Why we need to bring a gender perspective to dementia care

Dementia services need to take account of the way the disease disproportionately affects women, as service users and carers, says Vivien Ziwocha

By Vivien Ziwocha, head of care, Red & Yellow Care

I have worked in nursing and care since 1997, working with patients in hospitals, care settings and at home. I have had several roles in nursing management,and all of these roles have involved working closely with people living with dementia and their carers. The majority in both categories have been women.

Alzheimer’s Disease International (ADI) recent report Women and Dementia: A Global Research Review shows that my experience is representative of dementia care in general. The report highlighted that the majority of people living with dementia and those most at risk of developing it were women, and also that women account for an overwhelming majority of caregivers and health professionals.

How dementia affects women

In the United Kingdom, the government estimates that about 800 000 people currently have dementia, of whom approximately 61% are women, according to Alzheimer’s Research UK. The higher prevalence in women is likely to be due to the fact that women typically live longer than men and age is a big risk factor. In 2013, dementia was the leading cause of death among women, accounting for 12.2% of deaths – more than heart disease, stroke or the most common forms of cancer.

Furthermore, because women are more likely to be the caregivers for people with dementia, they account for 60-70% of all unpaid carers, according to Alzheimer’s Research UK.

Unsettling impact

From my experience of working with women caregivers, the narrative I have formed is one of a massive sense of duty and responsibility. Dementia can quickly unsettle the care ‘ecosystem’ and this can have a debilitating impact on women trying to provide care, who often lose themselves in the all-encompassing nature of dementia care.

It can be difficult for a caregiver to maintain their sense of identity, which can leave them feeling lost and out of control. The Women and Dementia report is a positive reminder that every woman has her own identity and understanding that is critical to addressing their emotional and environmental needs.

Importance of history taking

In addition, recognition that dementia might not always present as a single condition is crucial. Women will often be living with other long-term conditions which need to be taken into account when developing their care plan.  Comprehensive history taking is an important part of planning integrated, responsive care, and understanding the complexities and impact of a woman’s experiences is pivotal to delivering emotionally attuned care.

In my role as a specialist nurse, I have found that appreciating that one size does not fit all when it comes to dementia care is fundamental. Nurses need to tailor care to a person’s medical, psychological and social needs in order to improve their wellbeing and quality of life, and to help them continue enjoying what matters to them. Specialist nurses need to use their broad and versatile expertise to prevent, assess and deliver care solutions that encapsulate dementia and associated conditions.

Smart solutions

Smart care solutions, where specialist nurses provide a single access point and coordinate different care elements, can provide responsive health and social care to people living with any aspect of dementia. Furthermore, as the findings of this report show, there is a compelling argument for incorporating gender requirements into these solutions.

Vivien Ziwocha is head of care at Red & Yellow Care, which supports older people with long-term conditions. The Women and Dementia report was supported by grants from Red & Yellow Care and WomenAgainstAlzheimer’s.

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