Tia Powell’s book on dementia is important and useful. She is a doctor, an academic, and someone who has a great deal of experience with dementia herself, and her book is a discussion of how to live with the expectation we will or might develop dementia, how to behave with people who have dementia, and what policies we should adopt regarding dementia. Both her grandmother and mother had dementia, and she says she expects to develop dementia herself. She has thought a great deal about both the medical aspects and the personal aspects. She sets out some of the science of dementia and the history of theories of dementia, and the related ways that families and doctors dealt with their demented relatives over the ages. She also addresses the state of current scientific enquiry into dementia and the chances of a cure. Her main message is that the search for a cure for dementia is important but has dominated public policy at the cost of social support for people with dementia. The chances that we will find and be able to provide a cure for many forms of dementia in the next few decades are vanishingly small, while the number of people suffering from dementia is ever increasing. Dementia care is extremely difficult to give, and when it is provided by paid professionals, it is very expensive. Very often it is family members who provide the care for their relatives to be able to stay living at home, and this generally means that they have to give up doing a job or place themselves at major health risks because of the demands of caregiving Powell argues that we need to find social solutions that both improve the lives of people with dementia and also reduce the burden on families and overloaded medical systems. There are no easy solutions at hand, but Powell explores some promising approaches. The book includes many personal stories and narratives of families who have had a member with dementia, and the problems that they faced. Powell uses these to point to the sorts of changes in policy and medical practice that could help families cope. She certainly does not pretend to have simple solutions to the major social problems that dementia poses for American society, but she does map out the issues and points to areas of study that policy makers need to examine. The writing is powerful, especially in the last chapter where she addresses how people with dementia tend to die and how people can plan to have they kind of end that they would prefer.

© 2019 Christian Perring

Christian Perring teaches in NYC.