her I wished to make my points on dementia care in County Tipperary.

When a Minister is not available, the Ceann Comhairle's office should inform us of that and give us the opportunity, if we so wish, to wait for an opportunity for the relevant Minister to be in the Chamber. I make no criticism of the Minister of State, Deputy Butler. I have an excellent working relationship with her. This evening did not suit her work schedule, which I fully appreciate and accept, but I wish to make the point.

Dementia, unfortunately, is becoming an ever-bigger issue in our society. We had an historic budget this year that we have been talking about for the past number of hours. It includes €180 million for older persons. I give great credit to the Minister of State, Deputy Butler, for securing that in this year's budget. She has worked extremely hard to get her budget increased and has managed to do so for older persons in this year's budget. She has clearly stated that she wants to develop a dementia strategy following this budget allocation. I also welcome the announcement that a further €50 million of funding will be allocated to deliver a target of 24 million hours of home care in 2023. The Minister of State's priority and focus on development of dementia services and supports will continue. There has been an increase of 15% in new home-care hours ring-fenced for people with dementia, with a continuation of dementia home supports and continuing funding of the Alzheimer Society of Ireland. This is all very welcome news that will be viewed positively by many families throughout the country who have loved ones living with dementia.

I will highlight a serious need for long-term care for people with dementia in my home county of Tipperary. While I appreciate and fully support the fact that we should care for older people in their homes as much as possible, there are times when this is simply not an option for families. The Minister of State, Deputy Butler, and I visited a dementia-specific nursing home village in Bruff, County Limerick, which is leading the way in dementia-specific care in that area.

I was most impressed by the standard of care in this facility, the resources available and the specialised approach being taken to the residents. It was top class.

That is what I am looking for for my county. I am aware the Minister of State, Deputy Butler, is developing the strategy. Both she and I were there that day at the village in Bruff and we saw the excellent care and the model that is there. I want to push with the Minister of State, Deputy Butler, for us to get that nationwide and obviously as a Deputy representing Tipperary I am looking for the county to host one of the pilot dementia village projects.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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I thank the Deputy. Before I call the Minister of State, in fairness to the Minister of State, Deputy Butler, she is generally here for the Topical Issue debate herself, as Deputy Cahill knows.

Jackie Cahill (Tipperary, Fianna Fail)
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I accept that fully and am not criticising her in any way. I just feel the Ceann Comhairle should inform us and give us the choice if the Minister or Minister of State with responsibility is not available.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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That is a fair point.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Deputy Cahill for raising this issue. Improving services for people with dementia is a priority for the Government and the past three years have seen significant new investment in dementia-specific support services and care countrywide. Next year will see a further €12.16 million investment dedicated to dementia and this is in addition to the cumulative €27.9 million provided across 2021 and 2022.

I will bring the Deputy's concerns back to the Minister of State, Deputy Butler. In fairness to her, she is very much to the forefront of fighting for funding in her area and is a pleasure to work with in the Department. This funding over three years is allowing for the rapid expansion of dementia diagnostic services and post-diagnostic supports through the provision of new memory assessment and support services as well as two new specialist memory clinics in Cork and Galway. It is also providing for numerous other initiatives including: dementia-specific day care; quality improvements in hospital and mental healthcare; improved access to the National Dementia Adviser Service; dementia-specific education for home support workers; and the implementation of a national clinical guideline on the appropriate prescribing of psychotropic and antipsychotic medication. In addition, it is targeted at increasing the proportion of new home support hours specifically for people with dementia to 50% in 2023, which is up from 5% in 2021 and 11% in 2022.

In recent years the national network of memory technology resource rooms has expanded to 23 centres. Of these, two are located in County Tipperary. One is in Thurles and the other in Clonmel. These provide an occupational therapist assessment and guidance along with the opportunity to find out about assistive technology options to help manage memory difficulties. Dementia-specific day care is provided in Clonmel and Thurles and taken together all these investments are rapidly improving access to diagnostics, post-diagnostic supports and ongoing care for people with dementia.

While national policy on care for older people is focused on supporting people to remain at home for as long as possible, the national dementia strategy recognised that for some people long-term residential care may be required when home care is no longer feasible or appropriate. A majority of people with dementia reside in generic residential care facilities and this is reflected in the 2016 revised HIQA National Standards for Residential Care Settings for Older People in Ireland. The standards place a strong focus on quality of life and a person-centred approach to care for all residents, including those with dementia.

With regard to residential care for people with dementia in north Tipperary, following a meeting last month at Government Buildings, HSE mid-west community healthcare is preparing an options appraisal document for older people services in the north Tipperary area. As agreed at the meeting, the service is reviewing all options for the Dean Maxwell unit and the progression of the new older persons unit in Nenagh. The service is also examining the overall requirements for older people services in the region. HSE mid-west community healthcare is committed to delivering the best possible older people services to the people of north Tipperary and it is expected an options paper will be presented in quarter 4 of 2022. As for dementia-specific residential care services provided in south Tipperary, the Cashel residential older people services provides an 11-bed dementia-specific service for women configured as nine single rooms and one double. All other long-term residential beds are profiled as generic beds in order to meet the need.

The Deputy talked about the great facilities and excellent care in Bruff, County Limerick. I will also bring that to the Minister of State's attention.

Jackie Cahill (Tipperary, Fianna Fail)
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In case there is any misunderstanding, I am not criticising the Minister of State, Deputy Butler, in any respect. She delivered a Jigsaw project for Thurles that is fully operational now. We were waiting a long time for it and I am thankful. She has such an excellent record of delivery that I wanted to make the points about a dementia unit to her personally. She is developing the strategy for dementia.

The case I want to make is parochial and fairly straightforward. I have seen the facility in Bruff and it is an excellent model. The Minister of State, Deputy Butler, intends to examine a range of long-term residential care models for people with dementia and I want to strongly press that we want one of those facilities for Tipperary.

Early next year the National Dementia Office will publish a model of care for dementia that outlines care pathways for people living with dementia, from identification of symptoms through assessment, diagnosis, disclosure, care planning and post-diagnostic support. Other Government Teachtaí Dála will also be pressing the Minister of State to have their county included. We have a need for it in my county. There have been ongoing discussions about long-term beds in the Dean Maxwell unit in Roscrea. I am aware there are ongoing discussions with the HSE that were initiated by the Minister of State, Deputy Butler. I hope these will bring a resolution of long-term public beds for Roscrea. While those discussions were ongoing we talked about a dementia village and, as I said, we went to see Bruff. I am asking strongly that when the Minister of State, Deputy Butler, is putting our national strategy together, she consider County Tipperary for a pilot project. Unfortunately, if there is a unit put in place it will be fully utilised.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I outlined earlier the unprecedented level of investment made by the Government since 2021 to improve diagnostic and post-diagnostic care and support for the 64,000 people with dementia throughout Ireland. Last Wednesday was World Alzheimer's Day. This provided an opportunity to reflect on what more we need to do to ensure people with dementia can live well as valued citizens of this country. I am pleased to note that early next year the HSE will publish a model of care for dementia that outlines care pathways for people living with dementia, from identification of symptoms through assessment, diagnosis, disclosure, care planning and post-diagnostic support. This model of care will be used as a basis for future dementia-specific investment.

As I said previously, HSE mid-west community healthcare is preparing an options-appraisal document for older people services in the north Tipperary area. It is expected this will be presented in quarter 4 of 2022. There may also be opportunities to identify scope for a dementia-specific independent living unit to support people to age well independently for as long possible in the Roscrea area.

It was a good idea to go see the Bruff centre. I am in interested in calling down to see it as it seems to be the way forward.