A National Dementia Strategy for Ireland: Signposting the Possibilities A Clinician’s Perspective

1. A National Dementia Strategy for Ireland: Signposting the PossibilitiesA Clinician’s Perspective Dr. Henry O’Connell Consultant Psychiatrist in Psychiatry of Later Life, Laois-Offaly Mental Health Services and Adjunct Senior Clinical Lecturer, Unversity of Limerick Graduate Entry Medical School ASI National Conference, Dublin, October 25th 2012

2. Talk/paper Outline 1. Setting the context: why we need a plan 2. Principles that may govern the new plan for Ireland 3. Hearing the voice of the person with dementia 4. International dementia strategies 5. The Irish National Dementia Strategy: what could, should and must be included in the plan 6. How to evaluate outputs and outcomes of the plan? 7. Conclusion: what do we want for Ireland?

3. Talk/paper Outline • Brief summary of Faculty of Old Age Psychiatry submission for National Strategy on Dementia

4. Setting the context: why we need a plan • Our ageing population • Programme for government commitment to National Dementia Strategy (NDS) • This paper written from clinical perspective

5. Setting the context: why we need a plan • Key Irish documents: • An Action Plan for Dementia (O’Shea and O’Reilly, 1999) • Implementing Policy for Dementia Care in Ireland-The Time for Action is Now (O’Shea, 2007) • Vision for Change (2006)

6. 2. Principles for the new plan for Ireland • Prevention • Early detection • Access to best available treatments

7. 2. Principles for the new plan for Ireland • Prevention: • Presentation at advanced stages • Increased awareness and action on risk factors

8. 2. Principles for the new plan for Ireland • Early detection: • The role of Primary Care

9. 2. Principles for the new plan for Ireland • Access to best available treatments

10. 3. Hearing the voice of the person with dementia • The National Dementia Summit (ASI, 2011) Themes explored: • Getting a dementia diagnosis • Adjusting to a diagnosis • Living well with dementia • Awareness of dementia and public perceptions • Political messages • Younger onset dementia

11. 4. International dementia strategies • England • Northern Ireland • Scotland • France • The Netherlands

12. 5. What could, should and must be included in the plan • Should: • Screening • Individualised care-plan • National health policy • Education and training • Primary Care • Specialist services, including Old Age Psychiatry

13. 5. What could, should and must be included in the plan • Should: • Memory/Cognitive Disorder Clinics • Home-care solutions • Clear pathways • Best practice standards • Prevention measures • Research

14. 5. What could, should and must be included in the plan • Should: • Evidence based approaches • Palliative care

15. 6. How to evaluate outputs and outcomes of the plan? • Incidence and prevalence rates • Satisfaction surveys • Access to respite and long-term care • Regional and national variations • Cost-benefit analysis

16. 7. What do we want for Ireland? • To build on and coordinate what is currently available, based on best international evidence • Prevention • Early detection and diagnosis • Dementia awareness, education and training • Individualised care-planning • Access to best available treatments

17. Faculty of Old Age Psychiatry • Submission for National Dementia Strategy • Awareness • Early diagnosis and intervention • Community-based services • Long-stay residential care • Acute care • Community/Acute/Long-stay residential care • Research

18. Faculty of Old Age Psychiatry • Summary of recommendations • Fully staffed Old Age Psychiatry services: one service er 10,000 older people • Memory/Cognitive Disorder clinics • Consultation-Liaison services • Lead in Dementia Care • National Registry for Dementia

19. Thank you