Professor June Andrews is a recognised leader in the world wide movement to improve services for people with dementia and their carers. Care Talk caught up with Professor June and asked her about her career in social care, her thoughts on the current challenges and how the sector can come together to improve care provision for people living with dementia.
On reflecting on “my career in social care”, I have never actively intended my life to be this way so it never felt like a career.
It has been a journey through learning and work, but not ever actively managed. After a degree in philosophy and English, and time in telephone sales, I became a psychiatric nurse because I lived near the hospital and there was nothing much else on offer. But almost at once, I was hooked, and have stayed a nurse to the marrow of my bones ever since. Even now, as an independent consultant, whether I am talking to a government, a social care organisation or a family, in the UK or beyond, it is the nurse who is speaking. The basics of living well with illness and adversity are at the core of everything that matters to me.
I recall the things that concerned me when I was training, and no matter how gloomy the headlines, things are truly better now. I trained in a huge asylum, Mapperley Hospital in Nottingham, and my last NHS job in England was in another that was being closed, Long Grove in Epsom. All gone. I was a ward sister in a geriatric ward where the length of stay was sometimes nearly three years. Never again. I did an apprenticeship style training as a nurse at a time when you instinctively hid the fact that you were university educated, just to fit in. Not these days. So much has changed.
The current challenges in care of older people are spoken of again and again. We get told that the number of frail older people and people with dementia is increasing. Most of the money on health and social care is being spent in the last few years of life, sometimes with little impression on the quality of that life. It always sounds like gloom and doom, when we should really be celebrating. Old people in many cases are having much more fun for longer than their own parents or grandparents did. And many of them, because of pensions, and house price increases, have resources to care for themselves. They’re often better off than previous generations.
My concern for the future is that there will be old people who are much poorer, in greater numbers, than we have seen for generations. The pension pot is shrinking. Many older people now can sell their home which inflated in value in their lifetime to pay for care, but what about those who follow who never will have managed to get on the housing ladder? The resources through taxation that are available to pay for care are getting less. We do know what is happening up and down the country as care businesses fold because the local authority funds for care are just not enough to keep them going. Family top ups are increasing where families have any money at all, and if not, the outlook is bleak. How long before we reach the situation quoted in Beijing, China, where there were more than 10,000 applicants for the 1,100 beds in the capital’s No. 1 Social Welfare Home in 2013?
My vision for the future is a place where the responsibility for care of older people in the UK is going to continue to move from the State to the family. Most of us are unaware of the extent to which this has already happened. So, my role, for the present, is to work as hard as possible to help families to work out how they are going to cope.
Professor June Andrews FRCN, is the author of Dementia the One Stop Guide; practical advice for families, professionals and people living with dementia.