The aim of this book is to provide both a theoretical background to working therapeutically with older people and practical advice. Piercy does this by starting with some details about the ways in which older people may present. She then divides clinical issues up into general areas, including couples issues, intergenerational issues, problems with siblings and family members. She ends by describing support resources for families needing long-term care.
This book seems to operate on two levels. Piercy's background as a clinician (social worker) and researcher working within the North American system is very evident. Certain phrases such as “family of procreation” and “boomerang child” were jarring and may not be familiar to non-US readers. Of course, the description of the healthcare system and how it works is also environment-specific. All of this would make it extremely useful (possibly indispensable) for a therapist/clinician working in that region, but it could be off-putting to those working outside North America.
Fortunately there is a lot more to this book than a handbook on sourcing homecare in Seattle. The first chapter describes the increasing complexity of family ties, and discusses the effects of these changes (divorce, remarriage). I was pleased to see that much of the information Piercy provides is backed up by research, with the references listed at the end. Even more helpful were the practical “clinical suggestions” which tie the research to the real world. Piercy then begins to bring in theoretical models such as the “Life Course Perspective” and “Family Systems Theory”, which are explained in a straightforward way with clinical examples. Piercy draws on these theoretical frameworks when it comes to more in-depth discussions of issues in the following chapters.
The next four chapters on specific issues were, I felt, the real strength of the book. The structure of background information followed by a real life case and intervention worked well. The case studies were detailed enough to be interesting and the patients much like those I encounter in my practice. The formulations and interventions offered were also practical and sensible yet with a sound theoretical basis. These chapters would be relevant to clinicians working anywhere.
This book therefore has two functions. It is a practical handbook for those working in the North American system on how and where to find care and support for the older adult. Secondly, it can be used as a guide for therapists from a wide range of clinical backgrounds hoping to help older adults with mental health problems. I believe that Piercy has achieved her aims and I would recommend this book to workers from a range of disciplines working with older adults.
