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Review of "Always On Call"

By Carol Levine (Editor)
Vanderbilt University Press, 2004
Review by Kevin Purday on Oct 3rd 2006
Always On Call

This is the second edition of the already well-known guide to the problems encountered by caregivers, the attempts undertaken to alleviate those problems, and the resources available to them. This new edition is more substantial and even more useful than its predecessor. The book is divided into three sizeable sections and one smaller one.

The first section is called 'Voices of Family Caregivers' and allows nine contributors to express their own views about what it is like to be a caregiver. The recipients are family members with Alzheimer's, AIDS, the results of a heart attack or a serious stroke, etc. The accounts are always moving and sometimes so moving as to leave the reader moist-eyed. There are no happy endings (one story ends with the successful accomplishment of what seems to be a double suicide pact), just journeys which have been made easier by the dedication of the caregivers.

The second section is entitled 'The Impact of Caregiving.' Six chapters -- covering a range of aspects from the range of emotional responses elicited by finding oneself a caregiver to the financial impact of caregiving -- give the reader an insight into some of the very substantial effect that being a caregiver has on her or his life. Not all of these effects are by any means negative -- so much depends on the psychology of the individual. Some people derive immense satisfaction and meaning out of caregiving while for others it is too much to bear and can end with estrangement or, in the case of spouses, divorce.

The third section is about responding to Caregivers' needs. Four chapters deal with the public policy agenda, the visiting doctors program, a family-centered hospital unit for dementia patients, and connecting caregivers through technology. The chapter on the visiting doctors was particularly revealing. The reviewer knew nothing of this program and found many of the comments profound and extremely insightful.

The fourth section is made up of only one chapter. This is an extensive list of contacts for help and support. This looks very comprehensive and thus very helpful.

This is precisely the book which ought to be read by doctors, nurses and social workers who deal with patients suffering from chronic illnesses and who are therefore for all or part of the time being cared for in the home. With the elderly living for so much longer than used to be the case and with so many of them suffering from chronic illnesses especially forms of dementia, a huge proportion of the population is going to be involved in caregiving at some time or another. The various insurance schemes are notoriously unreliable and the burden of care will more and more fall onto the shoulders of relatives. This book very clearly lays out the challenges and helps those directly or indirectly involved to understand much better the stresses and strains imposed on caregivers. This is a highly recommended book.


2006 Kevin M. Purday


Kevin Purday is a consultant in international education working mainly in Europe, Africa and the Middle East. His main focus is on helping schools to set up the International Baccalaureate Middle Years and Diploma Programs. He has taught both philosophy and psychology in the I.B. diploma program.