ABSTRACT
In England, the role of social services departments and social workers has seen some marked changes of emphasis since the NHS and Community Care Act 1990. The welcome move towards more community-based services has been tempered by increasing demand on limited resources brought about by earlier hospital discharges, a growing elderly population and increasing life expectancy. At the same time, the quest for visible public accountability and charging policies has led to an emphasis on the more measurable ‘hands on’ physical aspects of care and keeping labour costs to a minimum. In dealing with younger people with dementia, however, traditional social work skills as well as care management are needed. A person-centred approach, as originally outlined in the work of Tom Kitwood (1997) (also discussed in Chapter 6), is essential. He demonstrated how the disability from dementing illnesses cannot just be seen in the light of neurological impairment but also by unmet social, emotional, physical, psychological and spiritual needs. We all have needs for attachment, occupation, comfort, identity and inclusion. The way these are met in younger people who develop dementing illnesses, particularly in those also who have rarer conditions, will often differ from their older counterparts. Expectations of, and interactions with, younger people in general are not the same as those of older people who have retired, have grown families and differing responsibilities. This difference in needs is
reflected in the needs of those with dementia and requires a specialist approach by the social worker (SW). This can be demonstrated by examining the skills and knowledge required of a SW in this field and exploring how they translate into interventions.
