care homes

Uniforms in dementia care: A barrier or a necessity?

Nursing ethics
In this case study Mitchell (2016) discusses a real ethical dilemma in a dementia care home in Northern Ireland. Two groups of care staff were divided on the issue of whether or not to continue wearing a uniform.
It had been proposed that staff wear their own clothes, including nightwear for night shifts or wear clothes appropriate for the 50s and 60s, an era familiar to most residents. Those supporting the change felt that clothes related to this era would stimulate discussion and reminiscence while staff wearing nightwear would help to orient residents to the fact that it was night time. Staff in favour of retaining uniforms felt that the change in practice might be disruptive and confusing to residents and that it could also contribute to stigma as agency staff and visitors might perceive that people with dementia are living in a fantasy world. There was also some concern that staff wearing nightwear could trigger inappropriate sexual responses from some residents. Both sets of views were framed within a person centred approach and management decided that the continued use of uniforms was the best approach for residents at this time.

Sexuality and Dementia: Law, Policy and Practice


Lennox and Davidson (2013) identify areas of law, policy and practice in NI that could be improved to manage sexuality and dementia, particularly in care home settings.

 They highlight the difficulties of establishing capacity and consent and the need for more open discussion, debate and research in this area.  A particular gap identified in research is the lack of service user perspectives.  They conclude that staff must be better informed on legislation and policy and must receive better training and support on effectively managing sexuality and dementia.  

Legal implications regarding self-neglecting community-dwelling adults: a practical approach for the community nurse in Ireland

Public Health Nursing (Boston, Mass.)

Ballard (2010) examines the legal implications for nurses working in the community when they encounter clients who are believed to be self-neglecting.  The paper examines the literature and reports on a case study where the client had dementia.

 Ballard highlights the complexity of capacity and competency, mandatory or discretionary reporting, trespass, homelessness and confidentiality concluding that it is often unclear where the community nurse’s legal responsibilities lie.

Older people and legal advice - the need for joined up and creative approaches

Journal of Social Welfare and Family Law

Duffy et al. (2012) use a mixed methods approach to examine the potential of the Internet as a source of legal advice and information for older people.

 While the paper is not about people with dementia it highlights the need for timely, legal advice on diagnosis of dementia and the impact on carers who are often exhausted and do not have the energy to pursue legal issues.

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