Writing a textbook that targets virtually every health professional involved in geriatric mental health is an ambitious task even for such renowned authors as Donna Cohen and Carl Eisdorfer. How does one pitch it at a level that is relevant and useful to psychiatrists and nurses, to neurologists and social workers? The authors pull it off surprisingly well, coming up with a manual that provides a solid grounding in the theoretical and practical aspects of the care of the elderly mentally ill.
The first part of the book lays down the conceptual framework, dealing with such issues as the principles of geriatric mental health care and the challenges that come with a rapidly ageing population. Particular emphasis is placed on patient-centered care. These first two chapters are crammed with useful information and links to external websites.
Specific mental disorders are dealt with in part two. The authors manage to put across a huge amount of relevant information about each condition in a concise and easily read format, making use of mnemonics now and then to facilitate learning. I found the section on cognitive impairment and the dementias particularly interesting and informative, containing as it does a clear description of age-related cognitive changes, and drawing attention to the variety of factors that might confound a clinical picture of dementia.
The third and final part covers special clinical issues such as capacity, suicide, and palliative care.
The patient-centered approach is a distinct underlying theme that gives the book a particular focus. The entire text is peppered with illustrative clinical scenarios. The reader is often directed to relevant websites for further information. The legislation, health policies, and care systems, where mentioned, are specific to the United States, but the principles of practice are universal.
From the point of view of a psychiatrist in training, it would have been helpful to have some more guidance on one or two practical issues. Driving with dementia, for example, would have fitted quite nicely in the “special clinical issues” section. More could also have been said on the subject of the pharmacological management of behavioral and psychological symptoms of dementia. That said, this book does not pretend to be a comprehensive reference textbook, and covers everything else quite thoroughly.
Some chapters presuppose a familiarity with concepts from the pre-clinical sciences that would be expected of medical professionals, but not necessarily of other clinicians. However, they are written in a way that makes it possible to skim over such details without losing the big picture.
Who would benefit from reading this book? I think every clinician working directly in the field of old age psychiatry will have something to gain from it. Anyone embarking on a career in the field will find that it provides an invaluable theoretical framework for their practice. The fact that it can be read from cover to cover in a reasonably short timeframe is an additional benefit. For the more experienced clinician, the book covers the individual disorders and specific issues in enough detail for it to serve as a quick and easily accessible reference text.
