Family and social supports

While the primary health-care team provides most of the individual's health care, the presence of adequate family and social supports is necessary to ensure continuity of care. Ideally, the team social worker functions as 'case manager', working with the family, patient, and treatment team to assess need and co-ordinate access to services. Where social services are administratively separate from health services, this can result in obstacles to the continuity of care. In the United Kingdom, a 1989 government publication(15 defined four essential objectives for the provision of community care: a proper assessment of need and appropriate case management; definition of agency responsibility and accountability; development of domiciliary, day-care, and respite services; and the provision of practical support for family and professional caregivers.

In order for case management to be effective, the social worker must function as part of a multidisciplinary team, taking into account the individual's physical and sensory, as well as psychiatric, impairments. Administrative obstacles to team collaboration must be avoided, and services should be planned to facilitate the sharing of common goals by family members and professionals in their efforts to maintain mentally impaired elders in the community.

Volunteer organizations and self-help groups, such as the Alzheimer's Disease Society, are often a considerable source of support to families. Through the support of such groups, carers become less isolated and feel more confident in managing some of the behavioural problems that arise. Individuals caring for family members with dementia are making increased use of online support groups that can be accessed from home through the Internet. There are also extensive amounts of written information and literature on the illness. The role of the health-care team should include helping the family to access and use appropriate information, and to avail themselves of formal as well as informal supports as needed.

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