As an ex-psychiatric nurse and having had first hand experience of dementia within the family, I welcome Malcolm Goldsmith's handbook sub-titled 'People with dementia and the local church'.   Any book or advice which helps ordinary members of the clergy or congregation to accept people who are 'different' is appreciated, but I fear that in some congregations this acceptance may be a long time coming, for we all know congregations who dislike a child running around or making a noise, so how much more difficult to come to terms with an adult who wanders around, gives orders, shouts at the preacher, is incontinent and may become aggressive when approached to behave.

Dementia takes no account of social class or intellectual ability, it does not discriminate as we are prone to do and it could strike you or your family at any time, no matter how much money one has to pay for private treatment, for the sad thing is that no treatment or cure is yet available.

Fr Goldsmith understands these problems, having been a priest for over forty years and latterly a Research Fellow within the Dementia Services Development Centre at Stirling University.   He is rightly insistent on the challenge not to see a person with dementia, but a person with dementia, and likewise nursing homes, as opposed to nursing homes, and I guess that a goodly number of us would have put the stress on the other without having really thought about it.

Throughout the book there are chapters that concern us all; to refer to a few: 'The response of the local church' subdivided into sections like, 'What about the faith of the caregivers', 'What brought this about?', 'Is it a punishment from God?', 'The experience of dementia', 'Communication and Dementia', 'Family Carers' and so on.

He deals at length with problems associated with worship and the need to keep it recognizable by the wearing of a clerical collar and/or alb and stole at all visits, so the person can recognize the 'vicar', and gives some sample services which could be used with those in residential care.

One particular section that struck a chord was when talking with carers, not to talk about loved ones unless very sure about the relationship.   Many a loveless marriage in latter years has nearly come to grief with the onset of dementia, with the carer being placed in a role that he/she did not ask for and definitely did not want, but doing it purely out of guilt and duty.

Caring for people with dementia is extremely demanding, especially when the carer is on their own with the person 24 hours a day and 7 days a week, and there is much that the church can do to help the carer, if not the person themselves.   Help them not to lose contact with their church, their friends and neighbourhood, be aware that there may be great financial problems and that this perhaps isn't the best time to ask for a large increase in their giving, appreciate that there may not be time to bake as many cakes for the fête and take them one instead.   Be aware too that the carer may be covering up for the person with dementia and therefore may be reluctant to let people know just how bad and difficult things have become.

This book makes one think, and it also encourages one to ask more questions, but it doesn't help one to deal with personal guilt that one didn't do more to help before death.   A copy of this book would be a welcome addition to a church library and may help more people than expected.