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Dementia Services

Yes, and I can see that the hon. Gentleman's brain is in an excellent state, because he has anticipated what I was about to say. My next point was that we need to educate GPs, the public and non-specialist health and social care staff to recognise and respond to the signs of early onset, and to distinguish accurately between normal absent-mindedness, which is not totally unknown even in this place, and the clinical symptoms of dementia. I see that both ways in my constituency work: I see people who are convinced that their partners have Alzheimer's when they perhaps do not and people who are shutting their eyes to it. Because we know that early recognition combined with memory services can delay the need to enter a care home, it is a cost-effective approach, which is important to the individuals affected. As an immediate measure, we need to help people to stay at home while they can, if they want to, with support for their carers—this relates to the point that the hon. Member for East Devon (Mr. Swire) made earlier. For most sufferers, there is a trade-off between the risks of being at home in a less guarded environment than a closed mental illness institution and the benefits of being in a familiar environment that they have cherished for many years, surrounded by people they know—and hopefully love—and of drawing comfort from that environment when their facilities diminish. We should not take away that choice. We are very risk-averse as a society. If somebody with dementia who lives at home has an accident—because they wandered on to the streets, got lost and were knocked down by a car, for instance—there are always questions asked. People ask, "How could that happen?", "Where were social services?" and "What were the relatives doing?" However, there are risks in every part of life, including being in a closed ward. There are risks to people's mental state and, basically, their happiness, so we should not take away people's capability to make rational decisions just because their memory is failing. In many cases it might be possible to have a serious discussion about that. The Personal Care at Home Bill is an important contribution to that, because if free personal care is available at home in the most critical cases, in many instances it will tip the balance between early admission and admission a little later. That will not only help to reduce costs, but be beneficial for the individual concerned. Finally, what is our long-term vision? In the long term, we hope to see effective treatment. Perhaps we will never have a complete cure for mental decline, as I have said, but we should aim for a continuous spectrum, which starts at the point at which the first symptoms are recognised and accepted as a normal part life—as one of the things that can happen when one gets older—in order to ensure that initially relatives, friends and carers are brought to accept what is happening as something natural that they can deal with; that if and when the symptoms start to get worse, there is additional care support from the local authority of the kind envisaged in the Personal Care at Home Bill; that if that person's condition continues to deteriorate, we have day care facilities and support for carers, so that that period is less traumatic than it often is today; and, if that individual eventually needs to go into a care home, that the home still treats him or her with the respect and dignity that he or she deserves. My father said in his final years that he had never been happier. I would like to think that in future that would be true for the majority of sufferers.