Dementia

This article is not traditional social work writing, because it is in the form of a memoir. It offers a window into lived experience, from which most professional writing is more distant. It explores the last year of life of an elderly woman, seen through the eyes of her daughter-in-law, who is a social worker and social work educator. The article chronicles the day-to-day experiences of progressive memory loss and the challenges of caregiving. Social work can develop similar narratives of other life experiences that can increase its practitioners' understanding and wisdom.

SHIELD is a research programme which aims to reduce disability, improve outcomes, and enhance quality of life for people with dementia and their carers. This article looks at the aims of three projects within the SHIELD programme: Maintenance Cognitive Stimulation Therapy (MCST); an Experienced Carer Package (ECP) to support carers; and an intensive Home Treatment Package (HTP).

As clinicians often rely on carer reports to identify adults with intellectual disabilities (ID) with early signs of dementia, this study focused on carer-reported symptoms to ascertain whether carer reports of decline in everyday function would be a more effective screening method to detect possible cases of dementia than reports of memory decline in older adults with ID. Subjects were 154 participants who were reassessed along with their carers two to three years after baseline.

Background: People with dementia often die badly, receiving end-of-life care of poorer quality than that given to those who are cognitively intact.

Aims: To define good end-of-life care for people with dementia and identify how it can be delivered across care settings in the UK.

Method: In-depth interviews were conducted with 27 bereaved family carers and 23 care professionals recruited from the community, care homes, general hospitals and continuing care units. Data were analysed using the constant comparison method.

Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups.

Currently, 5.4 million persons in the USA are diagnosed with dementia, and this number is projected to rise to 7.7 million by the year 2030. Family caregivers provide up to 80% of the care needed by persons with dementia and published work suggests that caring for persons with dementia can be very costly to caregivers' health. This study examined the mediating and the moderating effects of positive cognitions on the relationship between caregiver burden and resourcefulness in 80 caregivers of persons with dementia.

The literature suggests that pain in the elderly, especially among seniors with dementia, is under-assessed and under-treated. This qualitative study solicited the perspectives of seniors, front-line nursing staff, nursing-home administrators, and informal caregivers of seniors with dementia on the current status of pain assessment and management. The views of these participants complement the research findings reported in the literature.

Woods and forests can enhance the psychological well-being with early stage dementia. In this article, the author reports on initial findings from a pilot programme of activities based in an urban woodland setting for people with early stage dementia. Activities included woodland walks, tree planting, nature photography, fire lighting and woodland cookery. Data were collected through observing the activities and interviewing the people with dementia, carers and staff at the end of the 10-week programme.

The paper examines the conversational and discursive processes that occur within domiciliary visits between community psychiatric nurses (CPNs) and relatives of chronically confused people. Three conversation formats are identified, through which talk between CPNs and carers is organised. In addition, various discursive practices are also identified within domiciliary meetings. The contribution of these conversational and discursive features to the work of CPNs is fully discussed in relation to what they accomplish within the visit. The data comprised 48 paired tape recordings.