Lars-Christer HydenHilde LindemannJens Brockmeier

Edited by: Published by: Oxford University Press 2014 ISBN: 978-0-19-996926-5 Price: £35.99/$55.00

I approached this book with considerable interest professionally as I am a Clinical Geneticist by trade, and for 18 months I have held the position of Director of Mental Health Services in my University Health Board with responsibilities for delivery of services to people affected by dementia. I also find myself at that time of realisation when one recognises that the greater part of one’s life has been lived and thoughts of what lies ahead often creep, unbidden, into conscious thought.

Anyone who has lived or worked with individuals and families affected by dementia, in all its presentations and aetiologies, will recognise many of the lived experiences, vignettes and challenges explored in this collection of essays. Every chapter presents different facets of the condition and examines the impact of dementia on the individual and on all those with whom they interact, from immediate family and friends through to wider social issues.

This book is well researched and extensively referenced. It is divided into three sections: Persons, Personhood and Dignity; Identity, Agency, Embodiment; Communication, Family and Institutions. There is a detailed exploration of what it is to be human and how dementia has an impact on that. This exploration includes examination of notions of dignity, the meanings of love and an analysis of aspects of independence, couplehood and identity. These are issues that are often a complex, frightening struggle for people diagnosed with dementia and for their families. In particular, the loss of ‘self’ for the individual affected, and for their life partner who changes from being spouse, lover, partner in everything, to being carer with all the associated challenges, is an area that is particularly painful for the families I encounter.

Perhaps inevitably, some of the content feels uncomfortable, such as the description by one carer of being ‘chained to a corpse’. As a person who shares their life with a classical musician with a close family history of early-onset dementia, I found the exploration of musical embodiment, selfhood and dementia especially thought-provoking, both as a consideration of what it feels like to ‘lose’ parts of your loved one to dementia, and the more optimistic description of music remaining an avenue of communication with some individuals who otherwise cannot be reached by the verbal and physical exchanges they might once have been able to take part in.

Personally, I do not have psychological theorems and language easily at my fingertips, which meant that parts of this book were difficult to negotiate. The book is not an easy read nor do I feel that it could be described as a practical ‘aid memoire’. However, as a detailed reference book that uses psychological and philosophical approaches to extensively explore the effects of dementia, based on evidence of considerable experience and research, this is an erudite work of breadth and detail.

In summary, this book examines the impact, positive and negative, dementia can have on the lives of those affected and those around them, and it is a fantastic reference book from which valuable insights and information can be gleaned about dementia, identity and personhood.