Dementia creeps in softly at first. A kettle left on, a name that just won’t come. Families notice it before the person does, and the worry starts there. It’s a slow heartbreak, to be fair, and no one really knows what each day will bring.
One person alone can’t carry all that weight. The nurse may catch a fever early, the doctor adjusts tablets, and the social worker sorts the grant forms. When they meet, share stories over half-cold tea, the fog clears a little. That circle — the multidisciplinary team, or MDT — is what keeps care human. It’s less about rules and more about people pulling together.
Here in Ireland, the HSE Dementia Services and HIQA Care Standards (2016) keep saying the same thing: dignity first, always. In practice, teamwork makes that real. This essay looks at how that mix of skills and hearts works in dementia care, and how, all the same, kindness holds it steady.
In any Irish unit — a small ward in Kerry, a community day centre in Louth — you’ll find the same hum of shared work. Someone sorting charts, another coaxing a smile, someone wiping a counter clean. It’s quiet teamwork, the kind that keeps people safe without fuss.
The MDT brings all those voices together. Nurse, GP, social worker, occupational therapist, physio, psychologist, pharmacist, dietitian — and often a son or daughter sitting in. Everyone sees a different piece of the story. When they talk it through, the jigsaw fits.
At a Limerick memory clinic, meetings happened every Thursday morning. The room was small, the windows fogged, biscuits gone before the kettle boiled. Still, they managed. They spoke about one gentleman who wandered at night; the physio noticed his stiff hips, the nurse his sleeplessness. So it turned out the “wandering” was pain. A short stretch routine, and the nights grew calmer.
In practice, that’s what teamwork does — turns confusion into understanding. Not perfect, but better than facing it alone.
Each person in the team fills a gap that the others can’t. The nurse keeps an eye on skin colour, appetite, and small shifts that whisper change. The doctor checks the bigger picture — bloods, memory scores, and medication timing. The social worker links families with respite care. Occupational therapists make sure the home is liveable — rails near the stairs, clear labels on drawers. Physiotherapists keep bodies moving. Psychologists help calm the storms in the mind. Pharmacists and dietitians tie it all together, watching what goes in and what shouldn’t.
| Team Member | Main Role | How It Helps |
|---|---|---|
| Nurse | Watches health, listens, comforts | Feels safe, less fear |
| Social worker | Connects family, finds services | Reduces strain |
| Occupational therapist | Adjusts routines & spaces | Keeps independence |
| Physiotherapist | Builds strength, mobility | Prevents falls |
| Psychologist | Guides coping | Brings calm |
| Pharmacist | Checks prescriptions | Avoids side effects |
| Dietitian | Plans meals | Keeps up energy |
To be fair, most progress shows in small things. The right chair height, a calm hallway, one good night’s sleep. These wins look tiny on paper but change everything in practice. And that’s the quiet power of an MDT — shared effort making ordinary life possible.
The nurse stands closest. First in the morning, last at night. They see the small tremor, the frown, the appetite fading. They know the family’s names, the favourite song, and the cup that leaks a little at the side. Their notebook becomes the map others follow.
They work under HIQA (2016) and HSE Person-Centred Care Framework (2021), and they keep the HSA safe-handling rules (2020) in mind — but mostly, they rely on instinct and patience. Privacy, consent, comfort: those words aren’t policies in a binder; they’re habits built over years.
A nurse in Cork once tried soft fiddle tunes during evening washes. The usual restlessness melted. Fewer tears, less shouting. Families noticed. All the same, it wasn’t about the music really — it was about being seen, soothed. That’s what nursing adds to the team: a steady presence, a bit of heart when days grow heavy. In practice, it keeps the whole circle human.
Teamwork in dementia care rarely looks neat. Some days start smoothly, then turn sideways before lunch. Still, when people pull together, the difference is real. One voice alone misses things; a mix of voices fills the gaps.
A nurse might notice the poor sleep, the physio spots the tired legs, and the GP adjusts medicine times. It sounds small, but those tweaks calm whole nights. In a Cork day unit using the HSE Integrated Care Programme for Older People, fewer residents ended up back in hospital once the team met weekly. So it turned out the cure wasn’t more medicine — it was more talking.
To be fair, teamwork eats time and patience. Schedules clash, tempers flare. Yet when respect beats rank, things move again. It isn’t fancy management; it’s people listening with tired hearts but steady hands.
The social worker often walks in last and leaves late. Calls from families never stop. They soothe panic, dig through grant forms, and somehow find a respite bed when none seem left. Their calm voice holds the family up when paperwork would drown them.
Around them move others — the physiotherapist coaxing stiff joints, the psychologist helping a son understand guilt, the pharmacist fixing a dosage slip, the dietitian adding flavour to a plate gone dull. In practice, they keep life stitched together while the nurse and doctor handle the rest.
All the same, without them, the care would thin out. Each specialist colours a different corner of the day. They remind everyone that dementia care isn’t just medicine; it’s living made easier, one task at a time.
Late-stage dementia slows the air itself. The house quietens, food cools fast, words fade to gestures. Here, the team shifts again — from fixing to easing. Comfort becomes the plan.
The doctor watchesthe pain. The nurse adjusts pillows, checks skin, and hums a tune without meaning to. A chaplain might sit by the window, no words needed. Under the Irish Palliative Care Competence Framework (2014), dignity leads the way — gentle hands, slower voices.
One night in a Galway unit, a care assistant placed an old knitted blanket on a resident’s lap. The woman stopped fidgeting, eyes half-closed. Nothing grand, just peace. So it turned out compassion can quiet a room better than morphine sometimes.
Of course, not every shift sings. Short staff, broken printer, half the team off sick. Messages lost, tempers short. Someone forgets to chart a note, and the dominoes fall. That’s the job.
Still, good teams find small fixes. Five-minute huddles, scribbled reminders, the odd laugh to break the edge. Shared notes help; honest talk helps more. Reflective chats after shifts—when everyone’s half-wrecked—keep resentment from turning bitter.
At the same time, trust stays the secret glue. Once a GP backs a nurse’s instinct, or a nurse trusts the carer’s word, the rest follows. Collaboration lasts only when kindness outlives rank. To be fair, that’s the hardest trick and the truest one.
When it works, it feels quiet, nearly invisible. A dozen people moving around one life, not over it. The nurse notices, the doctor guides, the social worker steadies the family, and somehow the person in the chair feels safe.
Teamwork won’t stop dementia, but it softens the edges. At the heart of every plan sits one simple wish — to let a person keep their dignity for as long as they can. In practice, that’s the real victory.
Health Service Executive (HSE). (2021). National Dementia Strategy. Dublin: HSE.
Health Information and Quality Authority (HIQA). (2016). National Standards for Residential Care Settings for Older People in Ireland. Dublin: HIQA.
Alzheimer Society of Ireland. (2022). Working Together for Better Dementia Care. Dublin: ASI.
Irish Palliative Care Competence Framework. (2014). Health Service Executive. Dublin: HSE.
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