Catholic Medical Quarterly Volume 67(2) May 2017
Dementia, hope on a difficult journey
Dr Adrian Treloar
Redemptorist Publications (22 November 2016)
A diagnosis of dementia, which is an illness of the brain, can be very difficult for both a person being diagnosed with the disease, their family, their friends and their care givers. Having to deal with the unknown is often the most challenging aspect of dementia for all concerned and dementia is often a very emotive and sensitive subject with our society today.
Dementia: Hope on a difficult journey written by Dr Adrian Treloar, a consultant and senior lecturer in old age psychiatry, published by Redemptorist publications is a very informative, insightful and compelling book. It explores in a manner comprehendible by healthcare professionals and non-healthcare professionals alike, what dementia is, how to manage it and key aspects of spiritual care. Dr Treloar who states quite clearly that being a specialist in dementia care is a ‘real privilege’ identifies in the introduction to his book that ‘there is a real need for both practical and spiritual support for a person with dementia’. Dr Treloar also identifies that he is a Catholic and as such what he says in his book comes significantly from a Catholic perspective, however his book is very much applicable and relevant to individuals of all faiths and none.
Dementia: Hope on a difficult journey is laid out in a straightforward yet imaginative manner, there are many beautiful illustrations throughout the book and there are twenty-nine chapters that focus on a range of important issues some of which include: ways of communicating with people with dementia, distress in dementia, carer support, dementia and sin, spiritual care of dementia, the sacraments and bereavement. A number of comforting quotes taken from The Jerusalem Bible appear throughout the book and are laid out in a simple yet striking manner. Moreover Dr Treloar has chosen various different biblical excerpts that relate closely to the theme of each chapter which allows the reader the opportunity to reflect on the spiritual element of the practical issue being explored.
Dementia care can be a difficult journey for an individual living with dementia, their carers and loved ones alike. Seeing a fellow human being agitated or distressed as a result of dementia can be particularly upsetting and difficult. It is fantastic that Dr Treloar has dedicated an entire chapter of his book to distress in dementia and also some other chapters that focus solely on carers and it is central to good dementia care that distress and agitation are managed well. Within this book, Dr Treloar, through clear points, identifies and explores practical issues related to distress and agitation in dementia - which carers and relatives of a person living with dementia often find the most difficult elements of dementia to cope with. Communication is a key issue when interacting with a person who has dementia, keeping communication simple and remembering to value the person you are with is essential. Dr Treloar examines within his book effective ways to communicate with someone who has dementia and reinforces the importance of ‘not over complicating communication and the importance of talking about familiar everyday things’.
Further to this Dr Treloar dedicates a chapter of his book to memories, identifying that ‘memories can be a powerful way of using yesterday for today’s good’. An individual with dementia will undoubtedly have done many things in their life; they will have their own stories, memories, life experiences, talents and skills, family background, cultural background and religious traditions and beliefs. Memories can be powerful when interacting with someone with dementia. Dr Treloar explores in a beautiful manner the important issue of memories within his book and does so in a very informative manner. Emotional care of a person with dementia and emotional instability are also explored within this book, when focusing on this chapter of the book the reader really is afforded an opportunity to stop and ponder about the behaviours and emotions of people with dementia and just how important it is to understand them and be sensitive to such behaviours.
Good spiritual care can often be overlooked within healthcare. The faith of a person with dementia that was active in earlier life must be supported when appropriate - and it is important to remember that due to having an altered state of mind trying to convert someone or allowing someone who has dementia to be converted is really not appropriate at all. Dr Treloar examines in a clear and concise manner just how important the sacraments are for many Catholics and just how important the rites of the Catholic Church are and in many respects if these things were important prior to a diagnosis of dementia surely they are just as important post a diagnosis? Moreover Dr Treloar also explores how for ‘Catholics living with dementia, longstanding familiar routines of going to Holy Mass or being involved in prayer can be very important and highly beneficial for individuals, even if there are challenges along the way!’
One particular point of great meaning and significance raised throughout Dementia: hope on a difficult journey is how important it is to recognise that ‘difficult, angry, inappropriate, challenging and upsetting behaviour on the part of a person living with dementia is the illness and not the person’. For me personally and I am sure for many others constantly reflecting on this point and constantly ensuring that others understand that the person is communicating an unmet need can be a great help.
In summary Dr Treloar’s book, which is slightly smaller than A5 in size is a beautiful piece of literature that is a beneficial read for all healthcare professionals and those who know an individual with dementia. While it is written from a Catholic perspective the vast majority of the book is highly relevant to those of all faiths and none. I thoroughly enjoyed reading the book and will enjoy referring to it in the future, it has enabled me to spend some time considering and reflecting upon the many varied and important practical and spiritual care elements of caring for and interacting with a person who has dementia.
Reviewed by Donato Tallo