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There are almost one million people in the UK who are living with dementia. But dementia doesn’t only affect the person with the diagnosis. Dementia is a disease that can devastate many lives.

I'm thinking particularly of the hundreds of thousands of unpaid carers, often family members or partners. Caring for someone with dementia is hard, relentless work, both physically and psychologically. It can be simultaneously backbreaking and heartbreaking.

The April issue of the Healthcare Counselling and Psychotherapy Journal is almost exclusively dedicated to working therapeutically with dementia. But it pays particular attention to carers, who are often unsupported and overlooked.

Dr Cordelia Galgut writes of her experience of caring for her partner of more than 40 years, who has dementia in, Losing my partner to Alzheimer's. Cordelia describes the agonising struggle to manage her own feelings of loss, sadness and grief, while watching her beloved wife suffer from such a cruel condition.

Cordelia also suggests how counsellors and psychotherapists can support someone in a similar situation, by listening without judgment and by recognising and resisting the defensive pull to make assumptions and give advice.

Cordelia is perhaps asking us to follow the core and guiding principles of our profession – a request that is backed up by Liam Hallett, a counselling psychologist who works in the NHS with people living with dementia. Liam acknowledges the particular complexities of caring for a partner with dementia, but he wonders if an effective therapeutic response is, in some ways, rather simple.

The couple relationship is the focus of an intervention, Living Together with Dementia, that was developed by Tavistock Relationships and is explained in our April issue by Andrew Balfour, a clinical psychologist and the organisation’s Chief Executive Officer in, Dementia: caring for the couple.Ìý

A close couple relationship can have a positive impact on the symptoms and progression of Alzheimer’s, according to various studies. But Andrew recognises that caring for a partner with dementia is challenging, not least because of a likely shift in relationship roles. It can also lead to feelings of resentment, guilt, even hatred. Ìý

The aim of Living Together with Dementia is to foster and nurture the protective aspects of the couple relationship, in part by offering the carer partner the presence of the therapist as a third, containing figure.

We tend to associate dementia with old age, but young-onset dementia, typically defined as 65 years or younger, affects around half a million people in the UK. A diagnosis can also be tough for the family, often disrupting the familial system, which is why Dr Clive Holmwood, Dr Alison Ward and Dr Gemma Collard Stokes have set up a research project to examine the impact of workshops in neuro-dramatic play on people living with young-onset dementia and their carers in, Drama and dementia.Ìý Ìý

Carers often suffer from stress and burnout – a feeling that is common in the NHS and the wider population. Maybe gardening can help? Mike Morgan tells us about the social and therapeutic benefits of gardening and encourages us all to incorporate green spaces into both our professional and our personal lives in, Nurture in nature.Ìý