MEDICAL DIRECTOR’S BOOKSHELF Geriatric Mental Health Care: A Treatment Guide for Health Professionals Author: Gary J. Kennedy, MD Pub- lisher: The Guilford Press, New York and London. 2000; Price $39.00 Intended Audience The cover leaf indicates this book as intended for “mental health practitioners, primary care providers, and other health professionals without advanced training in geriatric psychia- try.” In the preface, the author indicates that, “Although there are a number of excellent geriatric mental health texts, none is written expressly for generalists in primary care and mental health, who represent the majority of practitioners providing care for older Americans with mental illness.” Style/Organization The book is composed of 347 pages, including index, with 15 chapters that are very well segmented into relevant sub- chapters. The chapters are referenced extensively with a com- bination of well-chosen older papers of historical value and up-to-date referencing. Tables are used extensively through this text, and some chapters have case presentations and appendices, which I thought were particularly good. Weaknesses/Strengths A number of the chapters in this book “miss the mark” as instructional to the primary care physician and those without a significant prior knowledge base in geropsychiatry. Chapter 7, Individual Psychotherapies for Older Adults, particularly suffers from the use of terminology that I believe would be unfamiliar to a primary care physician without first providing some basic instruction in this area. Chapter 13, Mental Health Consultation in the General Hospital, Home, or Nurs- ing Facility, was obviously written to instruct the mental health provider in properly conducting such a consultation rather than instructing the primary care provider in obtaining one or enlightening generalists on what to expect from a well-performed consultation or interfacing with their consultant. Most of this book is not particularly focused on nursing home medicine, although, since most of us practice geriatrics not only in a long-term care setting but other settings, this is not an important weakness. An extremely important Chapter 3, Dementias, was useful, but was not one of the chapters where case presentations were used. I believe this would have been helpful. In addition, the information presented on caregiver support could have been more extensive. And as nonpharmacologic techniques were discussed, it would have been helpful to include some refer- ences on efficacy or, since that literature is scant, the author’s comments on expected efficacy. Several chapters are of exceptional educational value, among them Sexuality, and Recognition and Reduction of Suicide Risks. The chapter on Legal and Ethical Issues was by far the most valuable segment of this book, in my opinion. It was clear yet concise and dealt with some of the most troubling issues which primary care physicians encounter in delivering mental health services to the elderly and those in nursing homes. Commentary Having made these statements about weaknesses and strengths of this text, I will leave it to the reader to decide whether this is a book that they should personally own or should recommend to their medical library as a reference. David A. Smith, MD, CMD Geriatrics Consultants of Central Texas Brownwood, Texas 274 Smith JAMDA – September/October 2001

Geriatric Mental Health Care: A Treatment Guide for Health Professionals

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Page 1: Geriatric Mental Health Care: A Treatment Guide for Health Professionals

MEDICAL DIRECTOR’S BOOKSHELF

Geriatric Mental Health Care: A Treatment Guide forHealth Professionals Author: Gary J. Kennedy, MD Pub-lisher: The Guilford Press, New York and London. 2000; Price$39.00

Intended Audience

The cover leaf indicates this book as intended for “mentalhealth practitioners, primary care providers, and other healthprofessionals without advanced training in geriatric psychia-try.” In the preface, the author indicates that, “Althoughthere are a number of excellent geriatric mental health texts,none is written expressly for generalists in primary care andmental health, who represent the majority of practitionersproviding care for older Americans with mental illness.”

Style/Organization

The book is composed of 347 pages, including index, with15 chapters that are very well segmented into relevant sub-chapters. The chapters are referenced extensively with a com-bination of well-chosen older papers of historical value andup-to-date referencing. Tables are used extensively throughthis text, and some chapters have case presentations andappendices, which I thought were particularly good.

Weaknesses/Strengths

A number of the chapters in this book “miss the mark” asinstructional to the primary care physician and those withouta significant prior knowledge base in geropsychiatry. Chapter7, Individual Psychotherapies for Older Adults, particularlysuffers from the use of terminology that I believe would beunfamiliar to a primary care physician without first providingsome basic instruction in this area. Chapter 13, MentalHealth Consultation in the General Hospital, Home, or Nurs-ing Facility, was obviously written to instruct the mentalhealth provider in properly conducting such a consultation

rather than instructing the primary care provider in obtainingone or enlightening generalists on what to expect from awell-performed consultation or interfacing with theirconsultant.

Most of this book is not particularly focused on nursinghome medicine, although, since most of us practice geriatricsnot only in a long-term care setting but other settings, this isnot an important weakness.

An extremely important Chapter 3, Dementias, was useful,but was not one of the chapters where case presentations wereused. I believe this would have been helpful. In addition, theinformation presented on caregiver support could have beenmore extensive. And as nonpharmacologic techniques werediscussed, it would have been helpful to include some refer-ences on efficacy or, since that literature is scant, the author’scomments on expected efficacy.

Several chapters are of exceptional educational value,among them Sexuality, and Recognition and Reduction ofSuicide Risks.

The chapter on Legal and Ethical Issues was by far the mostvaluable segment of this book, in my opinion. It was clear yetconcise and dealt with some of the most troubling issueswhich primary care physicians encounter in delivering mentalhealth services to the elderly and those in nursing homes.

Commentary

Having made these statements about weaknesses andstrengths of this text, I will leave it to the reader to decidewhether this is a book that they should personally own orshould recommend to their medical library as a reference.

David A. Smith, MD, CMDGeriatrics Consultants of

Central TexasBrownwood, Texas

274 Smith JAMDA – September/October 2001