AGING/ELDER CARE
AGING, DEATH AND THE QUEST FOR IMMORTALITY
By C. Ben Mitchell, Robert D. Orr and Susan A. Salladay, editors
198 pp., Grand Rapids, MI: Eerdmans, 2004, $24.00, paperback.
Review: Thirteen authors cover a variety of areas including personal, theological and geriatric aging perspectives; ethical issues; pragmatic aspects of caring and, philosophical views about aging, death and immortality. The professional discipline of the author clearly focuses the content of each chapter with respect to aging. For example, R. Geoffrey Brown described the theologian's view of aging by incorporating scriptural examples and concluded with the thought that death should be viewed as the "[horizontal ellipsis] consummation of the Christian's sanctification" (p. 29). Stephen Greggo presented the counselor's and psychologist's view by including a 6-page case vignette to illustrate Talk Therapy as an approach to elicit a client's wisdom and build confidence.
Several chapters present timely and thought-provoking ideas that differ from those prevalent in groups discussing ethical issues and planning church-based strategies for elder ministry. In "Age-Based Rationing of Life-Sustaining Health Care," ethicist John Kilner presents key ethical concerns regarding the influence of economy and utility in providing care for the aging. Kilner offers a non-utilitarian biblical alternative, along with pointing out that Christians need to be sure hidden injustices are not built into age-based rationing.
In "Neuropsychological Aspects of Aging and Their Implications for Decision-Making Among the Elderly," Robert Evans suggests that dying persons emotionally swing between denial and acceptance. Due to disturbed neurocognitive functioning that occurs in many elderly persons, he questions whether they should participate in decisions that involve medical-ethical choices. In "Local Church Ministry to and Through Older Adults," Gregory Waybright refutes inappropriate stereotypes of the aging population and suggests the focus be on the older adult as "[horizontal ellipsis] a potential growing disciple and contributing member of the congregation" (p. 111).
Much of the care information in this book on the palliative approach, dealing with suffering and treatment of pain, would be review for nurses, but content included in other chapters would stimulate helpful thinking, particularly for geriatric and parish nurses.-Julia Emblen, PhD, RN, Parish Nurse, Dallas, Oregon
THE MERCK MANUAL OF HEALTH & AGING
By Mark H. Beers, editor-in-chief
992 pp., Whitehouse Station, NJ: Merck & Co., 2004, $29.95, hardcover.
Review: Merck has done it again with their latest manual focusing on aging. This comprehensive reference written by physicians, a nurse and a pharmacist is for health care and lay people alike. Sixty-six chapters cover why and how aging occurs, the impact of aging on the world; preventive, community, palliative and end-of-life care; nutrition, pharmacology, complementary and alternative medicine; diseases of aging and treatment; practical social, legal, ethical and financial issues related to health and health care; and on and on. Extensive cross-referencing and indexing allows you to find topics from A-Z, from dystonia (prolonged muscle spasms forcing the body into abnormal, painful positions) to onychomycosis (fungal infection of the toenails) to Zenker's diverticulum (a pouch that forms in the upper esophagus, usually after age fifty).
As might be expected in a book prepared primarily by physicians, the major focus of the book is physiological with some mental and social aspects included; spirituality is handled on less than a page. Nevertheless, this book is a great reference for nurses and the myriad diagrams, charts and definitions are a great resource for patient teaching. A real bonus for the price!!-KSS
GROWING OLD IN CHRIST
By Stanley Hauerwas, Carole Bailey Stoneking, Keith G. Meador, editors
310 pp., Grand Rapids, MI: Eerdmans, 2003, $24.00, paperback.
Brief: Eighteen Christian thinkers examine biblical and historical perspectives on aging, explore aging in the modern world, and then describe a Christian practice of growing old. Important topics such as the medicalization of aging (everything can and should be fixed) and physician-assisted suicide are included. This book will benefit those seeking faith-based insight into growing old.
WHAT ARE OLD PEOPLE FOR?
HOW ELDERS WILL SAVE THE WORLD
By William H. Thomas
384 pp., Acton, MA: VanderWyk & Burnham, 2004, $24.95, hardcover.
Review: Thomas, a gerontology physician, is founder of the new intentional communities for elders known as The Eden Alternative and The Green House Project. Thomas confronts contemporary declinist thinking about aging. Aging is not a descent from the summit of youth, where the body breaks down like a worn-out old machine. Rather, aging is a ripening and opening up of new horizons, a time of extraordinary adaptation and development. Old age offers experiences and insights that the young cannot understand or appreciate. It is a time when being can once again take precedence over doing; life can be lived and enjoyed to the fullest.
But, Thomas argues, the predominant declinist view of society makes old age a monstrous time with little to look forward to. Nursing homes are "institutions of terror, designed, funded and operated by adults" (p. 158) as a way to care for patients in the final terrible stages of decline. The bulk of suffering in nursing homes is caused by plagues of loneliness, helplessness and boredom. Thomas's Eden Alternative strives to incorporate companionship and meaningful relationships into long-term care to combat loneliness; opportunities to give care instead of fostering helplessness; and variety and spontaneity to counter boredom. This new culture is created by changing the physical and social environments of nursing homes. Instead of focusing on tasks, knowing and being are enfolded into the daily rhythms of life, and life is lived together intentionally. Decision making and control are placed in the hands of the elders and their direct caregivers, not in a top-down bureaucracy. Elders are honored and respected. Thomas calls this wonderful vision eldertopia: a community where people of all ages are strengthened through a mutual protecting, nurturing and sustaining between the community and its elders (p. 302).
This book is about challenging the status quo on aging. It is an excellent treatise on our obsession with valuing adulthood and abhorring the natural, amazing process of aging. I was disappointed, however, in Thomas's whole-hearted embrace of evolution and his avoidance of spirituality. He purports that aging occurs because of evolution and diversification of the species; aging is merely a process of adaptation. God is entirely absent from this book, and spirituality is only remotely addressed through other concepts like meaning or transcendence. Old age is not a time of looking back on one's spiritual heritage or looking forward to entering eternity. For Thomas, there is great meaning and value in old age, but meaning and value seem to have nothing to do with God. Albeit, he has written a helpful book for anyone who is aging, knows an elder or works in caring for the aged.-KSS
THE CARING SPIRIT APPROACH TO ELDERCARE
A TRAINING GUIDE FOR PROFESSIONALS AND FAMILIES
By Nancy L Kriseman
208 pp., Baltimore, MD: Health Professions Press, 2005, $32.95, paperback.
Review: Kriseman, a social worker, has prepared a training manual to help health care workers and family caregivers use a spiritual approach to elder care. But don't let the term spiritual mislead you. Kriseman uses spiritual to mean "a way of living in the world in a trusting, peaceful, faithful, and compassionate state; being more aware and conscious of one's surroundings. For some individuals, spirituality is a path for connecting to a higher spirit, thus adhering to a more religious focus. For others, it is a way of connecting to themselves and recognizing something holy either through nature or in other sacred and special ways" (pp. 16-17). For the most part, the book focuses on self-connecting and searching for personal meaning, not connecting to a "higher spirit." Kriseman treats these two approaches to spirituality as equally valid and important. From a Christian perspective, the problem with equating finding spirituality within self and finding spirituality from a higher power is saying the sacred within me is good enough. I don't need God unless I decide I need him. As an example, the author describes her own spiritual journey connecting within, which has included exposing herself to teachings of different faiths, while "staying open and nonjudgmental." She has found the "most comfort" in Eastern and Native American Indian beliefs and teachings (p. 87).
The goal of the training outlined in this book is to change the culture of caring in long-term care. Kriseman draws from William Thomas's work and ideas (What Are Old People For?). Her method involves helping care staff and caregivers make the connection between spirituality and caring. Chapter titles are inspirational-"Creating a Spiritual Work Environment," "Why Working in Eldercare Is a Blessing," and "Spiritual Approaches to Caring for Elders," for example. Spiritual caring means caring for the human spirit with acts of spiritual kindness, which happen when human spirit touches human spirit through insightful, personal caring. Spiritual care can involve using some spiritual ritual like the Lord's Prayer. While both are spiritual care in that the human spirit is addressed, JCN author Sharon Fish Mooney (When Memory Fails: Helping Patients Remember God, pp. 6-14) clarifies that Christian spiritual rituals are distinctively different acts of spiritual kindness (human caring) because such rituals involve the biblical act of remembering God.
Kriseman sets forth a lofty and beautiful goal of developing a caring spirit approach to elder care. The environment she advocates would be a wonderful place to work and live. Her step-by-step training exercises to help caregivers become more insightful, soulful, sacred, connected and spiritual are warm and inviting, and will definitely feed the soul as well as improve long-term care environments. Sadly, though, they fall short of giving true life to the spirit (Eph 2:1-6).-KSS
VITAL CONNECTIONS IN LONG-TERM CARE
SPIRITUAL RESOURCES FOR STAFF AND RESIDENTS
By Julie Barton, Marita Grudzen and Ron Zielske
223 pp., Baltimore, MD: Health Professions Press, 2003, $23.95, paperback.
Brief: The purpose of this book is to assist long-term care staff in understanding the spiritual nature of all human beings and the spiritual dimension of their work. Practical lessons, exercises, discussion questions, journaling opportunities, multicultural and interdenominational case examples are used to sensitize staff to residents' spiritual needs and ways those needs may be supported through everyday care or special activities. Spiritual assessment, use of celebrations and familiar religious rituals, and helping people cope with end-of-life issues are among the myriad topics addressed. While multiple faith traditions are respected in this book, people are viewed as made in the image of God and needing relationship with him.
PERSON CENTERED CARE
A MODEL FOR NURSING HOMES
By Marilyn Rantz and Marcia Flesner
82 pp., Washington, DC: American Nurses Association, 2004, $22.95, paperback.
Brief: This book presents a case study of a troubled nursing home in Missouri and how the home was transformed to an "ideal nursing home," using the Person Centered Care (PCC) model. PCC is a model of human resource and care delivery management rooted in a principle and process of mutual empowerment and respect. Impressions of direct care providers, ancillary staff and residents are presented, along with clinical, financial, staffing and regulatory outcomes.
MENTAL HEALTH AND SPIRITUALITY IN LATER LIFE
By Elizabeth MacKinlay, editor
154 pp., New York: Haworth, 2002, $24.95, paperback.
Brief: This book will help you examine mental health in aging in the context of pastoral, spiritual and cultural issues. MacKinlay explores the relationship between mental health, spirituality and religion in later life, including the search for meaning; cultural and spiritual issues; depression; dementia; and issues of suicide in older people. The personal spiritual journey of a woman with early onset Alzheimer's disease offers insight into the experience and spiritual needs of clients suffering from dementia.
PARISH NURSING
HEALTH, HEALING & WHOLENESS
ENGAGING CONGREGATIONS IN MINISTRIES OF HEALTH
By Mary Chase-Ziolek
146 pp., Cleveland, OH: Pilgrim Press, 2005, $21.00, paperback.
Review: Chase-Ziolek, a nurse who teaches at a seminary, has written a unique book about how to engage church congregations in a ministry of health. She defines ministries of health broadly as "the components of church life that promote the health, healing and wholeness of individuals, families, congregations, and communities. Ministries of health may have an explicit purpose to promote health or they may have a purpose other than health promotion, yet health, healing, and wholeness are enhanced through participation in that ministry" (p. 7).
A strength of this book is Chase-Ziolek's emphasis on understanding congregational culture as the key to health ministries. She shows how to assess four qualities of congregations important for promoting health: 1) the homogeneous or diverse nature of the group shapes the nature of health needs and available resources; 2) how congregations engage in regular, intentional gatherings provides the context and ways health ministry can occur; 3) worship as a central activity provides opportunity to articulate and experience the connections between faith and health; 4) the physical setting where the congregation gathers shapes congregational life and provides opportunities for health ministry. The author provides a road map for gathering information in each of these areas in order to formulate an assessment of congregational culture. Her Congregational Assessment Guide provides specific guidance on what areas to assess, what and how to observe a congregation and what questions to ask of people and processes. The guide is an easily understood, invaluable map for developing a ministry of health in a congregation. Chase-Ziolek also offers instruction on how to build a congregation's capacity to promote health, using an "inside-out" community development paradigm. This means rather than using an "outside-in" approach where problems and needs are solved by professionals, the "inside-out" approach looks for community strengths and assets to meet needs.
Faith and health partnerships, models for health ministry, staff roles of the parish nurse, health minister and lay health promoter and methods for creating a sustainable health ministry are discussed. The author concludes by offering a vision of the church where health and ministry are seamlessly woven together, a place where health ministry occurs intentionally and intrinsically.
Reading this book made me think about the culture of my congregation and the possibilities for health ministry. After examining Chase-Ziolek's ideas, I feel like we could do this at my church!!-KSS
A PERSONAL RETREAT
THE GARDEN OF MY HEART
PERSONAL GROWTH
By Skip McDonald
52 pp., NCF Press: Madison, WI, 2005, $7.95, paperback.
Review: McDonald, a nurse and NCF staff member, offers readers a chance to dig into God's Word through this Bible study. Written with nurses in mind, the author encourages nurses to learn to care for themselves in order to better care for others. McDonald states, "As nurses, we often neglect caring for ourselves. Caregiving comes naturally to most of us-always looking out for someone else, often to our detriment. I am convinced that the care I give to myself reflects in the care I give to others" (p. 7).
Using the analogy of a garden, Skip provides a scriptural study that digs deep into the soil of our hearts. "Thinking of my heart as a garden helps me to focus on what's going on inside. Regardless of my inner state, the Master Gardener will meet me and show me how to care for my garden" (p. 5).
Chapter titles include: A Garden of Praise, Envisioning the Garden, Preparing the Soil, Building a Fence, Planting, Watering and Feeding, Pest Control, Pruning, Harvesting and A Bouquet for God.
McDonald's love for the Word and for beautiful things blooms throughout the study. Personal or group study methods work with this helpful Bible study tool.
I had the privilege of working with Skip to produce this helpful study guide. I trust you will invest in your heart's garden by spending some time with the Master Gardener. Grab your Bible and The Garden of My Heart, and prepare to have your heart's garden tended.-CW