England

A key feature of population ageing in Europe and other more economically developed countries is the projected unprecedented rise in need for long-term care in the next two decades. There is, however, considerable uncertainty over the future supply of unpaid care for older people by their adult children. The future of family care is particularly important in countries planning to reform their long-term care systems, as is the case in England.

The aim of this study was to help develop support services for carers of people with dementia on admission to a district general hospital. Qualitative methodology was used in the form of individual semi-structured interviews. These interviews suggest that service developments need to take into account the individual need of each carer. Identified themes included communication, vulnerability of the carers and the need to develop a therapeutic relationship with the carer as well as the person with dementia.

There has been a great deal of attention paid to young carers in recent research, social policy and service provision. In this paper we report on a survey and interview study of 46 young people aged 15 to 18, nine of whom had experience as young carers, to explore the ways in which young people construct the young carer and their disabled parent. A key theme arising from the interview data analysis is the construction of a series of normative assumptions about 'normal' childhood through which young carers and their disabled parent are viewed as non-normative and deficient.

This paper reports findings from a qualitative study concerning the influence of implicit models of mental disorder on shared decision making within community-based mental health teams. One-hundred participants representing five distinct multi-agency groups: psychiatrists, community psychiatric nurses, approved social workers, patients and informal carers operating within Leicestershire, England were interviewed using a standard case vignette describing a person whose behaviour suggests he may have schizophrenia.

Despite evidence of high psychological distress and unmet needs, evaluated interventions for informal caregivers in palliative care are few. This study involved an observational outcome evaluation of attendees, and a comparison group, in specialist home palliative care. The measures included carer psychological status and patient physical status at baseline, 8 weeks, and 20 weeks. Qualitative data were collected regarding content, satisfaction with, and impact of intervention. Process data described the uptake, resources, and group activity.

Objectives: To test the hypotheses that older people and their informal carers are not disadvantaged by home-based rehabilitation (HBR) relative to day hospital rehabilitation (DHR) and that HBR is less costly.

Design: Two-arm randomised controlled trial.

Setting: Four trusts in England providing both HBR and DHR.

Participants: Clinical staff reviewed consecutive referrals to identify subjects who were potentially suitable for randomisation according to the defined inclusion criteria.

Interventions: Patients were randomised to receive either HBR or DHR.

Aims: The worldwide phenomenon of an ageing population has considerable consequences for health and health care; leading to greater demand for long-term care and support from families for older relatives. In the UK this, together with the preference for dependent older people to be cared for in the community, has led to the growth of intermediate care services (ICS) that bridge hospital and home offering rehabilitation and care. However, there has been limited in-depth exploration of carer perspectives of these services.

Worldwide people with dementia are usually cared for at home by informal carers who may themselves have poor health and/or live in social situations which intensify their needs. The scale of these needs continues to be underappreciated and they are exacerbated by the limited social, cultural and emotional resources that carers can draw upon. This paper looks at the disparities in support, and the complex negotiations made by carers, as they reconcile the everyday realities of informal care in the home.

Yet further evidence has emerged of the huge number of young carers whose caring roles are not known to their school and who are therefore not receiving the support they need. Almost 500 young carers who were previously unknown to their schools were discovered during a project to offer young carers better recognition and support. The 35 schools taking part in the Young Carers in School programme reported a dramatic impact on the attendance, achievement and confidence of pupils who care for a loved one.

The Irish community is the oldest minority ethnic community in Britain. Despite an older age profile than general or minority ethnic populations, as well as excesses of mental and physical ill-health and socio-economic disadvantage, the age, poor health and social profile of the community is largely ignored by policy makers and providers. Several of these factors predispose the Irish community in England to a higher incidence of dementia. Unlike other minority ethnic groups with growing numbers of people with dementia, the incidence of dementia is already high.