Caring for an Alzheimer's Patient at Home »

Lovette, Katie

The book contains black-and-white illustrations. A step-by-step guide to help caregivers adminster proper care to at-home alzheimer's patients.

Doody Review Services

Reviewer:Sandy C. Burgener, PhD, MS, RNC(Indiana University School of Nursing)
Description:In this book the editor presents care giving and procedural guidelines for caregivers of persons with irreversible dementia, such as Alzheimer's disease. The guidelines seem to be based on the editor's experience in caring for her grandmother, rather than any scientific literature or review of accepted procedures.
Purpose:The editor is attempting to explain "functional methods that can be applied to the patient in detail," as the caregiver deals with the everyday needs of a person with irreversible dementia. A great deal of research has been conducted examining "best practices" for many of the procedures discussed in this text. By limiting the content to only the editor's experiences, a very abbreviated version of appropriate interventions is presented, resulting in omission of more appropriate techniques and approaches to care. The book meets the editor's objective of sharing her experiences and gained knowledge with caregivers. However, she falls short of providing a knowledge-based guide for caregivers. Some very complex issues, such as use of restraints, are dealt with so superficially that the suggested guidelines could result in harm to the patient.
Audience:This book is clearly written for the lay caregiver, probably family members of persons with irreversible dementia, both as suggested by the author and as evaluated in my review of the text. The editor seems to go beyond her personal experience at times (such as describing legal/placement issues that she probably did not deal with directly), but does not cite any other authority for her recommendations. By basing content on personal experiences only, the editor presents a very limited view of the types of interventions that are appropriate for the described care issues and needs. She seems to go beyond her expertise with many of her recommendations, such as the issue of restraints, use of lifts, etc., which would place some caregivers and care recipients at a much higher risk of inappropriate care actions and decisions.
Features:In trying to "cover the field of care giving" in a brief, easy to read text while basing recommendations on one person's experience, the editor attempts to cover a wide variety of care giving procedures and recommendations without the advantage of having broader knowledge and understanding available to most authors. The areas most effectively covered in the text are the areas of personal care, such as bathing, where the editor's experiences provide the reader with practical suggestions. The experiences of providing emotional and supportive care, such as reassuring the person with dementia and involving them in family activities, is a second strength of the book. The unique feature of the book is the editor's personal stories and insights. The shortcomings of this book include the restrictiveness of the suggested interventions and the lack of a true knowledge base for their recommendations. Some guidelines are so limited in scope as to actually increase the risk of harm to the patient, such as the discussion regarding restraint use, catheter care, etc.
Assessment:This book does not meet the standards for references offering guidelines and specific recommendations for care. The scope of the content is limited to one person's experiences with no scientific rationale or support being offered, greatly reducing the utility and depth of the suggested guidelines. Also, the editor attempts to address areas where it is doubtful that she has personal experiences from which guidelines are derived, as in the section on long-term care options and decision-making. The usefulness of this book as it is written is quite limited, and may actually prevent caregivers from seeking or receiving the full scope of assistance needed. It is not scientific- or knowledge-based, which most other texts in this field are, and it is much more limited in scope compared to other texts. Additionally, the editor consistently compares care approaches to those used with children and infants -- a tactic that tends to attribute infantile behavior to the person with dementia, something that family members and professionals should be guided to avoid.