Abstract
Care for people living with dementia is receiving heightened scholarly and public attention (Nguyen et al., 2022; Zhao et al., 2022) with the advent of global aging. Dementia researchers believe that in the aging society, clinical treatment alone can’t bring people living with dementia wellbeing and quality life (Swaffer, 2018). Caregivers and their education have played an increasingly paramount role in learning how to communicate with people living with dementia and support for such people has been more and more urgent. Against this backdrop, Dementia Caregiving East and West: Issues of Communication by Boyd H. Davis & Margaret Maclagan has just come out to enrich this field based on studies by dementia care researchers from Japan, New Zealand, Chinese Taiwan, Germany and the United States. It incorporates current practical and adaptable communicative approaches to dementia care from all over the world, especially the eastern researchers whose practice on communication as care for people living with dementia is often neglected. Through illustrating the value and the necessity of sharing caregiver experiences, this collection will greatly inspire more global health care researchers to work in this field such as domestic caregivers, institutional staff, both novice and advanced researchers etc.
This volume consists of 12 chapters, which are structured into 3 sections. Chapter 1, as the introduction, prepares readers with the background knowledge that with globalization and immigration, communication between caregivers and people living with dementia has become increasingly important and demanding since dementia caregiving can be multilingual, cross-cultural and interdisciplinary. Such communication takes on both verbal and non-verbal forms such as audio-visual digital system, virtual reality, graphic novel, and animate (such as manga or anime).
Chapters 2–4 in Section 1 further direct readers to ponder over three basic issues: what is successful aging, who should care for people living with dementia, and how is care for managed in the time of Covid-19. Successful aging in this context does not mean aging without illness but adjusting and integrating oneself to life, being independent, being content with life and longevity. By such yardstick, people with successful aging are numerous including those with mild cognitive impairment who may be cognitively healthy via training activities such as physical exercises, reminiscence, playing cards, music, dancing and puzzle words games. Other intervention activities (creative involvement and interpersonal synchrony) based on caregivers-recipients relationship and their characters are also beneficial to aged people’s physical and mental health (Chapter 2). Who may conduct such activities and who should be responsible for the wellbeing of people living with dementia? Chapter 3 believes that financial, institutional and social aspects (home, government and community etc.) may work together to guarantee aging people’s medical services. Meanwhile, awareness, education and training, less stigmatization and more caregiving service support all contribute to people living with dementia’s wellbeing. Chapter 4 deals with the voices of caregiving staff in the US in a time of Covid-19. The pandemic has made the caregiving service market for people living with dementia worse, namely shortage of caregivers, low income and welfare, and less room for professional promotion.
Section 2 (Chapters 5–7) focuses on language communication between caregivers and people living with dementia. Chapter 5 investigates code negotiations in three conversations with bilingual people living with dementia. The author points out that care-recipient relationship needs to be re-established and re-negotiated as speakers’ preference and code choices may affect the communication effect. An exemplary mixed approach including interview, conversation analysis and ethnography is appropriately employed to reach reliable conclusions. Chapter 6 talks about the family care work discourses via a contrastive study on German and British public online discussions about dementia. It reveals not only the discoursal structure and topoi of online discussions on people living with dementia’s care work, but also participants’ complex stances and the roles of family care work and institutional care work, which could contribute to more varied perspectives on dementia, and different forms of care work for people with different dementias. Chapter 7 emphasizes the importance of interactions among caregivers and people living with dementia in preserving communicative competency based on Japanese dementia discourses. The research findings re-emphasize Kitwood’s claim (Kitwood, 1997) that interconnectedness and interdependence between carer-recipient may promote people living with dementias’ personhood and identities.
Section 3 consists of 5 chapters that deal with the ways to communicate with people living with dementia such as hands-on talk and art therapy as well as hands-on technology. Chapter 8 lists the task-plus communication types in dementia care with detailed practical task-plus communication proceeds. It points out the equal importance to care for psychological well-being and relationship building via both verbal and non-verbal modes. Chapter 9 describes the elements of nostalgia in art therapy for people living with dementia and the detailed benefits of and steps for such therapy. Art forms include songs, dancing, and drawing that may stimulate past experiences for people with dementia. The two chapters demonstrate the importance of social interactions and the contribution of social engagement and environmental support for people living with dementia’s social health (Hagan & Campbell, 2021), which is also demonstrated in the next three chapters. Chapter 10 focuses on a more detailed therapy method that visualizes older adults’ life stories via sand tray work, which may improve their self-efficacy and help manage their chronic pain. This method demonstrates “their wisdom, creativity, and continued self-growth” as well as “their primary needs for physical care and cognitive health” (p.128). Chapter 11, as the first study to explore the attachment relationship and its influence on mental health in Chinese Taiwan, specifically deals with the positive role of social robots in taking care of older adults, which can operate in specific attachment styles with therapeutic effects on depression and loneliness. Chapter 12 tries to develop an interactive digital system for initial engagement with older adults. This system works as a time-travelling machine by which aging people’s favorite photos, pictures, music and videos can be shown on their computers (pads) to help them create fond memories and enjoy self-affirmation and gratitude. Such systems can continually expand their digital literacy and computer skills by taking advantage of interactive technologies, thereby reducing their social isolation. Practices in the last three chapters are, to some degree, consistent with the ‘being in the moment’ activity by Keady et al. (2020) and the use of a participatory social network mapping method by Campbell et al. (2019).
This volume investigates dementia caregiving in terms of communication, offering readers an alternative perspective, conversation as care, since pharmacological means of assistance can hardly address various issues in the field with the increasing number of people living with dementia in an increasing aging society. The communicative means for caring for people with dementia proposed in the book are essentially practical and adaptable largely due to the fact that they are based on an informative collection of multilingual, cross-cultural and interdisciplinary studies. Both western and eastern researchers in the fields of nursing, gerontology, anthropology, art therapy, counseling and linguistics work together presenting an insightful volume to a wide spectrum of readers including healthcare professionals, social care professionals in both family, community and institutional settings, and applied linguists involved in gerontology linguistics. The study is also of methodological significance for researchers in the field of heath care communication. Research methods including case studies, interviews, conversational analysis, and discourse analysis are properly integrated in these studies, considerably enhancing the validity of research and thus offering reference for prospect researchers. Different types of diagrams and vivid real-life examples are also employed to illustrate abstract concepts, greatly increasing research accessibility to readers with different backgrounds. To illustrate, the application of software of MAXQDA helps visualize the findings, making them compelling. One of the eye-catching breakthroughs is the implementation of industry-academic cooperation in dementia care, using robotics with different attachment styles for older adults with dementia.
One minor shortcoming, if any, is the lack of discussion on different countries’ policies (regulations) concerning communication issues in dementia caregiving, which does not dim the value of the whole book. Overall, this thought-provoking volume provides a new venue for dementia communication research, thus undoubtedly appealing to scholars with interests especially in empirical research in this field. I would recommend this volume as a useful and reliable guide, and hope the challenges and directions for further studies identified in this book will prompt more research in the growing field of health communication.