The increased incidence of Alzheimer's disease in Ireland's ageing population has prompted a call for a review of public policy on mental health. The number of people over 65 with mental disorder is set to increase by 20 per cent in the next decade, a conference, "Ageing and Mental Health", heard yesterday.
"Our concern is that this increased incidence of Alzheimer's disease is likely to prove a burden on both social service resources and society," said Prof Brian Lawlor, a consultant psychiatrist at St Patrick's and St James's Hospitals.
"To address the need to provide adequate care for these patients we are calling on the Department of Health to make Ireland the first country in Europe to put a public health policy in place for patients with Alzheimer's disease."
He said there were 100,000 people aged over 65 years with a mental disorder of some severity in Ireland, and this figure looked set to increase to 120,000 by 2011.
Speakers highlighted Alzheimer's disease, dementia and depression as the main types of illness in older people. They expressed concern that mental disorders in older people are often misconstrued as having an inevitable and untreatable course.
"However, the reality is that early detection of dementia is vital if the quality of life of both the patient and the carer is to be maximised," Prof Lawlor told the conference, which was sponsored by Modern Medicine of Ireland.
The devastating effects of dementia on the patient were self-evident but they may be just as devastating on a patient's family, said Mr Robert F. Coen, a psychologist at the Mercer's Institute for Research on Ageing at St James's Hospital.
The policy in Ireland was to keep patients in the community and out of institutions. From the carer's point of view there was an understandable reluctance to give up care of a loved one, and practical issues such as the high cost of long-term institutionalisation were also of relevance.
"There is a common goal of trying to maintain the patient in the community for as long as possible. In practical terms this means that the burden of care falls mainly on family or relatives already struggling with the adjustment and loss that dementia brings. The services that should have been put in place to support this community policy have not been built up," he said.
While carers can be considered "therapeutic partners" in the sense that they care for patients, they could also be viewed as potential clients themselves in view of the consequences of caring on personal life style and psychological well-being. "Many studies report increased levels of depression, anxiety and health problems among carers."
Carers were usually female, most often wives and daughters. "Wives are themselves elderly, while daughters are often caught in the `sandwich generation', with conflicting demands from caring for elderly patients and their own dependent children."
He said that informal social support for carers had been identified as an important factor in a number of studies.