Click Here To Purchase Alzheimer's Disease and Other Dementias - The Caregiver's Complete Survival Guide

Author: Nataly Rubinstein, MSW, LCSW, C-ASWCM

Publisher: Two Harbors Press (Minneapolis)

ISBN: 13:978-1-936198-13-9

I rushed to the chapter on diagnosis in this badly needed, authoritative, and comprehensive guide to dementia. My mother was declared “probable Alzheimer’s” in 2000. It was my job (I decided) to prove the doctor wrong, and to take my mother under my wing and restore her to a practically normal 80-year-old with vascular dementia. I believed her main problems were depression and fear.

Nataly Rubinstein has confirmed my position. My mother died in 2005, but she died a relatively contented woman. I don’t want to make this review personal, however, because, as this expert geriatric social worker says, each person is unique and there are many different kinds of dementia.

This author admits that the guide is four books in one, as every category of caregiver needs its own manual. She focuses as best she can on what all caregivers have in common. The chapter titles are geared toward someone unfamiliar with the complexities of this aging issue (which in my experience includes agency caregivers whose training and wages are insufficient relative to the task).

We know a lot more about the brain and about aging than we did in 2000. Advances have taken us closer to viable treatments. Still, families will cherish this book and probably use it over and over again.

One of the first “lessons” Rubinstein outlines is Know Thyself. She urges the reader about to take on the role of caregiver to understand who the person with dementia is, and — I find this critical in retrospect — what your relationship with him or her has been in the past. She also insists on an understanding of WHY you are choosing to be the caregiver. Let’s face it: often we feel there is no choice. Siblings may live too far away or be caught up in other problems and cannot help. In my case, knowing how my mother would behave in an institutionalized setting, I felt it would be easier to have her in our home. Fortunately, my husband encouraged me, and the prospect of having a man in the house was comforting to her.

Rubinstein is concerned about our recognizing when the time has come to step in, and she has terrific advice about how to navigate the health care system, what to ask for (and sometimes demand), and what the flaws in the system might be. Sometimes this involves changing insurance providers, and it might mean changing doctors. She describes side effects of popular medications, so you can be aware of them when a doctor prescribes one or more or there are several doctors involved. She discusses the value of light therapy (getting out of doors). She warns that the age of some diagnostic tools can misrepresent the situation; this is a question most of us would never think to ask.

Another extremely useful chapter is on communication. If the individual we are caring for cannot or will not express themselves in words, we have to be more sensitive to body language. We also have to be careful about how we express ourselves. The person with dementia is confused and fearful; they will seek the safety of what is familiar. Facial expressions and tone of voice become all the more important tools where words may fail.

Family dynamics create landmines. One example Rubinstein mentions is a person who confused her daughter with her own sister, for whom she had a complete dislike. In the realm of spousal relations, Rubinstein warns that for a couple who has had “a close physical/sexual relationship in the past, memory issues are not the major concern; the loss of physical intimacy is.”

Suggestions for coping are very specific, ranging from legal matters to respite care. Of course, the rules and resources vary from state to state. No doubt, the lists at the back will be kept up-to-date as this book is revised again and again for future generations. (I hope the index is better designed in future editions; this one is hard to read.)

The author’s insights are grounded in her practice, where she works with 800 clients a year, but equally impressive is what comes from the author’s heart. Her final chapter begins as a memoir of childhood; being taught how to live in the wilderness three months a year. If they had an emergency and needed to get to town, they had to flag down the occasional freight train, sometimes at night, using a flashlight. This becomes a metaphorical reminder that we cannot do everything by ourselves. After caring for her own mother with Alzheimer’s, she knows that each of us in that position will have times when we have to wait by the tracks with a flashlight.

This freight train of a book has a very strong beam that sweeps the countryside watching out for you.

Click Here To Purchase Alzheimer's Disease and Other Dementias - The Caregiver's Complete Survival Guide