Signpost Book Reviews  Vol  9.2  2004

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COMMUNITY MENTAL HEALTH NURSING AND DEMENTIA CARE
John Keady, Charlotte Clarke and Trevor Adams (eds)
Open University Press, ISBN: 0-335-21142-9
Price £19.99 in paperback

This is an academic collection of eighteen studies covering specific topics under the headings of Community Mental Health Nurse Practices, Dementia Care in the Community and Developing Community Mental Health Nursing in Dementia.

The general premise suggested in the ‘Foreword’ (sic) is that recent changes in health and social care have been so fast and frequent that the focus on independence and autonomy has eclipsed the equally valid but broader perspective provided by the partnership between the dementia sufferer, their carer and the community mental health (CMHN) nurse.

I found it welcoming and stimulating to read about the diversity of innovation and practice within community and dementia care in the United Kingdom. As a CMHN it gives context and direction to my own practice. As I found out, digest this book in small bites as over-indulgence might well lead to mental indigestion!!

Andy Littler
Community Psychiatric Nurse, Heol Don CMHT-OP, Cardiff

AGEING, SPIRITUALITY AND WELL-BEING
Albert Jewell (ed)
Jessica Kingsley Publishers, ISBN: 1-84310-167-X

This is a timely book, appearing when those in the medical profession are beginning to accept that the spiritual and religious needs of people, and in particular older people, are important subjects which deserve to be considered when assessing the quality of life of a patient.

Albert Jewell has gathered together an impressive list of writers from across the world and from various disciplines concerned with ageing. The main content of the book arose from keynote addresses given at the Second International Conference on Ageing, Spirituality and Well-being held in Durham in 2002, which have been rewritten for publication. Many are thought provoking such as Rosalie Hudson’s contribution looking at our holistic practices. She argues that really we compartmentalise our care into the three areas of body, mind and spirit; for example we give medications (body), the patient has a session with a psychotherapist (mind) and the chaplain calls by for a chat (spirit). There is no link between the three activities. She argues that our treatment, particularly with the elderly, should be modelled on being a relationship where all aspects of care depend on each other.

The main criticism of the Conference remains to be the main criticism of the book: what exactly is spirituality? As I was going through the book, I became increasingly confused, as each writer used a different definition of spirituality, often taking up half the chapter to explain this before getting on to their main argument. Now I know that spirituality has many different facets, but perhaps an agreed basic definition, allowing for some differing interpretations, would have made for easier reading and may have even strengthened some of the arguments. Bishop David Jenkins reflects on the Conference and the book in the final chapter, and it was reassuring to read that for him "everything was reduced to a question of ‘spirituality’, which I am increasingly finding to be a weasel word used to obfuscate or avoid basic questions of reality".

That said there is much to commend this book, especially if you wish to look at what one author or practitioner thinks. The problems associated with ageing, such as physical problems following a stroke or the effects of dementia, are well covered. There is nothing particularly new or original in the book, or anything that cannot be found elsewhere, but to have this all collected into one volume is certainly useful.

Reverend Martin Colton

Assistant Curate in the Rectorial Benefice of Whitchurch, Cardiff, and
Hon. Chaplain in the Cardiff and Vale NHS Trust

IN A STRANGE LAND . . . PEOPLE WITH DEMENTIA AND THE LOCAL CHURCH
Malcolm Goldsmith.
4 M Publications, ISBN: 0-9530494-6-9
Price: £14.95

"In a Strange Land" is intended to be a guide and an encouragement to churches as they take up opportunities and face the challenges of understanding and sharing in the lives of those in their midst who are affected by dementia.

The title comes from a verse in Psalm 137: ‘How shall we sing the Lord’s song in a strange land!’ (verse 4). Dementia is a strange land and Goldsmith asks whether it is possible to sing the Lord’s song within it; it is also a ‘foreign land’ for most churches and congregations. The author suggests that our experiences of dementia may not be dissimilar to the disaster and despair that the Israelites felt during their captivity in Babylon. This exile brought about new insights into the nature of God and new experiences of God’s presence and continuing care and love.

During the first part of the book Goldsmith attempts to describe the symptoms and behaviours that arise in people who have dementia. This is extremely well done for the lay reader and the metaphors he draws provide a very helpful understanding of the disease process. At every opportunity he introduces examples of the feelings and thoughts of real people who have written about their own experience of living with dementia, as well as the thoughts and feelings of those who care for them.

In dealing with the response of the local church Goldsmith emphasises the need to speak of a God whose nature is love, and encourages local congregations to approach those suffering from the disease in an affirming rather than a judgemental way. He encourages everyone to take seriously the spiritual needs of those involved with the disease including the carers, whose faith is often seriously tested. He reminds us that we have to minister to those with the disease and their carers at the spiritual level by allowing space and not simply by resorting to the use of language. He gives some very practical advice to churches and individuals on ways of ministering in a way that can be accessed by those with dementia and their carers.

This is a book that should be read and reflected on by all Christians, for what is said about dementia could be applied to other diseases and afflictions from which women and men suffer. It carries a message for all who seek to witness to the gospel by living it and seeking to communicate the good news of Jesus.

The book is about dementia, but it could be read as a guide to the ways in which churches approach the Disability Discrimination Act. When we are dealing with a person with a disability or dementia, the Christian is called upon to recognise the person involved. In all Christian relationships we are called upon to relate to the person and recognise the Christ as he is to be found in that person. It is as we love the Christ in each other that we will bring healing to that person and indeed to the whole of humanity.

Dr. Delyth Aldrick (Consultant Psychiatrist, Cardiff and Vale NHS Trust
Reverend Canon Roger Young Rector of St. Peter's, Peterston-Super-Ely, Vale of Glamorgan.