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Susan H. McFadden and John T. McFadden, Aging Together: Dementia, Friendship & Flourishing Communities, Johns Hopkins University Press, Baltimore, Maryland, 2011, 256 pp., hbk £28.50, ISBN 13: 978 0 8018 9986 7.

Published online by Cambridge University Press:  23 August 2012

KATHRYN MITCHELL
Affiliation:
Sydney, Australia
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Abstract

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Copyright © Cambridge University Press 2012

This is not just a book about ageing, dementia and friendship; it is a book that will take the reader on a journey that will, hopefully, leave them in a better place than where they started. The authors, often using vignettes, describe people with dementia who they have known as travelling along the dementia road, and you can't help but get on board with this analogy. Storytelling is highlighted to ensure their message gets across – real people with real stories, not just facts and figures although there are plenty of references to those too. There are lessons in this book that everyone can learn from. For example, it is better to say ‘someone is experiencing some dementia’ than to say ‘he has Alzheimer's Disease’ because with the former the emphasis is on the person and with latter it's on the disease (p. 30): this is very much a person-centred book.

Upon reading the preface and introduction I was a little concerned that dementia is regarded as simply about memory loss: ‘Can aging persons continue to have meaningful friendships and maintain vital communities even though some experience the accumulations of forgetfulness and others do not?’ (p. 3). The authors frequently lapse into describing dementia simply as ‘progressive forgetfulness’. It's not that they do not acknowledge that other processes are affected, but they seem to prefer to focus a lot on the memory loss, and I found this frustrating at times. The authors make it clear at the outset that they are both Christians, though they acknowledge in the Preface ‘we have much to learn from other religious perspectives’.

There is something for everyone in this book, with chapters written in different styles: the academic debate, the spiritual debate, the ‘what if’ scenarios, all these and more are represented. However, will this book teach you something about dementia you didn't already know? I would say that yes, it might. For example, the ‘take me as I am’ approach is one that we can all learn from: ‘Given the opportunity, they [people with dementia] can even teach the cognitively fit a few important lessons about growing old with grace’ (p. 15). This is further underlined in the last paragraph of Chapter 1, ‘Dilemmas of Dementia Diagnosis’, ‘Other persons have learned to appreciate those living with dementia just as they are; in other words they make no effort to orient them to “reality”’ (p. 17).

‘Beyond Fear and Anxiety’ (Chapter 7) was a little too academic for me, but having said that, it makes some excellent points, so it was worth my persevering with. I thoroughly enjoyed Chapter 11 and found it very uplifting and positive. It gives an interesting perspective on ‘Practising Friendship in Thin Places’ and I particularly like the example of ‘relational mindfulness’ on p. 174 where ‘George learned to practice relational mindfulness with Joseph. Even though he had heard Joseph's tales of his early life over and over, he disciplined himself not to allow his mind to wander and to enter into the moment of the conversation as if it was the first time he had heard Joseph's story’.

The authors have included an excellent Notes section at the back of the book, with in-depth explanations of terminology and useful websites for further information. They have also included summing up paragraphs in each chapter – useful if you lose the thread in some of the more academic chapters. Aging Together can be refreshingly light hearted at times and the discussion questions towards the back of the book add real impact to the overall message. It is one thing to passively read a book, but quite another to debate with yourself issues which are all too often swept under the carpet, e.g. ‘Have you ever inadvertently contributed to the stigma associated with cognitive decline?’ (p. 198).

This book is an excellent account of travelling along the dementia road. To me, the last paragraph of Chapter 4 (p. 75) says it all: it is about being in the moment with a focus in shift away from, remember when … to simply enjoying the moment together. In the final chapter the advantage of memory loss is explored, where past misdemeanours are forgotten and ‘loving connections are experienced in the present moment’ (p. 184). By this stage, you know what the authors are saying, and you know they're absolutely right.