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Purpose: The purpose this paper is to explore walking with purpose in extra care, retirement and domestic housing settings to better understand and support people living with dementia in these settings, develop recommendations and inform practice. Design/methodology/approach: A mixed-methods study was used: scoping literature review; online survey of extra care and retirement housing managers in the UK; case studies involving interviews with staff and family carers (n = 14) of ten individuals who engaged in walking with purpose in the different housing settings. Findings: Although residents who walk with purpose constitute a minority (0–2 residents), managing walking with purpose can be challenging and time consuming. Distraction or redirection was the most common response. Other strategies included identifying the resident's motivations and accommodating their wishes or walking with them. Culture of care, staff training and dementia-friendly design are keys to effective support for safe walking with purpose. Responses to walking with purpose in the domestic housing settings have raised serious deprivation of liberty issues. Research limitations/implications: This study had a number of limitations. The completed survey questionnaires represent a self-selected sample of extra care and retirement housing settings, and responses are based on the perceptions of the staff members completing the survey. There were a relatively small number of case study sites (three extra care housing and three retirement housing), and it was not possible to interview family members for all of the residents who walked with purpose. Originality/value: This study provides unique data on walking with purpose in extra care and retirement housing setting in the UK. [ABSTRACT FROM AUTHOR]

Purpose – People with Down's syndrome are at increased risk of developing early onset Alzheimer's disease. It has been recommended that all adults with Down's syndrome receive baseline neuropsychological testing for dementia. In certain areas prospective screening of people with Down's syndrome takes place to ensure the early diagnosis of the condition. However, little has been published on the value of this type of screening. The purpose of this paper is to report on a prospective screening programme and asks whether the programme is effective in identifying dementia-related changes in people with Down's syndrome and whether the current screening intervals are appropriate. Design/methodology/approach – All adults with Down's syndrome in Plymouth (UK) are identified and offered a comprehensive test battery at baseline at the age of 20 and then have testing biennially from 40 to 50 and annually after 50. All individuals diagnosed with dementia between 2001 and 2013 were identified and their case notes examined. The symptoms at the time of diagnosis were identified and whether these symptoms had been identified through the screening programme or by other routes were recorded. Prevalence data and age at diagnosis were also recorded. Findings – In total, 26 people were diagnosed with dementia during the study period. Of these, the diagnosis of dementia followed concerns being identified during the routine screening programme in 54 per cent of cases. In the younger age group (age 40-49) 63 per cent of people were identified through the screening programme. At the time of diagnosis a mean of 5.5 areas of concern were in evidence. Research limitations/implications – Limited by small sample size, however service development not original research. Implications for the use of prospective dementia screening in people with Down's syndrome. Practical implications – Implications for how services choose to run their Down's syndrome and dementia screening programmes, including the frequency of screening. Originality/value – The paper adds to a growing evidence base around the value of prospective dementia screening in people with Down's syndrome. It is also one of a few studies exploring the frequency of screening. Additionally, it adds further data about prevalence of dementia in people with Down's syndrome. [ABSTRACT FROM AUTHOR]

Purpose – Financial abuse of people with dementia is of rising concern to family carers, the voluntary sector and professionals. Little is known about preventative and early response practice among community services staff. The purpose of this paper is to investigate voluntary sector staff's views of the risks of managing money when a person has a dementia and explore ways that individuals may be protected from the risks of financial abuse. Design/methodology/approach – An online survey of staff of local Alzheimer's Society groups across England was conducted in 2011 and was completed by 86 respondents. Open-ended responses supplemented survey questions. Statistical analysis and content analysis identified emergent findings. Findings – Most respondents said their people with dementia experienced problems with money management, with almost half the respondents reporting encountering cases of financial abuse over the past year. Most were alert to warning signs and vulnerabilities and offered suggestions relevant to practice and policy about prevention and risk minimization. Research limitations/implications – Adult safeguarding practitioners are likely to encounter money management uncertainties and concerns about exploitation of people with dementia. They may be contacted by community-based support staff from the voluntary sector about individual queries but could ensure that such practitioners are engaged in local training and networking activities to promote their skills and confidence. Practical implications – As with other forms of elder abuse, professionals need to be aware of risks of financial abuse and be able to suggest effective yet acceptable preventive measures and ways to reduce risks of harm and loss. Further publicity about adult safeguarding services may be needed among local community support services. Originality/value – There have been few studies investigating the views of people working with people with dementia in the community about adult safeguarding. [ABSTRACT FROM AUTHOR]