Dementia, disability and contact with formal services: a comparison of dementia sufferers and non-sufferers in rural and urban settings

This paper is based on data from studies conducted in the City of Liverpool and in a rural area of North Wales, relating to people aged 75 years and over living in the community. It compares those identified in these studies as suffering from cognitive brain disorders with other older people identified as being cognitively unimpaired and looks at levels of competence with activities of daily living and the subsequent levels of contact with a range of health and social services personnel and other community workers. It shows that although levels of contact with formal services are generally higher for people with dementia than for non-sufferers, most of these differences are below the level of statistical significance. It was found that levels of contact for people receiving most services are low, especially for specialist mental health services and social work. The implications for community care are discussed, it is suggested that expansion of domiciliary care services for people with dementia and for their carers would demand more resources than are currently being made available but that it would be better value for money on a case by case basis.