The target population of these services includes not only the users but also their families and the carers by providing them necessary skills for coping with the pressures of sustaining assistance to the user.
During appraisal of services it was noticed that while there were a wide range of services which could have been covered, the scope of appraisal was limited to key issues which affect the user, the family and the carer. Thus appraisal of services has been carried out with reference to four principle skills befriending, informing, advising and coping skills for carers. A common factor observed while appraisal of all these services was the lack of suitable metrics for assessing efficacy of each scheme which militated against their optimum administration. It was also considered that a total understanding of the issue of consequence to a limited number of the population could possibly be a majoritarian one and thus may not be totally congruent with the needs of the users. (Payne, 1997).
Befriending. Befriending is a key issue for users. These services alone make the relationship and friendship fun for all the participants, the user as well as the friend. The availability of befriending services was seen to be limited and these were restricted in numbers and their commitment as well as ability to provide succor to the users.
Informing. Information should overcome the key encumbrance of dementia that it seemingly does not have a medical cure. Information services have been adequately provided for in the area. These have in many cases covered the individual needs as well as general user needs thereby catering for essential information on benefits available, support and care services as well as treatment that can be provided. However there is also a need for access to information for the carers which was seen to be inadequate. Thus while generally the focus of information is on users, it is also essential for carers. As also while information on benefits was available in adequate quantum; accessibility to legal information was poor.
Advice. There was adequate material for provision of early advice and guidance to the user. Diagnosis was however seen to be a grey area as some reluctance was observed from a number of practitioners to diagnose dementia and subject people to special treatment. This key deficiency needs to be overcome with greater awareness in general practitioners. On the other hand some patients were also extremely reluctant to take advice in the initial stages. The reasons were seen to be varied including acceptance of a personal inadequacy and possible stigma attached to the condition. Provision of advice was seen to be particularly weak in this area. However the dilemma of the advisors was also well appreciated, as advice cannot be intrusive in nature as it would then be counter productive.
Skills for Coping by Carers. The skills provided for copers should ensure greater confidence and enhance their skills for management of the user preferably at home. The carer should understand that his needs are