TY - JOUR
AU - Mantell, Andy
AB - This ambitious book attempts to consider policy, care and practice for rural people with dementia across the globe. The resulting text has considerable breadth but fluctuating depth. Chapter 1 outlines the global context to the national examples given in the book. Despite regional variations, common themes in how rural is defined are population density, and time and distance from population centres. The authors warn that the world faces a perfect storm of ‘out migration’ of youths and ‘in migration’ of older people, whilst financial constraints are leading to the downsizing of rural services and centralisation of specialist services in urban hubs. In Part 1, the policy drivers are explored, Chapter 2 focuses on low and middle income countries (LMICs), which may lack universal healthcare and social welfare. Older people may face extreme poverty, lacking food shelter and access to facilities. There is a lack of awareness and acceptance of dementia, which may be culturally contested and/or stigmatised, leading to isolation, hostility and even murder (Mkhonto and Hanssen, 2018). Poor access to specialists and equipment increases underdiagnosis. Chapter 3 explores how issues of isolation amplified problems in recruiting and training the workforce in Australia and how volunteers were trained to support people to navigate services. Chapter 4 highlights how a programme, Dementia ABC, has increased knowledge and skills amongst Norwegian care workers, and how day care has adapted to offer ‘green care’ (located on farms) and ‘blue care’ (on boats), providing meaningful activities, and improving quality of life. Part 2 considers research and evidence-based practice initiatives. These are from high income countries and the contributors point out that 66% of people with dementia are in LMIC, whilst only 10% of dementia research focuses on them. Chapter 5 explores the impact of the Rural Dementia Action Research project in Canada. It emphasises the importance of stakeholder involvement and embracing technology, such as a knowledge network and telehealth. The Austrian development of dementia service centres to improve early diagnosis and provide psychosocial interventions is explored in Chapter 6. This has been found to increase quality of life, reduce carer stress and delay institutionalisation. Social exclusion in Ireland is the focus of Chapter 7, which explores how people with dementia face multi-level, multi-faceted social exclusion. Part 3 grapples with practice challenges. Chapters 8 and 9 focus on the UK. Hicks and Innes demonstrate how men can be engaged, ‘shoulder to shoulder’, using mainstream technology, such as iPads to focus on their strengths. Then Marshall describes how farm-based care provides a more meaningful alternative to traditional day care, with the aim of improving wellbeing. The challenges of rural travel in Scotland and Canada are contrasted in Chapter 10. The authors point out that, whilst people with dementia, autism, attention deficit hyperactivity disorder, dyslexia and anxiety may all experience difficulties with travel, their needs tend to be overlooked. They call for co-production of public transport, for example, transport service developers learning from shared journeys with people with dementia. In Chapter 11, Jacklin and Chiovitte demonstrate how cultural safety and sensitivity can be used to recognise the legacy of structural and institutional racism, and to work alongside the indigenous peoples of Canada to produce ‘two eyed seeing’—embracing biomedical and indigenous cultural understandings of dementia. The last part of the book shares the powerful experiences of two people with dementia: one from Ireland and one from Scotland. They are moving accounts of loss, biographical disruption (Bury, 1982) and stigma, yet both contain hope and a focus on living well with dementia, rather than dying from it. The conclusion has the unenviable task of drawing common themes from these disparate accounts. These are the massive challenge that the world faces, logistically, materially, but also in raising awareness, educating and combating the stigma around dementia. There needs to be a shift in process from ‘doing to’ to ‘working with’ and in content from a biomedical focus to a humanistic perspective, concerned with the lived experience and wellbeing of people with dementia. The editors noted that the book includes insufficient content from LMICs. It would also have been beneficial to include chapters on: understanding dementia; health promotion—tackling the modifiable factors in dementia risk; the carers’ perspective and intersectionality—which could build on the concepts of ‘cultural safety and sensitivity’ and ‘two eyed seeing’ covered in Chapter 11. Practitioners may find there is insufficient material relating to their own context but they may be surprised by the commonalities. Central is the need for person-centred and relational ‘place-based services’, both geographically and metaphorically—services that are sensitive to each community’s particular needs, beliefs and culture. References Bury M. ( 1982 ) ‘ Chronic Illness as biographical disruption ’, Sociology of Health & Illness , 4 ( 2 ), pp. 167 – 82 . Google Scholar OpenURL Placeholder Text WorldCat Mkhonto F. , Hanssen I. ( 2018 ) ‘ When people with dementia are perceived as witches: consequences for patients and nurse educators in South Africa ’, Journal of Clinical Nursing , 27 ( 1–2 ), pp. e169 – 176 . Google Scholar OpenURL Placeholder Text WorldCat © The Author(s) 2022. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
TI - Remote and Rural Dementia Care: Policy, Research and Practice, Anthea Innes, Debra Morgan, and Jane Farmer (eds)
JF - The British Journal of Social Work
DO - 10.1093/bjsw/bcac061
DA - 2022-03-24
UR - https://www.deepdyve.com/lp/oxford-university-press/remote-and-rural-dementia-care-policy-research-and-practice-anthea-Ad3oUsQrcc
SP - 689
EP - 691
VL - 53
IS - 1
DP - DeepDyve
ER -