Guest blog

Blog – Rebalancing Gender in Dementia Care

Blog from Nathan Stephens

Reading Time: 6 minutes

Hello, welcome and thanks for checking out this blog. This is the second post of my monthly series on Dementia Researcher. In this post I attempt to unpack that big and complex topic that is males in care work, or more to the point the lack of them; and some key considerations in the area that are not just relevant to dementia care but to many workforces and society generally. This post was motivated by my experiences as a male in dementia care and by the belief that a more balanced workforce will better meet the growing need for care, but also address some of the deep-rooted issues that plaque society such as the gender pay gap.

This posts a bit of a wildcard and I am no expert here, so if I have offended you or am not politically correct, please contact me.

Better representation in workforces is a very real endeavour universally, check out the Gender Equality Policy Hub for key policies. However, dementia care and health and social care more generally is perhaps one area deserving of more focused interest and attention.

If you’re, or once were a young man working in care, I’m sure you’ll be used to explaining your place in a dominantly female workforce, perhaps being asked “why did you come into care?” and applauded by the fact that “you don’t see many lads your age doing it”. And they would be correct. Males make up a mere 18% of the 1.48 million people currently working in the social care sector, of which around 865,000 are care workers.

Of course, this is not the only workforce where gender can form the basis of a discussion, and in society more generally gender has become hyper visible. But what makes this debate so politically essential is the wider context in which it sits. This isn’t just a call for equity, it is a matter of need; and in real terms, peoples care needs being met.

There is a growing population of older people requiring care, and interestingly numbers of males aged 65 to 74 who live alone has increased 55% in a decade , making care provided by males more desirable. Also, the numbers of people living with dementia is forecast to triple by 2050, which, when considering there are an estimated half a million care jobs needed by 2030 alone, is all a bit worrying… A growing population adds pressure to an already stretched care sector, but it also has implications for the workforce.

Unsurprising then, this year’s Social Care 360 report from the Kings Fund recommends “workforce reform is essential” (I say that as though it’s never been an issue!), and, if ever there were a time for reform, surely that time is now? Demographic pressures, growing public concern following the injustice people face in COVID times, a social care system at breaking point, the list goes on. Now is a time of real social movement towards significant care reform whether the Tory’s like it or not; and I feel that at some intersection, I want, and am now questioning, to what extent can rebalancing gender in the workforce play?

A very big and complex question, and I have probably dug a fair old hole for myself, but it’s a question I find interesting especially as I am both a male in dementia care and self-proclaimed equalist.

What are the key considerations?

It’s in the name! Without returning to the time of cavemen the industrial revolution highlights a decisive and genderised change in the status of ‘work’ through the notions of productive and reproductive work, with productive being that of waged employment outside the home. Because care work is associated with ‘natural’ feminine attributes such as love and empathy, it was viewed as work suitable for females. This is based on the essentialist view that males and females have different characteristics which are inherently biological and has been significant in shaping the way different types of work is valued in society, and subsequently who enters labour markets and why. This social construction of gender roles has left an enduring legacy of inequality that has been continually and politically embedded into social and economic policy.

Of course, you need such personal qualities, but I have never been a fan of using the term care to define a role that is about so much more than just caring. By simply rebranding care work we can attract people of different gender, skill, and capacity. And interestingly, if we can attract more males to care, research suggests that “rather than seeking to imbue care with masculine traits, what will happen is a “crossing of gender boundaries” ; and that care work can loosen identity formations “opening new ways of being a male” .

Money matters! While care workers pay has increased in real terms through the National Living Wage it has failed to keep up with other sectors and we are now in a time when you can earn more cleaning, in a supermarket, or put bluntly, in any other job. In 2019 the average pay in the private sector for a care worker was £8.50 an hour and only around a 15p difference and hour for those that have worked 20 years or just 1! A disgraceful undervaluation of care work and one that fuels a growing gender pay gap. But what respect for all of us who have or continue to offer emotional, physical, and technical labour to ensure people live and die well.

I strongly believe that care work is not only emotional labour, but as I said, physical and technical labour too.

In the future, more and more carers will be needed to assist an ageing population, which means gender stereotypes will need to be challenged and overcome.

Yes, I provide trusted care, but I also operate personalised mechanical aids and assistive technology, make referrals across services, create and update support plans and risk assessments, and collect and manage personal information. To look at it as just physical is partial, and counterintuitive to efforts to change public attitudes of what actually defines care work. If replicated on a large scale in paid care work, reports in research of informal male carers redefining caring tasks as skilled and technical “emphasising care as professional work” could do wonders for the pay debate and be a vehicle for real social change by transforming gender relations.

Many commentators have called for a revaluation of care work over the years, but we are yet to see any significant change, with staff vacancies remaining at very high level and rapid rates of staff turnover, which in the jobs market is an indicator of how attractive an occupation is. Care work urgently needs fiscal stimulus to compete with other sectors! We will never move away from the gendered construction of care until we formalise and professionalise its practice to something that better reflects the real-world.

Anyway… this is beginning to become a longwinded post, and I feel as though I am firmly buried at this point so I will round it up.

So, will care work continue to be undervalued? Is the professional status of care work shifting? Will males continue to be underrepresented in the workforce? I’m not sure. But what we can be sure of is that carers make up 11% of the total UK workforce, 1 in every 9 employees. If we could have better gender balance here, then the impact would be huge across society and not only as a way to meet the needs of more people needing care.




Nathan Stephens

Nathan Stephens is a PhD Student and unpaid carer, working on his PhD at University of Worcester, studying the Worcestershire Meeting Centres Community Support Programme. Inspired by caring for both grandparents and personal experience of dementia, Nathan has gone from a BSc in Sports & Physical Education, an MSc in Public Health, and now working on his PhD.



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Nathan Stephens

PhD Candidate at Association for Dementia Studies, Worcester.

Working on the Meeting Centres Support Programme (see link below), specifically to understand regional approaches to 'scaling up' Meeting Centres nationwide.

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