Brain, Vol. 124, No. 9, 1877,
September 2001
© 2001 Oxford University Press
Book reviews |
PALLIATIVE CARE IN AMYOTROPHIC LATERAL SCLEROSIS.
Edited by David Oliver, Gian Domenico Borasio and Declan Walsh. 2000. Oxford: Oxford University Press. £49.50. Pp. 202. ISBN 0-19-263166-7.
Department of Neurology, Medical School, University of Sheffield, Sheffield, UK
This book is devoted to the palliative care and management of patients with motor neurone disease (MND)/amyotrophic lateral sclerosis. The goal of the editors was to provide clear guidelines for the management of MND in all its stages from diagnosis to death, based on published evidence and a great deal of practical experience in the day-to-day care of MND patients. The book is aimed at medical practitioners and paramedical health care personnel in different specialist fields, all of whom may be involved in the care of MND patients.
Throughout the book, a positive tone emerges reflecting the view that, despite the devastating effects of MND, much can be done to alleviate symptoms, improve the quality of life of the afflicted person and assist patients and their families to cope throughout the various phases of the disease.
The book is wide-ranging in its coverage, emphasizing the management of emotional, spiritual and social, as well as physical aspects of the disease. The first chapter sets the scene, highlighting key clinical and pathological aspects of MND, concepts of disease pathogenesis and disease modifying treatments, in a style which is accessible to the non-medical as well as medical readership.
The second chapter outlines the philosophy of palliative care and how these principles may be applied in the care of MND patients.
The third chapter describes a useful and practical framework for communicating the diagnosis of MND with honesty and compassion but without the destruction of hope and morale, and draws on experience from other disciplines such as oncology.
Chapter 4 covers the control of symptoms in patients with MND, with emphasis particularly on management of respiratory and nutritional problems. Practical aspects are highlighted, while accepting the dearth of published evidence in many areas of symptom control.
The chapter dealing with psychosocial aspects of the disease crystallizes important insights and coping strategies, illustrated by case histories. Comprehensive sections by paramedical professionals cover physical therapy, aids, appliances and environmental adaptations, management of communication problems and the role of the psychologist. Subsequent sections describe models of care offered by rehabilitation teams and management practices in different countries. There are excellent chapters on terminal care and bereavement. The books ends with sections on personal experiences of MND from both a patient and a family carer, and a summing up from David Oliver.
This book is reasonably priced and will prove valuable to medical and paramedical staff caring for MND patients. It provides comprehensive, evidence-based information clearly written and accessible to a multidisciplinary readership. The advice is practical, compassionate and based on extensive clinical experience.
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