Colette Kelleher (Independent) | Oireachtas source

I join others in commending Senator O'Donnell. This is a significant, thorough and necessary piece of work and, might I say, a very beautiful document. Senator Grace O'Sullivan and I were looking at the photographs. It is unusual in a report to look at it and be visually stimulated rather than daunted by the volume of the words. We can all join in paying tribute to Senator O'Donnell for the way that she has painstakingly examined the issue and produced a comprehensive report. I was lucky enough to be present at the deaths of my mother and of my sister and, more recently, of my mother in law. One of the things one learns is that not all deaths are equal. Some are much better and nicer than others. The Senator's report highlights the conditions that we can make for us to live well, but also for us to die well and with dignity.

The report has 16 key recommendations that I think we can all endorse. I particularly welcome the call for the full commencement of the Assisted Decision-making Capacity Act. The Citizens' Assembly is currently examining the challenge and opportunities of ageing. On behalf of the all-party Oireachtas group examining dementia, of which my colleague, Senator Devine, is an active member, I made a submission to the assembly. Many of our calls in that submission directly link as they are about ageing and dying as peacefully as possible. They directly talk to this report.

As Senator O'Donnell said, people who are old and dying want to live at home for as long as possible. We must do all that we can to facilitate people's wishes. I always think that, even if my mobility changes and I could not move, I would love to be near a French door, feel the wind on my face and be able to see the little birds, smell the grass, see the mountains and listen to some music. We need to appreciate all of those things when people are at home or in nursing homes so that we can make the environments that Senator O'Donnell speaks so passionately about fit for people. We know from the Irish Association of Social Workers, Age Action, the Alzheimer Society of Ireland and UCD that people with dementia want to live in a familiar environment. In fact, it can be a terribly disorientating and dreadful state of affairs if people are in a non-familiar environment. Therefore, home care is particularly key to that group of people.

In the submission to the Citizens' Assembly, we called for the creation of a national network of dementia advisers so that there is not only at least one dementia adviser in at least every county but one in each primary care network. We also called for dementia to be recognised as a chronic disease within the new GP contract. In every community, both urban and rural, there should be a dementia friendly community. This will involve education and awareness among those in An Post and shops as well as gardaí. Those can be the people that are available in a rural area when doctors, nurses or a hospital are not available.

As well as improving the community environment, we need to enhance the home environment. The Department of Health acknowledges that home care support can be a cost-effective alternative to long-term residential care for some older people and it has just produced a consultation paper. The consultation is fine but we kind of know what we need to do. Last year, 25,000 people signed the Alzheimer Society of Ireland's pre-budget call but we did not act on it. I am sure an equal number will sign it this year. We know that we need home care and a home care infrastructure. We have it in many other countries. We need resources for home care so that it does not disappear in the middle of the year or disappear for those living in one part of the country or another. It needs to be adequately resourced. We need the regulation that Senator Burke has been fighting for in this House and we need the right to it so that it is not just for residential care. Senator Devine spoke about the focus that we have on residential care to the expense of everything else. In Denmark, they have not built a nursing home since 1987 because they have a mixed provision. They have some nursing homes - we do need some - but they have alternatives because they looked ahead and did the joined-up thinking that Senator Marie Louise O'Donnell recommends in her report.

A campaign by NGOs, many of whom are represented here tonight, is calling for a proper home care infrastructure. We need to do it. I do not really believe that we need a consultation. We will all participate in it but we know what we need to do. This year, I also proposed a Bill to safeguard adults at risk of abuse, for which I thank my colleagues Patricia Rickard-Clarke, Mervyn Taylor and others. This Bill proposes additional protections to protect all adults, particularly but not exclusively as we come to the end of our lives.

A recent RED C poll commissioned by the National Safeguarding Committee found that one in three people believe that abuse of vulnerable adults is widespread. Some 80% of people are unclear about what constitutes psychological or financial abuse. While we do not have comprehensive statistics on abuse and neglect, the data we have paints a bleak picture. Last year, the HSE received nearly 8,000 reports of adult abuse.The National Study of Elder Abuse and Neglect in 2010 estimated that 10,000 older people are mistreated or neglected each year, with 6,000 cases of financial abuse. The study also showed that the only income of many people who were financially abused was the State pension, and this will be of particular interest to the Minister of State. The State pays in excess of €7 billion in pension payments and more than €3 billion in illness, disability and carers' payments, and again we need to be sure the people who are entitled to that money are getting it and are not being taken advantage of by unscrupulous people, some of whom can even be in their own families. The Department of Social Protection has a big challenge to give adequate protection to people. This is the aim of my Bill.

The Bill does two main things. It establishes a national safeguarding authority and mandatory reporting. We need these to uncover the scale of abuse we have. I hope to bring the Bill back before the Seanad before the end of the year. An ombudsman for older people would also be very helpful. While the Ombudsman and Information Commissioner for Ireland deals with complaints from or on behalf of older people relating to public bodies, there may be a need for an office solely focused on complaints made by older people which has the responsibility for promoting the rights and welfare of older people.

As highlighted by Senator O'Donnell, we need joined-up thinking. We need assistive technologies. We have wonderful technologies. I saw this while working among children with disabilities. Eyegaze is one example. Why can we not have this for people suffering from strokes or people who have communication difficulties? We should have assistive technology in our homes, for example, lights that turn on automatically in bathrooms. This does not cost a fortune when we get into it. We should have technologies that will remind us to take our medications. There is a world and an internet of things out there. We need to make the end of life as comfortable as possible for people. I believe enhanced home care, new rights and protections via a safeguarding Act and an ombudsman and the use of new technologies would do just that.

I congratulate once again my fellow Taoiseach's nominee, conduit - I recognise that word - and Independent Senator on her extensive and very detailed report. I have no doubt that the proposed changes will make the very difficult but inevitable process of death and dying easier for us all.