The Best Friends Approach to Alzheimer's Care (Paperback)

~ (Author), David Troxel (Author)

Editorial Reviews

From Booklist

The best Alzheimer's caregivers, say Bell and Troxel, become friends with the knack for calmly directing sufferers through their frightening confusion. Responding with the knack guides a patient to acceptable behavior while providing "cuing about roles and identities." For instance, to a patient's inappropriate sexual advance toward his daughter, a "no-knack approach" would be to angrily respond, "You dirty old man! Stop that" ; one with the knack would be, "Daddy, it's Mary, your daughter. Look what I have here--a photograph of Mother. Isn't she pretty?" The responses suggested for other situations are similar. Bell and Troxel stress that Alzheimer's victims are usually confused, not malevolent or willful, and compassion and indulgence will keep situations from worsening and enhance peace of mind for caregiver and patient alike. This approach is time and energy intensive, but its decency makes the book a potential gold mine for afflicted families. The fill-in-the-blanks "Best Friends Assessment" form, however, makes the book problematic for libraries. Mike Tribby

Product Description

Presentation of a model of care for Alzheimer's patients stressing empathy and friendship, for nurses, adult day center staff, and families of patients. Emphasizes the positive aspects of situations involving Alzheimer's care rather than patients' victimization. Softcover.

Product Details

• Paperback: 250 pages
• Publisher: Health Professions Press; 1 edition (October 1996)
• Language: English
• ISBN-10: 1878812351
• ISBN-13: 978-1878812353
• Product Dimensions: 8.9 x 6 x 0.8 inches
• Shipping Weight: 15.2 ounces (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (5 customer reviews)
• Amazon.com Sales Rank: #179,356 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

23 of 23 people found the following review helpful:

5.0 out of 5 stars You gotta have friends..., June 12, 2003

By	FrKurt Messick "FrKurt Messick" (Bloomington, IN USA) - See all my reviews (TOP 10 REVIEWER)

This past semester, my seminary (Christian Theological Seminary) was honoured to host Virginia and Wayne Bell as they led a conference on Spirituality and Aging. As we approach a time in which the issues of aging will take increasing prominence, as the baby-boomers reach a collectively-older age than any generation in history has reached, the issues surrounding health care for the elderly are of primary importance, and part of that health is mental (which includes spiritual) health. The Bells have spent much time investigating and helping in the area of Alzheimer's, a disease that affects mind, body and spirit. Virginia Bell, together with a colleague, David Troxel, collaborated on two books (one of which is the the subject of this review) presenting an innovative way for care of those with Alzheimer's: `The Best Friends Approach to Alzheimer's Care'.

Virginia Bell, MSW, is currently Program Consultant with the Lexington/Bluegrass Chapter of the Alzheimer's Association. She is a graduate of Transylvania University and the University of Kentucky, and has lectured widely at national and international conference. Her co-author, David Troxel, works with the Santa Barbara chapter of the Alzheimer's Association.

`"The Best Friends Approach to Alzheimer's Care" reflects a growing optimism in the field of Alzheimer's care that much can be done to improve the lives of people with the disease and to transform caregiving from a terrible burden to care that is manageable. This book represents the development of the first comprehensive model of care, which is easy to understand and learn.'

At the start of the book, Bell and Troxel describe the various experiences of those with Alzheimer's. By looking at the depression, confusion, and detachment that those with Alzheimer's experience, the caregiver gains a greater understanding and compassion for those suffering. Perhaps the most important key insight comes from a nurse and teacher, Rebecca, who began to experience symptoms of Alzheimer's at age 59.

`I dislike social workers, nurses and friends who do not treat me as a real person.'

Despite her slowly declining cognitive abilities, she is still able to sense that people are regarding her differently, as a patient, as an object, as a 'third person' rather than a real person.

Persons with Alzheimer's experience loss, sadness, confusion, isolation and loneliness, fear, frustration, anxiety, paranoia, anger, and embarrassment. The Best Friends model takes all of these into account as a normal part of everyone's life.

The second chapter gives a basic overview of Alzheimer's, giving symptoms, diagnosis, services, caregiving issues, and research news. The Best Friends model requires no specialised medical or scientific knowledge -- an appendix is included in the book for those who wish to pursue those topics in more detail.

The following chapters develop the aspects of care along the Best Friends model. This requires first assessing the strengths and abilities of the person receiving care (and this may require a daily update). An understanding of what persons with Alzheimer's may require is included as an `Alzheimer's Disease Bill of Rights'. These are important, and often overlooked, so I shall reprint them here:

Every person diagnosed with Alzheimer's disease or a related disorder deserves the following rights:

- To be informed of one's diagnosis
- To have appropriate, ongoing medical care
- To be productive in work and play for as long as possible
- To be treated like an adult, not like a child
- To have expressed feelings taken seriously
- To be free from psychotropic medications, if possible
- To live in a safe, structured, and predictable environment
- To enjoy meaningful activities that fill each day
- To be outdoors on a regular basis
- To have physical contact, including hugging, caressing, and hand-holding
- To be with individuals who know one's life story, including cultural and religious traditions
- To be cared for by individuals who are well trained in dementia care

A key point to being a Best Friend is that the caregiver becomes a memory aid to the person -- friends know each others' histories. Being reminded of past accomplishments, family connections, personal beliefs and traditions helps tremendously. It gets them involved in their own lives again.

Friends do many things: they share history, they do things together, they communicate, they build self-esteem, they laugh often, they work at the relationship, and they are equals. These carry over as key concepts in the Best Friends model. Bell and Troxel go into some detail about how to handle situations for the full-time caregiver, the volunteer, and for those who visit persons with Alzheimer's in care. Specific situations and general principles are presented in a clear, intelligible manner with great application potential.

An important part of the process of understanding and dealing with those with Alzheimer's is to understand oneself. Thus, there is a section on Being One's Own Best Friend. How do we react and respond? Do we give ourselves enough care? How can we care for others if we do not care for ourselves? How do we respect the needs and desires of those we care for while recognising and respecting our own needs? These are important questions, and Bell and Troxel address it by illustrating the relationship between Rebecca and Jo, her Best Friend.

`Because any of us can be touched by Alzheimer's disease, can have bad things happen to us, our friends, or our families, the ultimate message the authors wish to convey is this: We should treat everyone important to us as we would our own Best Friend.'

19 of 19 people found the following review helpful:

5.0 out of 5 stars A positive and practical approach to caring for those with A, August 27, 1999

By A Customer

This book is a must for anyone, including family, caregiver, or friend who knows someone with Alzheimers. The "best friends" approach is a caring, sensitive and thoughful way to work with and care for those with this disease. The authors provide practical examples of dealing with behavior problems, planning activities and most importantly how to be a "friend" to the person with Alzheimers. The authors have done a superb job of providing a creative yet common sense approach to caring for those with this disease.

5 of 5 people found the following review helpful:

5.0 out of 5 stars Philosophy of Care, April 27, 2002

By	Marjorie Frazier (GA) - See all my reviews

Seeing the Helping Hands Adult Day Care program, which is the fruit of the philosophy of this work, was a life changing event for me. The caring and love shown by the staff of Helping Hands are living testiment to the dedication of workers to improve the quality of life for clients affected by the devastation of Alzheimer's Disease and other dementias. If all facilities, both assisted living and nursing homes, truly invested in this approach, life would indeed be different for the persons affected by this disease and their caregivers. A definite must for those struggling with the problems of caregiving those with Alzheimer's disease.