We live in an ageing population and few of us have not had an experience of seeing at first hand the effects of dementia in a relative or friend. This new book by our previous Rector is therefore very welcome and will give a valuable insight into this condition for carers and patients. It should be mandatory reading for all medical students and family doctors who will find useful information not available in standard medical textbooks.
The book is really in two parts. The first half gives the reader a full description of the various forms of dementia and emphasises that this term is a generic one embracing many different causes. Alzheimer's disease accounts for 60% of all cases and vascular disease in the form of mini-strokes can be blames for a further 25%. Other obscure causes account for the remainder although Aids related dementia may become an increasing problem in countries overseas where this disease is rife.
The author makes a strong plea for what he terms a person-centred approach to dementia rather than a bio-medical one. The latter tends to focus on the dementia as a disease rather than a disability and in the past was characterised by 'profound therapeutic nihilism'. Every effort should be made to communicate with the intact elements of the personality which remain but which are often difficult to uncover. While many causes of dementia remain unknown, the future is not necessarily bleak and some new drugs may slow down the inevitable progress of the disease.
Wise advice is given regarding the approach and treatment of dementia and much of this could equally be applied to the way in which we deal with learning disabilities or mental ill health.
The second half of this thoughtful book deals with matters of spirituality, religion and faith and the author does not shirk from trying to provide answers to the difficult questions that may be asked by patients and carers alike. 'Why does God allow this cruel disease?' 'What will happen to my faith?' 'Is this God's punishment for past sin?' those of us who remember Malcolm' sermons will not be surprised at his firm belief that God does not select certain people, good or bad, to be the victims of illness like dementia. He emphasises that faith does not depend upon our love of God but God's love for us. He quotes one sufferer from Alzheimer's, who told her doctor tat her worst fear was that she might forget Jesus. "But I finally realised that I may not remember Him but He will remember me".
The book concludes with practical advice for ministers and church members who may be involved in organising services and visits to hospitals and nursing homes to those whose memories are fading and whose attention span may be brief.
The book is richly interspersed with quotations and prayers from many sources and has an extensive bibliography. We note that Malcolm has written widely on dementia, a previous best-selling book and contributing chapters to several others, and in addition to his Research Fellowship at Stirling University has lectured on this subject in this country and abroad.
There are few people who would not gain new thoughts and knowledge about many aspects of dementia by reading this book. It illustrates how the faith of carers and patients may be strengthened or renewed as they cope with what may be the most difficult challenge in their lives.
It is a gracious gesture that Malcolm has dedicated this book to Mary Moffett and Douglas Yeoman. These two people carry our regularly on our behalf the vital work of caring for the elderly. With their help, these loved and respected members of our community may be encouraged to 'sing the Lord's song in a strange land'.