Coping with dementia in care homes

Abstract

Dementia is now well recognized to present a large and rapidly growing burden to healthcare services worldwide. It is sometimes forgotten that this applies also to care in the community, especially in residential homes where a large proportion of people with dementia reside. For example in the UK one third of the 800,000 people with dementia currently reside in care homes [ [1] Alzheimer's Disease International World Alzheimer Report. 2009 Google Scholar ]. There are a number of triggers for institutionalization but the most common are either a worsening of symptoms which significantly limits the person's ability to care for themselves, or the development of behavioural or psychological symptoms of dementia (BPSD) which are distressing and may become too challenging for family carers to cope with. As a result, the majority of people with dementia in care homes are very frail, in the later stages of the condition and have complex needs for care and treatment. These needs far outreach the usual care provided for elderly individuals in care homes who do not have dementia. Recently the care sector has been the subject of some scrutiny with regards to the welfare of people with dementia, and the UK government has called for improvements in practice. There can be no doubt that current practice does not fulfil the needs of all residents with dementia in care homes in the UK. Yet it is vital to fully understand the challenges and obstacles facing the care home sector in order to drive forward change.