Britain’s largest philanthropic supporter of dementia care research talks about why the search for a cure needs more money.
Talking to Laurence Geller CBE is like being hit by a whirlwind. After a business career that started in hospitality, he is now the country’s largest philanthropic supporter of dementia care research and determined to improve the lives of those who suffer from the disease.
Not only is he chief executive at dementia care provider Loveday & Co, he is also chancellor of the University of West London where he founded the Geller Institute of Ageing and Memory (now the highest rated dementia research organisation in the UK and Europe) and the Geller Commission.
Here, he talks passionately to Healthcare Today about the need for investment in dementia research, why we need to look at dementia care in the UK and why he refuses to settle for mediocrity.
Dementia has been many times described as the defining medical challenge of our time. What, in your opinion, makes it so urgent and so under addressed?
Dementia is a profoundly destructive disease – not just for the individual, but for everyone around them. It is always fatal. It destroys far more lives than just the one affected. The emotional toll on loved ones and carers is immense. Unlike some other conditions, dementia erodes a person slowly, and everyone responds differently to the disease. That unpredictability adds to the burden on families.
What makes it urgent is that we have an ageing population. As longevity increases, so too does the risk of dementia. The Alzheimer’s Society often highlights that one in three of us will develop dementia – a statistic that is probably accurate and rising with age.
But the level of investment in dementia research is startlingly low. Just 20-25% of the funding that goes into cancer research is allocated to dementia. Only recently have major pharmaceutical companies begun reinvesting – there are now, I believe, around 16 to 19 promising trials underway – but even these focus on addressing aspects of the disease rather than offering a cure.
What is Britain or what are countries that are dealing with this getting right?
We – along with countries like New Zealand and Australia – have a better chance of tackling dementia on a national scale than the US. The US doesn’t have a centralised health system, and many aspects of healthcare are devolved to individual states. Having said that, the US does invest more than any other country in pharmaceutical research. When it comes to potential cures, or at least treatments that can delay the disease, they are ahead.
In the UK, though, there’s a major problem: fragmentation. Organisations have historically worked in silos. Until we brought them together through the Geller Commission, there wasn’t even a formal forum for them to talk to each other. Fundraising is similarly fragmented, and much of it is focused on cure rather than care.
That said, I do think the UK is getting some of its research priorities right – particularly when it comes to identifying what can be done around early diagnosis and testing. There is momentum. Many in government see dementia as a national imperative – even if it’s one of several.
“People with dementia are often in the wrong place, receiving the wrong care at the wrong time.”
Does AI play a significant future in dementia care? Or is it diverting us from what we should be doing.
If you look at what’s happening in hospitals, there are no standardised diagnostic tools, no agreed treatment protocols, no clear admission or discharge criteria for dementia. We’ve developed some good practices in individual places – the work of the British Geriatrics Society, for example, is excellent – but they haven’t been adopted nationally.
The consequence is that people with dementia are often in the wrong place, receiving the wrong care at the wrong time. It’s bad for them and bad for the system. It’s also incredibly expensive. We’ve costed it at Loveday, and our high-end model works out at about £120,000 per bed per year. That level of care is appropriate for some people, but 70% of those beds are filled with people who don’t actually need that intensity of support – they’re there because there isn’t another option. It’s a waste of money and of human potential.
That’s why we’ve invested so heavily in monitoring and technology – not just for efficiency, but to improve care and reduce avoidable harm. At Loveday, we use acoustic sensors, pressure mats, in-ceiling monitors and discreet CCTV to track night-time activity. We can tell if someone is snoring more than usual, if they’ve left their bed, or if they’re showing signs of incontinence. That data is reviewed every morning by a team and allows us to adjust each person’s care plan daily.
The next step is to feed that data into AI systems that can identify patterns and predict problems – for example, spotting the early signs of a urinary tract infection, which is one of the most common reasons people end up in A&E. We’re working with UCL in London on this, and our hope is that eventually, we’ll be able to offer the same technology to people in their own homes.
Why did you set up the Geller Commission?
My original hope for the Geller Commission was that it would change the world. When we looked seriously at what could make the greatest difference to the nation, it came down to money. Specifically, how money is being wasted because of a lack of system-wide coordination in dementia care.
At the moment, too many people with dementia end up in hospital not because they need acute medical care, but because there’s nowhere else for them to go. What they really need is well-structured, consistent care. We’ve seen at Loveday that people live longer and avoid hospitalisation when they’re cared for properly. If we could stop even 10% of avoidable admissions, the savings in bed nights – or more accurately, bed years – would be staggering.
“What we desperately need is the same level of passion and structure that is seen in nursing for carers.”
What changes do you think are needed for caregivers to meet the growing demand?
What I want – what we desperately need – is the same level of passion and structure that is seen in nursing for carers. That means national standards and recognised educational pathways. It means turning care work into a career, not just a stopgap.
At Loveday, I pay my staff more than the average. We provide better working conditions, and we experience far lower turnover as a result. Why? We’ve created a more humane environment, and that starts with valuing the people who work in it.
But this needs to be system-wide. We need structured roles – junior carers, senior carers – and clear career progression. One size doesn’t fit all. That’s where education is so critical, and yet getting national standards in place has been one of the hardest things I’ve ever tried to do.
How do you ensure that the research conducted at the Geller Institute of Ageing and Memory translates into actual improvements in care homes or community care?
I wish I had a neat answer for how to bring about change – but let me give you an example. I used to be quite a good schoolboy rugby player and played at national level.
During the pandemic, Oliver Dowden, the then secretary of state for sport, called me and asked me to work with civil servants to create proper, consistent concussion protocols. At the time, decisions were left to referees, but we already knew that repeated concussion could lead to dementia. That was the link to my work.
We brought in the devolved nations, worked with international experts and collaborated with all the key government departments and sporting bodies.
Getting the protocols adopted across professional sports wasn’t easy. But ultimately, the professional game has the infrastructure to support such changes and they did take it on.
Since then, other countries have followed. Australia has adopted similar protocols; New Zealand has them; Canada is discussing them; and various sporting bodies in the US are now looking closely at our model.
Do I think there’s a single method to get things done? No. There’s no template. What it takes is passionate leadership, relentless lobbying, and the courage to put your head above the parapet.
“I believe strongly in the need for leadership. You can’t have just soldiers – you need generals too.”
How should the care industry be interacting with the NHS?
Above all, it’s about refusing to settle for mediocrity.
You need people who are willing to stand at the front, take risks and lead. You need people who will put their heads above the parapet. That’s what leadership is. And in this work, it’s not just passionate leadership – it’s compassionate leadership too.
Of course, it also requires money. Fundraising is vital. Over the years, I’ve not only raised funds – I’ve also given away a large portion of everything I’ve earned.
The future lies with people like me – and, I hope, with a new generation of people far better than me. People better educated, with more intellectual scope. I’ve never been afraid of failure, and I don’t feel any shame in trying and falling short. But I believe strongly in the need for leadership. You can’t have just soldiers – you need generals too. You need planners, risk-takers, people willing to be mocked, to lose money, to be shouted down, even thrown out of government offices.
I know it might sound idealistic. I am, without apology, a naive, utopian optimist. I’ve never been embarrassed to say that. And I will never stop trying. Because if not me, who? And if not now, when?
It really is as simple as that.
