Described on its cover as ‘the leading work for caregivers of those with dementia’, this is the seventh edition of the well-established practitioner guide, providing insight and advice about the progression of dementia which is aimed predominantly at family carers of people with dementia based in the United States of America (USA).
Each of the 18 chapters explores different ways in which dementia can affect day-to-day living, with a main focus on the practicalities surrounding care. Early chapters explain what dementia is and describe its effects on the person with dementia, as well as their informal carers, and its impact on everyday living and the importance of seeking an early medical diagnosis.
Chapters Three to Nine provide an in-depth exploration of symptoms, including personality changes which a person with dementia may exhibit, as well as how dementia can affect one's ability to perform activities of daily living and instrumental activities of daily living.
Chapters Ten to Thirteen emphasise the need for informal carers to recognise the potential impact of caring on their health and welfare. In particular, the importance of taking breaks is recommended through organising cover from other sources, such as by other family members, or arranging respite care either through paid care at home or a temporary move of the person with dementia into residential care. The effects of dementia on the quality of the relationship within the care dyad is also considered, focusing mainly on negative impact arising from care-giver burden. The importance of factoring in rest and relaxation and suggesting activities such as socialising with others, healthy coping strategies such as exercise and psychosocial therapy or joining support groups is emphasised.
Practical advice on managing finances and planning long-term care on behalf of the person with dementia is offered in later chapters. A useful list of different types of personal income and expenses is presented, together with legal considerations if a person lacks mental capacity to manage their affairs. Applicable law is considered within the US context, so the content here is less translatable to other legal jurisdictions. The importance of planning long-term care arrangements in advance is highlighted, particularly for settings specialising in dementia care. Again, while most of this guidance is applicable to care options in the USA, there are universal considerations which are helpful, such as inspecting care facilities in advance to ensure they are fit for purpose, as well as strategies to enable the person with dementia to adjust more easily to a change in their living environment.
The last three chapters present an easy-to-follow explanation of the different types of dementia and other conditions affecting the brain. Known risk factors associated with developing dementia are presented, whilst emphasising the message that dementia is not an inevitable part of getting older. There is a clear explanation of the differences between common memory loss and early signs of dementia. Other brain disorders and causes of dementia, describing the characteristics of each type of dementia and an overview of other conditions affecting brain function, are outlined. Current avenues of medical research into diagnosis, causes and treatments for dementia are also explored.
The key strength of this book lies in its candid approach to the practical impact of dementia. It is clearly written in a style which makes the content straightforward to understand for non-experts navigating the subject for the first time. Most chapters contain case studies or short anecdotes which bring to life the real-world issues discussed. For example, the first chapter begins with an engaging and poignant case study highlighting an older woman's personal journey with dementia, which brings into stark focus the emotional and practical impact of the disease on both the individual and their social circle. Coping mechanisms and practical solutions are suggested throughout to help informal carers to navigate and mitigate issues.
Arguably, a better balance could be achieved throughout the book by a greater inclusion of the voices of people with dementia. This could provide fresh insights into understanding the condition from their perspective, e.g. hearing their views on role changes within their family units. The next edition could also benefit from consideration of the impact of the COVID-19 pandemic on the person with dementia, in particular, if certain types of behaviour might increase risk of infection.
Whilst the book is, without question, beneficial to informal carers of people with dementia in the US context, much of the content could assist carers living in other countries. In addition, it could provide constructive insights for health and social care practitioners new to their role. It could also be informative reading as a starting point for early career academics investigating dementia from a Social Sciences perspective. In particular, the topics discussed may provide valuable assistance to qualitative researchers exploring the lived-experiences of people with dementia and their informal carers.
