Scottish Parliament Equal Opportunities Committee - Age Taking Stock Exercise

Alzheimer Scotland's evidence submitted 21 April 2006

Introduction
Alzheimer Scotland is the major national charity representing the interests of Scotland’s estimated 64,000 people with dementia, and their carers. We aim to be the voice of and for people with dementia and their carers, to influence the improvement of public policies and to promote and provide high quality services for people with dementia and their carers.

Dementia is the progressive decline of mental functions, such as memory and cognition. The most common causes are Alzheimer’s disease, vascular dementia and Lewy body dementia. People with dementia gradually lose their ability to carry out the activities of daily living, their ability to communicate is progressively impaired, and eventually even basic activities, such as dressing and going to the toilet, become impossible without help.

There are an estimated 29,000 (i) carers providing a regular and substantial amount of care for the 60% of people with dementia who live at home (ii). Carers of people with dementia tend to be older; Moriarty and Webb (iii) found that that the mean age of carers was 63 years and most co-resident carers were over retirement age.

Dementia as an age-related issue
The prevalence of dementia increases with age, from approximately 2.2% of men and 1.1% of women aged 65-69, to 31.6% of men and 36% of women aged 95-99. About 62,000 of Scotland’s 64,000 people with dementia are over 65.

As Scotland’s population ages, the number of people with dementia will increase very significantly; based on population projections, there are predicted to be 108,900 people with dementia in Scotland by 2029.

Discrimination faced by older people with dementia
People with dementia and their carers require good quality, flexible services to help them cope. They are not alone in this – many other care groups also need services; for example younger people with learning or physical disabilities. Yet the Scottish Community Care Statistics 2002 show a significant difference in the level of expenditure between older people and other care groups (although these statistics do not differentiate between people with dementia and older people with other health needs).

Day centre expenditure for older people works out at works out at £3,979 per place per year, while for adults with learning disability expenditure is £6,674 per place per year. For long stay care, the average weekly cost for a residential care home in 2002 was £340 for an older person, £564 for an adult with learning disability (89% of whom are under 65) and £589 for an adult with a physical disability (83% of whom are under 65).

There remains a significant level of unmet need for people with dementia and their carers, with most people with dementia in the community not receiving the full range of services they need (iv). Only 12% received overnight breaks arranged by the local authority, 7% received day care, and 10% home care, yet as the Scottish Executive and Alzheimer Scotland Short Life Working Group (v) pointed out, research shows that the proportion in need of these services is likely to be 69%. The Short Life Working Group highlighted the absence of post-diagnostic support services, which ‘does not reflect good practice in community-based care, which should help prevent or at the very least delay admission to long stay or continuing care’.

Priorities for the Scottish Parliament 2007-2011
Alzheimer Scotland believes that dementia should be made a key priority for Scotland, if we are to ensure that the growing number of older people with dementia are not to be seriously disadvantaged by lack of the support they need. We call upon the Scottish Parliament to bring the issue of dementia to the forefront of planning, and to commit significantly increased resources to the care needs of people with dementia and their carers.

Kate Fearnley
Policy Director
21 April 2006

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i Alzheimer Scotland (2003) Signposts to support: understanding the special needs of carers of people with dementia Edinburgh

ii Alzheimer Scotland (2000) Planning Signposts to Dementia Care Services Edinburgh

iii Moriarty J & Webb S (2000) Part of their lives, community care for older people with dementia London: Policy Press

iv Alzheimer Scotland (2004) Short breaks services for people with dementia and thier carers in Scotland Edinburgh

v Scottish Executive Health Department (2004) The planning, organisation and delivery of joined-up services for those with dementia and their carers HDL 44 Edinburgh