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Murna Downs and Barbara Bowers (eds), Excellence in Dementia Care: Research into Practice, Open University Press, McGraw-Hill Education, Maidenhead, UK, 2008, 640 pp., pbk £29.99, ISBN 13: 978 0 33 5223756.

Published online by Cambridge University Press:  16 May 2011

JOHN KEADY
Affiliation:
Greater Manchester West Mental Health NHS Foundation Trust and University of Manchester, UK
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Abstract

Type
Reviews
Copyright
Copyright © Cambridge University Press 2011

For some time now, the contribution of both the editors of this book – Murna Downs (UK) and Barbara Bowers (USA) – have advanced the field of dementia care and provided a rich stream of inspiration for those confronting the complexity and myriad of issues wrapped up in the word ‘dementia’. Here I can speak from personal experience. If I wind the clock back 20 years, in 1991 I was practising as a community psychiatric nurse in a dementia team in North Wales and attending a part-time postgraduate certificate course in gerontology at Bangor University. In one of the course assignments I was attempting to locate a suitable evidence base for (nursing) practice in dementia. It was then that I was introduced to the work of Barbara Bowers, in particular her late 1980s articles on dementia and the identified five-stage temporal model of types of care: anticipatory; preventive; supervisory; instrumental; and protective (Bowers Reference Bowers1987). In 1991 this opened up my (neophyte) appreciation of the power of qualitative research, and in one way or another exploring, shaping and interacting with the properties of the ‘protective’ element of care has kept me busy these last 20 years. Given its pedigree, much would be expected of a comprehensive textbook on dementia care that combines the talents of these two editors and utilises their extensive academic/practice/policy/community networks. After reading and then using this book to help inform clinical practice in dementia and providing an evidence base for behaviours that challenge (Keady and Jones Reference Keady and Jones2010), I am pleased to say that the book more than lives up to its billing.

In presentation and content, the book is split into four parts with each part equally balanced to contain seven chapters. The parts are: (1) Principles and Perspectives; (2) Knowledge and Skills for Supporting People with Dementia; (3) Journey Through Dementia Care; and (4) Embedding Excellence in Dementia Care. As these titles intimate, the book provides a wide coverage of topics, and authors who diligently focus upon their task and promote their area of expertise. For example, in Part 1, the opening chapter of the book is written by Blossom Stephan and Carol Brayne who describe the prevalence and projections of dementia, taking an international lens to this focus of study. This was an excellently researched and well-written chapter that deserves wide dissemination and reference. Also in Part 1, Steven Sabat describes the constituent elements of the ‘bio-psycho-social’ approach to dementia and pays particular, and helpful, attention to the attributes of the self in dementia. In Part 2, I was particularly struck by the insights of developing and implementing life story work by Errolyn Bruce and Pam Schweitzer and the outline of evidence that helps support its use in practice. Also in this second part, Jiska Cohen-Mansfield builds upon her extensive contribution to understanding behaviours that challenge, to look at the meaning of the language of behaviour – it was this chapter that influenced our own care practice, as I highlighted earlier. In the remaining two parts of the book, a number of important areas are covered including diagnosis and early support; end-of-life care; relationships in dementia care; service development; workforce issues; quality and policy, although this last chapter is drawn mainly from a UK (and England) perspective.

The book is written in an accessible way, is judiciously edited with none of the chapters ‘dominating’ in the page allocation, and is very easy to read. Each of the chapters starts with a series of ‘learning objectives’ and has exercises that help consolidate learning and reflection. They (mainly) include case studies and conclude with a ‘further information’ section that helps to clarify any national idiosyncrasies in terminology for an international audience. Chapter references are included at the end of each chapter, which I have always found helpful, especially for workshop purposes and in teaching students.

Whilst I would have no hesitation in recommending this book, I was surprised that the book did not contain a chapter by a person – or people – with dementia and/or family carers since their subjective interpretation of the meaning of ‘excellence’ in dementia may have helped to further guide understanding and underpin the key messages in the book. However, that aside, this book is essential and required reading for anyone interested in dementia care, ranging from first-year health- and social-care students (of any discipline) through to experienced academics.

References

Bowers, B. J. 1987. Inter-generational caregiving: adult caregivers and their ageing parents. Advances in Nursing Science, 9, 2, 2031.CrossRefGoogle Scholar
Keady, J. and Jones, L. 2010. Investigating the causes of behaviours that challenge in people with dementia. Nursing Older People, 22, 9, 25–9.CrossRefGoogle ScholarPubMed