On Thursday morning I had the opportunity to be do the referral of a lady, Mrs White. Her husband had referred her to the centre as she has dementia and he is the sole carer. The plan was for her to attend one day a week and I was to do the referral forms and the carer's assessment.

When they came in we went into a room with comfy chairs which was a fairly relaxed and informal setting and I introduced myself to them and we discussed the purpose of all the forms and this visit. We went through details such as address and date of birth etc and I noticed that Mr White had to answer often in Mrs White's place but that he didn't do this too quickly, but allowed her at least a small chance to try and give the correct answer. She often looked to him and told him to answer. At these times they made comments about her memory and cognitive capacity saying things like 'she's still quite bright but just forgets things.' They were very honest and open about her strugles with memory and her confusion.

We came to the part of the referral designed for people with dementia asking a few questions about their uprbringing and family so as to see how well they remember things and to find out where they are coming from. I told them they didn't have to answer these questions if they didn't want but they said they would and I was later glad as I felt that this part of the referral gave me most information about Mrs White herself, her interests and her past experiences and background. I felt this allowed me to understand more where she was coming from and later in the day I was able to chat with her about some of these things and to understand what she was talking about if one of them was mentioned. I noticed again the great support that Mr White was in that he prompted her memory with things such as street names when she was trying to remember siblings and childrens' names and seemed to empower her in this way by being patient and allowing her to answer. This also emphasised to me the great dependence she seemed to have on him.

She told me family is the most important thing to her and they both told me stories about their children and grandchildren. Though Mr White is the sole carer, their children often come round and provide support in meals and things and this highlighted to me the importance of social networks and informal providers of care. It also made me consider the importance of policies and legislation regarding carer's rights and the huge amounts of carers who go unpaid and unsupported at the moment, often due to a lack of awareness.

Because of this I wanted to make sure that Mr White was receiving the support he needed and so, when doing the carer's assessment with him afterwards I made sure we talked about the part of it that offers him more information about support he can receive. However, he said he has received so many leaflets and his daughter-in-law helps him with that side of things, again showing the importance of informal support. Though he did not wish to do the carer's checklist that day he did tell me how difficult emotionally and physically it really is caring for Mrs W and how her coming to this centre and going to the other support agency etc helps him have a time to relax a little. We also discused feelings of guilt at leaving her and, interestingly, how one thing they both struggled with is the fact that often in 'these places' there are people much worse off than her and this makes them a little uncomfortable. This reminded me about a discussion with a local social worker about the future of older people's daycare and how there should be more provisions which recognise that not everyone wants to go to a daycare centre all day with people who are so much older and frailer than themselves. How can services be provided which recognise that even amongst older people there are still individual differences and big gaps in age and need?

Throughout the rest of the day I wanted to be around to help Mrs White settle and to introduce her to the other clients. At one point we had to go sit in the quiet room and just chat together as she was finding it a bit overwhelming and, later on, after 2 games of dominoes she expressed a similar feeling and had to come aside again. Her worries most of the day were about her husband not returning and at one point when I asked her what was troubling her she told me it was the fact that 'they' (which I assumed meant family) can go and do what they want all day while she has to stay here. She seemed very aware of the fact that 'this is my life now' and that she was losing some sort of freedom and possibly even her role in the family as she was now being cared for rather than a carer.

Throughout the whole process the themes of loss and grief were at the forefront of my mind because of situations like this and because of her husband's obvious grief at the kind of loss of his wife as she was and how he had expected her to be until she died. They expressed how they'd assumed she would be the same as her mum and live to an old age without any problems and it seemed that their unmet expectations were a major part of this loss and grief.

HAVE I INCLUDED TOO MUCH PERSONAL INFORMATION ABOUT THEM IN HERE? I FELL LIKE I'M BETRAYING THEIR CONFIDENCE SOMEHOW BUT I'M NOT SURE IF I AM?