Large numbers of people with dementia live in care homes. Decisions about permanent care are usually made by family members and professionals with little involvement from people with dementia. This qualitative paper explores the personal experience of this move among people with dementia. Eighteen people with dementia were interviewed before and after a move into permanent care. Before moving into permanent care, a realization of one’s own difficulties, clearly expressed hopes and fears, and a wish for a role in preparation for the move were identified. After the move, both positive and negative experiences of the process were recalled, with participants clearly identifying what had helped them most in the process. Moving to a care home need not be a depressing process for people with dementia, who may be meaningfully involved in the process. Further research will profit from direct interviewing of the core people in the move, the people with dementia themselves.

Organic disorder should always be considered before making a diagnosis of anorexia nervosa, particularly if the presentation is atypical.

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Abulia is a state of diminished motivation in which an individual may appear apathetic, disinterested, asocial and emotionally remote. There is currently a lack of information on the recognition and management of abulia in elderly patients, despite the fact that it occurs in conjunction with many conditions that are associated with ageing. Here, the authors review the current literature and describe three cases of abulia in elderly patients that responded well to treatment with bromocriptine. Copyright © 2010 Wiley Interface Ltd

The symptom of abulia is a state of diminished motivation where an individual may appear apathetic, disinterested, asocial and emotionally remote. It can exist independently but more commonly occurs as part of a constellation of symptoms accompanying a specific disorder, normally neurological or psychiatric. Although it is not a normal part of ageing, it has been observed in a number of conditions seen in later life. These include Alzheimer's disease, vascular dementia, Parkinson's disease, dementia with Lewy bodies, and frontotemporal dementia. Abulia and depression are separate entities but abulic patients are often thought to be depressed and experience long periods of anti-depressant treatment without benefit. the key difference is that abulic patients fail to disclose any sign of sadness or negative thoughts and show an obvious lack of concern for their condition.Abulia has significant clinical implications as it is associated with decreased function, poor prognosis and worse carer stress. It is also potentially treatable. the pharmacological agents that have received the most attention are dopaminergic drugs including Carbidopa/Levodopa, Amantadine, Bupropion and Bromocriptine. the research predominantly consists of case reports but no studies have focussed on the elderly. in this paper, the authors review the current literature and describe three cases of abulia in older people that have been successfully treated with Bromocriptine. the cases highlight the importance of recognising abulia and differentiating it from depression. They also show the need to consider treatment.