Advances in the treatment of Parkinson's disease have led to significant improvement in many of the disabling motor symptoms of the disease, but often at the cost of neuropsychiatric side-effects. These include psychosis, dopamine dysregulation syndrome, impulse control disorders, mood disorders and Parkinson's disease drug withdrawal syndromes. Such side-effects can be as disabling and have as much impact on activities of daily living, quality of life, relationships and caregiver burden as motor symptoms. Awareness of these potential side-effects is important both in terms of obtaining informed consent, and to aid early identification and intervention, as patients may not spontaneously report side-effects because of lack of insight, or deny them out of shame or embarrassment. The challenge of treatment can be a trade off between the emergence of such side-effects and the amelioration of parkinsonism, best mastered with an informed dialogue between clinician and patient.

Alzheimer's Australia (NSW) has developed the Living with Memory Loss Program, which is a structured psycho‐educational group program for people with early stage dementia and their carers. The aim of the program is to allow participants to explore the impact of a diagnosis of dementia on themselves and their family. This case study examines a carer's experience of the 7 weeks of the program. During this process the carer moves from being fearful, angry, critical and stressed to a position of greater understanding and acceptance of dementia. The carer also develops new capacity for coping with the challenges which dementia has brought into her life.