This qualitative study explores spouse caregivers' understanding of and responses to partners with dementia. Six wives who had been providing care to their husbands in the community for at least two years were interviewed. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA) and four interconnected themes were proposed: same person or different; relational change; emotional responses to behaviours; and impact on day-to-day life. Participants' sense of continuity with the past was suggested to influence each theme. The construct of continuity was proposed to be elastic, with both intra-psychic and inter-psychic factors impacting upon its elasticity. Broadly, a sense of continuity seemed to be associated with better adjustment to caregiving.

Assessment of carers' psychological needs Jan OyebodeAbstract Carers play a vital role in supporting family members who need help. Facts and figures on caregiving are set in the context of current UK policy. Research into the impact of caregiving shows that one-third to one-half of carers suffer significant psychological distress. Factors associated with carer stress are reviewed, including those related to the care-recipient, the caregiver, their relationship, and wider family and social support. The most well-known frameworks for understanding caregiving stress, including stress-process models, are introduced. Measures that may help in assessing psychological needs of carers are reviewed, emphasising the distinction between objective and subjective stress. The range of possible interventions leads to promising evidence of the effectiveness of individual psychosocial interventions, but further research is needed.

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The study provided some quantitative support for suggestions arising from qualitative research about how perceptions of continuity/discontinuity in the relationship may impact on the caregiving spouse's emotional well-being. Helping couples to maintain a sense of continuity and couplehood may assist their emotional adjustment to dementia.

Background: Young Onset Dementia (YOD), defined by first symptoms of cognitive or behavioral decline occurring before the age of 65 years, is relatively rare compared to dementia of later onset, but it is associated with diagnostic difficulty and heavy burden on affected individuals and their informal carers. Existing health and social care structures rarely meet the needs of YOD patients. Internet-based interventions are a novel format of delivering health-related education, counseling, and support to this vulnerable yet underserved group.