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Doody's Review ServiceReviewer: Nania Lee, M.A.(George Washington University)
Description: These therapeutic materials and ideas for enhancing aspects of memory and communication for people with dementia deal mainly with functional memory as it applies to activities of daily living, and long-term, biographical memory for increased orientation.
Purpose: In the introduction and first chapter, the author states that in order to function independently in society, we are constantly required to retrieve words, recall events, remember and execute instructions, repeat sequences in daily tasks, and recognize and interact with people around us. This places a significant cognitive burden on any individual, regardless of neurological impairment. But just as healthy individuals rely on devices and strategies to augment their memory skills, the author recognizes the need for compensatory strategies for those with neurological impairments. The author also addresses the importance of helping those with dementia retain meaningful autobiographical information, and she provides basic advice for caretakers when interacting with these individuals. I meet persons with dementia on a daily basis who require long-term solutions for their memory impairments and, on a basic level, the author provides some useful suggestions for family members/caretakers who know little about dementia. As a relatively new speech pathologist in an acute care setting, I was very familiar with many of the concepts and I didn't glean many new ideas, but this book would be a great tool for helping educate families on the developing needs of their loved ones with dementia.
Audience: The intended audience includes all practitioners who are involved in a patient's care, such as speech pathologists, occupational and physical therapists, nurses, lay caregivers, and family members. However, the most appropriate audience would be family members and caregivers. The author's research and publications on this topic are extensive and, based on the book's introduction, it appears that the author has tested the practical application of the strategies she suggests and has spoken with family members, practitioners, and patients to refine and modify her ideas.
Features: The book covers aspects of memory as they evolve/degenerate in persons with dementia, then provides suggestions to help these individuals augment and improve their memory deficits, using visual examples throughout. The ideas are based mainly on using photographic cues, lists, and strategies (such as sorting tasks and theme boxes) for keeping the ideas organized. The best thing about this book is its creativity. The author has gone to great lengths to make these ideas applicable to different people (i.e. those who live at home vs. people in assisted living/skilled nursing settings). I appreciated the section on using memory aids with children, as my current references fail to address how difficult it can be for children to interact with elders with dementia. The list of relevant books for children (p. 81) is a welcome surprise. I also like the way the book considers aspects of the individual's personal life and interests, as therapeutic settings tend not value or focus on these types of memories. When read as a whole, the book tends to become redundant. Although the issues are all pertinent (i.e. memory in communication, in expressing basic needs, in completing ADLs), the solutions are often very similar. Especially for family members and lay caregivers, the book could make a clearer distinction between suggestions intended for use with individuals with mild vs. severe cases of dementia. A statements such as, "Do not correct or contradict what was stated as a fact even if you know it is wrong," is misleading as it likely applies to individuals with a more moderate to severe grade of dementia. (I know the suggestions in this section are intended to encourage more casual, enjoyable conversation and I agree that a certain level of concession is required when interacting with persons with dementia, but I think, regardless, some of the suggestions could be problematic if used with a mildly affected rather than a severely affected person.)
Assessment: This would be a useful introduction for families and caretakers to the memory and communication needs of persons with dementia. Comparable therapeutic books that I use on a regular basis are the WALC series (Workbooks of Activities for Language and Cognition published by LinguiSystems). From a clinical standpoint, the books in this series are informative and provide more extensive suggestions for families and practitioners. They also have more reproducible pages for therapeutic application.