Rabins (1984) writes of staffworking in this area needing to have ‘dualskills’ required for problem management and psychological support. Probably they need to be multi- skilled with knowledge and ability to organize practical help and services, to apply for financial benefits, to have a psycho-educational role, to know about the appropriate use of medication, to be able to devise creative solutions for problem behaviours and at the same time to have a psychotherapeutic understanding so that the partner (and at times the patient too) may be helped to acknowledge and work through the sense of loss, anger and grief. Regarding the reaction to Alzheimer’s disease in a loved one as a grief reaction or series of grief reactions has implications for aspects of management. Freud’s work on grief involves changing the internal model of the world to accommodate the loss. The new widow is in a similar position to a new amputee (Parkes, 1972). The partner of the demented patient too has to change his or her internal schema to work through the loss of the other, loss of the other’s previously enduring traits, the loss of shared memories, the loss of part of the self, the loss of mutuality as well as other social and practical losses which may have been brought about by the disease. In this work, it is essential to look at meaning for the mourner: the meaning of the object that is lost: the meaning of the dementia symptoms. Anthony-Bergstone et al. (1988) noted that it was the wives not the daughters who scored highly on the depression subscale, suggesting for women there is a different meaning for the illness in a husband than in a father. Different behaviours and difficulties have different meanings for individuals and therefore stress carers in different