THE LOSS OF SELF: A Family Resource for the Care of Alzheimer's Disease and Related Disorders

A soft-focus once-over-lightly on how to care for a relative suffering from an irreversible dementia. Although such brain malfunctions may be caused by cardiovascular disease (which can reduce the brain's blood supply) or by structural brain damage (head injuries, small strokes, hydrocephalus), this book deals primarily with Alzheimer's disease: a progressive, degenerative illness of older people that starts with near-term memory loss and ends with loss of all mental function shortly before death. Cohen and Eisdorfer try to set out ground rules that will help a family cope with the emotional and physical stress of caring for a loved one who becomes increasingly irrational, helpless, bizarre, even violent. They suggest marshaling of all resources: friends, relatives, self-help organizations and community agencies to aid with the round-the-clock care required. Some communities, they say, have day-care facilities, homemaker services, voluntary ""companions"" and so on. Their suggestions on making the home ""safe and comfortable"" include a ground-floor room for the patient, ramps on the stairs, a ""safe and accessible area outside of the home,"" and a sealed-off kitchen. They examine other options such as senior citizens' housing and nursing homes, which must be considered when the patient deteriorates beyond the capacity of family care. Helpful is a chapter filled with guidelines and tips on preparing the patient for the move. The big problem, apart from the tremendous emotional and physical strain on the family, is cost: paid homemakers are expensive and a good nursing home, they say, can cost $36,000 a year. Insurance coverage (or non-coverage, as is often the case) is discussed in probing detail. The picture is somber, even tragic, yet Cohen and Eisdorfer fill the pages with (mostly) upbeat little stories of people cheerfully and lovingly caring for demented spouses or parents. The result is bromidic. Some readers, however, may find it helpful; and it quite neatly supplements Aging Myths by Siegfried Kra (see below).