Family intervention can have significant benefits in carers of patients with Alzheimer's disease and has a positive impact on patient behaviour.

The GDS4 and OMC appear to be useful instruments for screening for depression and cognitive impairment among older medical inpatients.

The development of a family clinic for later life families within an Old Age Psychiatry service is briefly described. An extended life cycle model has been found useful in understanding and working with such families and is also described, together with two cases which illustrate the practical application of the model.

SUMMARYFamily therapy techniques have, until recently, had little impact on the development of old age psychiatry and the services provided. The literature on family therapy in relation to people with dementia and their families is reviewed and illustrated with results from a study of families coping with dementia who attended the York House Family Clinic. Similar therapeutic techniques were used with families coping with dementia as with those coping with other mental illnesses in later life, but some differences were found in the areas of discussion during sessions. Families coping with dementia were seen for fewer sessions, but more family members were present per session and sons and daughters-in-law were more likely to attend. The literature and various hypotheses which might explain these differences are presented and discussed. Further work in this area is needed, but our findings suggest that family therapy can be useful in work with dementia sufferers and their families, and can be offered within an old age psychiatry service.

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