Modern developed societies are historical anomalies, having a high proportion of people of my age and upwards, coupled with the disappearance of traditional social structures in which children live with their parents up to the point where parents live with their children. This anomaly is reflected in the quantity of the literature – “Twenty-five years ago I would have been hard put to it if asked to recommend a guide to looking after people with dementia. . . My successors at the Institute of Psychiatry library must nowadays be equally hard put to it, choosing which of so many to recommend” (Guha, Reference Guha2012a). As the author of The Psychology of Ageing, Ian Stuart-Hamilton, says, “. . .writing the first edition . . . I was recommended to try the new-fangled method of performing an electronic data-base search. . . The resulting print-out . . . ran to under 100 pages.” Imagine the results of a literature search now! No one could possibly survey the whole of the literature on psychogeriatrics, but it might be interesting to look at some books, which have survived through several editions, to see how they have changed. Reading through all the book reviews in International Psychogeriatrics since it started in 1989 was, in itself, an interesting exercise. The very first review mentioned change: “There are ethical, political and economic developments that have already come into being since the book's publication” (Pollock, Reference Pollock1989). These developments should not be exaggerated however. There has been an enormous increase in scientific knowledge, and a sea change in public attitudes, but, as Lovestone (Reference Lovestone2007) pointed out: “It is sad that the huge body of research . . . has resulted in so few clinical advances.” Even when justifying his third edition of The Psychology of Aging (2000), Stuart-Hamilton said, “. . . the general tale which psychogerontology had to tell was not altering particularly drastically. However, after a certain point, even the same house needs a new coat of paint. . .” By the fourth edition (2006), he was more optimistically saying, “there has been an explosion of research. . .” I noted when reviewing that edition elsewhere that it was “full of references to longitudinal studies in progress” (Guha, Reference Guha2007). In this latest edition, he has reverted to the pessimistic mode: “The net result of a depressing proportion of my reading has been to retain essentially the same text as in the fourth edition. . .” though he still hopes that “we are on the verge of a radical shift in geropsychology.” Perhaps by the sixth edition? I do fear that, with some of these books, a new coat of paint is basically what we are getting. The Psychology of Aging has over the years proved itself to be a solid and workman-like general introduction to the psychological problems of growing older. Parts of it have been updated, although curiously, not the chapter on “The Future of Aging,” which still looks forward to increased leisure and the lowering of the retirement age! Predictions of a life of increased leisure and less labor have been flying around since the start of the Industrial Revolution, in spite of all the evidence to the contrary. Readers who possess the fourth edition may not feel that some rewriting and expansion, updated references, and a new chapter on death and bereavement justify upgrading to this edition, but I will continue to recommend this book to psychology students and trainees, as a very sound basic text.
The Psychology of Aging is a general introduction for professionals, first published in 1991. The 36-Hour Day is a guide for family members and carers, which started 10 years earlier and has also reached its fifth edition. I have previously suggested this book to enquirers as a good general guide to the practical problems of looking after relatives with dementia. Comparing it with the previous edition, there are few changes in the first half of the book, dealing with day-to-day difficulties. There is a new chapter on prevention, more material on less common causes of dementia, and updated information on the provision and financing of care. This last is, of course, American in orientation and might be less useful to readers in other countries. There is an enlarged section on assisted living, though I was disappointed to see little mention of the advanced assistive technologies that are under development (Guha, Reference Guha2012b). Nevertheless clinicians should note this as a practical guide, which they can safely recommend to family members.
It should be noted that The 36-Hour Day is a book about coping with people who have dementia rather than about communicating with them. The Validation Breakthrough is one person's approach to communicating. Naomi Feil had the unusual advantage of having been brought up in an old people's home (directed by her father). Her “best friend” was 68 when she was 8, so she has, in effect, been perfecting her technique since 1940. It first appeared as Validation: the Feil Method (Feil, Reference Feil1982), revised in 1992, then under its present title in 1993, second edition in 2002, and now its third edition. During that time the book has grown substantially: from 130 pages in the first book to 294 in the present edition. The message and the method have stayed the same however. It is extremely difficult to teach empathy – some people are empathetic by nature, while others, no matter how highly qualified, never really grasp the technique. Feil lays down simple but effective guidelines for encouraging communication accepting old and very old people's world-view, learning “not to contradict, patronise, argue, or try to use logic or give insight.” What works for one person may, of course, not work for another, but there is sufficient evidence presented here for me to recommend The Validation Breakthrough as a useful resource on communication skills for professional staff working with adults who are confused or disorientated.
Increasing a book's size is sometimes helpful. This journal's reviewer comparing different editions of Practical Psychiatry in the Long-Term Care Home noted that “to great advantage, the book has increased in length” (Snowdon, Reference Snowdon2008). In this instance, however, much of the increase has come from adding further case studies rather than an expansion of the method, so again readers who possess the previous edition may not feel the need to upgrade. Readers who have not come across Feil before are warmly recommended to look into the techniques described.
Other reviewers have pointed out that “there is no shortage of books aimed at those caring for people with dementia” (Peisah, Reference Peisah2007), but it may be worth noting that Feil's collaborator, Klerk-Rubin (Reference Klerk-Rubin2008) published Validation Techniques for Dementia Care: the Family Guide to Improving Communication, developing the same techniques for use by family carers. This perhaps complements The 36-Hour Day. If I had read both these, it might have made the last year of my mother's life happier for both of us.
Stuart-Hamilton, Nancy Mace, and Naomi Feil first wrote when they were relatively young, so have now reached the stage where they are describing their contemporaries. This may partially explain the increased size of their books: as we reach the age of reminiscence, more and more case studies come to mind. Part of the increase comes from the publishers however: there is noticeably more space available. The glossary in the early editions of The Psychology of Aging, for example, was a close-packed list of brief definitions but has now expanded into a more widely spaced mini-encyclopedia. As such it enters into competition with publications such as the Encyclopedia of Alzheimer's Disease, which has now, after 10 years, appeared in a new edition.
There are an enormous number of dictionaries, glossaries, encyclopedias of various sizes, and on-line lists of psychological and psychiatric terms. The journal Reference Reviews probably does not come into the purview of readers of International Psychogeriatrics as its target readership consists of public reference librarians, but, in my capacity as its medicine and psychology section editor, I feel as though I review one in every issue. There is at least one similar-sized book with an identical title (Turkington, Reference Turkington2003) plus Atlas of Alzheimer's Disease (de Leon, Reference de Leon1999) and A-Z of Alzheimer's Disease (Turkington and Mitchell, Reference Turkington and Mitchell2010), besides more general works. This book therefore faces stiff competition.
The Encyclopedia of Alzheimer's Disease is rather an oddity, as less than half of it consists of encyclopedia. More than half of it is taken up with a directory of American long-term and day care centers, arranged by state. The editor admits that she balked at the task of producing a new edition as so little had changed after 10 years – renovating an old house is a time-consuming task, and that, like Stuart-Hamilton, she was “struck by how many studies . . . described with enthusiasm a decade ago had been halted or stonewalled. . .” In the absence of major scientific breakthroughs this edition places greater emphasis on prevention, holistic therapies, dietary interventions, such as curcumin, genetic and environmental factors, etc. A wide variety of more or less relevant terms get brief and unreferenced definitions – usually only a paragraph or so. The definitions appear to be clear and accurate, though the absence of references makes evaluation difficult. I can see this section being regularly used in public libraries, but am less sure about the value of the other half. I suppose, there might be occasions when someone in, say, California wants details of care homes in South Bend, Indiana, but the one thing which has changed in the past decade has been the Internet. That sort of information is now at everyone's fingertips. Producing this new edition must have taken an enormous amount of work, but I am not convinced that it was worth the effort. Public and college libraries in the United States would definitely find this useful if they do not already have enough reference tools on ageing.
Reading these new editions, and reading all the reviews in International Psychogeriatrics left me slightly worried. I get the impression of a field in which enormous increases in scientific knowledge have not been fully matched by improvements in therapeutic methods. There have, of course, been changes: The concept of assisted semi-independent living, for example, hardly existed when The 36-Hour Day first appeared – you were either fully capable or entirely incapable.
The very first review in this journal quoted Sontag (Reference Sontag1977): “Everyone who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged . . . to identify ourselves as citizens of that other place.” All of these books can be recommended: a sound psychological introduction, a reliable practical handbook for families, a good guide to communication, and half a useful encyclopedia. Clearly, however, more than just a coat of paint is needed to fit that other place up for us all.