There is evidence of improvement in support and empowerment of carers of people with dementia over the last decade but true empowerment remains an ambition. The support needs of carers have been known for many years but they constantly need restating. Dementia can affect all sections of the community almost regardless of age, ethnic origin, gender, sexuality and domicile. Professionals can make a real contribution to supporting people with dementia and their carers. Multidisciplinary teams and specialist services like Admiral nurses have a valuable role. Carer support is needed at all stages of dementia, even when a person has been admitted into residential care. Different forms of dementia bring different support needs. Other factors to consider include the needs of black and ethnic minority people with dementia and their carers and those who may live in isolated areas. There is some evidence to show that telephone support groups can offer effective support. Gradual empowerment of carers can be identified through a range of social and health care legislation and policy guidance over the last 15 years. The recent culmination of this aims to put patients at the centre of everything the NHS does but not necessarily carers. Mental capacity is an issue that brings special challenges for carers of people with dementia. Impending legislation promises to give carers legal authority to make decisions on behalf of someone without capacity. The voices of carers themselves can be powerful, but energy and eloquence are prerequisites that many older carers may not have in abundance.
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