The British Journal of Psychiatry (2000) 177: 475
© 2000 The Royal College of Psychiatrists
Psychological Problems of Ageing: Assessment, Treatment and Care
Susan M. Benbow, Consultant Psychiatrist (Old Age Psychiatry)
Central Manchester Healthcare NHS Trust, Carisbrooke Resource Centre,
Wenlock Way, Gorton, Manchester M12 5LF
EDITED BY SIDNEY CROWN and ALAN LEE
Edited by Robert T. Woods. Chichester: John Wiley & Sons. 1999. 352 pp.
£19.99 (pb). ISBN 0-471-97434-X
This book is intended to be a focused text for all professionals involved
with the care of older adults, which is a broad perspective. It rises to the
challenge admirably.
I particularly enjoyed the thought-provoking chapter on identity management
in later life by Peter Coleman, and the chapter by Steven Zarit and Anne
Edwards on family care-giving. Both offer stimulating reading and have
implications wider than their titles might suggest. I found a small paragraph
about multiple roles and role strain in relation to care-giving pertinent to
work I have been involved in on burnout and stress among old age psychiatry
staff. I love the hypothesis that an additional role might generate energy
which can be used to fulfil the demand of other roles, but I have some worries
about where it might lead those among us who already feel overcommitted.
Other chapters are probably less useful to psychiatrists. I singled out
Robert Woods' chapter on mental health problems in late life for mention here,
but later found myself mulling over post-traumatic stress disorder in late
life and the impact of the Second World War. Also, we can become
blasé about what Woods calls the
"uncharted territory" awaiting many old age psychiatrists: a
deluge of patients with dementia and depressive illness in late life. Woods is
right that clinical psychologists have a key role to play in understanding,
assessing and treating the whole range of mental health problems affecting
older adults. But so too do old age psychiatrists, and we must continue to
have a vision of old age psychiatry services which are comprehensive,
collaborative and multi-disciplinary and which are resourced to allow the
reality of both psychological and physical treatments. Another perspective is
always useful: perhaps this chapter is relevant to old age psychiatrists after
all.
Time now for my confession. I made a mistake with this book: I decided to
read it from cover to cover for relaxation. This proved to be a recipe for
insomnia, and I suggest it is better used as a sourcebook, or text to refer to
on relevant topics. If I had not been asked to review this book, I doubt that
I would have bought it, but that would have been my loss. It will be
particularly useful for trainees, but cynics who have lost touch with their
training will also enjoy it.