Dementia, disability and contact with formal services: a comparison of dementia sufferers and non-sufferers in rural and urban settings

Abstract

This paper is based on data from studies conducted in the City of Liverpool and in a rural area of North Wales, relating to people aged 75 years and over living in the community. It compares those identified in these studies as suffering from cognitive brain disorders with other older people identified as being cognitively unimpaired and looks at levels of competence with activities of daily living and the subsequent levels of contact with a range of health and social services personnel and other community workers. It shows that although levels of contact with formal services are generally higher for people with dementia than for non-sufferers, most of these differences are below the level of statistical significance. It was found that levels of contact for people receiving most services are low, especially for specialist mental health services and social work. The implications for community care are discussed, it is suggested that expansion of domiciliary care services for people with dementia and for their carers would demand more resources than are currently being made available but that it would be better value for money on a case by case basis.

Early recognition of dementia by nurses

“…Although Pickard and Glendinning's (2002) small study of 24 older carers suggested that CNs had less contact with people with dementia than CMHNs, dementia is not a clinical domain for specialist nurses alone. Our study, therefore, confirms Burholt et al. 's (1997) finding that there was considerable contact between some people with dementia and CNs.…”

“…1993, Pickard & Glendinning 2001) and more precise tasks, such as the use of scales and assessments tools, are not standard features of pre‐ or postregistration nurse education (Keady & Adams 2001). Studies of service use by people with dementia and their families reveal contact with a broad range of nurses, notably community nurses (CNs) in some locations (Burholt et al. 1997), who may span domiciliary and residential settings (Manthorpe & Alaszewski 2002).…”

“…Work by the Nuffield Institute for Health and NHS Centre for Reviews and Dissemination (1996) suggests that dementia is associated with a higher risk of falling. A typical community nursing team, supporting 80 patients, can already expect to include between five and 15 people with dementia (Iliffe & Drennan 2001), with higher proportions where the older population suffers high rates of morbidity (Burholt et al. 1997).…”

The association between cognitive impairment and community service use patterns in older people living in Australia

“…Furthermore, formal support services and care services in the community may be inadequate to the needs of people with dementia and their carers (Burholt et al . ). As cognitively impaired individuals typically possess decision‐making restrictions and highly individualised needs, informal caregivers may be better able to interpret and meet the sporadic and individualised care demands of recipients.…”

A protocol for a systematic review of effective home support to people with dementia and their carers: components and impacts

“…Although older people with dementia receive a higher level of support than those without dementia, this is often less than expected given their level of impairment (Burholt et al . ). Home support services for older people with dementia may be under‐developed in terms of scale in comparison with services for older people generally (McDonald & Heath ).…”