Positive Approaches to Dementia Care (3rd Edition), Una Holden and Robert T. Woods, London: Churchill Livingstone, 1995

Abstract

As in the past with their 1982 book, Reality Orientation, these authors have provided a very readable and useful text well grounded in research, offering therapies which build on the remaining positive attributes of the confused person. However this book, in contrast to the 1982 text which focused solely on Reality Orientation, maintains the position that each client is an individual and as such, requires individually specific therapies. This leads to the philosophical stand that various approaches are complementary to each other, not in competition -an approach which will be applauded by the numerous clinicians who have found this to be a fact in practice.The book begins with an excellent brief overview of memory and learning, personality and adjustment, the current state of play in dementia research, and past and present approaches used in dementia care. A detailed section on how positive approaches work in practice and theory is then offered. Reality Orientation, as the most researched method, is discussed in great detail and the result is a very readable, solidly researched discussion on the results of the use of positive approaches for clients, carers and institutions. The reader is directed through what has often been a controversial discussion to be lead to the conclusion, based on research, that positive approaches offer significant changes both at client, staff and institutional levels. The debate on the practical significance of those changes is also noted. This section offers research results from a number of studies and is a must for researchers in the area and for managers of institutions that care for those with dementing illnesses. A brief overview of other complementary approaches including behaviour modification, reminiscence, validation therapy, and resolution therapy is included in this section.Part 2 offers an in depth guide to the practical application of positive therapy approaches based on values and principles concerning worth, humanity and dignity for sufferers disabled by dementia. This section includes an overview chapter on implementing an integrated approach to therapy, a very useful and detailed chapter on possible assessment measures, and one which included ideas for group work which practitioners will find particularly useful. A further excellent chapter, based on research studies, describes effective environmental and basic personal interaction approaches which are helpful in the care of persons with dementia. This book will be extremely useful for all professionals who diagnose, treat or care for persons with dementia, particularly those in institutional settings. All carers, clinicians, therapists, nurses, counsellors, educators and those interested in the betterment of caring for persons with dementia will also enjoy the convincing arguments offered in this book.