Fiona O'Loughlin (Fianna Fail)
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I welcome the Minister of State back to the Chamber. She has been a most frequent visitor since the Seanad reconvened and she was appointed to her position. I know of her compassion for older people. In her past life as a Deputy she was co-chairman of the all-party committee on dementia and did incredible work on the issue. We could not have anybody more suited to the position she now occupies.

As 1 October was International Day for Older Persons, I felt it was appropriate to table a Commencement matter on the issue of people dealing with dementia. My concern is not just for people with dementia but also those who care for them. There are approximately 66,000 people in this country with dementia and for every one of those people there are at least three others impacted as carers. We are talking here about mothers, fathers, grandparents, brothers, sisters, aunts, uncles, neighbours and friends. There is no community that is not impacted by dementia. Things were difficult for these people before Covid-19 but the pandemic has totally exacerbated the challenges that people with dementia and their carers face.

Two reports were commissioned by the Alzheimer Society of Ireland in April and late June to assess the impact of Covid-19 and the results are frightening. The surveys were carried out among carers and those with dementia. Following on from that, the society launched its pre-budget submission for 2021. A number of Members of the Oireachtas attended the launch. Carers were represented by a woman called Denise. To hear her speaking about carers being at breaking point and outlining the long-term impacts from both a mental and physical perspective would draw a tear from a stone. A man called Kevin who has dementia also spoke. I know that the Minister of State has spoken to him previously but listening to his concern, not just for himself but for his wife and those around him, was incredibly touching. However, these people need more than sympathy; they need support. First, we need to talk about the commencement of day services. I accept that today is day one of level 3 restrictions nationwide but that pushes the recommencement of services out even further. We need to support family carers in their own homes through enhanced in-home supports. Additional funding must be provided in the budget for appropriate homecare and for additional dementia carers. I thank the Minister of State for her efforts to ensure that there will be ten additional dementia advisors, bringing the total to 19. However, I would argue that every county should have a dementia advisor. We also need extra funding for infrastructure for those with dementia. They need joy in their lives which is made possible through social interaction with their peers. The same is true of their carers. They need an opportunity to have time for themselves, as do other family members. These are three key areas that must be addressed in the upcoming budget.

Mary Butler (Waterford, Fianna Fail)
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I thank Senator O'Loughlin for raising this matter. As she has said, this is an area on which I have worked tirelessly in the past as co-chairman of the all-party committee on dementia. I congratulate Senator O'Loughlin on taking over that role and I know she will do fantastic work.

Martin Conway (Fine Gael)
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Hear, hear.

Mary Butler (Waterford, Fianna Fail)
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I am fully aware that Covid-19 has placed significant additional pressures on people with dementia and their families. I recently convened a round table discussion with carers. Unfortunately we had to conduct it online and reduce the numbers involved but I specifically asked to speak to people caring for people with dementia and mental health challenges and particularly to people who were full-time carers and did not work outside the home. To be honest, listening to them was very hard. Their stories were very stark and there is no doubt that carers have really been challenged in the last six to seven months. The Covid-19 restrictions have meant that many carers are spending the whole day at home. Every single one of us, as representatives of our constituents in both Houses of the Oireachtas, are acutely aware of that. We also know that community services such as day care play an important role in enabling older people to continue to live in their communities and maintain their social connections. These services contribute to positive ageing and better overall health. However, the introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamics of social interaction.The suspension of day services has been particularly difficult for people living with dementia and their family carers, whose usual routines have been disrupted. Against this background, the HSE is continuing to work closely with providers and community staff to identify where service is most required. It has also been undertaking risk assessments of local services. This is to ensure, insofar as possible, that day care services can resume in the context of Covid-19 and having regard to public health advice.

In the meantime, my Department and the HSE have ensured that there has been a continued focus on the needs of people living with dementia since the onset of the Covid-19 pandemic. Through the HSE's "Understand Together" campaign on dementia, a range of initiatives and resources have been developed. Community services have been adapted to provide a flexible response that meets the needs of people with dementia during the Covid-19 pandemic. Referrals are being made to community supports, including the Alzheimer Society of Ireland, ASI, which does phenomenal work, a dementia adviser service and the local authority community response forums.

A majority of the HSE's memory technology resource rooms are now providing an adapted service through telephone and video assessment and consultation. While home visits have, of necessity, been restricted, the HSE uses prioritisation and screening measures to identify clients in need of home visits.

My Department and the HSE are undertaking work to determine the current level of service delivery in the community and to set out plans, which will include the required associated capacity, to resume services, including day services, in line with the roadmap for reopening society and business.

In addition, the ASI continues to support people through its live chat service, national helpline, home care, dementia adviser service and online family carer training. Alzheimer cafes have moved online and a new nurse line initiative has been launched with backing from the HSE and my Department. This gives people with dementia and family carers the opportunity to book a one-to-one session with a dementia nurse or a dementia adviser.

I also welcome the fact that the HSE's winter plan includes provision for a targeted work programme to double the existing home support hours in order to fully support those with high and moderate levels of frailty, including people living with dementia. The winter plan also provides funding to enable the recruitment of ten dementia advisers, which will bring the total number of dementia advisers to 28. As we headed into the budget last year, and for many years previously, we had eight such advisers. We finally made a breakthrough last year and secured ten. The additional ten to be recruited will bring the number to 20. I will talk about the Senator's other budget proposals in the next session.

Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State. It is welcome that the existing support hours are to be doubled in order to fully support those who need it, including people with dementia. The new dementia advisers are also welcome. An average of 11 people per day are diagnosed with dementia. That means that, since this Government came into being 102 days ago, approximately 1,122 people have been diagnosed. The number is growing all of the time.

The words carers used about their own roles in the survey include "devastation", "torturous", "exhausting", "depressing" and "incredibly stressful". We have to bear that in mind, as I know the Minister of State does. In my own county of Kildare, almost 1,500 people have dementia. We also have almost 4,000 carers. Over the past six years, day care support services have moved to four different places. The day care service in Monasterevin moved to Moore Abbey, then to Dunmurry and then on to Mill Lane in Naas in north Kildare. I have been to Dunmurry and Moore Abbey and have seen how wonderful these spaces were for those who were there. It is crucial that more money be spent to ensure permanent infrastructure to support those with dementia and their carers.

Joe O'Reilly (Fine Gael)
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As the Minister of State rises for the final supplementary, I join her in congratulating Senator O'Loughlin on being made chairperson of the joint committee.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator very much. Her points are very well made. In addition to the winter plan, which I mentioned earlier, some €22 million has been provided in the 2020 national service plan for dementia-specific services including more than €7.5 million in funding for dementia-specific home care packages and the extension of the dementia adviser services, with the additional ten advisers to be recruited this year. This should make a significant difference.

Support is to be given to key voluntary organisations such as the Alzheimer Society of Ireland, which has adapted its services to meet the needs of people living with dementia since the public health emergency began and for whose work I once again thank it. In addition to dementia-specific home care packages, people living with dementia can also benefit from standard home support services, which have a budget of €490 million this year.

As the Senator will have seen in the winter plan, which we will discuss in the Seanad later, €139 million has been made available for extra home care supports, which will cover an extra 4.7 million hours. The supports will, of course, also be offered to people with dementia. In addition, more than €6 million in dormant accounts funding has been secured since 2016 for a range of dementia-related project as part of the process of implementing the national dementia strategy.

Dementia has a prominent place in the programme for Government but I am also committed to ensuring that people with dementia can access the right services and supports to enable them to continue living in their own communities. It is an appropriate time for the Senator to raise this issue as I was in budget talks yesterday and this issue was discussed in the context of the Estimates. I am acutely aware of the challenges involved.