Perhaps the most important message of this book is that it is important to talk to patients with dementia when trying to design services for them. All too often, as the author points out, we dismiss these patients as being incapable of contributing to their care.
This book developed out of an evaluation into the design of a new purpose-built facility for elderly people with dementia. The author, with a background in health service administration, set out to determine the needs of the patients (or clients, as she annoyingly calls them).
Having interviewed elderly patients with dementia over many years, the author has used her experience to give four overall themes to the book: patients' awareness of themselves and their situation;
the importance for good or ill of others, the losses which preoccupied them, and their experiences of dependence.
Perhaps as healthcare workers, including myself as a GP, we do not pay enough attention to the psychological needs of patients with dementia - concentrating instead on their physical and social problems, and on the needs of their carers.
I feel sad, though, that the book was not more readable and has not got bite-sized chunks that one can dip into.
The text is dense, there is little in it to break the chapters up in themes, and often one gets lost in the wordiness of the text.
I think the length of the title and the use of the inevitable subtitle with inverted commas is typical of the book, which tries to achieve too much and might have been better cut by half. The writing is not made easier by the constant use of inverted commas to differentiate when a name is made up (as if we would notice when only first names are used anyway) and throughout for other undefined reasons. The little stories given to illustrate points do lighten the reading a little but they are often repetitive.
I am sorry I did not enjoy the read, but I am sure the author needs to be commended on the task she set out to do and for the fact that she obviously was effective in her project - of listening to patients with dementia and translating their needs into the design of the new service.
I am sure the work was undertaken with humanity - this is evident - and that those whom the author set out to influence could not fail to be impressed by her commitment.