A 'history of problematizations' for dementia education: a Foucauldian approach to understanding the framing of dementia.

BACKGROUND: Debates relevant to both undergraduate and postgraduate nurse education regarding the conceptualisation and disciplinary ownership of dementia, including its framing as a neuro-psychiatric condition, a terminal illness or a consequence of ageing, are important in supporting an understanding of the lived experience of dementia for individuals and their family carers and how, as a condition, it has come to be problematised in Western society. The work of Michel Foucault is useful in setting this debate within a critical historical context. AIMS: Using Foucault's 'history of problematizations' we present such debates around dementia's conceptualisation in Western society and consider how a Foucauldian critical historical project influences nursing education by re-examining the problematisation of dementia within society, what it is to be a person with dementia, and how alternative conceptualisations shape how we see the condition - as well as how we provide learning opportunities for dementia-care professionals. RESULTS: Six differing ways of conceptualising or problematising dementia were found (as a natural consequence of ageing, a mental disorder, a bio-medical disease, a neuro-cognitive disorder, a disability and a terminal illness), each offering alternative ways we might present it in an educational context. CONCLUSIONS: We argue for both undergraduate and postgraduate student nurses to engage in learning that locates what it is to be a person with dementia within particular conceptual frameworks that would allow understanding of how these ideas or constructs are reliant on historically contingent assumptions. Here, taken-for-granted assumptions are unsettled, and a more critically reflective position is adopted. This will have an impact on the type of nurse to emerge from educational institutions, thus also affecting service delivery and the dementia care provided, as well as the knock-on effects for dementia education in other medical, health and social care courses and for institutions whose role it is to approve professional practice curricula content.

Suicide risk in informal carers of people living with dementia.

With an ageing population comes an increasing risk of illnesses such as dementia and a growing need for care. There are 670,000 informal, unpaid carers in the UK, reducing costs for health and social care services but presenting other concerns for healthcare professionals. Carer burden and carer stress are well-documented concepts, and can lead to depression and a risk of suicide in some individuals. It is important that this risk is considered when supporting informal carers of people living with dementia. Admiral Nurses work with families living with dementia to provide the one-to-one support and expert guidance they need to manage. This article discusses a case study that highlights how caring can affect an individual, leading to thoughts of suicide. It also demonstrates how an Admiral Nurse could support the carer in a relationship-centred way, using appropriate interventions to avoid crisis. The article offers implications for practice and provides recommendations for nurses working in this field.

Dementia education in Higher Education Institutions.

This article is a contemporary issues piece which discusses the challenges in providing dementia education in Higher Education Institutions.