Karen Harrison Dening

The value and ethics of dementia research in the wake of COVID-19

Researchers are keen for findings on the effects of the pandemic, but sensitivity must be considered

Advance care planning and decision-making in dementia care: a literature review

Advance care planning and decision-making in dementia care: a literature review

Role of ACP in identifying preferred place of care or death for people with dementia

Supporting family carers via the Admiral Nurse Dementia Helpline: reflection on a case study

Supporting family carers via the Admiral Nurse Dementia Helpline: reflection on a case...

The role of telephone helpline to support families affected by dementia

Differentiating between dementia, delirium and depression in older people

Differentiating between dementia, delirium and depression in older people

How to clinically assess, diagnose and treat patients

Open access
Managing pain in dementia

A relationship-centred approach to managing pain in dementia

The presence of pain in a person with dementia can often be missed. The diagnosis of dementia can overshadow the pain-inducing symptoms of other co-morbid conditions with distress behaviours being attributed to the behavioural and psychological symptoms of dementia. Such distress behaviours of a person with dementia often have a profound and alarming effect on family carers. This Admiral Nurse case study explores the assessment and management of pain in a person with dementia in partnership with the family carer.


Implementation of e-portfolios for the professional development of Admiral Nurses

Nurses are required to maintain their fitness to practise through continuing professional development activities, and must demonstrate this by maintaining a portfolio of evidence that should be available for inspection every three years. The Nursing and Midwifery Council introduced revalidation in 2016 to demonstrate that nurses are practising safely and effectively. Nurses, however, are busy healthcare professionals and, as well as clinical practice, they have other demands on their time, such as providing evidence for annual appraisals. Admiral Nurses, specialist dementia nurses who support families living with dementia, also have a three-tier competency framework designed to demonstrate their acquired expertise and knowledge in dementia care. To support Admiral Nurses in managing these activities, the charity Dementia UK gave them access to the PebblePad e-portfolio system. This article details the implementation and outcomes of this project.

Admiral Nurse

Role of the Admiral Nurse in supporting a person with dementia and their family carer

Distress is commonly experienced by those caring for someone with dementia, and can occur whether the carer is living with a person with dementia, or supporting a person with dementia who lives alone to maintain their independence. It is essential for health and social care professionals to support family carers to balance their needs with those of the person they care for. However, this might be challenging because many influencing factors can affect these needs, and identifying the needs of the family carer and balancing them with the needs of the person with dementia is often complex. This article uses a case study to explore the role of one Admiral Nurse (KG) in supporting the main family carer of a person with dementia, and the model of reflection used by the Admiral Nurse to undertake critical thinking and analysis in relation to their role.


Admiral Nursing: case management for families affected by dementia

The number of people with dementia is expected to increase globally. People with dementia are not affected in isolation and any intervention should also support their families and carers. Intervention is best delivered using a relationship-centred approach and a case management model. Case management has an established and successful history in supporting people with long-term conditions and those with a diagnosis of severe mental illness. This article, the last in this dementia series, discusses the Admiral Nursing case management approach to supporting patients and families affected by dementia, and provides recommendations for establishing a gold standard model of case management.

Promoting participation of people with dementia in research

Dementia is a neurodegenerative disorder that can have a severe effect on the quality of life of individuals with the condition, and can place considerable strain on informal carers and healthcare systems. Research is required to identify ways to prevent or delay the onset of dementia. The government is committed to dementia research, yet funding for dementia research is eclipsed by funding for research into other conditions. Moreover, dementia research can only progress if individuals with the condition participate in research studies. This article discusses barriers associated with research into dementia and describes a UK government initiative, Join Dementia Research, which supports research participation for people with dementia.

Palliative and end of life care for people with dementia

Dementia is a life-limiting condition that is largely a disease of ageing. However, older people in general, and older people with dementia in particular, have not always had equal access to effective palliative and end of life care. As a result, people with dementia at the end of life often receive aggressive and burdensome interventions, or inadequate assessment and management of their symptoms. Patterns in how people with dementia experience and present symptoms as they near the end of life can indicate when the goals of care should change and a palliative approach should be adopted.

Advance care planning in dementia

Advance care planning is the basis for delivering person-centred end of life care that accords with the wishes of the individual. It is important to support people with dementia in developing an advance care plan, since they may lose the capacity to make decisions associated with this early in the disease process. Healthcare policy indicates that we should all consider our wishes for end of life care. However, this may not be straightforward for people with dementia. This article considers the main issues in enabling advance care planning with people with dementia, reviews the limited evidence and offers possible solutions.

Introduction to the dementia series

A NEW SERIES of articles in Nursing Standard, starting this week, aims to help nurses understand the multifaceted nature of dementia. This introduction outlines the scope of the series, which will discuss and explore the signs and symptoms of dementia, its diagnosis, the evidence base for various interventions, palliative and end of life care and how nurses can relate this knowledge to clinical practice.