The management of incontinence is often a neglected area of community care, even more so when allied to older people, and it is essential that community nurses consider the effect of the ageing process and its impact on continence. Often, this can involve the specific effects of dementia and the management of urinary incontinence can then become complex due to the range of practical approaches required and the need to adjust these for each patient. A large percentage of the community nurse’s time is spent supporting carers; therefore, it is essential to consider their feelings when suggesting any strategies as they may feel that they are already incorporating them in the patient’s daily activities. It is also important to focus on few key elements of advice around incontinence and to listen empathetically to appreciate the challenges experienced by carers, which will help in identifying suitable strategies.
The management of nutrition in people with dementia is complex as it involves weight loss due to cognitive and physical problems caused by the condition. There is a range of practical approaches that the community nurse can implement, but these must be adjusted to suit each person. Often, a large proportion of the community nurse’s time is spent supporting carers, family and friends who are looking after a relative who has dementia at home. This can be a demanding role and carers often experience physical and emotional fatigue. For those working with patients with dementia in nursing, residential and care homes, it is particularly important that staff are supported with strong leadership to provide a flexible approach to meal times and that suitable menu options are available.
As with many conditions, diet has a crucial but often underrated relationship with serious mental health problems. In this article the author examines how diet, nutrients and different food types can have a deleterious or beneficial effect on mental health problems such as dementia, schizophrenia and bipolar disorder. Understanding the complex reactions between healthy eating and cognitive and emotional development can help community nurses provide holistic care for their patients.
Beth Britton is a freelance campaigner and writer specialising in issues affecting older people, health and social care, and specifically dementia. Her father had vascular dementia for the last 19 years of his life and she aims to provide support and advice to those faced with similar situations, as well as informing healthcare professionals and the wider population on how to improve dementia services.
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. In this issue, after recent reports of poor care, we take a look at services for older people and ask the question...
Gaye Kyle discusses the nurse’s responsibility for administrating medication in a safe and acceptable manner to patients with dementia and makes recommendations for practice in the light of current evidence.
Gaye Kyle RGN, BA(Hons), Dip Ed, MA, is an Independent Lecturer
Article accepted for publication: October 2011
Damon Thompson and June Campbell discusses a Scottish project aimed at increasing the awareness of the needs of people with dementia and their carers, through providing teaching sessions and information packs for district nurses and health visitors.
Kirstie Davison reports on the South Cotswolds memory project. April 1999-October 2000.
At the time of writing Kirstie Davison MCSP was a Project Worker for Dementia Voice, Blackberry Hill Hospital, Bristol. She is now employed as a Resource & Training Officer, Age Concern, Herefordshire & Worcestershire.
Article accepted for publication
September 2001.
Deborah Edwards et al. describe a Welsh study which looked at the factors surrounding increased stress levels in community mental health nurses.
Deborah Edwards MPhil, BSc (Hons) is a Lead Researcher.
Ann Fothergill PhD, BSc (Hons), PGCE, RGN, RMN is a Lecturer.
Ben Hannigan BA (Hons), MA, RGN, RMN, DPSN (CPN) is a Lecturer.
Philip Burnard PhD, MSc, RGN, RMN, DipN, CertEd, RNT is Vice Dean.
Dave Coyle is a Lecturer.
All employed at the University of Wales College of Medicine.
Article accepted for publication May 2001.
Zahra Pah Lavan continues her neurology series with an overview of Alzheimers disease.
Zahra Pah-Lavan BSc (Hons), RN is a freelance health writer.
Article accepted for publication: January 2006
