Signpost Book Reviews Vol 10.2 October 2005

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This page shows books which Signpost has reviewed. If you would like to become a Signpost book reviewer, please contact Signpost. For guidelines click here.

For a full list of published reviews click here.

Health And Well-Being For Older People: Foundations for Practice
Ann Squire
Publisher: Bailliere Tindall
ISBN: 0702023159

This book was published in 2002 and not surprisingly it took several years to write with 376 pages. As we all know, the world of health and social care changes very rapidly and therefore some of this book is now a little out of date.

With the rising number of older people within the UK population and across the world health promotion is a very important subject. This book looks at the demography of an ageing population and describes the normal ageing process. It examines ageism, ethical dilemmas and positive ageing. The author stresses the importance of evidence- based practice and gives excellent guidance to health promoters on how to operate in this mode. There is a self- directed learning approach with numerous learning activities, discussion points, case studies, and examples and suggestions for further reading. It would be a very useful resource for those carrying out training in health promotion.

I did feel that the book is very slanted towards physical health. I was very disappointed in the description of dementia with the reference suggested written in 1989. It suggests that the cause may range from drug toxicity, malnutrition to an organic cause. There was no mention of Lewy Body or frontal lobe dementia, and states that it is associated with persistent wandering, incontinence, general aggression and an increased risk of accidents and falls. I felt that the multiple problems and distress that carers cope with were very understated. It is no use encouraging carers to look up old friends and go out, when there is nobody to care for the person with dementia, and friends appear to drop you. Person centred care was not mentioned, there was no discussion about the need for an early diagnosis, so that the person with dementia can receive help in their own right such as groups, medication and time to put their affairs in order. Carers also need an early diagnosis so that they can be helped to understand the person that they are caring for, and get counselling and information and support in their own right. Regrettably Admiral Nurses whose function is to help carers of people with dementia, as well as consultancy work with other professionals, were not mentioned at all.

There was a lot of very useful information. I particularly liked a whole page dedicated to tips for looking after your health. There were useful models to follow when planning health promotion.

There were errors. For instance a person cannot claim attendance allowance and disability living allowance. The description of the function of Crossroads was not at all clear. Benefits such as the direct payment scheme were not mentioned.

I did feel that this would be a useful book for practice nurses, health visitors, trainers, and district nurses. There are a lot of ideas and a huge amount of useful information. It is a useful book to have in a library.

Madeline Armstrong, RMN, BSc (Hons), Dip Gerontology, Dip Counselling, Admiral Nurse for dementia, 02078747217

Dancing with Dementia.
Christine Bryden

Publishers: Jessica Kingsley
ISBN 1-84310-332-X
Price: £12.95

Bryden was a single parent bringing up three daughters when diagnosed with Alzheimer's disease at the age of 46, and, in her first book 'Who will I be when I die?', wrote about the threat to identity and personal fears involved in facing an uncertain future.

'Dancing with Dementia' has a wide remit, examining the doubts, hopes and strategies that make up the lives of people in the early stages of dementia. Subtitled 'My Story of Living Positively with Dementia', this book also provides an account of a journey of self-discovery, change and growth, what Bryden refers to as her continuing spiritual journey. Most importantly, 'Dancing with Dementia' aims to change society's largely negative perceptions of dementia and to encourage appropriate emotional and social support.

Bryden describes her growing determination to overcome the medical model of looking at dementia, to be open to the 'unexpected', to change her life and remain positive. An important affirmative message is that although cognition is affected, people with dementia can relate to others on emotional and spiritual levels, and that communication of such ideas offers opportunity for greater empathy, understanding and respect. With this in mind, Bryden helped develop Dementia Advocacy and Support Network International (DASNI), a global cyber network with others who similarly wanted to explore a non-medical model of living with dementia, to be more active and not simply a passive 'patient' or 'sufferer'. On a personal level, Bryden enrolled for a theology degree, though uncertain she would live long enough to complete it, and joined an introduction agency, where she met Paul, now her husband and personal assistant.

On a very practical level, Bryden provides suggestions of practical and emotional ways that people with dementia can be helped by both formal and informal carers, friends and acquaintances. These include counselling, support groups and user-friendly home environments, as well as greater tolerance and attention to individual abilities and experience. A very useful appendix of frequently asked questions explains medical definitions, early signs of dementia, diagnosis procedures, advice for carers, treatments and advantages of forward planning.

'Coming out' as a person with dementia has given Bryden a high profile in her native Australia, and she has used this to expound the reality of living with dementia, to educate others to listen to people with dementia and not assume they have nothing worthwhile to say. At the heart of Bryden's campaigning work is the message that the person with dementia is an individual and should not so readily be compartmentalised or dismissed.

Writing this book was clearly a struggle and yet it has been produced in a very accessible and personable style, and cogently rebuts the 'toxic power of the pointing-bone' of negativity often brandished at people with dementia. While the book's religious connotations may not appeal to everyone, the power of individual spirit, Bryden's abiding message of hope, is persuasive in the context of her overall thesis. 'Dancing with Dementia' provides a rallying call for looking afresh and more constructively at the dementia experience and, as such, is essential reading for those with a personal or professional interest in this subject.

John Percival

Lecturer in Health and Social Care, The Open University.

Cognitive Neuropsychology of Alzheimer's Disease (Second Edition)

Edited by: Robin Morris and James Becker
Published by: Oxford University Press, Oxford
ISBN: 0 19850830 1
Price: £60.00

The title of the first edition of this book referred to Alzheimer-type dementia. Published less than ten years later, the second edition uses the more confident terminology of Alzheimer's disease. No longer is clinical diagnosis reached solely on the basis of exclusion of all other causes of dementia, but rather it is now more positively based on the characteristic presentation, neuroimaging appearances and cognitive profile which are typical of the condition.

Our growth in understanding has arisen from a decade of experimental and clinical research undertaken on both sides of the Atlantic and this is reflected in anew co-editor from North America and 13 of the 22 chapters in this edition being new topics or having new authors.

It is the neuropsychological dysfunction typical of Alzheimer's disease that is the subject of the 220 pages at the core of this book. This is the valuable section, with individual chapters focusing on each key domain. As well as coverage of predictable topics such as aspects of memory, language, motor functioning, attention and executive skills, there are contributions on less familiar areas of reading

aloud and spelling, number processing skills, emotional processing and loss of awareness. Surprisingly, visuospatial functioning no longer deserves a chapter of its own.

Most chapters start with an historical perspective and an outline of the theoretical background, before reviewing relevant studies in Alzheimer's disease and comparing them with the findings in other neurodegenerative dementi as. There is relatively little to guide the clinician as to choice of neuropsychological test in each domain, though chapters on measuring impairment and charting decline in Alzheimer's disease and on the assessment of dementia go some way towards addressing this.

Other chapters concern the value of single case studies, the natural history of Alzheimer's disease, neurobiology and cognitive psychopharmacology. It is disappointing that coverage of cognitive approaches to the management of dementia is restricted to an excellent but very brief chapter by Jennifer Rusted and Linda Clare, though the four pages of references serve as a useful introductory bibliography to the topic. The longer chapter on pharmacological approaches was out of date by the time the book was published, with only one reference after the year 2000, several drug names mis-spelt and some misplaced confidence, for example in the potential of COX2 anti- inflammatory drugs and oestrogen replacement therapy.

The back cover of the book suggests it will be an essential source of information for neurologists, neuropsychologists, psychiatrists and neuroscientists. I think the publishers are optimistic. It will certainly be an excellent introduction for clinical psychologists working with older people and for others wanting to get a feel for the subject. At sixty pounds in hardback, it is probably one for the library rather than the clinic or the personal collection.

Dr. Tony Bayer
Senior Lecturer in Geriatric Medicine, Cardiff University