Special Measures – My view

Last week's announcement that adult social care providers who deliver sub-standard care face being put into Special Measures from April 2015 proved to be quite a momentous event for me. I was involved in the announcement (details here), and it understandably produced a lot of mixed reaction.

I'd like to use this blog post to clarify some of my thoughts around this issue in more detail. The singularly most important thing to stress in this debate is that the majority of care is good care. I have written extensively about the amazing care my father received from many dedicated and caring professionals (for examples see: 'Continuity is key', 'Sense and simplicity', 'End-of-life care - A very personal story') some of whom are still good friends of my family. The coverage I have given to the positive aspects of my father's care on D4Dementia and elsewhere far outweighs coverage of our negative experiences.

It is widely known that adult social care has a poor reputation, badly tainted by the actions and culture of a minority whose conduct hits the headlines in a way that the many positive stories of wonderful care never do. Yet, as I said in my statement in the press briefing for the Special Measures announcement, "Most care is excellent. Most care workers are dedicated, and often undervalued, professionals". 

I am the first to acknowledge that there are huge issues in the recruitment and retention of good care workers (see this blog post), and that the terms and conditions that many work under fall well short of the professional standing and associated remuneration that I would like to see given to care work. But none of this is an excuse for poor care. Many good care workers have terms and conditions of employment that do not fairly reflect the work that they do and yet they still deliver great care, and of course the many volunteers who help to prop up services earn nothing at all and often make an amazing contribution to the lives of vulnerable adults. 

None of that in any way belittles the issues around employment of care workers, but aligning debates about employment with debates around poor care almost gives the impression that unfair employment conditions are an excuse for poor care, when there can never be an excuse for poor care. I know for a fact that the many wonderful people who cared for my dad weren't paid enough, or valued by their employers as they should have been (one of my dad's care homes had 4 different owners in the time he lived there), but they were fundamentally dedicated and caring people who did amazing work in often very difficult circumstances.  

In terms of the proposals about Special Measures, many people have asked me what will be the difference between Special Measures and the powers CQC have now to issue warning notices and if necessary take action to remove the registration of a provider and close a service. To clarify, CQC have been asked to develop a Special Measures regime for adult social care by the Secretary of State. That process will begin in autumn 2014 and be done via the Adult Social Care Co-Production group that I am a member of. At present, the in depth details of what Special Measures in adult social care will look like are still to be decided on.

In the meantime, I have my own personal 'wish list' that draws on the experience of poor care that we had in the last 6 months of my dad's life. This list includes:

1) Timely intervention - Often vulnerable people don't have weeks and months to wait for improvements to happen. If the 'care' they are receiving is acutely failing, it could cause serious injury or premature death.

2) Targeted intervention - A Special Measures style intervention should, in my view, directly address particular concerns by signposting to resources that can make an immediate difference to the lives of the people receiving a care service. There are loads of great resources available, and accessing them doesn’t necessarily require a provider to spend a lot of money. We are very fortunate in the UK to have The Social Care Institute for Excellence and Skills for Care alongside many other innovative and highly effective national and local organisations, businesses, charities and community interest companies that can provide guidance, practical resources and be catalysts for change. Indeed, independent of regulation some care providers work with me in a consultancy capacity to evaluate, improve or change aspects of their service, so there are many proactive and forward-thinking providers out there already.

3) Sensitive intervention - It is vital to be mindful that a care home is the home of the people that live there. In my view Special Measures must do everything possible to turn a service around in a timely and targeted way without the people that live there having to find a new care home, unless of course those people want to find new care home. Having to move can be very distressing, and again possibly hasten a person's death is they are particularly frail or have advanced dementia.

4) Public accountability - I hope that, like with hospitals, Special Measures will provide clarity for families about the status of a service. Families aren't stupid - they know when care isn't good enough, but generally they are often too afraid to speak up. They need to see CQC taking firm but fair action that addresses shortcomings if a service isn’t safe, caring, effective, responsive and well-led. As part of that process, I would like to see all providers actively working with families in a renewed effort towards teamwork and inclusivity in the day-to-day life of a care home.

So how are care providers likely to react? In my view, if you are a good care provider you have nothing to fear. If you are a provider who is found to have a service that is delivering sub-standard care but you are prepared to work hard on turning that service around you have nothing to fear. If, however, you are a provider of a sub-standard care service and you are complacent and disinterested in improvement then you are a danger to the people who rely on you (people receiving your care, their families and any good care workers that you employ), and anyone who may come into contact with your service in the future. It is then the role of CQC to take action and it would be indefensible if they didn't.

There is some disquiet that putting a service into Special Measures will mean that the provider cannot maintain their revenue stream if one of the conditions of Special Measures is to prevent the provider from having new admissions to their care home or new clients to their homecare service. This, however, isn't new - there was a period when one of my dad's care homes was closed to new admissions due to safeguarding. In my view this actually helps providers; it enables them to focus on their service and the improvements that are needed without the added responsibility of caring for more people, and it safeguards the public from anyone else coming to harm whilst the service implements improvements.

Is privatising care the reason poor care exists? In my view poor care can occur whether the provider is making a profit, is a not-for-profit or indeed is a public sector organisation. The causes of poor care practices are, more often than not, centred around the culture of an organisation, its leadership and in some cases individual staff teams or members. Can hospital-style Special Measures work in social care? No, because clearly there are significant differences between hospitals and social care, but there are certainly some positive examples of hospitals turning themselves around as a result of being placed into Special Measures.

Can CQC be trusted with this? As is well known, CQC didn't provide us as a family with the support we needed when my father was alive, but arguing about the regulator isn't going to change the fact that they are still the regulator. Working with them to improve social care, celebrating the outstanding examples of care and uncovering inadequate care is the only option in terms of the regulation of UK health and social care services. As I have said in the past, inspection - however rigorous and informed with intelligent monitoring - will still only be a snapshot of a service. Whistleblowing is as vital now as it has ever been, whether you are a person receiving care, a family member or a social care worker.

I believe as a country we owe it to every person who needs social care and their family to ensure that care is the very best it can be. I will always champion that regardless of who is in government and who the regulator is. I feel passionately that we must be the change we want to see, and constantly strive for improvement and the eradication of poor practice.

Until next time...

You can follow me on Twitter: @bethyb1886

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Challenging stereotypes about families and care homes

Ask a cross-section of individuals what they think about care homes and you will often hear negative views of both the homes themselves and the families whose loved ones live in them. Having a relative in a care home has long been seen by the ill-informed as some sort of bypassing of responsibility, but for the majority of families that couldn’t be further from the truth.

Embarking on the heart-breaking process of finding a care home, and then trying to adjust yourself and your loved one to this new way of living, isn’t quite the throwaway experience that many people - including some of our politicians - have portrayed it to be. As someone whose dad lived in 3 different care homes over a 9 year period, the suggestion that we as a family somehow negated our responsibilities towards him infuriates me.

Neither my father nor us as his family were given a choice about dad’s care: his doctors decided that he would be a danger to himself and to others if he returned home after hospitalisation for a larger stroke that had led to a diagnosis of vascular dementia. Without a health and welfare Power of Attorney (such a document didn’t even exist then) or any advanced care directives, we were powerless to change that decision, although I don’t actually believe that the doctors were wrong in their assessment.

As a family we knew virtually nothing about dementia, and there was precious little support for us in trying to understand how best to alleviate my father’s symptoms and provide him with the best quality of life possible. With dad utterly miserable in hospital, it was an immense responsibility to be charged with finding him a care home. Like many families, we had no idea what we should be looking for and moved from visit to visit almost in a daze – arguably we were as lost and bewildered as poor dad was.

Against this backdrop, imagine feeling the need to justify yourself to people entirely unconnected with your own situation who feel it is their right to sit on the moral high ground and verbally punish relatives for talking what is seen by some as an ‘easy way out’. Moreover, those who proliferate this view only serve to further stigmatise care homes at a time when they have taken an immense public bashing.

Perhaps most worryingly of all though, is that by stigmatising those who seek help to care for a loved one we are in danger of making carers – that most isolated and undervalued group of people – even more isolated. We know that carers desperately need more support but many don’t feel that they can ask for help. They fear being seen as someone who ‘can’t cope’, and feel guilty at the prospect of asking for some respite for fear of the effect on their loved one. Yet no one can carry on caring alone forever without it having potentially very serious consequences for their own health, and in turn the welfare of the person that they are caring for.

There is also a particular stigma that many families from minority ethnic backgrounds face. Their culture is rooted in caring for ageing relatives at home and in private, but at the same time they are living in a UK society that has incompatible expectations and priorities. Often in Asian countries, different generations of a family are likely to be living in the same accommodation and can share the caring duties – both when nurturing the younger generations and helping the elders. The women will usually remain at home to perform these duties and can support each other.

In the UK, women increasingly need to work in order to contribute to housing and living costs, generations often live apart (and in the future more people will age as single adults with no children), and whilst there is support from employers for parents with young families, support for those who are caring for ageing relatives is severely lacking. Many families also feel very ill-equipped to take on a caring role, especially if someone becomes very frail or has advanced dementia. If they make mistakes, or a lack of specialist equipment leads to an injury or accident, those feelings can be compounded.

At the very least most families will end up needing a level of domiciliary care in order to look after a relative and continue to work, and many will eventually need a care home if the person’s needs become very complex. Ultimately, of course, that decision can also be taken out of the hands of families by health and social care professionals. They are duty bound to act in the best interests of the vulnerable person, and indeed a carer who they may have identified as someone who can no longer go on providing 24/7 care, particularly if that carer is older and in poor health themselves or has more than one person to care for.

So the idea that somehow families are abandoning their loved ones, en-mass, to abusive sub-standard care homes is wholly wrong. For a start most care homes are actually staffed by very caring people who do a wonderful job, as I spoke about in my recent film for Care England. In the minority of homes where that isn’t the case, it is completely abhorrent to take the view that families have ‘got what they deserved’ and if the care isn’t good enough that they should ‘do it themselves’.

Social care has, for a long time, been part of the fabric of UK society, and rather than trying to reverse that model we should be embracing ways to use it as creatively as possible. Ensuring that everyone has access to good quality care, be that short-term respite or long-term care, is vital for a healthy and vibrant society. When care is caring and compassionate, it can be a breath of fresh air into the lives of all that it touches.

I also believe that we need to stop looking at care as ‘them’ and ‘us’. Care, in all settings, should be about professionals and families working together, sharing knowledge and experiences. With an ever-increasing ageing population, my view is that this will need to become the norm if everyone - be they a person needing care, a family or a social care professional - is to cope with this new reality.

Until next time...

You can follow me on Twitter: @bethyb1886

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A holistic approach to multiple long-term conditions

One of the great myths around dementia is that it exists in isolation. If every person with dementia was only living with dementia and no other conditions, and they weren't at more risk of developing other conditions during the course of their dementia, then care and support would be infinitely more straightforward. The reality, however, is very different.

The description 'multiple long-term conditions' is relatively new terminology, and the knowledge around how to manage multiple long-term conditions isn't comprehensive. We don't know enough about the interactions between different conditions, or indeed how the associated polypharmacy (where a person is taking multiple medications) is going to affect each individual now and in the future.

Some conditions are explicitly linked with specific forms of dementia, a classic example being the association between vascular problems (IE: high blood pressure, heart disease and stroke) and vascular dementia. More generally, there have been many headlines written linking diabetes with dementia, and for people with a learning disability and dementia, the risk of epilepsy is increased.

There is so much more to this multiple condition landscape though, and a person who is living with dementia could quite easily be living with many other conditions that aren't specifically linked to their dementia but add additional layers of complexity, medication and even danger into their lives. Examples would include asthma, arthritis, ME, osteoporosis, eczema (and other skin conditions), coeliac disease and the many different cancers. Never forget also the numerous individuals who live with chronic pain, given that we know pain is very poorly recognized and treated for people with dementia. 

As a person ages they are also at more risk of hearing loss and sight loss. Macular degeneration, for example, can leave an older person blind. Coping with that type of sensory loss when an individual has dementia is inevitably going to make adjusting to losing your sight considerably more difficult, and likewise will make living with dementia much more complex and potentially lead to even more exclusion and loneliness. Equally, if joints like knees and hips begin to wear out and need replacing, that can also be very difficult for a person with dementia in terms of their ability to consent to an operation and successfully complete the long-term rehab that’s required.

Dementia can also lead to the development of other conditions, either though the progression of a person’s dementia or because they haven’t received optimum care – examples include: incontinence, dysphagia (swallowing problems), pressure sores (pressure ulcers), dehydration, malnutrition and the many circumstances that can lead to temporary or permanent immobility.

Equally, whilst being focused on the different physical conditions that a person with dementia can develop, it's important to remember that there are many mental health conditions that can live alongside dementia, and indeed sometimes be mistaken for dementia. Two of the most common are depression and delirium.

Yet despite all of the links that can be made very logically between multiple long-term conditions we are not good at treating people holistically. The NHS is largely organized to treat individual conditions, but as our population ages and more people live with multiple long-term conditions the need for that holistic model of care will only grow.

Worryingly then, I've heard of huge difficulties in providing care and support to people who are living with diabetes and dementia. These are two of the most common long-term conditions in the UK today, and the numbers of people living with both are likely to increase, particularly with obesity levels rising. Mismanagement of diabetes can have life-threatening consequences, and just because a person has managed to keep their diabetes under-control prior to developing dementia is no guarantee that they will be able to in the future as dementia complicates their landscape.

The challenges of caring for people who are living with dementia alongside other conditions are huge. A person can forget why they need to take certain medications, avoid particular foods or drinks or participate in certain tests, all of which can adversely affect the management of conditions that they live with alongside dementia.

One of the great mantras of my work has always been that a person with dementia will not be able to manage their dementia alone long-term. This is an even more prudent comment when you consider the other conditions a person may have that they require a family carer, alongside health and social care professionals, to help manage and support.

Only by treating and caring for a person in a holistic way throughout their entire life with dementia can we truly hope to meet the aspiration of enabling them to living well with dementia. Whole-person care, as part of the more widely recognized person-centred care model, is the only way forward. Expanding that to relationship-centred care will also enable carers and families to be seen as partners in care and receive the support that they need too.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook 

Please note: In 2015 the NICE/SCIE 'National Collaborating Centre for Social Care' will publish guidance on the Social Care of Older People with Multiple Long-Term Conditions. Find out more here.

Carer's questions - How do I look after myself?

Welcome to the last of my seven ‘mini’ blogs for UK Carers Week 2014.

As regular readers of this blog know, I cared for my father for 19 years during his vascular dementia. For the majority of that time, however, I never considered myself a carer - just a daughter looking after her dad. As I said in my G8 Dementia Summit film, "You become a carer, but you don't realise you've become a carer."

For UK Carers Week 2014, I want to focus on questions carers often ask me, and indeed many questions I frequently asked myself during my father’s dementia. 

Day 7 - How do I look after myself?

Most carers are great at caring for others, but less good at caring for themselves. In my case once a carer, always a carer – I’m still much better at looking after others than I am myself. Sadly I no longer have my dad to care for, but my love and dedication towards him is now focused on the rest of my family, sometimes to my own detriment.

I have no excuses though – I should be able to recognize when I need to give myself some TLC. However, in the pressure cooker of caring, with its intensity and all-consuming nature, carers are renowned for being terrible at spotting when they need help themselves, sometimes leading to severe consequences for their health.

I remember many people saying to me when my dad was alive and I was trying to juggle 10 different tasks at once that I needed to take some time out for me. Switching off is actually extremely difficult though, and knowing we were always just a matter of hours from dad being intensely poorly (infections always hit him fast and hard) made any concerns I had for myself pale into insignificance. Carers are always reminded that if you are poorly your loved one will suffer too, but whilst that’s great advice the practical application is much more difficult. 

As more carers try to juggle multiple responsibilities, and are perhaps caring for more than one family member or friend, they are likely to think even less about themselves. The toll on their health can be huge, and can lead to the carer needing care, particularly if they are an older person or have other long-term health problems. Your GP practice can advise on a carer’s health assessment – remember, taking care of YOU is important too. 

Further reading:

D4Dementia: 'Caring for carers'

D4Dementia: 'Be inspired, be very inspired'

D4Dementia: 'The carer's job description'

All D4Dementia blog posts for Carers, including many with tips and advice on coping with particular aspects of your loved one's dementia

External links: 

Dementia Action Alliance Carers' Call to Action: http://www.dementiaaction.org.uk/carers

Carers UK: http://www.carersuk.org/

Carers Trust: http://www.carers.org/

Carers Direct: http://www.nhs.uk/carersdirect/Pages/CarersDirectHome.aspx

Carers Week: http://www.carersweek.org/

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Carer's questions - Is this normal?

Welcome to the sixth of my seven ‘mini’ blogs for UK Carers Week 2014.

As regular readers of this blog know, I cared for my father for 19 years during his vascular dementia. For the majority of that time, however, I never considered myself a carer - just a daughter looking after her dad. As I said in my G8 Dementia Summit film, "You become a carer, but you don't realise you've become a carer."

For UK Carers Week 2014, I want to focus on questions carers often ask me, and indeed many questions I frequently asked myself during my father’s dementia. 

Day 6 - Is this normal?

As a carer with no medical background whatsoever, I found that one of the biggest challenges in caring for my dad was understanding what was happening to him during his dementia. I suspect that anyone who is caring for a person with complex cognitive problems is destined in some regard to struggle – even professionals can find it hugely difficult. In fact, taking that into account just imagine what it's like to actually be the person LIVING with dementia.

When you are a carer and your loved one cannot communicate easily or respond to you in ways you expect, finding an understanding between you both can be a steep learning curve. I managed to find other techniques beyond traditional speech to communicate with my dad (read my blog about expression), and in fine-tuning those it has hopefully made me a far more intuitive person. Finding the subtleties, sensitivities and sometimes tiny movements that indicate the communication of a particular message from your loved one isn’t easy though.

Whenever you are going through a rough patch, and encountering actions or situations that you find difficult to cope with, it’s inevitable to wonder if they are ‘normal’. Defining normal is almost impossible, since one person’s normal is another person’s abnormal (or indeed somewhere in between). Over time you do get a sense of what is your loved one’s normal, but that takes patience and involves trial and error.

No person is a behaviour, and whatever you are going through with your loved one underneath those immediate concerns is still the person. It’s easy to lose sight of that sometimes, and indeed overly stress about changes that we don’t consider ‘normal’. Trust your instincts; if you feel something is wrong seek help, but at the same time consider what you are really experiencing – the progression of dementia is such that either temporary or permanent changes in a person may be within what is their ‘new’ normal.

D4Dementia blog posts that I frequently signpost dementia carers to:

Symptoms: 'What is dementia?'

Communication: 'Talking the talk'

Aggression: 'Understanding aggression'

Swearing: 'Turning the air blue'

Disorientation/confusion/frustration/paranoia: 'Day-to-day with dementia'

Hallucinations: 'Another world'
 

Further reading:

D4Dementia: 'Caring for carers'

D4Dementia: 'Be inspired, be very inspired'

D4Dementia: 'The carer's job description'

All D4Dementia blog posts for Carers, including many with tips and advice on coping with particular aspects of your loved one's dementia

External links: 

Dementia Action Alliance Carers' Call to Action: http://www.dementiaaction.org.uk/carers

Carers UK: http://www.carersuk.org/

Carers Trust: http://www.carers.org/

Carers Direct: http://www.nhs.uk/carersdirect/Pages/CarersDirectHome.aspx

Carers Week: http://www.carersweek.org/

Next post on 15 June 2014.
Until then...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Carer's questions - Does everyone feel that they can’t cope?

Welcome to the fifth of my seven ‘mini’ blogs for UK Carers Week 2014.

As regular readers of this blog know, I cared for my father for 19 years during his vascular dementia. For the majority of that time, however, I never considered myself a carer - just a daughter looking after her dad. As I said in my G8 Dementia Summit film, "You become a carer, but you don't realise you've become a carer."

For UK Carers Week 2014, I want to focus on questions carers often ask me, and indeed many questions I frequently asked myself during my father’s dementia. 

Day 5 - Does everyone feel that they can't cope?

Possibly not everyone, but certainly most carers feel like this during their caring role and often feel like it frequently. I personally don’t ever recall meeting a carer who at some point didn’t feel that they weren’t coping, and that includes carers from many different backgrounds. 

In my father’s 19 years with vascular dementia I struggled when big decisions had to be made, mostly health-related, or when we were waiting on the decisions of others, usually healthcare professionals. The absolute worst times, however, were when dad was seriously ill in hospital – as a carer you feel helpless and often very excluded from what is happening to your loved one. In those times I honestly wondered how we would get through it – the fear of losing dad was huge and so very real.

It’s easy to believe that you are the only person feeling like this. When my dad was alive I wasn’t involved in the online ‘carer community’ at all, but having become connected to it through my work I can see how valuable it is. A huge number of carers contact me through social media seeking advice, and I’m always very happy to help where I can. I also regularly look at the #dementiachallengers hashtag on twitter - it's a place where anyone and everyone can come together to talk about dementia.

One of the most powerful testimonies of the power of social media for carers comes from the wonderful Sally who tweets as @nursemaiden. She engaged with twitter in the last hours of her father’s life, looking for reassurance with the palliative care that she and her mum were providing. Why you might ask? Simply because twitter offered her instant and informed advice thanks to the huge number of experienced professionals on the site.

A small plea from me though – for all that is great online, and there is a huge amount, we must never forget people who aren’t online. Having a computer and broadband (plus someone to teach you) isn’t an option for everyone due to cost, preference or other associated reasons. It is those people who are possibly feeling like they can’t cope most of all – another great reason why we should all look out for our neighbours and friends more, and signpost to helplines and printed materials.  

Further reading:

D4Dementia: 'Caring for carers'

D4Dementia: 'Be inspired, be very inspired'

D4Dementia: 'The carer's job description'

All D4Dementia blog posts for Carers, including many with tips and advice on coping with particular aspects of your loved one's dementia

External links: 

Carers Direct helpline: http://www.nhs.uk/carersdirect/carerslives/updates/pages/carersdirecthelpline.aspx

Admiral Nursing Direct: http://www.dementiauk.org/information-support/admiral-nursing-direct/

Dementia Action Alliance Carers' Call to Action: http://www.dementiaaction.org.uk/carers

Carers UK: http://www.carersuk.org/

Carers Trust: http://www.carers.org/

Carers Direct: http://www.nhs.uk/carersdirect/Pages/CarersDirectHome.aspx

Carers Week: http://www.carersweek.org/

Next post on 14 June 2014.
Until then...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Carer's questions - Is it wrong to want something more for myself?

Welcome to the fourth of my seven ‘mini’ blogs for UK Carers Week 2014.

As regular readers of this blog know, I cared for my father for 19 years during his vascular dementia. For the majority of that time, however, I never considered myself a carer - just a daughter looking after her dad. As I said in my G8 Dementia Summit film, "You become a carer, but you don't realise you've become a carer."

For UK Carers Week 2014, I want to focus on questions carers often ask me, and indeed many questions I frequently asked myself during my father’s dementia. 

Day 4 - Is it wrong to want something more for myself?

This is perhaps the one question carers, people who are often naturally more selfless than selfish, struggle with. I had huge battles with myself over balancing my dad’s needs with my own. It isn’t easy to be in your twenties and watch your friends furthering their education and beginning exciting careers and not doing the same yourself.

Choosing not to do what everyone else was doing had nothing to do with coming from a privileged background or not wanting to work - quite the opposite in fact. I just realised that dementia was a terminal disease and that I had limited time left with my dad. Spending as much time with him as possible had to be my priority. 

There are huge and inescapable practical considerations for carers around finances, working and/or studying. Caring can be all-consuming, yet with a pitiful carer’s allowance and with many people finding trying to claim it impossible, it can make paying your bills a huge worry. For many people caring isn’t for a set period of time either, so trying to plan for future study or a career can be really difficult.

Respite care for your loved one is vital to give you some work or study options, but as we all know respite can be unavailable, expensive or unworkable for far too many families. By way of offering a bit of hope, however, I have known of carers who’ve made a success of home-based work solutions, started up their own enterprise with products or services that they’ve identified a need for, embarked on distance learning courses or managed to negotiate flexible study or work arrangements. There is no denying though that for most people this is difficult, if not impossible, until after their caring duties end, hence why my career only began at 31 after my father passed away.

Further reading:

D4Dementia: 'Caring for carers'

D4Dementia: 'Be inspired, be very inspired'

D4Dementia: 'The carer's job description'

All D4Dementia blog posts for Carers, including many with tips and advice on coping with particular aspects of your loved one's dementia

External links: 

Dementia Action Alliance Carers' Call to Action: http://www.dementiaaction.org.uk/carers

Carers UK: http://www.carersuk.org/

Carers Trust: http://www.carers.org/

Carers Direct: http://www.nhs.uk/carersdirect/Pages/CarersDirectHome.aspx

Carers Week: http://www.carersweek.org/

Next post on 13 June 2014.
Until then...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook