INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY

Int J Geriatr Psychiatry 2003; 18: 559–562.

BOOK REVIEWS

Counseling the Alzheimer’s Caregiver. A Resource forHealth Care Professionals. Mary S. Mittelman,Cynthia Epstein, Alicia Pierzchala. AmericanMedical Association, Chicago, USA, 2003. Pages:346. $42.95.

Marvellous! At last a book that actually describes, indetail, what professionals can offer carers after all theassessments have been completed and all the tea hasbeen drunk. Too often in dementia care one readsabout ‘supporting carers’ or providing ‘emotionalsupport’ but rarely is that process articulated. Dividedinto 13 chapters this book addresses most of the com-mon issues for carers, spanning the spectrum ofexperience from disease information and initialassessment, family counselling and managing beha-vioural and psychological symptoms, right throughto death, bereavement and autopsy. Each chapterdescribes the issues carers face, the possible reactionsand provides suggestions for a counselling inter-vention. I was especially pleased to find reference tospecific strategies that can be adopted when sup-porting carers, e.g. socratic questioning and the useof role play. There are useful and practical sugges-tions for almost any situation that caregivers couldfind themselves in. This is accompanied throughout

by helpful worked examples illustrating variousscenarios. The book is refreshingly client centred,appropriately highlighting the need to include theperson with dementia in decision making whereverpossible. Although aimed at the US readershipthere is sufficient overlap for the internationalcommunity.

My main concern about this book is the lack of the-oretical underpinnings to support the interventions.Reference is made to research but not cited. This isa significant omission, as it would provide weight totheir argument in terms of evidence-based practiceand act as a resource for those wishing to pursue theseideas. However, this is an easy read and most profes-sional groups working in the area will probably findsomething useful in the book. I would particularlyrecommend it to anyone with a specific remit for‘carer support’.

HELEN PUSEY

Lecturer & Department of Health ResearchAward Holder, School of Nursing

University of Manchester, Manchester, UKPublished online in Wiley InterScience

(www.interscience.wiley.com).DOI: 10.1002/gps.879

Caring for Older People—An Assessment of Com-munity Care in the 1990s. Linda Bauld. Ashgate,Aldershot, 2000. Pages: 408. £49.99.

This book is part of a huge study from the PersonalSocial Services Research Unit and runs alongsideother titles encompassing related themes of commu-nity care such as care management and case manage-ment. In fact this book is one of a set, and can becomplimented by others. ‘Caring for Older People’is the core text, however, and provides a point ofreference for the others. This book contains post-1994 data from a project running from 1980, thathas analyzed social care from the perspective of allusers. Although the volume contains a huge amountof data and looks daunting, it is quite readable chap-

ter by chapter. Many results are presented in tablesthat are easy to view. For those with a special interestin mental health, cognitive impairment, depressionand morale were measured and these groups arecompared. However, this book is about a wholerange of older people who access services. The focusis very much on the relationship between resourcesand output and how these vary considerably betweenolder people. As a doctor who often only seems tohave contact with social workers when a care pack-age has broken down, I found the sections on caremanagement interesting. I had not fully appreciatedthe concepts or complexity of interval need, consis-tency, carer outcome and informal carer inputs.Being involved with the single assessment processand planning future care for older people, this book

Copyright # 2003 John Wiley & Sons, Ltd.

has put some of what is happening within theNational Service Framework into a more meaningfulcontext. Students of health and social care, and any-body involved with planning the complex needs ofolder people will find this book a useful referenceand as a source for research and audit ideas for theirlocal communities.

C. A. GORDON

Millbrook Mental Health UnitKing’s Mill, Mansfield Road

Sutton-in-Ashfield, Nottinghamshire, UKPublished online in Wiley InterScience

(www.interscience.wiley.com).DOI: 10.1002/gps.873

The Person with Alzheimer’s Disease. Phyllis BraudyHarris, John Hopkins University Press, Baltimore,MD, Year. Pages: 2002. £15.00.

For many of us working with the realities of dementiacare the greatest challenge is not only to ‘hear thevoice’ of people with dementia but to do so in away which allows us to learn and from this learningto provide care which positively affects those peoplewe have elected to care for and care about.

This publication is a well selected collection ofwork from those who have taken the time to sit andlisten to people with dementia, and who have pre-sented their work in such a way that we as readershear much more than just a faint echo of those peo-ples’ voices. Clearly the book is rooted in the socialmodel of care and considers, within fourteen chapters,Alzheimer’s disease from the perspective of thosepeople who are personally living the experience.

Qualitative research studies are described withclarity and the findings presented in a sufficientlyengaging way to offer insights into how people withdementia view those things we as professionals routi-nely do. Consequently, we are offered a fresh way ofviewing the person’s assessment, diagnosis, use ofservices but, perhaps more importantly, their percep-tions of themselves, their means of communicatingand their relationships with others.

Qualitative interviews form the basis for mostchapters but the essential inclusion of work from art

therapy and the poetry of John Killick has allowedthe voices of those with greater impairment to beheard. Crucially, each chapter offers appropriate les-sons to be learned which emphasise the importance ofpursuing partnerships and doing things with peoplerather than to them and for them.

Ultimately, what comes out of this superb book is areflection of what Tom Kitwood constantly argued,people with dementia are just people like you orme. They just happen to have a particular illnesswhich we as professionals, through our style of prac-tice, have the potential to make unduly miserable orvibrant and positive.

If, like me, you believe that Alzheimer’s is an ill-ness people can live with rather than being a conditionthey die from, then this is the book for you. It has thepotential to influence and change the experience ofcare by influencing and changing the practice of thosewho read it, who hear the voices of those involvedwith it and who reflect on the lessons which may belearned.

It is competitively priced at £15.00 and everyoneworking in the field of dementia care should read it.

SEAN PAGE

Manchester Memory ClinicWythenshawe Hospital, Manchester, UKPublished online in Wiley InterScience

(www.interscience.wiley.com).DOI: 10.1002/gps.860

A Community Reinforcement Approach to AddictionTreatment. Edited by Robert J. Myers and WilliamR. Miller. Cambridge University Press, Cambridge,2001. Pages: 188. £49.95.

Many drinkers seem able to stop drinking for briefperiods of time, but soon relapse to their usual pat-terns of drinking when they return to their normalenvironment. As well as there being many factors in

the environment which are potent in terms of increas-ing the chances of relapse, there are also positive rein-forcers in a drinker’s environment which couldencourage continued abstinence from alcohol. TheCommunity reinforcement approach (CRA) describesa systematic treatment which promotes changes in anindividual’s environment to reduce substance misuseand improve healthier life styles. It encourages closercontact with the positive reinforcers of abstinence

Copyright # 2003 John Wiley & Sons, Ltd. Int J Geriatr Psychiatry 2003; 18: 559–562.

560 book reviews