who's going to care? informal care and an ageing population

B o o k s h e l f

54

Australasian Journal on Ageing Vol 26 No 1 March 2007 53ndash56copy 2007 The Authors

Journal compilation copy 2007 ACOTA

and are at the forefront of diabetes education research andmanagement

The book appears to be primarily written for a graduateaudience with the inclusion of numerous lsquopractice pointsrsquo to applyto clinical work and the assumption of some basic scientific andhealth-related knowledge It would be most useful to nursesand other health professionals involved in the prevention andtreatment of diabetes in older people but would also be ofvalue to those developing screening programs devising health-care plans allocating resources and identifying those at risk

Catherine TurtonRoyal Brisbane and Womenrsquos Hospital Aged Care Assessment Team

xxx 2007261BookshelfBookshelfBookshelfBookshelf

Spiritual growth and care in the fourth age of life

E MacKinlay Jessica Kingsley Publishers London 2006 ISBN-13 978-1-84310-231-1 (pbk) ISBN-10 1-84310-231-5 (pbk) $A4895

This is a text about understanding spiritual growth in olderage specifically the fourth age lsquothe age of frailty dependencyand being in need of carersquo (p 11) It extends the authorrsquos earlierresearch which was on the development of a spiritual tasksframework with independent living older people to frail agedresidents in aged care facilities This very readable book is anexcellent successor to the authorrsquos earlier text [1] about thespiritual dimension of ageing

The author an Anglican priest and registered nurse has againused in-depth interviews and the research approach ofgrounded theory to probe important spiritual themes for frailolder people MacKinlay also recognises the importance ofunderstanding the views of residential care staff and under-took workshops with staff to raise awareness of spiritual needsThe findings from MacKinlayrsquos studies form the basis fora sensitive portrayal of the spiritual tasks of ageing and impor-tantly how care staff can systematically assess the spiritualneeds of frail older people Spiritual assessment as MacKinlaypoints out is not limited to those with a religious affiliation

MacKinlay introduces the topic of spiritual growth and olderpeople with a succinct review of contemporary literature theresearch methods that inform the content of this book and theassessment tools needed to lsquoprovide guidance for practice ofspiritual and pastoral carersquo (p 8) Highlights include the use ofexcerpts from participant transcripts to explain the modelof spiritual tasks of ageing the significance of narrative orlsquostoryrsquo to find purpose and meaning in life the importance ofmeeting the challenge of older people with dementia a chapterauthored by MacKinlayrsquos colleague Corinne Trevitt and wor-ship and the use of ritual among older people Other chaptersfocus on a number of challenges that face older people (andcare staff) in residential care such as vulnerability and tran-scendence relationship and intimacy needs and grief deathand dying The concluding chapter draws together a number of

ethical issues implied throughout worth and dignity copingwith end of life and use of health resources

MacKinlay is an established author in this field and the bookprovides a welcome and accessible addition to the literatureabout the spiritual dimension pastoral care and end of lifeissues for older people The book is a worthy addition to publicand university libraries because of its relevance to professionaland family carers and for older people themselves The sum-maries provided at the end of each chapter are effective aids tolearning and the assessment tools will be particularly useful toundergraduate and postgraduate students

Deanne GaskillQueensland University of Technology

Reference

1 MacKinlay E

The Spiritual Dimension of Ageing

London and PhiladelphiaJessica Kingsley Publishiers 2001


Whorsquos going to care Informal care and an ageing population

NATSEM University of Canberra (2004) Report prepared for Carers Australia by the National Centre for Social and Economic Modelling Canberra

The repercussions and ramifications of Australiarsquos ageing popu-lation will come home to roost within a few decades Those witha huge vested interest in this issue Carers Australia commis-sioned this report from The National Centre for Social andEconomic Modelling (NATSEM) based at the University ofCanberra The objective was to provide projections for the demandfor and supply of carers for older people in Australia This wouldenable policy decisions that impact carers to be based on soundinformation of what Australia in the future may look like

Carers Australia is a national organisation that representsfamily members and friends who are the unpaid carers for frailolder people and people with disabilities Carers Australia wasconcerned that the contribution and the future capacity of theinformal carers were not being given due consideration in theongoing discourse about issues surrounding Australiarsquos ageingpopulation

The majority of care for older people with disabilities and ill-ness is provided in the personrsquos home by unpaid family andfriends Governments and most older Australians want thecurrent trend towards community care to continue Informalcare to support older people in the community is a valuableresource but according to Carers Australia it is finite There-fore the needs of carers should be more prominent whenplanning and allocating resources Using a cell-based modellingtechnique the report examined the current circumstancespolicies and demand for care and contrasted them to the likelysupply of informal care over the next 30 years where thegreatest impact of the ageing population is going to be felt Themost interesting findings are

aja_206fm Page 54 Monday January 29 2007 1143 AM

B o o k s h e l f

Australasian Journal on Ageing Vol 26 No 1 March 2007 53ndash56

55

copy 2007 The AuthorsJournal compilation copy 2007 ACOTA

1

Between 2001 and 2031 there will be a 160 increase(from 539 000 to 1 390 000) in the number of older peo-ple with profound or severe disability The greatest changein the composition of this population will be in the over 85years cohort which will increase from 14 to 21

2

In 2001 there were 57 carers for every 100 people needingcare By 2031 it is projected that there will only be 35carers for every 100 people needing care

3

The number of informal carers will increase but at a lowerrate (57) than the increase in people requiring care

4

The majority of informal carers will being co-residentcarers Informal carers will be older than they are now withslightly more males taking on the caregiving role

5

The impacts of changing household compositions (iemore people living alone because of divorce rates andabsent children) and labour force participation rates (iemore women in full-time paid employment) are projectedto only have a small impact on the number of carers

6

The notion that in the future older people and their carerswill overall be healthier than they are now only slightlyoffsets the projected figures

The outlook is that the demand for care will rise and that thisneed is not going to be met by an adequate supply of informalcarers There will be a greater demand for institutional care butpeople will prefer to stay at home in the community To effec-tively deal with this looming issue recommendations are forinnovative policies to support and encourage informal care byprimary carers and to also harness the assistance of secondaryand other carers to care for frail older people in the community

Christine NevilleUniversity of Southern Queensland


Psychosis in the elderly

A Hassett D Ames amp E Chiu Taylor and Francis London UK 2005 ISBN 1-84184-394-6 (Hard cover) $A8995 Distributed by Thomson Publishing Services

This is an important book that deals with aspects of mentalhealth in older people that may be overlooked because of thepredominance of interest in the lsquobig tworsquo issues of old agedementia and depression It is particularly important becauseof population ageing since the (previously small) numbers ofolder people with psychoses will increase greatly in comingdecades and clinicians need to become more proficient in theiridentification

While primarily directed at clinicians the book is written in anaccessible way (provided the reader can understand medicallanguage) and will be of interest to many gerontologists The mainfocus is on schizophrenia but the full range of other psychosesis also covered The editors have drawn together prominentauthors in this field their work collectively illustrates thatthere has been very little research on the psychoses of old agerelative to the lsquobig tworsquo and that what research there has been

is on the whole inconclusive and at a fairly primitive stage Eachchapter consists of a concise literature review comprising a state-of-the-art summary and points to the ways forward in researchAmong the many strengths of the book is the consistent referenceto the complexity of psychopathology in older people and theneed for a multidisciplinary approach to diagnosis treatment andintervention However while acknowledging other approachesthe emphasis is primarily on drug-based treatment The needfor careful differential diagnosis is emphasised throughout

I do have some minor concerns which I hope will be addressedin future revisions The term lsquothe elderlyrsquo in the title impliesthat older people are a homogeneous group I would like to seemore discussion of the role of context particularly gender andcultural and socioeconomic factors The book is couchedwithin the Western medical paradigm with its tendency to uni-versalise discrete diagnoses Increasingly research indicatesthat psychopathological disorders are culture-bound and thatdiagnoses need to take the cultural context into account to avoidmisdiagnosis and hence what may be inappropriate treatment(eg [1]) There is some degree of repetition particularly inthe introductions to some of the chapters As a non-specialistI would have liked more case studies and stories to give a morehuman flavour to the description of these disabling disorders

The layout is good Each chapter is quite short and there is agood use of relevant headings and subheadings and informa-tive tables and most chapters end with succinct summaries andtake-home messages For me the main value of the book is toraise awareness of a relatively neglected area which will becomeincreasingly important and to point out how little useful researchhas been conducted I hope as the authors emphasise in theirconcluding chapter that the book will lsquospur further endeavoursto help the clinical community better understand and managethis common and distressing array of clinical phenomenarsquo

Rob RanzijnUniversity of South Australia

Reference

1 Westerman T Engagement of Indigenous clients in mental health ser-vices What role do cultural differences play

Australian e-Journal for theAdvancement of Mental Health

2004 3 (3) Available from httpwwwauseinetcom journal vol3iss3westermaneditorialpdf


Ballinclay Lane patterns of polio and priesthood

Brian Sparksman Diocese of Toowoomba Toowomba 2005 ISBN-0-949122-53-x (Soft cover) $A2000

Ballinclay Lane provides a series of autobiographical memoirswritten by Reverend Brian Sparksman of the Diocese ofToowoomba

A favourite phrase is lsquoIrsquom just a simple country boyrsquo whichaptly describes his largely happy and idyllic Australianchildhood growing up on the eastern slopes of Mount


B o o k s h e l f

Australasian Journal on Ageing Vol 26 No 1 March 2007 53ndash56

55

copy 2007 The AuthorsJournal compilation copy 2007 ACOTA

1

Between 2001 and 2031 there will be a 160 increase(from 539 000 to 1 390 000) in the number of older peo-ple with profound or severe disability The greatest changein the composition of this population will be in the over 85years cohort which will increase from 14 to 21

2

In 2001 there were 57 carers for every 100 people needingcare By 2031 it is projected that there will only be 35carers for every 100 people needing care

3

The number of informal carers will increase but at a lowerrate (57) than the increase in people requiring care

4

The majority of informal carers will being co-residentcarers Informal carers will be older than they are now withslightly more males taking on the caregiving role

5

The impacts of changing household compositions (iemore people living alone because of divorce rates andabsent children) and labour force participation rates (iemore women in full-time paid employment) are projectedto only have a small impact on the number of carers

6

The notion that in the future older people and their carerswill overall be healthier than they are now only slightlyoffsets the projected figures

The outlook is that the demand for care will rise and that thisneed is not going to be met by an adequate supply of informalcarers There will be a greater demand for institutional care butpeople will prefer to stay at home in the community To effec-tively deal with this looming issue recommendations are forinnovative policies to support and encourage informal care byprimary carers and to also harness the assistance of secondaryand other carers to care for frail older people in the community

Christine NevilleUniversity of Southern Queensland


Psychosis in the elderly

A Hassett D Ames amp E Chiu Taylor and Francis London UK 2005 ISBN 1-84184-394-6 (Hard cover) $A8995 Distributed by Thomson Publishing Services

This is an important book that deals with aspects of mentalhealth in older people that may be overlooked because of thepredominance of interest in the lsquobig tworsquo issues of old agedementia and depression It is particularly important becauseof population ageing since the (previously small) numbers ofolder people with psychoses will increase greatly in comingdecades and clinicians need to become more proficient in theiridentification

While primarily directed at clinicians the book is written in anaccessible way (provided the reader can understand medicallanguage) and will be of interest to many gerontologists The mainfocus is on schizophrenia but the full range of other psychosesis also covered The editors have drawn together prominentauthors in this field their work collectively illustrates thatthere has been very little research on the psychoses of old agerelative to the lsquobig tworsquo and that what research there has been

is on the whole inconclusive and at a fairly primitive stage Eachchapter consists of a concise literature review comprising a state-of-the-art summary and points to the ways forward in researchAmong the many strengths of the book is the consistent referenceto the complexity of psychopathology in older people and theneed for a multidisciplinary approach to diagnosis treatment andintervention However while acknowledging other approachesthe emphasis is primarily on drug-based treatment The needfor careful differential diagnosis is emphasised throughout

I do have some minor concerns which I hope will be addressedin future revisions The term lsquothe elderlyrsquo in the title impliesthat older people are a homogeneous group I would like to seemore discussion of the role of context particularly gender andcultural and socioeconomic factors The book is couchedwithin the Western medical paradigm with its tendency to uni-versalise discrete diagnoses Increasingly research indicatesthat psychopathological disorders are culture-bound and thatdiagnoses need to take the cultural context into account to avoidmisdiagnosis and hence what may be inappropriate treatment(eg [1]) There is some degree of repetition particularly inthe introductions to some of the chapters As a non-specialistI would have liked more case studies and stories to give a morehuman flavour to the description of these disabling disorders

The layout is good Each chapter is quite short and there is agood use of relevant headings and subheadings and informa-tive tables and most chapters end with succinct summaries andtake-home messages For me the main value of the book is toraise awareness of a relatively neglected area which will becomeincreasingly important and to point out how little useful researchhas been conducted I hope as the authors emphasise in theirconcluding chapter that the book will lsquospur further endeavoursto help the clinical community better understand and managethis common and distressing array of clinical phenomenarsquo

Rob RanzijnUniversity of South Australia

Reference

1 Westerman T Engagement of Indigenous clients in mental health ser-vices What role do cultural differences play

Australian e-Journal for theAdvancement of Mental Health

2004 3 (3) Available from httpwwwauseinetcom journal vol3iss3westermaneditorialpdf


Ballinclay Lane patterns of polio and priesthood

Brian Sparksman Diocese of Toowoomba Toowomba 2005 ISBN-0-949122-53-x (Soft cover) $A2000

Ballinclay Lane provides a series of autobiographical memoirswritten by Reverend Brian Sparksman of the Diocese ofToowoomba

A favourite phrase is lsquoIrsquom just a simple country boyrsquo whichaptly describes his largely happy and idyllic Australianchildhood growing up on the eastern slopes of Mount


who's going to care? informal care and an ageing population

Documents