Mental Health and Morbidity of Caregivers and Co-Residents of individuals with Dementia: A Quasi-Experimental Design.

Maguire, A., Rosato, M. and O’Reilly, D.
International journal of geriatric psychiatry
The Northern Ireland Mortality Study (NIMS) is a prospective study, which is unique in that it links Census returns with deaths that are subsequently registered. For this study by Maguire et al.
(2016), data from the 2011 Census were linked with subsequent deaths records from the General Register’s Office which were followed up for 33 months. Using the Census 2011 returns, 19,863 people were identified as having ‘dementia symptoms’, used in this study as a proxy for cognitive decline. People who co-resided with a person with dementia symptoms and who either self-identified as a caregiver or non-caregiver were enumerated. The caregivers were better educated, living in more affluent households, and had better physical and mental health than non-caregivers. Caregivers providing intense levels of care were older and more likely to be women. The study found that caregiving co-residents were at no greater risk of poor mental health than non-caregiving co-residents. The analysis revealed that caregiving co-residents were 33% less likely to die during the study period than non-caring co-residents and this percentage was greater for caregivers providing intense levels of care, suggesting, in keeping with some other studies, a significant mortality advantage associated with caregiving. The findings of this study highlight the important of assessing both the risks and benefits of caring for a relative with dementia.

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.

National Carers’ Strategy: Recognised, Supported, Empowered

Department of Health

The National Carers’ Strategy sets the strategic direction for future policies, services and supports provided by Government Departments and agencies for carers.

This includes carers of people with dementia, the majority of whom live at home in their own communities and for whom carers are the cornerstone of their care. The Strategy is a Cross-Departmental Strategy. It sets out guiding principles, goals and objectives addressing priority areas (income support, health, information, respite, housing, transport, training, employment, children and young people with caring responsibilities) and a Roadmap for Implementation containing 42 Actions to be achieved on a cost-neutral basis in the short to medium term.

The four goals of the National Carers’ Strategy are to:

  • Recognise the value and contribution of carers and promote their inclusion in decisions relating to the person that they are caring for

  • Support carers to manage their physical, mental and emotional health and well-being

  • Support carers to care with confidence through the provision of adequate information, training, services and supports

  • Empower carers to participate as fully as possible in economic and social life

The implementation of the National Carer’s Strategy is reported in progress reports. The First Annual Progress Report (September 2012 – September 2013) can be accessed here.

The Second Progress Report (September 2013-September 2014 can be accessed here.  

The Third Progress Report (September 2014-September 2015) can be accessed here.

The Fourth Progress Report (September 2015-December 2016) can be accessed here.

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