Mary Harney's new policy for people with dementia is not the fair deal she asserts, writes Maurice O'Connell
At best, care services for people with Alzheimer's disease and other dementias are inadequate, patchy and fragmented, so it is with a healthy measure of scepticism that the Alzheimer Society of Ireland receives the Minister for Health's recent announcement regarding "A Fair Deal on Long-Term Nursing Home Care". Scepticism because this new policy is fundamentally flawed and cannot offer a "fair deal" for the 40,000 people in Ireland with dementia and their carers and families.
As things stand, the proposal is not cognisant of the distinct needs of people with dementia. It ignores the complex nature of providing care for people with these conditions and the need to always look to the continuum of care. It assumes that one size of service will fit all, regardless of the nature of an individual's dependency.
The proposed scheme doesn't deliver a strategy for the provision of specialist nursing homes/units for people with dementia services that offers the appropriate environment, levels of trained staff and philosophy of care to adequately meet the needs and maximise the quality of life of each individual resident. Nor does it detail any programme to ensure there will be an adequate volume of and equitable access to such facilities by January 1st, 2008.
And what about the younger people with dementia that require residential care - those under 65 years old? There's no fair deal in long-term care for them. Currently many of this group have no option but to receive care in psychiatric facilities or, at best, in nursing homes geared towards older people. We have to do better.
To ensure a fair deal in long-term nursing home care for people with dementia, a full and comprehensive debate is required within the framework of providing a continuum of care and the relevant resource implication. The Government needs to implement and enforce the long talked about Health Information and Quality Authority (HIQA) quality of care standards for nursing homes, which hopefully will standardise the quality of long-term care services available. Worryingly for people with dementia though, these HIQA standards do not deal directly with specific regulations for dementia care and this must be addressed immediately.
People with dementia deserve a fair deal - full stop. To deliver, the Government needs to prioritise dementia. The Minister needs to follow through with policy change and investment not just in the area of specialist long-term care services but also in the areas of community-based services; awareness and risk reduction initiatives; and social/scientific research. Most importantly, Government needs to provide deficit funding to the Alzheimer Society to ensure viability of existing dementia specific services.
Maurice O'Connell is chief executive officer of the Alzheimer Society of Ireland