1-6 As Training Director for the Northwest Mental Health Hotline,

Mr. B has been receiving home care services for several years. He has dementia and his needs have gradually increased, but he is capable of living semi-independently for now. His two daughters live nearby and at least one of them visits daily. Mr. B gets on well with the care staff and makes it clear to them that he wants to keep doing as much of his own housework and personal care as he can. However, his daughters express concern to the provider that he is no longer capable of making decisions that best meet his needs. They ask the provider to add grocery shopping, meal preparation, and gardening to their duties, tasks that Mr. B has been doing himself until now without mishap. The care staff who look after him directly tell the service coordinator they think this change is unnecessary and risks making Mr. B unhappy and affecting his confidence. The provider has to balance the wishes of Mr. B’s family with Mr. B’s own preferences. The main priorities are Mr. B’s safety, his well-being, and respecting his wish to keep doing his daily tasks. There are certainly safety and nutrition issues to consider. So far these have not arisen but may as Mr. B’s dementia progresses. A care coordinator with experience in dementia meets with Mr. B to talk about these issues. Mr. B understands the concerns being raised by his daughters and decides that the risks discussed with him are outweighed by the importance of the benefits he gets from doing his own grocery shopping and meal preparation. Mr. B agrees to a small increase in staff supervision for these activities. In explaining the plan to Mr. B’s daughters, the coordinator emphasises how important it is for their father to maintain a sense of independence, self-worth, and purpose. The coordinator also makes it clear that the provider has carefully discussed the health and safety risks with their father and will continue to monitor them from day to day and welcomes further input from the family about their observations of how he is coping. answer following questions with references 1. From your understanding about diversity in older people, explain how Mr B’s case is different in terms of his needs when compared to some older people living with dementia?

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