Much research has investigated the impact of dementia on spousal relationships. Most often this is from the point of view of the spouse, but occasionally people with dementia are interviewed independently or in parallel. The current study was novel in its aim to understand ‘couplehood’ as it is co-constructed by the couple when one partner has dementia and employed an innovative design that involved interviewing couples together about their relationship. Using grounded theory methodology, the study identified the changing identities within couplehood and the strategies couples employ to maintain their relationship, including normalizing, externalizing, sharing the experience and reframing the experience in light of the past. These findings are discussed in relation to other relevant research and suggest that co-constructed accounts of couplehood are valuable not only when researching the experiences of couples with dementia but also in their clinical assessment and treatment.

This critique of the term ‘carer’ argues that, although developed as a result of well-intentioned and socially-engaged research, it fails the people with whom it is most concerned, that is ‘carers’ and those who are cared for. The paper considers the historical and political development of the term ‘carer’ before examining research in various ‘carer’-related settings in the United Kingdom, namely mental health, physical and intellectual impairment, cancer and palliative care and older adulthood and dementia. The article concludes that the term ‘carer’ is ineffective and that its continued use should be reconsidered. This conclusion is based on the consistent failure of the term ‘carer’ as a recognisable and valid description of the relationship between ‘carers’ and those for whom they care. Furthermore, use of the term may imply burden and therefore devalue the individual who is cared for and in this way polarises two individuals who would otherwise work together. Consequently, this commentary suggests that descriptions of the caring relationship that focus on the relationship from which it arose would be both more acceptable and useful to those it concerns. Furthermore, a more accessible term may increase uptake of support services currently aimed at ‘carers’, therefore inadvertently meeting the original aims of the term, that is, to increase support for ‘carers’.

Tel. +44 (0) 1206 873817 BSE Plans 3 ABSTRACT Implementation intentions, plans relating to when and where behaviours will be performed, have been effective in increasing health behaviour. Two studies are reported that test the impact of this strategy in promoting breast self-examination (BSE), a behaviour shown to aid the early detection of tumours. In study 1, 457 participants were randomly allocated to either implementation intention or control conditions. Implementation intentions significantly increased likelihood of BSE at one month. The effect of the intervention was marginally significant at six months. Study 2 (N=101) tested the efficacy of a collaborative implementation intention intervention that required female participants to plan, with a partner, collaborative BSE performance. Results indicated that both implementation intentions and partner involvement were associated with BSE performance at one month, whilst the collaborative implementation intention intervention showed a 100% success rate. Collaborative implementation intentions may reduce forgetfulness. Interventions that encourage partner involvement in planning and enacting behaviour appear to enhance implementation intention utility.

Purpose: Although peer support has received research attention within different health related contexts, there is limited research considering individuals who have experienced an amputation. In particular, the peer mentoring role is under-explored. Therefore, this research aimed to explore the experiences of participants delivering peer support interventions to individuals with lower limb loss. Methods: Eight people who acted as peer mentors for people with limb loss took part in semistructured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA). Results: Two overarching themes were identified from the data: 'Developing a Helpful Self', in which the personal value and meaning of being a peer mentor is presented, and 'Connecting with Vulnerability', which addresses the emotional challenges of peer mentoring and the impact of these on well-being. Conclusions: Findings suggest positive experiences of providing support, including increased hope, resilience and a sense of belonging and connection to others. However, peer mentors experienced challenges related to uncertainty and doubt about their mentoring abilities and with developing and maintaining resilience in the role. Recommendations include the development of training packages and increased clarity for volunteers of the peer mentor role.

Physicians should consider the discussion of end-of-life issues preferably when patients are stable. Decision aids may prove to be a valuable adjunct in framing treatments such as mechanical ventilation.

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