This short study looks at the issue of anti oppressive practice and the way that it relates to the care of people with dementia. In particular it considers ways in which people can be empowered and given choices around aspects of day-to-day living in a care setting. The study took place over a period of 6 months and utilized the Dementia Care Mapping (DCM) observation process to assess the level of well being of residents in the setting studied. The results can only be seen as a first stage in the process of understanding ways in which people with dementia may be empowered. It is demonstrated that a change of practice developed over the 6 months between the two observation periods. Areas such as communications and day-to-day activities are examined to identify both problems and strategies for such change. The conclusion highlights the need to continue the mapping exercise as a way of ensuring that change is not only maintained but also advanced.

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The growing debate about the ability of the nurse to empower patients has featured frequently in the nursing journals over recent years. This paper seeks to address the issue around the need to empower dying patients by an examination of nurses' written reflections on critical incidents in their practice. Geertz's 'thick description' has been used to interpret the data. The issues of power and professionalism are central to the discussion. The results are tentative given the sample size but point towards a redefinition of the empathetic approach and the adoption of a 'facilitative' approach to the sharing of power. The paper recommends careful examination of the role of the nurse and the communication process to identify further barriers to patient empowerment.

The issue of advocacy has dominated discussion of the ethical dilemmas facing nurses. However, despite this, nurses seem to be no further towards a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty. This article considers some of the problems around advocacy and, by the use of critical incidents written by nurses involved in a diploma module, attempts to highlight where the problem could lie. A communications model is outlined, using a theoretical framework taken from the work of Jürgen Habermas, and applied to nursing practice. Finally, two examples are given from the research, which illustrate how the model could be used, highlighting the problems and pitfalls that still have to be overcome. The conclusion is a positive one, in that it suggests that advocacy is possible if nurses re-examine their practice in the light of the model proposed.

Problems related to the ability of the nurse to act as advocate for patients have caused dilemmas in the profession over recent years. This paper seeks to address the issue from the aspect of ritual action which pervades the day-to-day activities of nurses and could therefore have an effect on nurse-patient relations. By looking at a short study based on data from nurses working with dying patients, part of work in progress on the subject, it is possible to draw some conclusions about the effect that such rituals and routines have on practice. Examination of the work of Douglas leads to speculation about the ways that rituals associated with restricted language can undermine the nurse's ability to advocate successfully. Results from the study are limited given the small sample, but they give some indication of trends and possibilities that more exhaustive research may confirm.