Care-giving in Dementia: Research and Applications.

The primary purpose of this text is to provide a multidisciplinary approach to the problems one may encounter when caring for individuals with dementia. The editors' claim that this is "a practical book for practical people" is supported by the writings of the 26 contributing authors. Most of the authors are from Europe, Canada, or the United States and have clinical backgrounds in psychology, psychiatry, or nursing, as well as gerontology. Their writings are aimed at both professional and family caregivers of individuals with dementia, and focus on the various models and theories, intervention strategies, and educational approaches that might be used with this patient population. The secondary purpose of this text is to increase the reader's awareness level about research in this area of health care and to promote caregiving for individuals with dementia as a specialty area of clinical practice.

The book is organized into five parts: models and theories, interventions for persons with dementia in care facilities, interventions for persons with dementia in the community, interventions for family, and a summary. The first part may be most useful for physical therapy clinicians because it provides a general epidemiology and neuropathology of dementia and distinguishes it from the physiological process of aging. Various types and stages of dementia are described along with their resulting impairments. Subsequent chapters in the first part focus on learning and memory problems, reminiscing theory, and communication models for dementia. They also contain information that could enhance the physical therapy evaluation and treatment process. The specific intervention strategies presented in parts 2 and 3 include general descriptions, case studies, and research findings associated with approaches such as reality orientation, validation therapy, structured life-review process, music therapy, occupational therapy, psychotherapy, and other specific programs. Although these approaches provide interesting reading and research data, they have little practical implications for physical therapists who do not work with this specific patient population. Part 4 deals with family interventions and provides some useful insights into the relationships between elderly institutionalized persons and their family members, which may help to sensitize physical therapy practitioners who are working in extended care facilities. The summary section presents a model for interdisciplinary education for professions that work with dementia but has few direct implications for physical therapists. The final chapter of the book presents a brief synopsis of each of the previous chapters and is followed by separate name and subject indexes.

Overall, the book is well organized and may be easily read by individuals who have no content expertise in dementia. Each author provides research data with clinical implications and a list of current references. The authors and editors present their findings with a realistic perspective, emphasizing both the advantages and limitations of each intervention technique. No single intervention is promoted as being the best approach, and the authors do not attempt to claim that any of them have a permanent or reversible effect for patients with true dementia of the Alzheimer's type. In conclusion, this book may be a useful reference text for physical therapists who specialize in geriatrics or who care for individuals with dementia. It may also be of interest to those who are involved with geriatric or psychosocial research.