Whose responsibility is adult social care? Is it the family? Is it the state?


Whose responsibility is the care of older adults? Is it the family? Is it the state? Is it the older person herself? How should we respond ethically to the needs of an increasing older population with fewer younger people available to deliver care?


These and other related questions were the focus of a three-day research meeting at the University of Surrey. The meeting is part of an international networking project funded by the Wellcome Trust and is led by Professor Ann Gallagher at the University of Surrey and Dr Michael Dunn at the University of Oxford in collaboration with Professor Yonghui Ma, Professor Zhaoxu Xu and Professor Ya Fang from Xiamen University, China.


The research meeting focussed on case studies developed by the team relating to residential and home care in China and the UK. The case studies focused on ethical challenges for older people and families in negotiating roles and responsibilities. Commentaries were invited from experts across 11 different countries including from the UK, Hong Kong, Singapore, Canada and the USA. During the three-day networking meeting, experts discussed the case studies and broader issues of philosophy, policy and practice as they concern the future of caregiving for older adults in different parts of the world.


Day two was devoted to public engagement, with local caregivers and family members joining with the group of international experts to share their perspectives. The international group had the opportunity to learn about one of the best places to age in the UK with a visit to historic Whiteley Village. The day ended with an innovative immersive theatre performance by the Entelechy Arts Company. This performance enabled international experts and the public to engage with the question ‘Whose responsibility is the care of isolated elders?’. The company is recognised for its pioneering programmes of work supporting the creative and social inclusion of isolated older people.


One participant said: “I thought the performance was very impactful, mainly because it felt ‘real’. I felt slightly awkward in the interactions with the actors because some of the stories were quite emotional, and I did not know to what extent the actors were drawing on personal experiences or the experiences of people close to them”. Another said:  “One of the main things I gained from the performance was a reminder of what really could make a difference for isolated elders:  reciprocal relationships and connection.  It was interesting and rewarding to listen to the stories of the actors and it brought to my mind the challenges within nursing of creating the time to sit and listen when there were so many pressures to “do”.’ A third said: “The performance was both enjoyable and disconcerting at the same time.  I remember the first thing that ‘Iris’ asked me was to help her with her medication and I thought, help, I’m going to do the wrong thing here!”


A panel discussion, chaired by Ann Gallagher, followed the performance with panel members: Mikey Dunn from Oxford University, Jean Woo from Hong Kong, David Slater from the Entelechy Arts Company and Jonathan Essex from the Green Party.


An audience member commented that: “The panel discussion was also good. It was great to have such a diverse panel, and some important points were made. It was good to have the input of ‘lay people’/service users in the audience’. It was pointed out that there is ‘a tendency to view elders as homogenised ‘others’ and to deny ageing as a natural part of the lifespan.’ There was also a focus on the value of volunteering with reciprocal benefit.”


Day three of the networking meeting was devoted to agreeing to the next steps for the project. Ann Gallagher, Professor of Ethics and Care at the University of Surrey, said:


“We’re delighted with the quality of cross-cultural exchange and insights gained during our time with international and local experts. We’ve also seen, at first hand, the value of the arts in facilitating reflection on important topics. We’re looking forward to developing publications from the project and to attracting new funding to take this work forward.”


  1. I will be very interested in seeing the results from the project.

    However, I would also be interested to be advised why it seems that all care is for the elderly and why it is presumed that the elderly person requing care will be female.

    Caring can and certainly is a need for everyone, irrespective of age and gender.

    This could be children with physical and/or intellectual disabilities or adults of any age.

    As to who is responsible for adult social care that all depends on the circumstances.

    Each and everyone of us should be responsible for our own care, that is if we have the capacity and ability to do so. As to the family, most families will care for their relatives and do so until they themselves are not able to.

    So eventually the state will have to undertake the reponsibility and in some instances sooner than others.

    Caring is working togethe.

    It is therefore essentual that the state is more than competent do undertake this responsibility and be there whenever they need to help with the care.

    Financing is essential and therefore the Government needs to fund all the respective authorities fo they can do so. We also need a competent care profession which again is suitably funded and that they provide good quality care, which can not be achieved on a ‘shoe string’, which is currently the case.

    Unfortunately with Government austerity cuts virtually all the authorities are far from capable to do so. This in turn is bringing more problems for an already over stretched NHS.

    The petition – Pay all employed carers the Living Wage.

    This is what I have been saying regarding the Petition

    ‘You may be aware of some of the problems with Social Care and the Government’s austerity cuts to Local Authorities and how this is affecting care services.

    So, may I advise you about the petition – Pay all employed carers the Living Wage.

    Please support the petition


    For more information please see https://www.dropbox.com/s/zl0iyfa75tz1oth/Living%20Wage%20Petition%201.docx?dl=0
    Hopefully this will inform the Government and in doing so they will increase the funding to local authorities. These authorities can then contract to Care Service Providers on an increased rate so they can then pay their care workers at least the Living Wage, currently 9.00 per hour, outside of London, London being 10.55 per hour.’

    This petition is just the start as is paying all care workers the Living Wage, for good quality care needs to be achieved in all instances of care and then be sustained.

    This is going to be a long, long road to cover, but if we all work together it is achieveable

    Thank you



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