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Why you should read this article: • To understand the complexity of the needs of people with delirium superimposed on dementia • To enhance your knowledge of second-generation activity theory • To recognise the consequences of the separation of physical health and mental healthcare. Background: Delirium superimposed on dementia (DSD) affects the physical, mental and cognitive well-being of the person. The separation of physical health and mental health means that the care of people with DSD is at odds with the multifaceted aetiology and presentation of the condition. There is a lack of research on DSD from a mental health perspective. Aim: To explore UK mental health nurses’ experiences of providing care for people with DSD. Method: Individual semi-structured interviews were conducted with seven mental health nurses from one NHS trust in England. Participants’ experiences were considered through the lens of second-generation activity theory. Data were analysed using framework analysis. Findings: Six themes were identified: awareness of guidance and tools; guidance or tools as ‘paper exercises’; knowing the patient; the multidisciplinary team; care burden; and mental health versus physical health. Conclusion: When providing care for people with DSD, mental health nurses use their skills in knowing patients as individuals. However, this aspect of ‘knowing’ cannot be readily translated into the use of a numerical scoring tool. An integrated approach is required to support the care of people with DSD. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To better understand the detrimental effects of domestic violence and abuse on children and young people • To acknowledge the importance of having independent domestic violence advocates in children’s hospitals • To reflect on how you can enhance your practice with regard to domestic violence and abuse. Domestic violence and abuse (DVA) has detrimental effects on the health and well-being of children and young people exposed to it, whether they witness or experience it. The introduction of independent domestic violence advocates in UK hospitals has enhanced the safety of victims of DVA. In 2020-2021 an independent domestic violence advocate post was piloted at a children’s hospital for one year, the advocate’s role being to train hospital staff and support women who had experienced DVA. A service evaluation showed that the training and support provided by the independent domestic violence advocate had benefits for women, children and staff. It also confirmed that the commissioning of services for children exposed to DVA is often underfunded and overshadowed by the provision of support to adults. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To appreciate the importance of effective management of service users’ discharge from inpatient settings • To understand the factors that can enhance service users’ experience of transition from inpatient rehabilitation settings to the community • To learn about what elements of the discharge process could be improved to enhance service users’ experience. Discharge from inpatient rehabilitation settings can be a stressful experience for service users and mismanagement of the transition process can have negative outcomes, such as early readmission. This service evaluation explored the experience of people transitioning from inpatient rehabilitation settings to the community to identify what works well in the rehabilitation pathway discharge process and areas for improvement. Eight service users participated. All eight completed a bespoke questionnaire, six of whom took part in a subsequent semi-structured interview. Findings suggest that, overall, participants had a positive experience of transition, particularly in relation to practical and emotional support from inpatient and community rehabilitation services. Areas identified for improvement include increased involvement of family and carers during the discharge process and greater clarity about the role of the various professionals and teams involved in service users’ care once they are discharged to the community. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your awareness of the effects of mesothelioma on veterans and their family caregivers • To recognise the positive and negative influences of a military background on veterans’ and their caregivers’ experiences of mesothelioma • To appreciate the need for sensitive, skilled and honest communication when discussing diagnosis, prognosis and care interventions with veterans with mesothelioma and their caregivers. Background: In the UK, around one in eight adults aged over 65 years is a veteran of the UK armed forces. There is little research into the experiences of veterans with mesothelioma and their family caregivers. Aim: To explore the psychological effects of mesothelioma on UK veterans and their family caregivers from the caregivers’ perspective. Method: Purposive sampling was used to recruit six participants to this qualitative interview study. Individual semi-structured interviews were conducted and data were analysed using interpretative phenomenological analysis. Findings: There was an underlying influence of the military background on several facets of caregivers’ and veterans’ experiences. Veterans and caregivers made efforts to ‘just keep on going’. Psychological benefits were derived from having a stoic outlook, retaining one’s sense of humour, being goal-oriented and putting others first. Holding to high military standards such as loyalty led to broken trust and anger. Straightforward ‘need to know’ communication is a priority in the armed forces and this also influenced caregivers’ and veterans’ experiences. Conclusion: It is important that nurses are aware of the specific cultural factors present in armed forces veterans and their caregivers so that they can assess and address their needs adequately. [ABSTRACT FROM AUTHOR]