I don’t think anyone ever thought ‘if dementia friendly communities are a success, people are bound to vote Tory’. That would be ludricous. Or, by the same virtue, people are counting down month-by-month until 2025 when David Cameron, former Prime Minister, is expected to deliver a cure for dementia as part of the David Cameron Dementia Challenge.
That there has been bordering on contempt for social care in high political circles has not gone unnoticed. When the Alzheimer’s Society talks about ‘Fix Dementia Care’. the attention is focused on hospitals. But any practitioner or professional, not necessarily charity employees, knows that the entire health and social care system acts as one big system.
Today the report from the House of Lords on the sustainability of the NHS reported that years of no pay rises for nurses had led to a culture of low morale in the NHS. This is of course no big surprise. That junior doctors also had contracts imposed against their will, and had to go on marches to protest lawfully, further compounded the demoralised ethos in the NHS.
And yet it is staggering that senior managers in the NHS, let alone the Secretary of State for health, Jeremy Hunt MP, could possibly deem the wellbeing of its staff as irrelevant to the delivery of person-centred care in hospitals. As hospitals run up deficits, not because of financial mismanagement but due to years of deliberate underfunding, there are political questions to be asked from senior people in charity as to why the NHS is failing.
That this question has not been asked publicly for England in the delivery of dementia friendly communities is disappointing. That there is no ‘caring well’ in the NHS Transformation Network for living well with dementia is also a failure of policy, in the delivery of dementia friendly communities.
But I am also concerned about what is more a subtle problem with policy. That is, the operation of the dementia friendly communities seems to be concerned about the quality of the interaction of a person with dementia with commercial businesses (so that these businesses can improve their competitive advantage) than other key aspects of living in a community.
A person living with dementia might be living alone, I applaud very much sensitivity to someone’s religious or spiritual beliefs, such as dementia friendly churches or Sikh temples, but I what I think is less impressive are religious institutions being plastered with big logos of charities promoting their services in the name of ‘dementia friendliness’.
I recently ran a Twitter poll on whether living at home should be a priority for dementia friendly communities. The reason I asked this is that care at home is most definitely part of the World Health Organization’s concept of a dementia friendly community.
That domiciliary care is on its knees, due to provider problems and deliberate social care cuts, should be a concern for the idea of living well with dementia, unless you believe that a person living with dementia has such good facilities and transport links that he or she never stays at home anyway.
Surely the purpose, however, of dementia friendly communities is for people to live independent lives, even if that means living well at home, with their basic human rights (such as right to health) being respected and valued.
Looking after the primary carer, whether this be a paid carer, unpaid family carer, or friend, is also pivotal to the wellbeing of a person living with dementia pursuing ‘independent living’, and we know that this can fundamentally affect the timing (if at all) of a person living with dementia moving into residential care.
My Twitter poll not surprisingly provided that 95% of respondents felt that care at home should be a priority for dementia friendly communities, but an obsession for charity leaders to present dementia friendly communities as cost neutral or apolitical (e.g. “politeness costs nothing”) means that there are two unfortunate conclusions of policy. They are, firstly, charities can improve their branding under any definition of ‘dementia friendly communities’, and, secondly, the wellbeing of people with dementia and carers might suffer if the wrong political decisions are made locally.
This would be immoral.