George H . Pollock , MD , PhD Enhancing the Abilities of Persons with Alzheimer ’ s and Related

These academic research-oriented nurse/scientists, who are also experienced clinicians, have written a volume that promises to expand a relatively new field-the enhancement of abilities of individuals who have Alzheimer’s disease and other related dementias. Although this relatively brief monograph is about the nursing care of older individuals with Alzheimer’s disease, an incurable condition as yet, the emphasis is on “caring.” The authors begin by describing what an imaginary experience of dementia might “feel like.” Not only is this description fascinating, it suggests a model that can be used by all mental health caregivers: Ask the student to construct anarrative or scenario in which she or he is the patient, then describe the feelings, behaviors, thinking, and fantasies of the imagined patient. This technique is a vivid way of helping one “learn” empathy. The first section of the book deals with enablement: “Enablement involves assisting the other to use her abilities or resources. This constitutes a shift from the traditional preoccupation with the disease, its pathology and related disabilities” (p. 3). Enablement is guided by an in-depth knowledge of the disease, as well as the abilities present, at risk, and absent in the patient. This knowledge can help the patient and can prevent additional disability. The four areas of abilities the authors have identified as necessary for daily living are self-care, social, interactional, and interpositive abilities. The second section of this report focuses on self-care abilities-clinical features, threatened abilities, and methods of assessment. The discussion of nursing actions that are ability-enhancing and ability-compensating is most informative. The overview of spatial orientation disturbances simply addresses these dysfunctions in a useful way. For example, when these spatial abilities are lost, several ability-compensating nursing actions that can be helpful include mapping, adaptive clothing and special devices, orientation to the environment, visual barriers, a wanderer’s lounge program, and nonverbal