As part of his first speech as Britain’s new Prime Minister, Boris Johnson stated that “We will fix the crisis in social care once and for all with a clear plan to give every older person the dignity and security they deserve“.
No matter your views about Boris Johnson’s capabilities as Prime Minister, or of politics in general, it is clear that social care is at a bit of a crisis point at the moment in the UK, and social services, care agencies and other care support services are really struggling to provide the right amount of support for everybody, when funding for these services have decreased and demand for them is getting ever higher.
However, where I personally feel the Prime Minister went wrong in this statement, and where many media outlets and others both within social care and in the general public also often get it wrong, is to assume that those using social care services are of pensionable age and nearing the end of their lives.
When searching for information about social care on the internet, images like the one above, or of a young person’s hand clutching an elderly person’s hand, are often found. They reinforce the stereotype that personal care and support is something that people won’t require until they are very old and that the role as a ‘carer’ is a medicalised one where they will make regular calls to complete physical tasks like washing, dressing and cooking meals, which will be the same for everybody, every day.
This is an incredibly old fashioned and institutionalised way of looking at social care, but unfortunately many tropes of this stereotype are still visable today.
As a 30-something adult, who was born with a disability and have had regular care support from various agencies in the last 10 years of my life, I still see the people supporting me being referred to as ‘carers’ (and I’ve ended up using that term myself as it is just so commonly used) when I find it is a word filled with conotations of the person being cared for as ‘vulnerable’ and unable to have control or make decisions in their lives – which does not describe how I want to live my life at all! Many younger people often refer to those supporting them (particularly when they employ them themselves rather than through an agency) as ‘assistants’ or ‘PAs’ which I feel are much better descriptions – they are people helping us to live our own lives, not doing things for us!
Also, many care agencies, including the ones which I have used, still require their employees to wear uniforms, not dissimilar from the ones nurses and medical staff wear in hospitals. Again, reinforcing the medicalised model of disability – “We are here to fix the problems your disability causes (e.g. not being able to dress yourself independently)” rather than “We are here to support you to live your own life as independently as possible”.
With agency care, you often have to manage seeing numerous different people supporting you with daily, often intimate, tasks where you might not be given prior time or notice to introduce yourself and explain your routines, likes and dislikes in detail. This can be incredibly difficult and stressful for both the person needing support and the person doing the task work. With little time, flexibility or continuity of support staff, it can lead to you feeling like you have little or no control over the most basic areas of your life as you are at the mercy of the support of others every single day.
In my opinion, the images and depictions of social care and the agencies and services often employed to carry out that work, are still incredibly back dated and need to change.
Image wise, things appear to be changing more in the fields of supporting people with learning disabilities and neurodiverse conditions such as autism, where more support is offered around going out to do daily activities, socialising and voluntary or paid work; and those employed to support are encouraged to wear their own, more casual clothes to help build a friendlier relationship. Many people who employ their own group of PAs or support workers also don’t insist on the formalities of a uniform.
However, within the categories of ‘home care’ agencies, which still provides a lot of support for people with mainly physical disabilities and elderly people, there sadly doesn’t seem to be as much visible change. In my opinion, much of this probably boils down to the increasing number of people requiring support from home care agencies due to an ageing population and a struggling social care system and NHS. This, together with the high turnover of care staff (often due to low wages, incredibly long working hours with little break time), probably makes it difficult for agencies to provide a good enough service as it is with the amount of people they have to support, let alone finding the time and staff numbers to make the system more personal and (to use a horrid social care jargon phrase) ‘person centred’.
I wish I knew exactly what could be done to improve the image of social care for new generations who probably won’t be half as willing to be treated like patients and medical cases in their own homes as many have been treated by the care system in the past. I know as a relatively young adult with (hopefully) years ahead of me, I don’t want to spend the rest of my life feeling I don’t have control over basic things such as when I can go to the toilet, or what time I can go to bed every night. Until the image of social care has changed and more of the population realise that disabled and elderly people can still play a productive contribution to society if we were given more control and choice over our own social care needs, and that we don’t want to be just sat at home waiting for someone to make us a cup of tea and a sandwich, then I don’t think much will be done to help us.