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It is morally unacceptable to continue funding for Dementia Friends

I don’t deny that awareness in dementia is crucially important, but we do need to face some unpalatable facts – there is not an unlimited ‘money tree’ for dementia. It is morally unacceptable to continue Dementia Friends from the Alzheimer’s Society, Public Health England and marketing companies from the tune of millions, while social care is on its knees.

In this list of achievements compiled by the the Alzheimer’s Society of the Harold Macmillan variety, “you never had it so good”, there is absolutely no mention of the parlour state of social care funding.

achievements

Dementia cannot be a brand solely for the benefit of the surplus of large charities. People living with dementia and carers need much more support.

Whilst some people have benefitted enormously from the Prime Minister Dementia Challenge, others have been totally wrecked.

The claim that the UK will be the best place to have dementia is a complete lie, and people should stop pedalling it.

The wreck of devestation in dementia care is disastrous and consistent.

In August 2016, it was reported that carers and families of people with learning or physical disabilities or dementia, that use Hertfordshire County Council’s day services were appealing to the Council to rethink plans to reduce staff and activities.

Stephen, who cares for his wife who has dementia and attends a centre three times a week, has written to the Council objecting to the proposals.

He said: “The day centre provides social interaction and care for my wife and gives me a break from caring so that I can continue working. Please look again at the proposals and come up with a more justifiable approach.”

Stephen continued: “If the day care service is reduced it may lead to problems and greater costs elsewhere in the care service. Replacing in-house catering and the flexibility it offers with a delivered meal may mean that some centre users with specific eating habits, may not get a balanced nutritional meal.”

Many people with dementia will need care and support as their condition progresses. This is often a mix of care from family, friends and professionals. Paid care can take a number of different forms and focuses on meeting the person’s needs to improve their wellbeing. In the UK, the term ‘social care’ is often used to describe this type of care, as opposed to care that is provided by the NHS or by families.

MPs have now painted a hugely grim picture of the future for health and social care, saying the scale of the funding challenge in health is “colossal” and historical cuts to social care funding have gone beyond the search for “efficiencies”.

The Health Committee in a recent report on Impact of the Spending Review on health and social care has revealed that the NHS is under ‘unprecedented strain and struggling to keep pace with relentlessly rising demand’.

Reductions in how much local authorities pay care homes, or below-inflation increases, mean that some are on the brink of collapse, leaving vulnerable people at risk.

The cuts, combined with shortages of nurses and care workers, the introduction of the “national living wage” for staff and increasing reliance on people who can fund their own care, mean that many care homes are under unprecedented pressure.

And now the possibility of large-scale provider failures is highly likely, and such a failure would jeopardise the continuity of the care on which many people with dementia depend. Unless the government addresses the chronic underfunding, there will be devastating consequences.

“Savings” have become very dangerous for dementia, cutting services and reducing budgets. That’s anything from closing day centres to carrying out fewer home visits.

Councils have worked hard to protect budgets, but dementia never ‘travels alone’, with more needing support and increasingly complex needs, fewer are getting help and councils are having to make unacceptable cuts.

The 1948 settlement – which established the NHS as a universal service, free at the point of use, and social care as a separately funded, means-tested service – is no longer fit for purpose. With so many people living longer with a mixture of needs that cross the boundaries of health and social care, the historic divide between the two systems is not in my view acceptable or justifiable any more.

The independent Commission on the Future of Health and Social Care in England in England, chaired by economist Kate Barker, was established by The King’s Fund to consider the case for change and how to ensure adequate funding to meet future needs. It suggested a radical package of measures to pay for this including tax reforms, limiting some universal benefits paid to older people and changes to prescription charges.

Adult social care and the future of dementia care are beyond doubt now at a crossroads. Social care is at risk of becoming a residual service available only to those with certain incomes and highest needs, leaving thousands of people and their families struggling to meet the costs of care

There’s now striking agreement that social care should be the immediate priority if any more funding is available, and this is desperately needed for dementia care.

 

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  • Thomas K. Wood

    Interesting article, a few more thoughts to throw in to the pot if I may.

    The figures invested by the government in ‘awareness raising’ campaigns around mental health and dementia, whilst perhaps not huge in the overall terms of deficits and GDP are quite vast in terms of choosing to back a tiny number of major charities whose ongoing gov’t sponsored work seemingly lacks evidence of improving the lives of the people they are targeted towards.

    It takes little searching to see an initial £2.5m being awarded to Alzheimer’s Society to build a campaign called dementia friends, with a further commitment of £4m from Public Health England provided to fund an advertising campaign for it. The press releases for this £4m from PHE invested in one media agency also mentioned a similar amount, possibly more, would be invested in the programme the following year. Cabinet Office have apparently backed the campaign too, though figures are not as easily spotted. They described DF as biggest public movement being mobilised since WWII.

    All well and good, 1.47 million dementia friends have apparently been created. But where is the evidence? In a world of open data, something cabinet office frequently champion, some basic data should be made available for all to see, if only to help promote the success of the campaign. As the deadline to create one million loomed, a remarkable increase in sign up rates seemingly occurred over a four month period. For future campaigns and those working in the field of health promotion, awareness raising, public health campaigns, demonstrating how this was achieved, in which parts of the country, which industries and the demographics of DF’s could surely be easily made available.

    What would equally be fascinating would be to see what impact dementia friends has had on people living with dementia and their families. 1.47million is not an insignificant number, even allowing for perhaps a 60% drop out rate post ‘training’, that should still provide some wonderfully robust data and insights as to how the biggest public movement is making a difference.

    What would also be interesting would be to ask those who have become friends, to post ‘training’ to explain what they saw their role to be and what they now feel able to do to assist people and families. Having personally worked with pwd for nearly 30 years, I’m still learning everyday, so find it concerning to hear people say ‘they have done their dementia training’ and have a badge for having done it.

    Dementia Friends could still be a very worthy campaign and activity, but what it needs to do more than anything right now is to openly demonstrate meaningful impact, not based on a survey of 500 or 1,000 friends or through some media agency’s info graphics but by producing accessible open data and ‘opening the books’ in order to help us all understand how we can tap into this huge, seemingly untapped resource of people who could make a massive difference to improving the lives of people living with dementia and their families.

    I’d also like to throw the same challenge over to Time to Change – recently awarded £20m of public funds when the £400 million promised investment in actual mental health services seemingly got forgotten.

    Maybe we should all approach the Gov’t with a marketing agency and an idea for a campaign for open data in campaigning, we’d surely secure a few million?