Evaluation in Dementia Care is an excellent and authoritative edited collection that covers a much neglected topic in the literature on dementia care. Chapter 1 sets the scene. It explains the theoretical basis of evaluation in dementia care and identifies a gap in current knowledge and research. The text is then neatly split into three sections. In Section 1, Caroline Cantley (Chapter 2) presents the problems that can be encountered in evaluating dementia care such as evaluating the effectiveness of drug treatments. Recent United Kingdom Alzheimer's Society campaigns and National Institute for Health and Clinical Excellence (2007)Guidelines have highlighted just how difficult this can be. The push for evidence-based practice is eloquently discussed and the conflicts that exist within the professions that dominate dementia care about suitable methodologies and the nature of evidence. Quality of life and the involvement of service users and carers are also discussed in this chapter. The need to include people with dementia and also to evaluate their inclusion is emphasised. Cantley discusses the complications associated not just with measuring quality of life but particularly of measuring it from the perspective of the individual with dementia. In her discussion of working ethically, some more exploration of research on proxy consent would have been useful in this chapter.

Carolyn Lechner (Chapter 3) looks at the pros and cons of evaluating your own workplace and the care provided. Again a strong feature of the chapter is the emphasis on stakeholders taking part in service evaluation. The reader is asked to challenge their view of just who the stakeholders are in a care setting and to consider whether or not all stakeholders have an equal voice in the process. Lechner goes on to debate internal versus external evaluation. The tables discussing the advantages and disadvantages of these approaches provide an excellent summary for the reader who just wants to dip into the book. Issues associated with the utilisation of Dementia Care Mapping (DCM) as an evaluation tool are identified. For example, unpleasant dynamics can be brought to the surface within a staff team once feedback is provided through DCM. Staff in care settings often perceive DCM as a big brother tool that is used to observe them rather than the care provided. The culture of dementia care must be right before staff and people with dementia can benefit from the process. The comparison of internal and external evaluation brings together many ideas and is very thought provoking. Louise McCabe (Chapter 4) introduces the policy context for evaluation in dementia care. People with dementia may come into contact with a variety of services and these do not remain static. Although changes have occurred in the way services are regulated since this book was published, McCabe provides a very interesting overview of regulation and the role of the Commission for Social Care Inspection in England.

The second Section of the book focuses on the practicalities of conducting dementia care evaluations and includes personal reflections by authors on the process. It includes an interesting view on evaluating technology and the limited evidence base that currently exists for using telecare in dementia. Alison Bowes (Chapter 5) brings together the available research evidence on the use of technology. She highlights the views of people with dementia and their carers and ethical issues relating to the use of technology in dementia care. This is a huge growth area and a chapter that will be relevant to practitioners and researchers in the fields of health and social care. Wijk (Chapter 6) considers evaluating the environment in long-term care settings using the ecological model of ageing. This is again an important topic which despite being the subject of other research is still a sadly neglected area of care. One criticism of this chapter is that it does not present the views of those who challenge the idea of specialist care units and who argue that people with dementia should be integrated into mainstream care settings. Gibson, Haight and Michel (Chapter 7) describe the evaluation of a life review and life storybook project involving direct care staff (care-givers) in a variety of residential care contexts. Readers would find this useful in conjunction with the more recently published book by David Sheard (Reference Sheard2007) and the growing body of research in this topic area. Innes and Kelly (Chapter 8) discuss evaluation of long-stay settings and Dementia Care Mapping (DCM), and consider its strengths and weaknesses. The final part of their chapter suggests a toolkit approach and this could have been further developed. Kirkevold (Chapter 9) provides a Norwegian perspective on concealing medication which has been an issue for a long time in all care settings and care relationships. Chapter 10 is based on a small research study in France in 2003 on the experiences of people with dementia in decision making. The author discusses a useful model for evaluating freedom of choice in health- and social-care along with the challenges that poses.

In the final Section of the book, future challenges for evaluating dementia care are identified. Christie (Chapter 11) examines ethics, evaluation and dementia taking a very person-centred view of the topics discussed but a reference to Nolan and colleagues' (Reference Nolan, Davies, Brown, Keady and Nolan2004) senses framework would have been useful. In Chapter 12, Murphy discusses user involvement highlighting the many issues, such as consent, reciprocity, intrusion, and tokenism, in what is a very complex topic area. Chapter 13 presents the issues around evaluation of dementia care in resource scarce settings in Lithuania. Many of the issues discussed are relevant to an international readership. In Chapter 14, the editors, building on the lessons of evaluation, discuss key challenges and sum up the earlier discussions. This book will be a useful resource to many health professionals and educationalists involved in training staff in the various services that contribute to dementia care. The text should also prove an excellent resource for students and researchers with an interest in this area and it is excellent value for money. One hopes that the focus on evaluation will not deter readers who would truly benefit from the wisdom contained in the text.