Helpmates: Support in Times of Critical Illness.

The author's stated purpose of this book of offering information and advice about caring for a sick or injured spouse on a long-term basis is well achieved. As a caregiver for his wife who had a stroke, the author interviewed caregiving spouses around the country to research the topic and develop insightful suggestions based on his own experiences and those of others.

This book includes first-person accounts and reflections by caregivers and their spouses relative to many topics in the psychosocial, emotional, and interrelational realms. It provides concrete suggestions for coping, adjusting, and reordering one's life emotionally, physically, and materially.

The book flows well, beginning with an examination of the thoughts and reactions from the time when there is a confirmation of a serious illness that is or could be life-threatening. The book immediately explores feelings often experienced and ways to cope with them. The author encourages the caregiver to become an integral part of the health care team because of the caregiver's unique position as being one of the most knowledgeable individuals, other than the person who is ill, about all of the circumstances that influence the patient's life. Suggestions are given to caregivers on how to interact with the health care team. A description of what caregivers want in return from the health care team (ie, involvement, influence, information, sensitivity, and awareness of legal consequences) is provided. Practical advice including how and where to select home health care providers is also given. Reliance upon family, friends, and community support services is encouraged. The author also recommends that the caregiver focus on his or her own physical and mental health and well-being and suggests support systems, further counseling, or psychotherapeutic intervention if needed. Helpful advice and warnings about the reimbursement of costs for health care are provided. The author directly, but delicately, addresses issues encountered when the illness ends in death. In addition to the emotional adjustment, the practical issues of funeral arrangements, financial affairs, and legal matters are covered. The book concludes by offering some spiritual advice and reflections based on principles and thoughts rounded on Judeo-Christian beliefs and values. Throughout the entire book, there are occasional quotations from theologians and philosophers and from the Old and New Testaments of the Bible. At the very end of the book, a short, but valuable, reference list of books is provided, as is a sample of a living will and a sample document of power of attorney.

This book is well written, especially for the person whose spouse has just been diagnosed with a serious illness or has incurred a life-threatening injury. It offers enough advice to be read rapidly and during a time of shock or grieving. The level of advice is somewhat superficial, but there is encouragement to use other identified resources if more help is needed. Although the book is dearly biased in its content and language toward married couples, the principles and suggestions could easily be extrapolated to any couple engaged in a significant relationship. The book focuses primarily on the helpmate or caregiver and, in some parts, leans more toward caretaking rather than caregiving. Little to no emphasis is given on the role of the person who is ill or injured in also assuming some of the responsibility in his or her care, but this was not a stated purpose of this book.

This book would be a valuable addition to a patient library and could be a secondary resource for physical therapy students and physical therapist assistant students in their study of psychosocial aspects of disability and its effect on the family.

Paulerie M Cebulski, PhD, PT University of Michigan Hospitals Ann Arbor, Mich