Flying Scotswoman

Mental Health Nursing,  May 2000  by Pollock, Laurence

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Mary Marshall was once `too frightened' to become a childcare officer but she took on dementia when it was deeply unfashionable. Laurence Pollock caught up with an angel of ageing at Paddington Station

She is effusively apologetic about being late for our appointment although it was the elements that delayed her flight from Edinburgh. Professor Mary Marshall is a tall imposing figure with an air of authority But her assurance is not based on purely academic achievement. She is a pioneer in the field of dementia who has worked both in research and teaching, on the ground and in the voluntary sector.

Just over 10 years ago she was appointed the first director of the first UK Dementia Services Development Centre, in Stirling. There are now five DSDCs in the UK and others are under development. Two more have been established in Norway and the Netherlands.

Networked and committed to a set of core principles, they provide services and information, consultancy and research, within their geographical areas. The target is service commissioners and providers, not front line users. The centres were joining up thinking, years before anyone in the present government dreamed of the idea. They are committed to improving the lives of those with dementia in a measureable way.

It is a long way from the attitude to dementia which prevailed when Marshall was first involved in the early 1970s in Liverpool.

"When I became interested in dementia people thought I was bonkers. There were low expectations which involved keeping people `comfortable and clean'. For me, working with dementia is the most intensive and interesting field you could be in."

Ironically, she began her professional life as a childcare officer in the London Borough of Lambeth. Quite candidly she acknowledges she was `too frightened' by the role: "You were making and breaking families in a way."

Thirteen years in Liverpool followed beginning as a social worker attached to a GP practice, organiser of an Age Concern project on the discharge of elderly people from hospital and lecturing in applied social studies at Liverpool University Her beliefs were honed by a sabbatical in Australia where she saw a social model of care in action well before it appeared in the United Kingdom.

"I was fizzing with excitement and coming back to teaching social work was pretty boring."

In this mood the link to Age Concern became more explicit and she was appointed director of Age Concern, Scotland. It was a return to roots of a sort. Both sides of her family were Scottish but had relocated in previous generations to India and Argentina. She herself was born in Darjeeling but educated at Edinburgh University.

It was also formative for her immersion in campaigning issues: "All sorts of issues were coming at us from fuel poverty to housing and income tax. To cope with this we decided we would have annual themes starting with dementia in 1985.

"A conference to plan it the previous year led to the birth of Scottish Action on Dementia. There was a huge source of rage and frustration at what was available but Scotland moved very fast after that. The Scottish Health Service gave carers a top priority in the late eighties, early nineties - something that could not happen in the UK as a whole because the NHS is too big to have one overarching priority.

"In Scotland we are very collaborative - you cannot fall out with each other because you are likely to meet someone the next week with a different hat on."

She is particularly pleased at the development of the Scottish Parliament: "It is very exciting, we now have a feeling we are doing it our way."

Marshall was an obvious choice when Stirling University took the initiative to set up the first Dementia Service Developmnent centre in 1989. It was an obvious step for such a well connected and accomplished researcher (she has a huge publications list), teacher, practitioner and campaigner - allowing her to pool her skills and energy.

When we met in Paddington station she was en route to a DSDC network meeting. "That woman in the corner (of the cafe) is from the Bristol centre," she remarked, as if the whole of the dementia world was floating around the concourse.

Perhaps it's like that when you are as gregarious as Mary Marshall. Her work keeps her travelling, mostly throughout Scotland and she says she lives in her car. She would be in Dumfries the next day doing a conference. After that she could be meeting students, reading and lecturing and subsequently going into residential homes and day centres. For many fifty-somethings it might be a hard grind but there is a strong optimistic streak, verging on the visionary which seems to drive her on.

"Dementia is one of the most exciting areas to work in because you are charting new territory, things are getting better. For me it is endlessly rewarding."

There is no `mega message' however about tackling or preventing dementia. She observes that those who age most effectively are the ones who complain: "The first source of knowledge is yourself."