Dementia is the national emergency we refuse to look in the eye. It now accounts for one in nine deaths, claiming 76,000 lives a year in the UK. Yet despite its scale, dementia continues to sit in the shadows of health policy - underfunded, misunderstood and deprioritised. As a leader in social care and someone supporting a close family member with dementia, I see first-hand the family stress and frustration this neglect creates.
At a time when the Casey Commission is examining the future of health and social care, there is a real opportunity to change course. It is encouraging to see dementia recognised as a core priority. If handled properly, this could be a turning point - but only if that focus translates into sustained action on diagnosis, support and research. We stand ready to support that ambition. And as a business we know full well the urgency of the task is clear.
Our latest New Ageing Index shows dementia has become the fear of our times. One in three adults (31%) now say it is the disease they fear the most. For family carers - the people who live this reality every day - that figure has risen sharply from 27% to 31% in just twelve months. Over the same period, fear of cancer has fallen from 30% to 21%. This shift tells a powerful story. Decades of investment in cancer research, early diagnosis and treatment have improved survival and instilled hope.
Dementia, by contrast, still feels intractable. It progresses slowly, unpredictably, and for many families, including my own, steals the person you love in ways that are emotionally shattering. And unlike cancer, there is no national screening programme pushing to improve early diagnosis.
Our research also shows more than two in five (43%) of people supporting a relative with dementia now say they have left employment to do so - up from 37% in just ten months. I see this not just through the data, but through the families we support every day at Home Instead. And it is not just us sounding the alarm.
Every week brings new headlines and new warnings from the Alzheimer's Society, Age UK, the Care Quality Commission and others outlining a crisis growing unchecked. Dementia is devastating thousands of families, draining our workforce and putting unsustainable pressure on social care.
Despite this, dementia was quietly deprioritised in NHS planning last year, when the national dementia diagnosis target was removed from operational guidance. In one stroke, the system signalled that dementia no longer required focused management attention. This is a serious mistake. You cannot improve diagnosis, treatment or support for a condition that is no longer measured or driven through national planning.
So why, when the need is so great, are we not doing more? Part of the answer is uncomfortable. Ageism plays a significant role. Research funding often follows public sympathy, and society pays less attention to diseases associated with older age. The impact of this is devastating for families trying to support loved ones living with the disease.
For those navigating dementia at home, the sense of being overlooked by the system is deeply felt. The Care Quality Commission's extensive review last year shows England's health and social care system is fundamentally failing people with dementia, with widespread poor-quality state care, severe staffing shortages, and a lack of mandatory dementia training leaving many unsupported and unsafe
Cancer - which impacts people of all ages - is tackled far more effectively. It carries a narrative that mobilises public emotion and political will. Dementia does not. There are no survivor stories, no triumphant breakthroughs, no ringing public campaigns that galvanise government action.
Fundamentally, the playing field is not level. We are not pitting one disease against another; cancer devastates lives and deserves every penny it receives. But decades of sustained investment mean that with early intervention, many forms of cancer are now highly treatable. Dementia research, by contrast, has lagged behind. Promising new treatments are emerging, but the science is still underfunded and under-prioritised.
Dementia has an enormous financial impact on the whole of society. It already costs the UK £42billion a year - rising to £90billion by 2040 - yet most of this burden falls outside the NHS, absorbed in lost earnings, unpaid care and wider economic disruption.
Because these costs sit largely beyond the health system, they generate far less political urgency than pressures visible on hospital balance sheets. Cancer shows up in NHS budgets and waiting-time targets; dementia shows up in reduced workforce participation and rising economic strain, consequences that are hidden and far too easy for policymakers to ignore.
This is why dementia remains the health system's most neglected major condition.
But it cannot remain that way. We urgently need a national reset: dementia must be prioritised in NHS planning guidance, government must commit to research funding that matches the scale of the crisis, and we need a truly joined-up national dementia strategy that bridges health and social care rather than leaving families to navigate a fragmented system alone. How we support people with dementia is a test of who we are as a society.
As someone who has seen the personal cost of dementia up close, I know we cannot keep asking families to sacrifice their livelihoods, health and futures because the condition has been allowed to slip down the national agenda.
Dementia is the defining health and economic challenge of our ageing society. The government must act - not in five or ten years, but now. Every day we wait, more families reach breaking point.
