I welcome Cian and Jordan Adams and everyone else in the Public Gallery. I thank them for their fundraising efforts and for shining a spotlight on the issue of dementia. As the Minister of State said, I am sure their late mother Geraldine would be very proud of their work. They are very welcome here today. Dementia is a significant health and social care challenge facing the State and it is growing due to our ageing population. More than 64,000 people are living with dementia in Ireland today and this number is expected to double over the next 20 years. Every year, thousands more people and families are affected by this life-changing condition, often with too little support and too much left to chance and to a postcode lottery. While it has a massive impact on the individual who has dementia, I am sure the Minister of State will also acknowledge the impact it has on their family and friends as well. My grandmother had dementia for six or seven years and my mother was her carer. She lived with her and looked after her. I watched my grandmother regress over the course of six or seven years. It was very rewarding for my mother to be caring for her almost every day but also very challenging. Unfortunately, my mother got cancer and died about a month before her mother died, after all of that caring. There are a lot of challenges and a lot of stress involved in caring for people but it is also very rewarding. That is why those in the Public Gallery are here and why they have done the work they do. Our starting point has to be dignity. People living with dementia, whether early onset, advanced or advancing, deserve care that is person centred, timely and properly planned. They deserve supports that delay progression where possible, manage symptoms, protect safety and preserve independence and autonomy for as long as possible. A serious dementia policy must begin with early intervention and wraparound supports to support the person and their family. This is especially true for people with early onset dementia. They may still be in work and I know some people in that circumstance. They may have children at home. They may have mortgages, caring responsibilities and an active family life. They need a timely diagnosis, clear information, income and employment supports, counselling, therapies and practical advice. The national dementia strategy was published in 2014. It was important, but 12 years later too many services remain fragmented, under-resourced and uneven across the State. Families still describe a system where they have to fight for information, assessments, home support, respite and continuity of care. Everybody accepts that the strategy must be updated, but an updated strategy alone will not be enough. It must be tied to funding, workforce planning, local delivery, data accountability and clear rights for people who need care. It must sit in a wider reform of ageing social care, primary care and communities services. We had some discussions with the Minister for Health earlier during priority questions and oral questions on many of these topics. The health service must be built around getting people the right care in the right place at the right time. That is what Sláintecare promised and it is the reform we need to keep driving towards to ensure everybody, including people with dementia, get that support. For many people with dementia, that means care at home and in the community for as long as it is safe and appropriate. People do this. Families do everything possible to keep somebody in the home until it becomes impossible, but for this to happen, all of the supports, including home care, outside of what families can do have to be in place. Very often it is patchy and it is very difficult for people if they are not getting it or are only getting partial hours. We have to look at this in the context of all of the supports that are needed, especially when somebody is still living at home. These debates inevitably circle back to the long-promised statutory home care scheme. This has been promised for years. I do not know why it has not been delivered. It is very important. It was in the programme for Government not just this time but the last time as well. We go around in endless debates on this. I have never been given a clear reason that it has not been developed. A statutory home care scheme would not solve all of the problems but it would set out a legal right for people to have access to home care. Whether it is people with dementia or older people more generally, keeping people in the home for as long as possible is about dignity, is the right thing to do, and is obviously better for that person. Home support hours do need to increase. As the Minister of State knows, I have been raising this issue year after year. This is just one of a number of issues. Home care itself needs major reform. The statutory home care scheme needs to be put in place. It must also, however, recognise the different levels of need, from basic support with daily living to intensive home care nursing support, therapies and medical care. There is so much that we need to do. I welcome that we will have a review of the dementia strategy but when we are doing this, resourcing it will be the most important part of it.

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