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Anthea Innes, Fiona Kelly and Louise McCabe (eds), Key Issues in Evolving Dementia Care: International Theory-based Policy and Practice, Jessica Kingsley Publishers, London, 2012, 264 pp., pbk £24.99, ISBN 13: 978 1 84905 242 9.

Published online by Cambridge University Press:  28 March 2013

CLAIRE DICKINSON*
Affiliation:
Newcastle University, UK
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Abstract

Type
Reviews
Copyright
Copyright © Cambridge University Press 2013

In this collection of edited chapters Innes, Kelly and McCabe have produced an up-to-date and comprehensive overview of issues in dementia care. The book has an international focus with chapters that explore elements of dementia care in Canada, England, France, Scotland, Malta, India, Australia and the United States of America. The book is structured into three sections: conceptualising dementia; policy development; and innovative approaches to care. Each section has four chapters, and the 12 chapters are tied together with an introduction and conclusion that clearly summarise theoretical, practice and policy issues in dementia care and identify gaps in existing knowledge.

One of the strengths of the book is undoubtedly its international focus, taking its scope beyond Western, high-income countries. An additional strength is the integration of issues related to theory, policy and practice, which ensures that the book presents a holistic approach to dementia care. The inclusion of areas such as epidemiology (Chapter 3, Coley, Berr and Andrieu), environmental design (Chapter 11, deVries and Traynor) and staff training (Chapter 12, Johnson and Johnson) demonstrates the diversity of areas that we can draw upon to improve our understanding of dementia. A weakness of the book is that some of the chapters do feel particularly specialised. For example, Part II includes chapters on national strategies or plans for dementia from England, France and Malta but also a chapter (Chapter 7, McCabe) on implementing a regional strategy in Fife, Scotland, which did feel a little out of place amongst the chapters describing the national plans. However, that chapter itself provides a comprehensive overview of the development and implementation of a regional strategy which would be a useful resource for policy makers responsible for implementation, either regionally or nationally.

The book's focus is unashamedly broad without being unwieldy and the conclusion identifies five key interrelated themes that run throughout the chapters. The themes are firstly the importance of dementia-specific policy, especially policy with a holistic approach to dementia. The second theme is the importance of early detection and diagnosis as an opportunity to promote support at an early point in the journey for people with dementia and their families. The third and fourth themes are the need to conceptualise dementia so that it is better understood by all those affected by it; and the importance of the views of people with dementia. The final theme to run throughout the book is the need for change and innovation within dementia care. Areas of inadequacy of care are identified and innovative ways of addressing these are needed in times of restricted financial resources and cutbacks in many countries.

The five themes are strong throughout the book. However, this diverse collection also highlights the stigma associated with dementia in all countries. Stigma is identified as a factor that hinders people in seeking early diagnosis and support and leads to the diagnostic gap where 60 per cent of the affected population remain undiagnosed. The need to change the public perception of dementia so it is not feared is consistently seen across countries. Changes that may lead to the destigimatisation of dementia are identified, such as national strategies; the provision of adequate information and advice about diagnosis and treatment; and the identification of positive role models who challenge the negative stereotypes of dementia, e.g. the author Sir Terry Pratchett. The stigmatisation of those who work with people with dementia is also explored by Christopher Jay Johnson and Roxanna H. Johnson (Chapter 12), highlighting the need to address stigma from a variety of perspectives if dementia care is to be improved. It is clear from this collection that an enormous amount of work is needed globally to reduce the effect of stigma.

This collection has an academic feel to it and draws on up-to-date research and policy. It will be of particular use to academics, researchers and policy makers, although there is also a lot that is directly applicable for practitioners who are interested in developing and improving dementia care. Whilst integrating theory, policy and practice, the book retains a human focus and emphasises person-centred care throughout. The need to include the voices of people with dementia and carers is repeatedly made throughout the book, though it would have been powerful to see the views of people with dementia and their care-givers, in their own words, given a little more room throughout this collection.