This brief book is a useful guide to communication with people with dementia. It is pitched at the right level for non-professional caregivers, although professionals will also find plenty of timely reminders about communication, valuing the personhood of patients, and understanding the person in the context of their life course. The message is that people with dementia are people first, and need person-centered communication to help manage the deficits caused by progressive cognitive decline.
Hearing the Person with Dementia is a well-chosen title, as people with dementia are often treated as 'cases'; patients whose needs are wholly determined by their diagnosis and not by their individual histories and preferences. Psychologist-author Bernie McCarthy provides a clear outline not just of the reasons for treating people with dementia as meaning-making subjects, but with a model of person-centered care, and some practical learning exercises that would be useful for agencies providing dementia services.
The first chapter provides an introduction to the functioning of the brain and how the degenerative processes of dementia cause cognitive and performance deficits. The language of this chapter is clear and straightforward with many examples that family members and caregivers will find familiar. The second chapter outlines McCarthy's model for hearing the person with dementia. The VIPS (Value, Individual, Perspective, Social) model recognises both the individuality of the person and their social context, each section with its own exercise for rehearsing specific skills. Next there is a chapter on verbal and non-verbal communication, followed by a chapter on the needs of people without speech or mobility. The following chapter on specific situations is a practical guide to implementing the principles of person-centered situation in day to day scenarios such as showering, meals and dressing. The final chapter on caring for yourself addresses the important issue of carer fatigue.
Hearing the Person with Dementia has much to commend it. The prevalence of dementia will increase in western countries in the next few decades, and models of care will need to evolve from the deficit focused models of the past. This book covers many important areas and succeeds in rendering care of the person with dementia in accessible language. The book is not just readable, but usable, so deserves to be readily applied in day to day care.
© 2012 Tony O'Brien
Tony O'Brien is a lecturer in mental health nursing at the University of Auckland, New Zealand