Martin Browne (Tipperary, Sinn Fein)
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371. To ask the Minister for Health the supports his Department has made available for persons with dementia or Alzheimer’s since the start of March 2020; and the supports planned for the coming months. [27945/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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Covid-19 and the resultant lockdown have generated specific challenges for people with dementia. Day care and respite services have been suspended, and usual routines have been disrupted, creating additional pressures for people with dementia and their family carers.

My Department and the HSE have ensured that there has been a continued focus on meeting the needs of people living with dementia throughout the period of the Covid-19 pandemic. Through the Dementia Understand Together Campaign, led by the HSE and working with the Alzheimer Society of Ireland (ASI), a range of initiatives and resources have been developed, to ensure that people living with dementia stay safe, well and connected, during this time of crisis. The HSE is also signposting people with dementia to voluntary organisations for additional community supports.

The HSE has adapted its community services in order to provide a flexible response so that the needs of people with dementia continue to be met during the Covid-19 crisis. Primary care team support is operating nationwide, with referrals being made to community supports, including the ASI’s dementia adviser service and the local authority community response forums. While home visits have been necessarily restricted, the HSE uses prioritisation and screening measures to identify clients needing 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, including associated required capacity, to resume services, including day services, in line with the Roadmap for Reopening Society and Business. This process will take on board the learning of the current period, including the possibility of delivering services in a new way, and the requirement to adhere to public health guidance. As part of this process, the National Dementia Office is developing a new model of care for dementia.

The HSE’s Memory Technology Resource Rooms (MTRRs) now have a central line, where people can speak to an occupational therapist for advice on Assistive Technology and aids to support people at home. The majority of MTRRs are now providing an adapted service through telephone and video assessment and consultation.

In addition, the ASI continues to support people throughout the Covid-19 crisis: its live chat, national helpline, home care, dementia adviser service, and online family carer training all remain up and running. Alzheimer Cafés have moved on-line and ‘virtual cafés’ are now taking place. The ASI has launched a new nurse line initiative with backing from the HSE and the Department of Health. The free call-back service offers people with dementia and family carers the opportunity to book a 1:1 session with a Dementia Nurse or a Dementia Adviser during the Covid-19 public health emergency. This creates a space for people with dementia and / or their families to raise issues that may be arising for them during the cocooning phase of the Covid-19 Emergency. This is hoped to assist people and may help plug the gap where Geriatrician appointments have had to be postponed due to Covid-19.

Guidance for re-opening day centres, including those for people with dementia, has been issued to CHOs. CHOs have been requested to undertake local risk assessments of centres to determine if infection, prevention and control measures can be put in place, to determine if social distancing can be maintained and in addition in order to determine approach to transporting clients to and from centres.

Advice issued from NPHET is that the over-70s, as medically vulnerable people, should continue to cocoon and not be in congregated settings. This cannot be facilitated in day centres unless the number of clients attending services are reduced. The HSE is committed to reopening day services but needs to determine Covid-19 testing strategy for these clients; mindful of increasing Covid-19 community transmission and resolve issues related to physical environments at day centres and ensure a safe transport strategy to facilitate people’s attendance at day centres.

Paul Murphy (Dublin South West, RISE)
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372. To ask the Minister for Health his plans regarding the full restoration and preparation for the winter of day services, respite services and residential services for persons with disabilities, including children and adults with either physical or intellectual disabilities, in view of the fact that these measures are missing from the HSE winter plan 2020-21; and if he will make a statement on the matter. [27952/20]

Anne Rabbitte (Galway East, Fianna Fail)
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I was pleased to announce with Minister Donnelly this week that €10 million is being made available to support the resumption of day services and enhanced home support services for disability service users. As issues around the resumption of disability day services are COVID specific, funding was sought from the National Action Plan on COVID-19.

Of this €10 million, €7.5 million will increase disability day services by one day a week for over 14,000 adults. €2.5 million will provide 210 intensive support packages to enable children and young adults to remain at home and in their communities.

The additional funding will further support the resumption of day services, which began to gradually resume throughout August and September. However, it should be noted that capacity in day service locations will be reduced, in line with public health guidance. The HSE and service providers will keep this measure under review and as public health guidance evolves, capacity to provide supports will adapt accordingly. Both the HSE and service providers are committed to maximising the support that can be provided within these restrictions.  

The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, and the latest update, a video message from the Head of Strategy and Planning HSE Disability Services, is available at the above link.  

An information portal that contains the dates on which the 966 disability day service locations reopened around the country is available. This information can be accessed at www.hse.ie/newdirections

With regard to respite services, the HSE’s A Safe Return to Health Services outlines a three phased approach to the return of health and social care services. In accordance with this plan, short-stay residential and emergency/residential respite re-opened from July to August with activity set to increase in the next two phases; September – November and December 2020 to February 2021. The main assumption underpinning this schedule is the level of illness and health service pressure caused by COVID-19. If this increases in later surges, the timelines in this document will change.

Residential settings are people’s homes as well as places where health and social care are provided, and so services and supports for those in long term residential settings continue. Where some regular activities for people with disabilities in long term residential care, such as attending separate day services, are curtailed, alternative supports are provided in the residential setting.  

The Department of Health is very much aware of how difficult restrictions on visiting are for residents and their families, and it is hoped that re-introduction of restrictions can be minimised. As Dublin city and county has been placed on Level 3 of the Framework for Restrictive Measures, it is unfortunately the case that visits to long term residential care facilities are paused until Friday 9th of October, but service providers are asked to take account of exceptional circumstances and facilitate visits on critical or compassionate grounds where needed. All guidance is available on the HSPC website and reviewed regularly.