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This paper examines community mental health in rural and remote settings, characterized as sole practice. Using a grounded theory approach, the research reported here explored how meanings of health and health care are advanced within the context of rural mental health care, dominated and in the main led by nurses. Five different practice sites in rural New South Wales were involved. The study articulated a model of therapeutics that foregrounds a relationship of intense professional intimacy and trust against a context of geographical disadvantage and professional isolation. The meanings of the relationship are elaborated in terms of unusually high levels of responsibility, professional ingenuity, powerlessness and the independent and risky character of life in the bush.

A programme involving Tai Chi and structured reminiscence was trialed with nine people suffering from moderately advanced dementia. The analysis reported here aimed to examine stories the people told with a view to understanding the purpose of story telling in their lives. Themes derived from the narrative data had a strong evaluative quality, ranging from simple evocative expressions to more cognitive complex insights or treasures. The study indicated a major aim in story telling as being able to generate life values, both for the enrichment of identification of self, and to pass on or leave for today's youth. Findings here further substantiate Luke and Freiden's view that old age has its own cognitive and spiritual goals to achieve. There is strong evidence that people with moderate dementia still aim to participate in that endeavour.

Consumers and clinicians put different emphasis on perspectives related to improving care of older people in the acute hospital setting. The disconnect between what consumers viewed as 'simple' organizational behaviours to change and what the clinicians viewed as complex, led to a recognition that the approach to organizational change needs to be reconceptualized.