Supporting the Caregiver in Dementia is written for health-care professionals and strives to go beyond the current scientific literature by demonstrating how research translates into state-of-the-art clinical practice. Each chapter draws on extant theory, presents a comprehensive review of the literature, and includes practical treatment guidelines and training implications. There is emphasis on practitioner-relevant findings, and case examples are used to demonstrate the impact of research in clinical settings. The editors are to be commended for ensuring that the authors have followed a consistent framework, and while some chapters have succeeded more than others, overall the text works well. The book has five parts. Part I explores the history of care-giving. Part II focuses on the profiles of individual care-givers of people with dementia. Part III examines care-giving from an interpersonal context. Part IV concentrates on the clinical implications of research on the individual and interpersonal aspects of care-giving. Part V addresses overarching social concerns.
Steven Zarit, a pioneer in the study of care-giver burden, appropriately introduces the volume by reviewing the history of care-giver research (Chapter 1). Zarit sets the framework for the remaining chapters by not only sharing the existing literature but by informing the reader of the challenges that need greater exploration. Zarit specifically calls for more longitudinal studies and intervention research, more studies that include persons with dementia themselves and that represent more diverse populations, and increased attention to social and policy implications. Later chapters expand upon Zarit's list with suggestions for future research on care-giver resilience and the beneficial effects of care-giving (Chapter 5), the role of pharmacotherapy in managing challenging behaviour (Chapter 9), and factors contributing to the burnout of not just care-givers but also their social support networks (Chapter 11).
Several of the chapters are written in an accessible manner that may be useful to Alzheimer's support-group leaders and could be recommended directly to the family or other informal care-givers. Chapters 8, 12, and 14 are especially worth noting. The steps associated with grief and loss are described in Chapter 8. We are reminded that the partnership between the clinician and the patient or care-giver needs to address both mental health and medical interventions to provide as smooth a transition as possible from optimal health to the eventual death of the care recipient. Chapter 12 discusses United States federal government policies on health care, including family and medical leave, Medicare and Medicaid, and on hospices. It also underscores the importance of participation in federal research programmes. Chapter 14 offers important insights on the ethics of dementia care-giving. Table 14.1 suggests five steps for working through ethical dilemmas and could usefully be shared with both formal and informal care providers. As a researcher who grapples with the meaning of informed consent when studying persons with dementia at varied stages of the disease process, I found Chapter 14 particularly enlightening.
Supporting the Caregiver in Dementia will directly benefit both researchers and practitioners committed to dementia care and support. The chapters are useful as stand-alone references and the full text would provide the primary resource for a semester-long seminar in a multi-disciplinary academic setting.
