Current concepts of dementia often act to exclude the internal world of the dementia sufferer from consideration as a valid object of study. This paper presents a three stage model of the subjective world of dementia sufferers, drawing on ideas from both clinical and social psychology. The first stage involves the feelings engendered by the process of dementia and includes at least four discrete states: anxiety; depression; grief; and despair/terror. The second stage of the model concerns the behaviour provoked in response to the process of decline. Finally, we consider the social nature of emotional behaviour, with emotional actions falling along a continuum. The ability of an individual with dementia to engage in emotional behaviour depends upon the extent of their cognitive impairment and the social context in which they are located. This model has implications for the delivery of services, including psychotherapy, to people with dementia.

An estimated 25,000 people of Black, Asian and other Minority Ethnic (BAME) origins live with dementia in UK – a number which is expected to increase sevenfold by 2051. People from many BAME communities experience dementia in a markedly different way to their white British counterparts. For instance diagnosis is more likely to occur at an advanced stage of the illness, while there is a lower take-up of mainstream dementia services. This research study focused on the experiences of caregivers for family and friends living with dementia from South Asian, African Caribbean and Chinese communities in Bristol. Data were collected through interviews with 27 participants and 8 focus groups attended by 76 participants. Additionally, interviews were carried out with 16 paid staff and volunteers working for Voluntary and Community Sector Organisations (VCSOs) that provided services for older people from these three communities. As concepts emerged during data analysis, so these were checked with each community. The grounded theory, ‘fear of diminishment’ was present across all communities: participants both needed and wanted support, but they were reluctant to accept this if it came at the cost of being diminished as a person. To resolve this dilemma, informants turned to BAME-led VCSOs, which provided ongoing support and advocated on behalf of their members. However, the services provided by these VCSOs varied and reflected differences in the ways in which communities enacted the theory. Given the increasing importance of cultural diversity within dementia care, this study has important implications for communities across the UK and elsewhere, and points towards the need for sustainable and equitable resourcing of dementia care within BAME-led VCSOs.

Psychotherapy and counselling approaches are being used increasingly with people with dementia, but there has been little structured research into the effectiveness of such work. This research reports findings from the evaluation of six, ten-week long psychotherapy groups for people with dementia in the south of England. Measures of depression and anxiety were taken independently of the clinical work at four time points: six weeks before the group began, at the start of the group, at the end of the group and at follow-up after a gap of ten-weeks. Forty-two participants entered the project at different points, of whom 19 completed the baseline, intervention and follow-up phases of the project. Analysis of the data for depression and anxiety levels using a repeated measures ANOVA showed a statistically significant treatment effect for Cornell depression scores which was maintained at follow-up and a similar reduction in anxiety as measured by the rating for anxiety in dementia (RAID) which was borderline for significance. Although not all people with dementia would be suitable for group psychotherapy, nevertheless this research provides some of the first clear evidence that group psychotherapy may have a role to play in reducing levels of depression and anxiety of people with mild and moderate levels of dementia.

Background: Studies with non-clinical populations show that nostalgia increases psychological resources, such as self-esteem and social connectedness. Objectives: Our objectives were to find out if the benefits of nostalgia in non-clinical populations generalize to people with dementia and if nostalgia facilitates recall of dementia-related information. Methods: All three experiments recruited participants with mild or moderate levels of dementia. Experiment 1 tested whether nostalgia (compared to control) enhances psychological resources among 27 participants. Experiment 2 used music to induce nostalgia (compared to control) in 29 participants. Experiment 3 compared recall for self-referent dementia statements among 50 participants randomized to either a nostalgia or control condition. Findings across experiments were synthesized with integrative data analysis. Results: Nostalgia (compared to control) significantly increased self-reported social connectedness, meaning in life, self-continuity, optimism, self-esteem, and positive (but not negative) affect (Experiments 1–3). Compared to controls, nostalgic participants also recalled significantly more self-referent dementia-related information (Experiment 3). Conclusion: This series of experiments extends social psychological research with non-clinical populations into dementia care, providing evidence that nostalgia significantly enhances psychological resources. The finding that nostalgia increased recall of self-referent statements about dementia suggests that this emotion lends participants the fortitude to face the threat posed by their illness. The finding has potentially important clinical implications both for the development of reminiscence therapy and for facilitating adjustment to a diagnosis of dementia.

Background: To date, surveys of attitudes toward dementia have largely been conducted using unvalidated materials or have focused on healthcare professionals supporting people affected by dementia. The aim of this study was to carry out a survey of public attitudes toward people affected by dementia in Bristol and South Gloucestershire. Methods: A survey was carried out using a modified version of the Approaches to Dementia Questionnaire (ADQ). Data from people living outside the area, and people who were working with people affected by dementia were omitted from the analysis. Responses from the remaining 794 ADQ questionnaires were weighted to correct for under-represented age, gender, and ethnic groups. Results: Younger people held more positive attitudes toward dementia than older people. Individuals who identified themselves as White held more positive attitudes than non-White individuals. Individuals with personal experience of dementia held more positive attitudes than those with no experience of dementia. When considering age differences, gender played a role, with younger men having more positive scores than other groups. Conclusions: This is one of the first surveys of public attitudes to dementia to use a validated questionnaire such as the ADQ. The study provides a baseline of attitudes toward dementia for the Bristol and South Gloucestershire areas, against which we will be able to compare changes over time. This is important due to the emphasis in public health campaigns on improving attitudes toward dementia.