The Invaluable Guide to Life After Stroke: An Owner's Manual.

This book is written by Arthur Josephs, who experienced a stroke at the age of 53 years. He has much practical experience and advice to share with stroke survivors, their families, and health professionals who interact with them. The book consists of 18 short chapters that address common questions, experiences, frustrations, and triumphs that individuals may encounter following stroke. Josephs draws on extensive, successful involvement with a stroke support group and personal experiences to provide "real-life" vignettes as illustration of his messages.

Written in language that is easy to understand, he addresses the definition, causes, and possible symptoms of stroke, interspersed with descriptions of possible cognitive, physical, functional, and communicative deficits that he has observed in himself and bther stroke survivors he has known. He offers simple but insightful tips on communicating with individuals who are aphasic. Josephs offers supportive encouragement for the potential emotional adjustment that often follows stroke, and focuses attention on health maintenance and promotion, so that stroke recurrence may be avoided. Chapter 8, for example, is titled "Serve Yourself a Generous Portion of Health," and consists of advice in the following categories: be social, slow down, use extra care, be independent, and get involved.

Although most of the information that is provided is brief and anecdotal, the positivism that the author presents is inspiring. Mr Joseph's style is somewhat "stream of consciousness," so sometimes the tide and the content of the chapter fail to match as one might expect. The book, however, is an excellent resource for clinicians to have "on the shelf" for patients, clients, or family members to read. Not all of what he says will apply to every stroke survivor, but the overall message may prove motivating.

Throughout the book, he emphasizes the value he has found in a local support group for stroke survivors, "for educational and psychosocial purposes first, then for social benefits." He provides a brief listing of supportive resources that he has identified in a number of regions across the country. If used as a resource for families, however, additional information about local support groups and resources would be required.

Josephs is a powerful messenger for self-advocacy for the stroke survivor, urging individuals who are recovering from stroke to take responsibility for themselves and continue to work to improve in the areas that offer particular challenges. This book is a welcome addition to resources available for stroke survivors, their friends and families, and the professionals who interact with them, and is therefore heartily recommended.

Ms McCulloch is clinical assistant professor and academic coordinator of clinical education. Her primary teaching and clinical interests center on the rehabilitation of adults with neurologic dysfunction.