CRC DEMNTA PDF

Preface

There is an old and probably apocryphal story about a performace of Il Trovatore in a provinicial Italian opera house. After a stentorian account of the big aria di quella pira had ended in a loudly forced top C, the tenor was generously applauded and encored the piece. After more applause he sang it yet again, but when elements of the audience called for a fourth rendition he put up his hands for silence. ‘Friends', he said, ‘I would love to sing the aria again for you, but if I do that I will have no more voice for the rest of the performance'. At this point the tones of one of the highly knowledgeable loggionisti rang out from the seconda galleria ‘You will sing it until you get it right!'. After four goes at Dementia we are starting to hope that if it isn't yet right it is at least getting close!

When Hodder received our proposal of a fourth edition they commissioned a number of reviewer reports to assess whether there would indeed be any demand for a new edition and, if so, what form it should take. These reviewers and others who wrote about the third edition for various periodicals seemed to agree on a number of things. Some of them berated us for not including mention of Tom Kitwood and person centred care in the third edition (which was odd because if you look carefully he and it are indeed mentioned), there was a consensus that the numbering of subchapters in previous editions was a little confusing, and everyone seemed to think that the large section on dementia services in numerous countries had passed its use-by date and could now be retired. More than one reviewer felt that the third edition contained more about transgenic mice than some people wanted to know (i.e. anything!). We were very encouraged that another reviewer noted that the third edition had a notable lack of typographical errors and inaccurate references (clearly due to AB's obsessional checking of each line of text). While agreeing that a new edition would be timely, various reviewers encouraged us to include additional emphasis on the overlap of vascular and primary causes of dementia, prevention of dementia, a template for national service models, enhanced information about the management of behaviours of concern, care of those with dementia in acute hospitals, complementary therapies, music therapy and the relationship between health practitioners and the pharmaceutical industry. ‘Go for it', said Hodder, ‘and by the way could you please shave 100 pages off the length of the book'.

Most of the planning for this edition was then done over beer at a Chicago hotel during the 2008 International Conference on Alzheimer's Disease. Out went the national service chapters, the transgenic mice and some other esoteric topics. It was agreed that there would be no subchapters, but that each chapter would stand as a complete entity in its own right, though the sectional organization of the text would be retained after an overhaul. In came chapters on the lived experience of dementia, emerging techniques of molecular imaging, medical co-morbidity and hospital care, dementia and residential care, a detailed review of research on nonpharmacological management of disturbed behaviour, music therapy, the global challenge of dementia, an exemplary national service model, the relationship between the health professions and the drug industry and complementary therapies. The overlap between vascular and primary degenerative causes of dementia would be emphasized by having its own dedicated section. All but a classic and timeless handful of the remaining chapters have been completely rewritten, usually (but not always) by the authors who wrote them for the third edition. After a lot of discussion we decided not to include a chapter by a person with dementia, not because we don't think the views of people with dementia are important (we do), but because such a chapter would either end up being written largely by that person's carer or else the person's experience and expression of dementia would be highly atypical and hence not necessarily representative of the experience of most people with dementia. The chapter we did commission on the lived experience of dementia also has the advantage of giving a complete picture of one person's entire trajectory from beginning to end of the illness, which, by definition, no living person with dementia could yet offer.

Some people have commented on the rotating order of the editors' names on sequential editions of Dementia. This simply reflects the fact that we have taken it in turns to act as lead co-ordinating editor. On this occasion DA did the bulk of the editing while on three months sabbatical leave in London, based at the Imperial College Department of Psychiatry at Charing Cross Hospital, Fulham, in the last quarter of 2009, and while travelling in and around Northern Italy over Christmas/New Year 2009/2010. Thanks are due to Craig Ritchie for facilitating his attachment, to Sheila Mackenzie for clerical support there and to Sara Graham for the loan of her flat, where much of the work was done to the accompaniment of music broadcast by BBC Radio 3. The contribution of Trenitalia to the book's genesis should not be underemphasized either. Their complete inability to run a single service used by DA to an on-time schedule over 16 days gave numerous unforeseen extra opportunities for editing, and indeed one chapter was completely edited while an allegedly fast train to Milan was stuck in a tunnel north of Florence! Last we would like to thank our regular secretaries, Lynette Bon, Amanda Gaunt and Anne Maule for their patience and help, Stephen Clausard, Caroline Makepeace, Amy Mulick, Philip Shaw and all former and current staff of Hodder with whom we collaborated for their encouragement and assistance, our chapter authors for their marvellous contributions, and our wives and daughters for tolerating our distraction by the book when we could have been focusing on them.