Models

Background: Family caregivers of persons with dementia often experience a negative impact on their health. More studies based on nursing theories are needed to improve the provision of care. Aims: To describe the care provided by family caregivers of persons with dementia and the impact on their health, as well as to analyse how personal variables of caregivers are related to care tasks and their health impact.

Projection models enable users to assess the costs and benefits of changes to long-term services and supports policies and to compare policy options, using a consistent set of underlying assumptions. Outlined are key challenges model developers face, including data limitations, difficulties anticipating potential behavioral responses, the need to assign appropriate benchmarks, the value of family care and intangibles like autonomy and quality of life, and grappling with uncertainty.

The present article explores professional attitudes to family members supporting an older person newly diagnosed with dementia. It draws on professional perspectives derived from a series of 24 multidisciplinary workshops held in the UK, analysed using a typology developed by Twigg in 1989. The primary care workers' understanding of carers' needs and circumstances fitted best with Twigg's models of carers as resources and co-workers, but showed limited awareness of carers' responses and attitudes to caring.

This paper reviews recent research on care-giver networks and the concepts and approach that they apply, with particular reference to the support networks of the primary care-givers of older people with Alzheimer's disease. It makes the case for an integrated approach to the explanation of the various combinations of formal and informal support that are found. It argues that more attention needs to be given to transformations in care-giver networks over time, and that this will require more development of both theoretical perspectives and analytical tools.

The authors review current research on provision of services to older people and their carers in remote and rural areas across the UK, with specific reference to Scotland. They consider the policy implications for dementia services in this context.

Staffordshire's Welfare to Work Joint Investment Plan is an inter‐agency approach to improving job opportunities for disabled people and carers, emphasising the need for their participation in this process. A partnership with Staffordshire University has enabled disabled people to acquire research skills and survey the views of other disabled people on barriers to employment and strategies to overcome them. The article shares this innovative approach to participation and welfare to work.

Much confusion still surrounds the concept of empowerment and how it is to be translated into practice within the context of community care for service users and carers. A major limitation has been the tendency to treat empowerment as synonymous with participation in decision-making with little attention given to the ‘ecological’ model of empowerment where linkages have been found between community participation and measures of psychological empowerment.

Objectives: This review aims to explore the role of self-efficacy (SE) in the health-related quality of life (QoL) of family carers of people with dementia.

Methods: A systematic review of literature identified a range of qualitative and quantitative studies. Search terms related to caring, SE, and dementia. Narrative synthesis was adopted to synthesise the findings.

SPECAL is a person-centred approach to the care of people with dementia which could also have the potential to reduce carer stress and lead to improvements in quality of life for people with dementia and their carers. The approach prioritises meaning over detail. It has 'three golden rules' for the care: do not ask direct questions, learn from the expert by listening and discovering what is important to the person with dementia, and do not contradict. This article describes the origins and rationale of SPECAL.

Hilary Arksey and Claire Bamford report on the first stage of a two-year national study of respite care and short breaks for people with dementia and their carers