The focus of this paper is the experiences and needs of family carers of people with end-stage dementia. The project involved in-depth, qualitative interviews with 15 carers. The major themes emerging from the accounts of participants' experiences were: getting support; having to trust others with care; managing the loneliness of being a carer; witnessing a loved one fade away; anticipating and experiencing death; and re-establishing life after the funeral. Carers expressed a range of instrumental and psychosocial needs. The study has provided a more personal account of the caring experience than much of the related literature. It has emphasized the need of carers for genuine understanding and connection -from family and friends as well as healthcare staff. The study highlights the amount of support carers can provide to each other through support groups and associated friendships, and stresses the importance of healthcare staff acknowledging and respecting this capacity of carers.

Policy development should be informed by better understanding of the potential and limitations of the Internet as a tool for generating and sustaining social capital in old age.

Semi-structured telephone interviews were conducted with nursing managers from 198 randomly selected residential aged care facilities (RACFs) in New South Wales, Victoria and Queensland, Australia to gather information about how they perceive and respond to the sexual expression of elderly residents, particularly in relation to policy and training. Participants expressed positive views about the rights of residents for sexual expression but few facilities had any formal policies or training programs in place. Managers identified a range of sexuality-related issues as sources of concern in their day to day operation, however, these tended to be dealt with in an informal and ad hoc way. The lack of policy guidelines and training in this area leads to inconsistent and uncertain practice, with negative implications for the sexual health of residents and the smooth functioning of facilities. A national level approach to policy development is indicated.

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Quality of life needs to be understood from multiple perspectives. Caregivers' views are a central part of this understanding and should be used to inform future research and service development.