Vol. 443 No. 3
7 Mr. Currie asked the Minister for Health the extent of available research into the causes of Alzheimer's disease; whether sufficient resources are available to make a meaningful impact on the problem; and if he will make a statement on the matter.
143 Mr. Durkan asked the Minister for Health whether adequate support, counselling, respite or long term care exists for Alzheimer's patients and their families; if such services are comparable to that currently available in other EC countries; and if he will make a statement on the matter.
I propose to answer Questions Nos. 7 and 143 together.
Alzheimer's disease, first described in 1908 by Dr. Alois Alzheimer, is a degenerative, terminal disease of the brain cells which causes memory loss and gradual mental and physical deterioration. Its cause is unknown and as yet there is no effective cure for the 20,000 to 30,000 people in Ireland who have this disease.
The report, The Years Ahead — A Policy for the Elderly, stressed the need to develop a range of services for people with dementia and their families, including purpose-built accommodation. The report was adopted as official Government policy towards the elderly. Between 1909 and 1992 an additional £9 million was made available to the health services to implement the key recommendations of the report, including the strengthening of home and community support for people with dementia and their families. The investment by boards is additional to support available to sufferers of Alzheimer's disease and their carers. The care of those with dementia is clearly emerging as a priority for many boards, a development which I fully support.
In 1994 funding is being made available to provide specialist services for those with dementia in south-east Dublin, Limerick and Cork. It is hoped that these services will be in operation before the end of the year or early next year. My Department is also considering a request for funding from the Alzheimer Society towards the development of the valuable services of the society.
The Health (Nursing Homes) Act, 1990, which commenced on 1 September 1993, widens the options available to those caring for dependent relatives with dementia. Under the Act, health boards may pay a subvention towards the cost of care in a nursing home of a person who needs that care and who does not have the resources to pay the cost.
The report, Caring without Limits, which was published by the Alzheimer Society in July last year provides an important insight into the lives of those who bear the brunt of Alzheimer's disease — the carers. I was pleased that my Department allocated a grant to the Alzheimer Society to enable this important research to be carried out.
The Government has expanded the eligibility criteria for the carer's allowance in recognition of the burden on relatives of caring for dependent elderly people such as those with dementia. As Minister for Health I am very conscious of the contribution made by carers to the maintenance of dependent people in their own homes, and I will continue to encourage health boards to develop and extend support services for these informal carers, whether by services in the home or by way of respite care in a hospital or nursing home.
Research on Alzheimer's disease being carried out in Ireland includes scientific research on the causes of the disease using animal models in Trinity College, Dublin, which was recently published in an international journal. The Mercer's Institute, St. James's Hospital is examining early diagnosis of dementia and the quality of life and burden for care givers of dementia sufferers. It is also involved in a longitudinal follow up study on dementia. The North Dublin Psychiatry of Old Age Service has carried out research on service provision available for dementia sufferers in the community. It has also examined the referral of dementia sufferers to general hospitals and abuse of dementia sufferers.
Regarding comparison with services available in other European Union countries, my observation since I became Minister for Health is that services for the elderly in this country compare favourably with those provided elsewhere in Europe.
Is the Minister satisfied that all research is being made available to the Alzheimer Society and to the friends and relatives of people with the disease? Have contributory causes been put forward over the years? If so, to what extent has an advance been made in recent times on those factors and will such information be made available?
I have given the information on research. There is very close liaison with the research institutes and the Alzheimer Society and also between my Department and that society, whose work is greatly valued by us. I am anxious that any information required by the society will be made available to it. It initiates its own research and I am happy to fund that research.
When talking about carers, in the main we are talking about women. Is the Minister taking action to review means testing of the carer's allowance to such an extent that it will make a difference and so that women whose husbands have means and are thereby disallowed support will get the support they need, not only in terms of money but also by way of respite care?
I am anxious to support carers to the best of my ability. I acknowledge that the overwhelming majority of carers are women. The carer's allowance is a matter for the Minister for Social Welfare and I know he shares my concerns in this matter. It is much more desirable to treat, support and help people who suffer from dementia or Alzheimer's disease in their homes rather than institutionalise them and that is a policy we will be working towards.
I am sure the Minister will agree that Alzheimer's disease is a particularly distressing condition and it is difficult to care for people with this disease. To assist people living on low incomes who care for those with Alzheimer's disease, will the Minister consider providing grant aid for facilities such as central heating, wheelchairs and so on? It is not easy to provide that kind of physical support because there is no specific provision for these facilities. I am sure the Minister will agree that such assistance would make a big difference to people caring for those with Alzheimer's disease.
I do not wish to trespass on the area of responsibility of the Minister for Social Welfare who is responsible for income maintenance. I hope, by agreement, to transfer all income supports, including disabled person's maintenance allowance, to the Department of Social Welfare. I am mindful of the points made by the Deputy.
The incidence of Alzheimer's disease is increasing as people live longer. That will have to be borne in mind if we are to achieve the objective of caring for people in the home setting for which I have expressed my support.
Will the Minister consider setting up specialised long stay and respite units to cater for people with this disease? With one or two exceptions there are no such units to cater for this problem and they would be of great benefit to patients and their families.
Many geriatric facilities now have Alzheimer units, several of which I have visited. Those units will become part of the general provision for the elderly. People who can no longer be supported in the home setting will require a degree of support greater than that normally given to people in geriatric facilities.
