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Aging together: Dementia, friendship & flourishing communities

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Title: Aging together: Dementia, friendship & flourishing communities

Authors: McFadden SH & McFadden JT

Publisher: The John Hopkins University Press 2011

Reviewer: Ed Shields, nurse lecturer, Queen’s University Belfast

What was it like?

The thesis of the authors, one an academic psychologist and the other, a senior pastor of “large liberal congregations”, is that it is possible, necessary and rewarding to have meaningful relationships with people who are, “travelling the dementia road”.  In this book they argue that dementia should not be seen as an individual tragedy but should be seen as an experience of personal change occurring within communities. They remind readers that the lives of those who struggle with memory loss have worth and value and that they should remain and be part of flourishing communities. The authors acknowledge that this is not a “how to” book but instead gives some information on the projected growth of dementia in American communities in the coming years, names the types of dementia and then begins to discuss some of the shortcomings of biological models of dementia. They caution against bio-medical descriptions of decline and deterioration that lose sight of people living with these diagnoses. They invite readers to reflect upon the implications of receiving such a diagnosis and on the fear and anxiety that people have at the prospect and consequences  of a diagnosis. The book develops the thesis that too many people with dementia suffer fear of abandonment, dependency and exclusion. It argues that peace, compassion and love can replace this fear only in the context of flourishing communities; they exhort involvement of religious fellowships, service clubs, sports leagues (church communities, voluntary bodies and youth clubs in UK parlance?) to invite and welcome people who have dementia. They contend that these attitudes are culturally acquired; perhaps their point is best illustrated by the Taiwanese person who came to study medicine in the US who said that she did not know her grandfather was sick before she came to study in America; “he just changed but he was still grandfather”.


What were the highlights? 

One particular highlight of the book is the use of vignette to illustrate points and give insight: these are readable and useful. There is an absence of, what may be termed, technical jargon and the language is accessible.

Strengths & weaknesses:

At the end of the book there are suggested questions on each chapter to promote thought and discussion. The book is written for an American audience and, not unnaturally, makes many such social, cultural and political references that may not transfer easily to other audiences. Some may find many points could have been developed and arrived at more succinctly.

Who should read it?

Anyone who wants to teach, practise or encourage person-centred care for people with dementia will find a lot in this book. However, it is difficult to be more specific than that; it seems also to be directed at community groups, church congregations and, perhaps social groupings; it is not made entirely clear.

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