Researcher profile - Prof Eamon O'Shea on calculating the cost of dementia care
Professor Eamon O’Shea is no hurler on the ditch. Whether gathering evidence for optimising dementia care in Ireland or managing the Tipperary hurling team, he has been in the thick of the action. Claire O'Connell spoke to him recently.
How much does dementia cost us? It sounds like a simple question, but the answers reach far into our pockets as a nation and they get to the heart of what it means to be a person in society.
It’s a question that has kept healthcare economist Professor Eamon O’Shea busy gathering evidence, writing policy reports and ultimately helping to decide how we tackle the burgeoning issue of caring for people with dementia in Ireland’s ageing society.
His latest HRB-funded project is gearing up to model and analyse how we allocate resources to dementia care in Ireland, and how we measure the impact of health and social care delivery for people with dementia.
'The focus of dementia research is often on the biomedical side – how does dementia arise and are there ways we can prevent and treat it, and that is really important', says Professor O’Shea, who is a professor in the School of Business and Economics at NUI Galway.
'But delivery of dementia care is also key, and we need evidence-based policies for that delivery to be optimal for people with dementia and their family carers. In the Irish context we need to get more resources for dementia into home-based care, so we are looking at the best ways to do that'.
Part of any dementia care strategy will boil down to resources – how much do we need and where should we be spending it to get the best outcomes for people with dementia, their carers and communities. But there are also less tangible factors to take into account, like preserving the ‘personhood’ of the person with dementia.
Professor O’Shea agrees that ‘personhood’ is hard to define and even harder to measure.
'It has individual components to do with self and identity and other elements like self respect', he says. 'It has social connotations as well, to do with the connectivity of the person with dementia to themselves, to their own life and their former life and also to the people in the communities in which they live'.
We have to strive, he stresses, to deliver care for people in dementia in a way that protects the basic humanity of the relationships between the person with dementia and the people around them.
'You may walk into a nursing or family home and you may say this is good or not-so-good care, but how do you really know'? he asks. 'The direct involvement of the person with dementia in making judgements about their own care is very important. So too are the outcomes measures we use to judge the quality of the care and supports provided by families and health professionals.
Measurement has practical implications too - if the care is not protecting personhood, that needs to be considered in terms of resource allocation and funding'.
One ambition of the HRB-funded research, which will run over the next five years, is to get a handle on what optimal provision of dementia care might look like in Ireland, explains Professor O’Shea. 'We want to bring together decision makers in the HSE and the Department of Health and healthcare practitioners and ask them to make decisions about what optimal provision would look like for different case types of dementia', he says. 'There is a really practical orientation to the work'.
As part of his academic training, Professor O’Shea did a Masters degree in health economics in University of York and a PhD at the University of Leicester. In York he became interested in research into the quality of life of older people thanks to inspiring lecturers such as Alan Williams and Alan Maynard, who were pioneers in the field of health economics. On his return to Ireland, his research at NUI Galway focused on economic and social aspects of ageing. His work for the National Council on Ageing and Older People meant he became well used to writing policy reports on a variety of ageing issues in Ireland. In time, thanks to Atlantic Philanthropies funding, he set up the multi-disciplinary Irish Centre for Social Gerontology at NUI Galway in 2006.
All the while, Professor O’Shea was living a parallel life in hurling in his native Tipperary – he initially played for his county and then went on to coach the Tipp hurling team between 2008 and 2010 and he was manager between 2012 and 2015.
'Sport is an outlet for me, it gives you a different perspective on things', he says. 'It changes your landscape really quickly, which for me is really important. You can get engrossed in your work and sometimes if you are not careful it can take you over'.
But the academic perspective is still there: 'I am really interested in how communities work and also how sport can be used to build social capital and provide balance in younger people’s lives', says Professor O’Shea. 'So as well as being a physical outlet and an enjoyable pursuit, sport has fitted in with an ideology I would have about the importance of engagement, belonging and identity and how that rootedness can provide support for people'.