Tailoring localities to support the vulnerable and elderly

Bernadette Ryan (66) has early stage dementia but is succeeding in maintaining a relatively independent life. She lives in an apartment on her own in the Lakes Retirement Village in Killaloe, Co Clare, and every week she visits Waterman’s Lodge Respite and Day Care Centre in Ballina, Co Tipperary, where she enjoys socialising.

The centre provides dementia services for people in the region as well as respite for carers. Owned by the Alzheimer Society of Ireland (ASI) with funding from the HSE, it is at the core of Ballina/Killaloe’s development as a dementia-friendly community (DFC).

Ryan is consulted by the Friends of Waterman's Lodge about the needs of the DFC and is very accepting of her condition.

Accepting people
"I thank God I never get depressed and that I always find a way out of things if there is a problem. The idea of a dementia-friendly community is wonderful. It's about accepting people for who they are and what they're at. That's very important.

“I guess we’re living in a more confused society where religion is almost on the back burner. Religion is the most important thing in my life after my children.

“People ask me if I got cross with God when I was told I had dementia. But I told them God had nothing to do with it. It’s just something that has evolved. My gift is being able to accept my dementia.”

Ryan no longer drives and doesn’t carry money. Her two grown-up children look after her financial affairs.

Apart from that, her life is self-directed and involves writing and reading as well as attending daily Mass and going to Waterman’s Lodge on Wednesdays on a bus for the weekly song and dance session. If she loses something, she prays and says her requests are eventually answered.

The chairman of the Friends of Waterman’s Lodge, Henry O’Connell, is a consultant psychiatrist attached to St Fintan’s Hospital in Portlaoise, Co Laois. Specialising in old age psychiatry, he lives in Ballina/Killaloe. Separated by a bridge, the two villages operate together as a town. The population of the area is 5,000, with about 500 people over the age of 65.

“Between 25 and 50 members of the population would have dementia,” says O’Connell. Ballina/Killaloe will be one of the first, “if not the first, dementia-friendly communities in Ireland”.

He is anxious to dispel some myths about the condition. “Society thinks people with dementia can’t manage and should be in nursing homes. Certainly, there are people who will need nursing care and maybe long-term care in the future. But we expect to develop our DFC to the point where people with dementia at all levels can be supported and can remain independent as long as possible.

“One of our views is that the person with dementia doesn’t necessarily have problems. It’s the community that can have problems. We’re trying to reverse that. We want to avoid early hospitalisation.”

Citing the recent tragic death of Alzheimer's patient, 65-year-old Peggy Mangan, found in Ballymun after going missing for a number of days, O'Connell says a DFC would look out for someone like her.

“If a community is geared towards being aware of older people with vulnerabilities, then you are more likely to prevent something like that from happening. If people are more open about having dementia, then it could be the case that shopkeepers, local school children and residents would be able to help someone like that woman. It’s not always easy in a big city but you could develop dementia- friendly areas within the city.”

Ballina/Killaloe is one of six areas recently awarded funding from the ASI to develop dementia-friendly initiatives. “We have a three-year plan. Our first and second years will be spent raising awareness about dementia, developing educational initiatives and involving as many interested individuals, businesses, voluntary groups and schools as possible.

“In our third year, we’re going to work on improving the physical infrastructure such as walkways, signage, public seating and public toilets. Over the next three months, we’re going to put up some new signage to demonstrate that Ballina/Killaloe is on its way to becoming a DFC. Once we’ve established ourselves, we’ll be able to be co-funded with money, for example, coming from the local county councils.” Ballina/Killaloe DFC has so far received €20,000 seed money.

The area is a tourism hub. “We get walkers and fishermen visiting here. We hope the area will become a well known tourist destination that’s also known as being a DFC.”

Waterman’s Lodge, opened two years ago, strengthens the case for Ballina/Killaloe becoming a DFC. The staff and the users of the facility “take part in a lot of DFC initiatives. We’re spreading the word that dementia is important and that people need to be more aware of it.”

With Ireland’s ageing population, “we’re going to see more and more dementia”.

“At the moment, 40,000-47,000 people live with dementia in this country. That number is going to go up to over 100,000 in the next 25-30 years. Our view is that if a community is aware and equipped to meet the needs of people with dementia, it will be a safer and more welcoming place for them.”