Description: This book gives the intellectual history of the Eden Alternative a restructuring of long-term care for persons with dementia. In shifting the attention from the institution to the person, different paradigms of care emerge.
Purpose: The purpose is to demonstrate a different way of caring for persons with dementia in long-term care. This is a large segment of long-term care and the author meets the objectives handsomely.
Audience: The audience is persons who care for persons with dementia in long-term care. This covers a wide swath of individuals physicians, nurses, social workers, psychologists, administrators. The author is an expert in the area.
Features: The first of the book's three sections, on paradigms and problems, outlines the gaps in historical treatments of persons with dementia and lays the groundwork for discussing the Eden Alternative approach to care of these patients. The second part describes how changing to a more person-centered model of care brings better outcomes. The final section, on solutions, describes approaches to paranoid behavior, anxiety and agitation, communication, and "I want to go home." Throughout, well-articulated vignettes and clear descriptions of new approaches to care, linked to well-cited references, give the underpinnings for new approaches to care. Finally, an appendix lists resources.
Assessment: This is a most intriguing book. It broadens the traditional medical model, which, in its most classic form, gave medications to treat symptoms and therefore mitigate suffering. A deeper understanding of the psychological nature of persons with Alzheimer's disease permits a better understanding of what lies behind their behaviors. The book gives the beginnings of how to operationalize this understanding by changing the physical layout of long-term care facilities and by changing the agenda of these facilities. How to understand what persons with dementia mean in their language and actions and, in turn, how we can best respond are laid out in this timely book. It synthesizes a large body of new knowledge and presents it with very good vignettes. The gentle storytelling is done here to great effect. This is one of the most original works in geriatrics in a long time. It deserves a wide readership and much discussion.