This thesis considers whether the concept of resilience is applicable to people ageing with dementia; and, if so, what the implications are for social work practice. It begins with an exploration of the literature on dementia, resilience and social work. Using a symbolic interactionist approach it then details how the interactions of people with dementia and their social workers can potentially influence the realisation of resilience in practice. I collected data over a two year period. During this period six dyads comprising a person with dementia and social worker provided rich verbal accounts of their respective experiences. Using narrative analysis the stories of each person with dementia were explored to reveal threats to identity and possible resilience strategies. A resilience lens was applied to the verbal accounts of social workers in order to reveal opportunities and challenges to using resilience in practice. The findings indicate that identity continues to be of importance to people who are ageing with dementia. The preservation of identity could therefore be re-framed as the outcome of a resilience process. Each person could potentially acquire resources over their life which could help to mitigate threats to identity. This is referred to as the resilience reserve. This thesis details the potential domains of such a reserve. Further, it contains details of possible resilience strategies that a person with dementia might employ within stories of self. These strategies are placed within the context of protective and vulnerability factors in order that a resilience framework can emerge. This thesis argues for a re-framing of theories of what social work is. This, combined with a definition of resilience, and the development of a resilience practice framework could promote and realise the resilience of the person ageing with dementia.

Exploratory case studies investigated the day care benefit from the multiple perspectives of the person with dementia, caregiver, and day care worker. The routines, daily processes, and factors promoting benefit were reported. The day care client was also queried to explore their ability to contribute useful information about their care environment. The adult day care is primarily a social occasion for its clients, who enjoy the benefits of companionship and interaction. Day cares were differentiated by the environmental features: worker:client ratio, size, suitability of the site for intended purpose, quality of client-worker relationships, and quality of the activities offered. The quality of each of these features is an important component in the day care environment. All components at their highest quality are not necessary for the environment to be beneficial. The most important factors contributing to day care quality were workers who (1) communicated safety to the client through a relaxed, uncritical environment, and (2) facilitated client stimulation through activity and personal interaction, satisfying the clients’ basic needs to be safe and occupied. This evaluation was comprised of: two sets of case studies. Each evaluation was concurrently conducted and consistently designed. Participant observation and survey were the primary methods of data collection. Informed consent was sought from day care clients with dementia, family caregivers, and day care workers.

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