Background
to the
Research
- Over the last decade there
has been a growing body of research relating to dementia, some of
which focuses on people who live alone. However, few studies focus
on the area of risk associated with the subsection of people living
alone with dementia.
Research
Approach
- The current research selected 33 out of
69 people living alone who had been identified in a study carried
out earlier in 2003. Using data from the Social Science Computer Package,
the next of kin, social worker (or social worker assistant), district
nurse and GP were interviewed using a semi-structured interview schedule.
CarenapD was used to gather background information on the needs of
people with dementia living in the community and their carers.
Main
Findings
- The 33 people living with dementia had
a Global Deterioration Score of 4-5, indicating that the degree of
dementia was 'moderate or moderately severe.
- One year on, of the 33 people who lived
alone only 11 remained living in their own homes in the community,
2 had died, 6 now lived with relatives and 14 had moved into residential
or nursing homes.
- Of the 11 living alone, 2 men and 8 women
with dementia were included in this study; their average age was 83.3
years (age range 74-93).
- Five people lived in a main town, 3 in
villages and 2 in remote country areas. All but 2 had family living
within the same geographic area and had daily contact with them. Nine
had care packages managed by social workers employed by local social
services. Six had been comprehensively assessed and were care managed.
People with dementia
- Six people indicated frustration with their
memory and the majority appeared accepting of care staff involvement.
- Many people's comments indicated a desire
for structure and meaning to their daily lives and some expressed
appreciation of family support.
Family carers
- All of the family members indicated that
these people faced risks, the main types identified were dealing with
heating, falling, managing money, road safety, getting lost and cooking.
Care staff
- Care staff tended to emphasize the importance
of locality in terms of assessing and managing risk; people were felt
to be at less risk because they knew their local areas well and were
well known to members of the community in their local areas.
- Care staff appreciated that other professionals
accepted a level of risk existed where people lived alone with dementia.
General practitioners
- All GPs indicated that the person with
dementia ideally should remain in his/her own home, despite the risks
posed.
District nurses
- Falling was the most common problem identified
by nurses, adequate nutrition for their clients was a concern for
3 of the nurses. Some nurses were keen to establish rules about risk
management.
Social workers
- Social work staff echoed the types of risks
raised by family members. Some social workers indicated a lack of
communication/trust between themselves and family members.
Conclusions
- The research points to the invaluable and
often unacknowledged contribution of family members, neighbours, care
staff and members of the community in supporting people living alone
with dementia. Future development of services should take these into
account.
- The study emphasizes the importance of
close working together within primary care in relation to assessing
and managing risk; developing the social work attachments to primary
care may help this.
- Additional resources invested in training
and staff development may be necessary to attain skill and confidence
in order that all interested parties may work together more effectively.
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