As the number of people with dementia is increasing alongside the social trend of a greater proportion of the population living on their own, this article seeks to explore a number of issues arising from these circumstances. It summarizes a qualitative study of ten people with dementia who live alone in their own homes. The views of these individuals, their families and care staff, GPs, district nurses and social workers are described and analysed, providing insights into the different perceptions of risk. The findings and discussion highlight issues relating to assessing and managing risk and problems and opportunities related to living alone with dementia. In this study no incidents of major harm were reported and daily contact with others was considerable. However, resources and support are needed to enable professionals, families and people with dementia to achieve a sense of shared negotiated responsibility for risk taking.
Get full access to this article
View all access options for this article.
References
1.
Adams, T. (1999). Developing partnership in the work of community psychiatric nurses with older people with dementia. In T. Adams and C. Clarke (Eds), Dementia care: developing partnerships in practice (pp. 305-324). London: Baillière Tindall .
2.
Alaszewski, A., & Manthorpe, J. (1991). Literature review: measuring and managing risk in social welfare . British Journal of Social Work, 21, 177-190 .
3.
Alaszewski, A., & Manthorpe, J. (1998). Welfare agencies and risk . Health Society and Care Community, 6(1), 4-15 .
4.
Alaszewski, H., & Manthorpe, J. (2000). Finding the balance: older people, nurses and risk . Education and Ageing, 15(2), 195-209 .
5.
Alaszewski, A., Alaszewski, H., & Harrison, L. (1998). Professionals, accountability and risk. In A. Alaszewski, H. Alaszewski, & J. Manthorpe (Eds), Risk health and welfare. Buckingham: Open University Press .
6.
Alaszewski, A., Alaszewski, H., Ayer, S., & Manthorpe, J. (2000). Managing risk in community practice. London: Baillière Tindall .
7.
Allan, K. (2001). Communication and consultation. York: Joseph Rowntree Foundation .
8.
Alzheimer's Society (1994). Home alone. Living alone with dementia. London: Alzheimer's Society .
9.
Alzheimer's Society (2000). Living alone: advice leaflet. London: Alzheimer's Society . URL: http://www.alzheimers.org.uk
10.
Bamford, C., & Bruce, E. (2000). Defining the outcomes of community care: the perspectives of older people and their carers . Ageing and Society, 20(5), 543-570 .
11.
Barnett, E. (2000). Involving people with dementia in designing and delivering care:'I need to be me!' London: Jessica Kingsley .
12.
Beck, U. (1992). Risk society: towards a new modernity. London: Sage .
13.
Bond, J., Corner, L., Lilley, A., & Ellwood, C. (2002). Medicalization of insight and care-givers' responses to risk in dementia . Dementia, 1(3), 313-328 .
14.
Brearley, C. (1982). Risk and social work. London: Routledge and Kegan Paul .
15.
Campbell, J., & McLaughlin, J. (2001). The `joined up' management of adult health and social care in Northern Ireland: lessons for the rest of the UK? Managing Community Care, 8(5), 6-13 .
16.
Carson, D. (1995). Calculating risk . Community Care, 26 Oct, 26-27 .
17.
Clarke, C. (1999). Dementia care partnerships: knowledge, ownership and exchange. In T. Adams & C. Clarke (Eds), Dementia care developing partnerships in practice. London: Baillière Tindall .
18.
Clarke, C. (2000). Risk: constructing care and care environments in dementia . Health, Risk and Society, 2(1), 83-92 .
19.
Cox, S., & Minter, J. (1999). Exploring creative responses in housing and support . Journal of Dementia Care,3, 15-17 .
20.
Crabtree, B., & Miller W. (Eds), (1992). Doing qualitative research. Thousand Oaks, CA: Sage .
21.
Gallagher, E., Alcock, D., Diem, E., Angus, D., & Medves, J. (2002). Ethical dilemmas in home-care management . Healthcare Management, 47(2), 85-97 .
22.
Gilmour, H. (2002). Dementia in Fermanagh Northern Ireland. Stirling: University of Stirling Dementia Services Development Centre .
23.
Gilmour, H., & Bolton, D. (1991). The Fermanagh dementia survey. Enniskillen: Blue Moon Publications .
24.
Gilmour, H., Gibson, F., & Campbell, J. (2003). People with dementia in a rural community . Dementia, 2(2), 245-264 .
25.
Jacques, A. (1992). Understanding dementia. Edinburgh: Churchill Livingstone .
26.
Kemshall, H., & Pritchard, J. (Eds), (1996). Good practice in risk assessment and risk management. London: Jessica Kingsley .
27.
Kemshall, H., & Pritchard, J. (1997). Vulnerable people taking risks: older people and residential care. In H. Kemshall & J. Pritchard (Eds), Good practice in risk assessment and risk management 2: protection, rights and responsibilities. London: Jessica Kingsley .
28.
Levin, E., Sinclair, I., & Gorbach, P. (1994). Better for the break. London: HMSO .
29.
Lloyd, P. (1997). Dementia in older people living alone . Generations Review, 7(4), 8-9 .
30.
MacDonald, C. (1999). Support at home: views of older people on their needs and access to services. Edinburgh: Scottish Executive , Social Work Research Finding No. 35.
31.
Mahoney, F., & Barthel, D. (1965). Financial evaluation - The Barthel Index . Maryland State Medical Journal,14, 61-65 .
32.
McWalter, G., Toner, H., McWalter, A., Eastwood, J., Marshall, M., & Turvey, T. (1998). A community needs assessment: the care needs assessment pack for dementia - its development, reliability and validity . International Journal of Geriatric Psychiatry, 13, 16-22 .
33.
Miller, G., & Dingwall, R. (1997). Context and method in qualitative research. London: Sage .
34.
Moore, B. (1996). Risk assessment: a practitioners guide to predicting harmful behaviour. London: Whiting and Birch .
35.
Moriarity, J., & Webb, S. (2000). Part of their lives: community care for older people with dementia. Bristol: Policy Press .
36.
Mozley, C., Huxley, P., Sutcliffe, C., Bagley, H., Burns, A., Challis, D., & Cordingly, L. (1999). `Not knowing where I am doesn't mean I don't know what I like': cognitive impairment and quality of life responses in elderly people . International Journal of Geriatric Psychiatry,14, 776-783 .
O'Conner, D., Pollit, P., Brook, C., & Reiss, B. (1989). The distribution of services to demented elderly people living in the community . International Journal of Geriatric Psychiatry,4, 339-344 .
39.
Reisberg, B., Ferris, S., de Leon, M., & Crook, T. (1982). The Global Deterioration Scale for the assessment of primary degenerative dementia . American Journal of Psychiatry, 139, 1136-1139 .
40.
Stalker, K., Gilliard, J., & Downs, M. (1999). Eliciting perspectives on what works . International Journal of Geriatric Psychiatry, 14, 120-134 .
41.
Stevenson, O. (1999). Old people at risk. In P. Parsloe (Ed.), Risk assessment in social care and social work. Research Highlights in Social Work, 36. London: Jessica Kingsley .
42.
Stone, S., Ali, B., Auberleek, I., Thompson, A., & Young, A. (1994). The Barthel Index in clinical practice . Journal of Royal College of Physicians of London, 28(5), 419-433 .
43.
Tinker, A. (2000). Population aspects of the dementias . International Journal of Geriatric Psychiatry,15, 737-757 .
44.
Tuokko, P., MacCourt, P., & Heath, Y. (1999). Home alone with dementia . Aging and Mental Health, 3(1), 21-27 .
45.
Waterson, J. (1999). Redefining community care social work: needs or risks led . Health and Social Care in the Community, 7(4), 276-279 .
46.
Webber, P., Fox, P., & Brunette, D. (1994). Living alone with Alzheimer's disease: effects on health and social service utilization patterns .The Gerontologist,9, 721-732
47.
Wenger, G.C. (1994). Understanding support networks and community care. Aldershot: Ashgate .
48.
Wenger, G.C., Scott, A., & Seddon, D. (2002). The experience of caring for older people with dementia in a rural area: using services . Aging and Mental Health, 6(1), 30-38 .
49.
Woods, B. (1999). Promoting well-being and independence for people with dementia . International Journal of Geriatric Psychiatry, 14, 97-109 .
