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Hearts of Wisdom: American Women Caring for Kin: 1850-1940.

Emily K. Abel, Harvard University Press, 79 Garden Street, Cambridge, MA 02138, 2000, 352 pages, $49.95, ISBN 0-6740-0314-4

As the title suggests, this book is of interest to neuroscience nurses who are curious about social policy, caregiving, or history. It is a very engaging read.

The author divides the analysis of an enormous amount of historical material into two parts. Part one is the shorter, most likely by necessity, owing to the paucity of reliable and accessible primary sources for the period it covers, the years 1850-1890. There are three chapters in part one; the chapter titles speak for themselves. The first, "Hot Flannels, Hot Teas, and a Great Deal of Care: Emily Hawley Gillespie and Sarah Gillespie, 1858-1888," relies heavily on the diaries of a mother and daughter, the Gillespies. The focus is on home care provided by "kin" during these years. Chapter 2 is "An Overview of Nineteenth-Century Caregiving." The final chapter in this part is "Tried at the Quilting Bees: Conflicts between `Old Ladies' and Aspiring Professionals."

Part two covers the period 1890-1940 and contains six chapters and a conclusion. Chapter 4, "A Terrible and Exhausting Struggle: Martha Shaw Farnsworth, 1890-1924," is about struggles of caring for a declining family member. Chapters 5 and 6 are "Just as You Direct: Caregiver Translations of Medical Authority" and "Negotiating Public Health Directives: Poor New Yorkers at the Turn of the Century," respectively. These chapters address social changes in caregiving. Chapter 7, titled "Caregiving During the Great Depression: Mothers Seeking Children's Health Care and American Indians Encountering Health Nurses," focuses on health and wellness care and the early stages on community activism. Chapter 8 is "Very Dear to My Heart: Confronting Labels of Feeblemindedness and Epilepsy," while chapter 9 is "Like Ordinary Hearing Children: Raising Offspring According to Oralist Dictates." The conclusion briefly summarizes the changes in caregiving after 1940 and then explains how lessons from the past can be used to shape current policy.

What's really amazing about this book is the author's ability to analyze and synthesize enormous amounts of historical material. In chapter 5, for example, she examined letters women wrote to the U.S. Children's Bureau between 1914 and 1936 for one section, and then 114 letters from family members of tuberculosis patients written to a physician between 1906 and 1925 for another section. Almost every chapter has more than 100 notes about the sources used.

The author acknowledges the bias of the materials used, that is, that they tend to be from white, middleclass women. This limits the scope of the conclusions that could be drawn, but she attempted to get beyond the limits of the available materials by examining slaves in the antebellum South as well as Native Americans.

My one slight criticism is that, being the concrete individual that I am, I was looking for definitions of family caregiving and caregivers, but the author fails to give these in a straightforward manner. The themes and essence of caregiving, as well as how these changed over the period of time studied, however, are very well portrayed. For those of you who think history is "dry and boring," I challenge you to read this book; it will change your mind because it holds your interest from beginning to end.
Reviewed by Janice L Hinkle, PhD RN
Assistant Professor
Villanova University College of Nursing
Villanova, PA
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Author:Hinkle, Janice L.
Publication:Journal of Neuroscience Nursing
Article Type:Book Review
Date:Oct 1, 2002
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