Adams, Trevor

This paper critically examines the trend within dementia care to focus either on people with dementia or their informal carer. Attention is given to the alliances and collusions that may develop within triads comprising people with dementia, their carers and dementia care practitioners and the implications for this upon the distribution of power. The paper outlines an inclusive model of dementia care in which the needs of the person with dementia, family carers and the dementia care practitioner are understood in terms of inclusion.

In this second of two articles on community mental health nursing in dementia care, John Keady and Trevor Adams review published accounts of the CMHN role in work with people with dementia and their carers, and suggest a way in which the role might develop in future.

Describes the relocation of dementia care from the institution to the community, the development of person-centred care and its emerging critique leading to the development of a more systemic approach taking into account the sufferer and family and paid-for carers. Discusses developing an inclusive model and dementia care and society.

This article develops an approach towards dementia care that highlights the nature of dementia care triads comprising the person with dementia, their informal carer, and the health and social professional. In particular, the article highlights various social practices that are shown, from our practice, to contribute towards the inclusion or exclusion of particular triad members. The article reviews existing work on triadic interaction, particularly in relationship to dementia care. Various communication processes are identified and illustrated using examples taken from casework.

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.