My first impressions of this book were mixed – the joyous cover picture of a man and woman laughing and holding hands, coupled with its interesting title and the large-format (especially for a paperback) and 254 pages promised a great deal. However, once I opened it, I was struck immediately by the unusually large number of nearly blank pages containing just a few lines (the shortest one being just 28 words long), leaving me to wonder – was this a book that would be as good as its cover?
Certainly, you cannot fault the author's passion for her subject. She clearly has talked to a lot of older people about their feelings about their sexuality and understands how the attitudes of the staff toward sexuality and aging will impact on the care the older person receives.
Neither is there any problem with the book's scope. The book is set out in 11 chapters. The first discusses sexuality from the residents’ viewpoint, then the next staff attitude, followed by one on family influences. Other chapter topics include dementia, inappropriate behaviors, and then lesbian, gay, bisexual, and transgendered residents, with later chapters dedicated to environment, health and sexuality, and policy (a chapter that reflects US legislation and practice and may be of limited use to a reader in the United Kingdom).
It took me a little time to catch on to the intent of the book's organization. Generally, each chapter begins with a suggestion for exercises, questionnaires, or case histories that could be performed or discussed with the care staff – for example how they might cope with particular situations to help them question about their attitudes before moving on to a discussion of the topic. Unfortunately, it is not immediately apparent that one is allowed to photocopy and use the material as each page bears a very prominent copyright logo and it is only if you have read a line buried in the introduction (on page 8) that you would know that there is a license for these pages to be copied for use in these activities. However, once this is understood, the reason for the amount of white space becomes a bit clearer.
This mystery solved, one is still left disappointed by the lack of clear guidance on the points, one might want to draw out of the discussions generated by the exercises or of how to deal with common pitfalls that you might expect a discussion to engender. You would have to be a confident knowledgeable trainer to be able to use this book – in which case you probably would have thought of many of the ideas yourself.
A further cause for disappointment was to see that one page (p. 173) made specific reference to reflecting on what you have seen in a particular film. When you go on the website that the book suggests to see the film you find you have to pay $19.95 to download the 4-minute trailer or $399 for the training kit.
Even so, the book does include much useful content. There are some helpful sections such as the brief check list for treatment options, although the information on behavior mapping is overly brief and does not really provide enough detail to be useful – (which is disappointing in a reference-sized tome). The chapter on writing a policy for the care home was in my opinion the most useful, containing a list of areas a policy should cover, which could easily be forgotten.
The book is as much a polemic for the proposition that elder sexuality should be taken seriously as it is a handbook on dealing with the topic, and as a polemic I found it fairly convincing. Having read this book, along with the recent paper in International Psychogeriatrics (Benbow and Beeston, Reference Benbow and Beeston2012), I am even more convinced that sexual activity in long-term care is an important issue and that more recognition of this fact is needed.
However, if readers want a book also based on real experience that encourages them to think about their own attitudes as well as the importance of sexuality for people with dementia, I think they might get more out of reading Dementia and Sexuality: A Rose that Never Wilts by Elaine White (Reference White2010), which deals with much the same content more succinctly and provides at least as good a grounding for a smaller investment of money and time.
However, I have to admit this book does have the better cover.
