‘Bureaucracy restricts dementia direct payment take-up’

Direct payment take-up among dementia patients in Scotland remains low because of bureaucracy, high eligibility thresholds and a lack of promotion by councils, Alzheimer Scotland said today.

It estimated that just 300 of the 71,000 dementia sufferers in Scotland received a direct payment in a report today, based on a literature review and interviews with 12 carers and staff in 10 councils.

This was despite all council staff interviewed saying that direct payments had benefits for people with dementia and their carers, including flexibility to tailor support to the circumstances of the family and complement informal care.

Social work staff interviewed that the time it took to set up direct payments was prohibitive given the fact that people’s condition tended to deteriorate while they waited.

Some staff also said that high eligibility thresholds meant that users with dementia were often not eligible for direct payments until their condition had deteriorated to the point where it was hard to know their wishes.

Staff also reported that clients or their carers were sometimes reticent to take on the responsibility and complications of a direct payment. Some respondents said the administration and reporting that went along with this was a burden.

However, the report identified a lack of promotion by councils of direct payments for people with dementia, with over half of the carers interviewed finding out about them through friends or families.

Henry Simmons, chief executive of Alzheimer Scotland, said the benefits of direct payments remained a “well-kept secret” for dementia patients, adding: “Availability of direct payments is being filtered through the systemic assumption that this approach is unrealistic.”

The report recommended improved promotion of direct payments, a streamlined process to reduce the time taken to put them in place for dementia patients and more straightforward reporting requirements for recipients and carers on how they use their payments.

The Scottish government is due to publish its first national dementia strategy this summer. The report said this needed to help provide direction for social workers on how to deliver personalised services for dementia sufferers.

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