Psychiatric Disorders in Old Age, by Tony Whitehead. Second edition. England, HM & M Publishers Limited, distributed by Springer Publishing Company, 1979. 124 pages. $5.95.
Dr. Whitehead developed this handbook in order to promote an awareness of the psychiatric problems particular to the elderly. The book is much more than a mere listing of illnesses. For the British psychiatrist early recognition of symptoms comes first, then, equally important, the need for adequate and sympathetic treatment. Experience taught the author that the social community and even many health professionals are appallingly ignorant about the psychiatric conditions that affect the elderly.
The book is arranged so that it can conveniently be divided into three sections. The first of these explores some of the salient factors that contribute to the problems of the aged, i.e., mandatory retirement (there is absolutely no reason why the skills and experience of the old should be discarded prematurely), lack of public and familial support for the aged, and far-too-limited psychiatric services available for the geriatric patient. Dr. Whitehead presents a series of hauntingly typical patient histories as an effective means of stressing the prime importance of community support and of the clinical team approach as a means of dealing with psychogeriatric imbalances. The author is convinced that far too many elderly are hospitalized or institutionalized when they should not be. The effect is pathetically counterproductive for the obvious reason that, uprooted from a familiar environment, the patient becomes even more confused and disoriented. Day centers, day hospitals and home care are in most instances more preferable alternatives. Further, it is essential that treatments be designed so that the patient's dignity is respected; when possible, the patient should be involved in treatment decisions.
The second major section (chapters five to ten) describes in detail certain psychiatric conditions: affective disorders, paranoid reactions, neurotic disturbances, organic brain disease and other serious symptoms. Again, the case study method is employed to clarify the respective behaviors of each of these conditions. Throughout this section, Dr. Whitehead dispels common, traditional myths regarding the problems of the aged.
In the final section (two chapters) there is an explanation of support treatments like psychotherapy, occupational therapy, and behavioral therapy. In addition, there is a chart to suggest appropriate treatments for each of the major disorders. There is also an informative table listing the side effects of those drugs prescribed commonly for the treatment of psychiatric disorders. In conclusion, Dr. Whitehead emphasizes the importance of a positive approach in the care of the elderly patient.
The medical models described throughout this book are based upon the British National Health plan. That is an incidental concern for the American reader for, after all, the needs of patients and the care that should be given to them are not national but universal responsibilities. Therefore, Dr. Whitehead's book is vaulable forali who are entrusted with the care of the aged.