Coming from the position of believing that meaningful activity can, and should, be embedded in everyday routines, I approach books with guidance on activities with a little caution. Any such concerns about A Creative Toolkit for Communication in Dementia Care were allayed from page 1, where I was reassured to read that ‘Communication is always possible’ in almost the first sentence in the book. The stated purpose of the book is to share activities and creative methods of communication that have been developed and used by the author. The material included has been based on her experiences of engaging and interacting with people at all stages of dementia over a significant period of time. The book exceeds this stated purpose as each chapter also contains crucial background information to give context to the activities. In a few chapters, the references appear a little dated and may have benefited from a more current evidence base. However, Marshall does not shy away from difficult issues with examples including an easy-to-understand explanation of why memory and communication change as dementia progresses, recognition of the importance of maintaining a sense of self-identity, the need to pay attention to physical health and support for end-of-life connections.
Of particular note is the call for increased and improved night-time care to maximise the potential for individualised and meaningful activity overnight. This is an area that may have been covered in even more detail to raise its often neglected profile, and increase involvement of night-time care staff in particular. Mealtimes too are not overlooked, recognising that changing communication can make it harder for preferences to be expressed, yet with awareness that much of the day may revolve around mealtimes for a person with dementia. The activities included commendably place the emphasis on individual and impromptu interactions, rather than organised group activities. Picnics, stargazing, high teas, hand massage, hand study and even ‘talk like a pirate day’ are among the long list of fun activities, but with a clear message and understanding that not all suggested activities will be welcomed by all people. There is recognition of the sensitive and individualised approach needed for life-story work, with a contemporary twist included by adding the suggestion of online blogging.
Sensibly, and contrary to my initial perception from the title, the book is not primarily aimed at staff who have a responsibility for organising and providing activity programmes. Instead, the primary audience is family members and care staff generally. This reinforces the notion of introducing meaningful activity and creative methods of communication into everyday activities, most of which have little or no cost attached and are completed ‘with’ or ‘by’, rather than ‘on’ or ‘for’ individuals with dementia.
Overall, an informative and respectfully written text that deserves to be read by carers of people with dementia. This includes family members, health and social care staff, and volunteers and allied health professionals, in addition to those with formal activity co-ordination roles. Whilst not presented as an academic text, it will make invaluable reading for students prior to placement opportunities to raise awareness and confidence in communication methods, both verbal and non-verbal. If the proof of the pudding is in the eating, then I can report that, despite considering myself to be non-artistic or creative, I thoroughly enjoyed music doodling to Bernstein's ‘The Great Escape’, and was particularly proud of the results.