The growing crisis in dementia care
There is no doubt that there is growing urgency to address the impact of dementia: the media regularly report on the increasing number of people facing it. This year in the UK alone there are 850,000 people with dementia but the problem is growing worldwide.
This urgency has reached the radar of the G7 nations and in March this year the World Health Organisation held its first Ministerial Conference to look at the issue. However, most countries are a long way from really addressing the growing impact of dementia and in particular the impact on women.
More women than men develop dementia. After all, dementia, like many other conditions, is more likely to affect older people. The impact on women is even greater because a large proportion of carers are women: our care home, hospital and home workforce is predominately female. Also two thirds of family carers are women.
A report published earlier this year by Alzheimer’s Disease International looks into the main issues from an international perspective. Women and Dementia A global research review, looked at all the current English language research and policy on women globally. It can be found here along with a helpful summary.
As someone who has worked in healthcare and research for 30 or so years, both in the UK and Botswana, a number of findings resonate with me personally.
The first is just how little research there is into the impact on women. Only 22 papers were found that related directly to women and dementia, and a further 38 looked at wider gender and dementia issues.
The report found that most of the research has been carried out in high-income countries. Yet by 2050 over 70% of people living with dementia will be living in low- and middle-income countries.
The review also found that little of the research actually asked women who had dementia about their experience. Most of the research came from care givers or clinical information. Also very few reported on the long-term impact on women, particularly as family or formal care givers.
Another factor that interested me is that at least some education helps to protect against dementia by promoting intellectual development. A report from Nigeria showed that primary education protected against dementia and yet still in many countries girls are far less likely to attend school.
There remains a cultural expectation that women will take up the role of family carer: they make up two thirds of informal carers. As well as the impact on physical and mental wellbeing, caring can often carry a financial penalty if there’s a need to take unpaid time off or reduce working hours to meet commitments.
Another stand out feature is that women make up a higher proportion of the dementia workforce (87%) than in general care, where three quarters are women. They receive less training and gain fewer qualifications. There is already a significant pay gap for people working in health and social care, with women’s hourly earnings 10% lower than men’s.
The report makes a number of welcome recommendations. The most significant is that caregiving needs to be seen in the context of gender issues, as men and women react and cope differently. Therefore services, professionals and policy need to acknowledge and reflect these differences when providing physical, emotional and other support.
We must prioritise not just finding treatments and cures for dementia, but also taking care of the armies of family carers. It is vital that the workforce and carers supporting people with dementia are recognised for the important work they do, both by good training and appropriate remuneration.
Read about Fawcett’s role in a new care crisis Commission
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