Living alone with dementia: risk and the professional role.

These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review. The number of people with dementia is increasing alongside the social trend of a greater proportion of the population living on their own. But there appear to be few studies that focus on the theme of people with dementia living alone. The related area of risk associated with this client group also appears to be relatively under-researched, particularly from a multi-disciplinary perspective. Can professionals work as partners with people with dementia and their families? Can there be a consensus on what constitutes risk and how it can be addressed? This article summarises a qualitative study of ten people with dementia who live alone in their own homes. The views of these individuals, their families and care staff, GPs, district nurses and social workers are described and analysed, providing insights into different perceptions of risk. The aim of the study was to explore the concepts of risk in the context of the social circumstances, lifestyle, health status, and range and intensity of services utilised by a small group of people with dementia who lived alone in a rural area and who had been identified from an earlier study (Gilmour 2002). The objectives of the study were to illuminate the daily experiences of these people, to identify their awareness of risk as well as perspectives on risk held by their principal family carers, various care staff and health and social services professionals who supported and sustained them in their present living arrangements. It was also hoped that the study might identify why these people managed to remain living in their own homes and what health and social services developments might be needed to sustain other people with dementia who, in similar circumstances in the future, might also wish to remain at home. The findings and discussion highlight issues relating to assessing and managing risk and both problems and opportunities related to living alone with dementia. In this study no incidents of major harm were reported and daily contact with others was considerable. However, resources and support are needed to enable professionals, families and people with dementia to achieve a sense of shared negotiated responsibility for risk-taking. Background The research reported in this article carries on from a larger study of people with dementia living in a dispersed rural area in the south west of Northern Ireland (Gilmour 2002, Gilmour et al 2003). This area has a total population of 57,527 people and 7,961 people over the age of 65. Within Northern Ireland, health and social care services are delivered, unusually in the context of the rest of the UK, within an integrated structure (Campbell and McLaughlin 2001). This earlier, mainly quantitative research itself followed on from a study undertaken in the same location ten years previously (Gilmour and Bolton 1991).