Engage: Dementia and Politics – from the social work perspective
The last few years in the UK have been marked by a surge in interest in dementia from politicians. It dates from the dawning realisation that dementia costs more than cancer, heart disease and stroke put together, the realization that there is no early prospect of a cure, and an awareness that the numbers affected are going to double in the next twenty years.
The political problem with this is that the plans to do something different to deal with dementia lie in a timescale outside of the normal political cycle. From the political point of view the problem is now. The local hospital is generating a workload for the care budget. The national reputation of the NHS is fragile and at risk because of the “burden of older people.” All politicians want to show that they’ve sorted something, and sorting dementia is not possible during an election cycle. Cost of care is now a feature of Private Eye cartoons.
Partial solutions can be proposed and implemented, like increasing research funding, creating “dementia friendly communities”, increasing education for staff, trying to control care fees….but as each innovation is punted by elected representatives as if it is a complete response, each of them is open to criticism by whoever is in opposition to the people in power. Those who make the decisions are between a rock and a hard place. If they say, “We can’t solve this now…” they’ll be dragged down by those who want their place in local or national government. If they say, “Here is the solution that we have agreed with the stakeholders….” they will have fended off current criticism, but history will judge them mercilessly. And more importantly, people affected by dementia, their families and those around them, will be no better off when the circus has moved on and all those powerful people have retired.
In this 25th anniversary year of the Dementia Services Development Centre at the University of Stirling (DSDC) we have been holding a Festival of Ideas, trying to get new thinking into this space. Uniquely we have a tiny amount of our income from government or University sources, so we can afford to be controversial open and honest, as well as authoritative, a situation that many charities and public sector organisations cannot afford. DSDC is not linked like a think tank to any political point of view. The debates that we will be having at our International Conference in November in Birmingham will be focusing on subjects that are not often central to dementia events where there has been a marked political, economic and ideological predominance or control over the thinking about dementia and what needs to be done. Internal, sponsored, cultural hegemony of this type is only successful if those affected by it consent. We do not consent to be told what to think about dementia. Already 2,000 people internationally have responded to our ground-breaking survey about what people really think dementia means to them and we will be reporting on this at the event. You can take part in this survey up till November.
If you want to be involved, there is still an opportunity through master classes and discussion sponsored by the Dementia Services Development Trust.
We have not reached any conclusions about this debate, but there is a general direction that is easy to see. In future there will be more older people and less public money, so unless we start now teaching families again, like in olden times, to care for their own, we are walking into a disaster. That includes when they are in hospital, care homes and at home. Social work, no matter how much it is better resourced in future, will never be able to fill this gap.
About the Author
Professor June Andrews is Director of the Dementia Services Development Centre (DSDC) in the School of Applied Social Science at the University of Stirling. The purpose of the DSDC is to devise and implement interventions to drive change in clinician behaviour and health and social care organisations in order to achieve the ambitions of national dementia strategies in the UK and beyond.
