Billy Kelleher (Cork North Central, Fianna Fail)
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679. To ask the Minister for Health in view of the recently published national dementia strategy indicating that up to 29% of all patients in a typical general hospital may have dementia while the Irish national audit of dementia found that 94% of hospitals have no dementia pathway in place; the actions that have been put in place to ensure that dementia patients are provided appropriate care and that hospital beds are therefore available for those patients currently in accident and emergency on trolleys; and if he will make a statement on the matter. [1575/15]

Billy Kelleher (Cork North Central, Fianna Fail)
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680. To ask the Minister for Health in view of the acknowledgement in the national dementia strategy that the average cost to the State per person with dementia here is €40,500 per annum as the bulk of the care for persons with dementia is provided free of charge by their family care-giver and that the informal cost of dementia to family caregivers is estimated to be €807 million per annum, if he will provide a breakdown of the €27.5 million allocated to fund the strategy; and the financial support that will be provided to family care-givers who are burdened with the most significant proportion of the cost of dementia. [1576/15]

Billy Kelleher (Cork North Central, Fianna Fail)
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681. To ask the Minister for Health if the national dementia strategy monitoring group has been established to monitor progress towards implementation of the strategy; the details of membership if already established; and details of the members' remit in terms of ensuring that all actions are successfully implemented. [1577/15]

Billy Kelleher (Cork North Central, Fianna Fail)
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682. To ask the Minister for Health regarding the assignation of the overall responsibility for the implementation of the national dementia strategy within the Health Service Executive to the office of services for older people and the 4,000 persons currently affected by early onset dementia, if he will indicate the specific programme of care for these persons under the management of that office; if his attention has been drawn to the specific challenges for persons with early onset dementia are compounded by the lack of a specific care programme in terms of attaining funding for carers, nursing homes and the additional financial struggles affecting these particular groups of persons [1578/15]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Questions Nos. 679 to 682, inclusive, together.

A Monitoring Group, chaired by the Department of Health, is being established to assist with and advise on implementation of the National Dementia Strategy, including the National Dementia Strategy Implementation Programme. This Group will again include health professionals, administrators, researchers, and advocates. In addition, the Group will include a number of new members including a person living with dementia and a representative of those who care for people with dementia.

With one exception (because the relevant person is directly involved in implementing elements of the Strategy and is therefore unavailable), all the members of the expert Working Group which assisted in formulating the Strategy have been invited to join the new Monitoring Group. In addition there will be a number of new members, as follows:

- Ms. Helen Rochford-Brennan, who will represent people living with dementia.

- Dr. Richard Aboud, who is a General Practitioner.

- Professor Eamonn O’Shea, who is an expert on ageing issues and will represent Atlantic Philanthropies.

- Mr. John Linehan, Head of HSE’s Dementia Strategy Implementation Office.

The Monitoring Group’s remit is as follows:

- To monitor and assess progress on the implementation of the recommendations in the National Dementia Strategy;

- To identify any factors with the potential to affect the delivery of the Priority Actions, including the three Priority Activities within the Implementation Programme agreed with The Atlantic Philanthropies;

- To make recommendations in relation to the manner in which the Strategy is implemented;

- To advise on the establishment of a monitoring and reporting framework (to include key performance indicators) which is valid both nationally and locally to track change and improvement over the agreed period in respect of dementia services,

- To advise on the commissioning framework for Strategy evaluation following from the Expert Advisory Panel (This is a small technical group to advise specifically on evaluation issues),

- To report to the Minister of Statefor Older People twice yearly on progress made towards implementing the recommendations of the National Dementia Strategy. The Minister will in turn report to the Cabinet Committee on Social Policy and Public Service Reform .

The Strategy specifically acknowledges the fact that many people under the age of 65 are living with dementia, and both the members of the Monitoring Group and those leading the Strategy’s practical implementation are very conscious of the particular challenges posed for younger people by dementia, and of the need to respond to those challenges

A number of the priorities identified within the Strategy will be of benefit to people under 65 with dementia. Early diagnosis will assist in ensuring people under 65 will be diagnosed earlier. A key aim of the Strategy is to identify the services currently available to people under 65, and to plan to address gaps that may now exist. The Dementia Awareness and Stigma Programme element of the National Dementia Strategy Implementation Programme will seek to increase awareness of dementia in this age group, and to provide more age specific information for them. Six Dementia Advisors (under the aegis of the Alzheimer's Society of Ireland) are also in place in various locations and will support people with a diagnosis of dementia, including those under 65. Early onset dementia may cross a number of care groups, and a HSE Cross Departmental Group will work to integrate service provision for people under 65 with dementia. Consideration will also be given to providing tailored packages of intensive home supports that are appropriate to younger people with Dementia, as part of the National Dementia Strategy Implementation Programme.

The Strategy’s objectives include the need to make hospitals dementia-friendly from admission to discharge or death, which includes environmental aspects as well as clinical support. There is a commitment to the development by the Health Service Executive of a dementia and delirium care pathway, which can be fitted to existing acute care pathways and implemented on a local level in each acute hospital. In addition the HSE will assign responsibility within its own facilities and elsewhere will encourage the assignment of responsibility to a senior clinician within each hospital to lead the development, implementation and monitoring of the care pathway.

Hospitals will be required to ensure that people with dementia have a specific pathway through Emergency Departments and Acute Hospital Medical Units that is appropriate to their particular sensory and psychosocial needs. The HSE will develop guidelines on dementia-friendly ward specification to be taken into account at the design stage of all refurbishments and new builds. Elements to be considered should include safe walking spaces and the use of colour, lighting, signage, orientation cues and space used to promote social interaction.

Hospitals will prioritise the assessments of social and environmental supports to meet the needs of people with dementia and their carers, including access to appropriate social work support.

While exact financial allocations will be firmed up as implementation progresses, our agreement with the Atlantic Philanthropies provides that the €27.5m which is available for the National Dementia Strategy Implementation Programme will broadly be allocated as follows:

Provision of intensive home supports ~ €22.1m

Dementia Awareness Programme ~ €2.7m

Education programme for GPs/Primary Care teams ~ €1.2m

National Dementia Strategy Implementation Office and supports ~ €1.5m

Financial supports for Carers are mainly provided through Schemes administered by the Department of Social Protection. Details of these supports are available on that Department’s website (www.welfare.ie), these include - Carer’s Allowance, Carer’s Benefit, Respite Care Grant, and Domiciliary Care Allowance.