by Gerry Nosowska, Member of the College of Social Work’s Adults Faculty
This week the Association for Directors of Adult Social Services (Adass) released new figures which suggest that rising eligibility thresholds mean around half a million people who would have qualified for social care support five years ago are no longer entitled to receive it.
This huge and growing gap between need and resource is made all the more urgent by the fact that approximately 60% of users of local authority services are older people, and that this demographic is set to surge over the next 15 years. By 2030 the number of people in Britain aged 85 and over will have shot up by an incredible 100% since 2010, and those aged 65 and over will have increased by 50%.
Longer, older age is something to be celebrated, however the resulting pressures on services will already be familiar to many social workers. Older people’s needs are affected by factors from their whole life. Poverty has a massive impact: a woman born in Glasgow can expect to live nearly 12 years less than one born in Kensington and Chelsea.
Older people experience age discrimination, including limited involvement of social workers. Many have multiple health problems and the number of people with dementia is growing. Loss and transitions, including end-of-life, are part of ageing. A third of all carers are above pension age. Older people are the largest group of recipients of safeguarding from neglect and abuse, including institutional abuse.
Despite this, policy makers appear to be slow to grasp the scale of the change. Last year a House of Lords committee criticised the government for lacking any coherent vision and strategy to meet these demographic challenges. The committee was particularly forthright about the current state of the healthcare system, and argued that without radical changes in the way that health and social care serve the population, needs will remain unmet and cost pressures will rise inexorably.
It is important that social workers speak up on behalf of the older people they work with every day and advocate for urgent action from whoever ends up in government next year. The College of Social Work has already taken important first steps and published a vision for social work with older people. Written by eight gerontological social work academic experts, the paper argues that social work has a key role in enhancing the quality of life and wellbeing of older people and their families while promoting their independence, autonomy and dignity.
Under the Care Act 2014, promoting wellbeing for adults and carers, preventing needs, providing information and advice, working with other agencies, strengthening safeguarding and advocacy will all require the capabilities that social workers have, particularly in complex situations. The number of adults, carers and self-funders requiring assessment will continue to increase, and social workers will be able to make judgements about what an appropriate and proportionate response looks like.
Social workers have the legal knowledge, skills and values to support people who have limited or no capacity to make decisions, to promote best interests and to manage disputes. They can mentor and support other staff. Using social workers well will improve the experience and outcomes of older people, and help councils to discharge their duties effectively and efficiently.
Changing demographics will also bring opportunities. Social workers have the skills to help older people build on their strengths and, while this may help reduce social care needs, it may also benefit other areas. This could include older people supporting childcare or volunteering in the community to ensure that other care users aren’t isolated. Social work involves looking for creative solutions and overcoming discrimination to ensure that people can contribute.
The College of Social Work’s adults faculty, of which I am a member, is looking to build on our vision paper. We are currently drafting a manifesto that sets how we might support social workers to enhance social work with older people. We want social workers who work with older people to share their expertise and evidence, to advocate for the importance of their work, and to inspire others through showcasing what older people value from social work.
The manifesto will therefore set out how social work can enhance social care with older people, and how it can be strengthened through practice, research and policy. This reflects the roles of social workers as practitioners, social scientists and professionals that the Croisdale-Appleby review of social work education emphasised. The manifesto will emulate the work of the mental health Faculty on the role of social work in mental health launched earlier this year. In the next few months, we will be sharing our ideas with social workers and asking them to get involved in making social work with older people more valuable and more valued.