Existing levels of dementia diagnosis are 58%. This study finds an additional 31.8% of residents without a diagnosis of dementia who score within the range of possible dementia, giving a ceiling of 89.8%. It appears that underdiagnosis of dementia exists within this 31.8% group.
Carer stress is well documented, especially in those caring for individuals with dementia. A recommendation of all national dementia strategies is to provide excellent support and information to informal carers of people with dementia. NICE guidance suggests that a range of tailored interventions, including psychological input, psychoeducation and training courses, should be offered to reduce caregiver burden and stress, although good-quality outcome-based evidence is lacking. On the basis of a narrative review of the literature, we describe individual and multicomponent carer support packages and discuss their evidence base, reflecting on outcomes for carers. Multicomponent interventions have the best evidence for effectiveness.Learning Objectives• Consider the risks of both physical and psychological harm experienced by carers of people with dementia (often referred to as carer burden or caregiver burden)• Be aware of the interventions available for the support of carers of people with dementia• Consider the evidence for the effectiveness of these interventions and be aware of the limitations of the evidence
With a growing awareness that hoarding can be found in many psychiatric conditions, clinicians may recognise an increase in referrals for people presenting with hoarding. Here, the authors present three cases of hoarding behaviour stemming from different psychiatric conditions and discuss how hoarding can be managed.
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