The lack of attention to the mental health of older people, particularly in the care home setting, makes this is a long-awaited resource. The editors – Tom Dening and Alisoun Milne – have brought together an impressive group of contributors comprising service users, care providers, practitioners, researchers, educators and writers who provide a richness and depth of insight that is both informative and thought-provoking. The book is comprised of 26 chapters grouped into four parts: the insider view (addressing service user perspectives; the outsider view (addressing issues of safeguarding, law, quality and financing of care); mental health and care (dementia, depression, psycho-social and practical aspects of care-giving); and finally five chapters focused on promoting mental health and wellbeing. All of this makes this book a practical text book for students across disciplines and a useful resource for care providers, carers and others seeking specific information.
Having identified this book as a ‘dip in’/‘dip out’ resource, it must be said that it would be unfortunate if any reader did not commence with the first two chapters of Part One. The first chapter is an account by Pat Singer, who resides in a care home, writing of her experiences of moving to and living in a communal care setting after many years of living alone. Pat's living experiences lay the foundation for thinking about the good practice concepts that support mental health explored in later chapters. Chapter Two is titled ‘A Carer's Account’, in which with a powerful description of his experiences Eric Berger strips bare the emotional journey of people living with dementia. He presents many practical aspects of the journey that are seldom discussed from the carer's perspective, within this book that also contains research evidence and practice issues. The elements of the journey he describes continue to resonate in so many of the chapters that follow, making this an especially powerful contribution. In essence, these two chapters lay very strong foundations that ensure measured reflection on the concepts and issues explored in later chapters.
Initially, the book does appear to have a heavy focus on dementia but when considering, as the editors point out in the introduction, that there are a significant number of people who have dementia living in care homes, this is actually well balanced with other important topics. The chapters that do address issues relating to people with dementia in care homes revitalise research evidence and better practice elements in relation to the focus of each section of the book. For example, Alisoun Milne's review (‘The Inside View – Living in a Care Home’) presents the research evidence on the lived experiences of residents with dementia in a discussion that highlights both the ways in which such evidence can be collected, and how such evidence provides insight that is so important for better practice in dementia care. Chapter 18 (Jill Manthorpe and Jo Moriarty) also provides new insights into thinking about minority groups in care homes. In addition to a sensitive and informative discussion of older people from Black and minority ethnic groups, the authors bring a 21st-century perspective to understanding the needs of men and raise awareness of the urgent need for a better understanding of residents who are not heterosexual. This is a clever chapter that, like the rest of the book, moves away from the expected rhetoric. In Part Four (‘Promoting Health and Well-being’), Dawn Brooker's work highlights the utility of the VIPS framework (Valuing, Individuals, Perspective and the need for an positive Social environment) in promoting health and wellbeing: demonstrating how achieving this is a function of leadership at many levels within a care home. Other chapters specific to dementia tackle areas that have been taken for granted of late: one of which is the contribution of Buz Loveday, in Chapter Twenty-Four, which is a much-needed discussion of dementia training in care homes. Although the importance of education and training appears frequently in the literature, seldom does a discussion articulate with ease the key objectives of dementia training and often overlooked elements of training such as readiness to learn, and the learning needs of staff who are participating in training. Loveday's chapter also raises important questions relating to the role of leadership to maximise the effects of training and ways in which this can be facilitated.
Complementing the dementia-specific contributions are some necessary discussions of depression, functional mental illness, safeguarding, regulations and funding. Innovative inclusions come in the guise of chapters on support to care homes, physical health issues, palliative care and end of life, and how health services work with care homes (Chapter Twenty-Two). Most impressive are offerings seldom afforded chapters in their own right. Recognition of how risk averse care can be is addressed in the chapter by Sheila Furness, with a compelling argument for a more ‘benefits-focus agenda to substitute for the risk-oriented one’ (p. 323). Raising awareness of the untapped creativity of people with dementia, John Killick and Lynda Martin describe an innovative creative writing project. Their personal reflections of the process and broader learning points, along with participant comments, demonstrate how thinking outside the square provides new opportunities for supporting mental health.
Clearly explained concepts and minimal jargon, combined with good coverage of key areas in the manageable size of just over 400 pages makes this book accessible to a wide audience. It has international appeal, with only the legal, policy and funding discussions in Part Two limited in their relevance to broader international audiences. This is a valuable addition to the field that should be required reading for students, health professionals and care providers.
