Managing Projects in Health and Social Care

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    Feeding and Swallowing Disorders inDementiaby Jacqueline Kindell.Speechmark Publishing Ltd, Oxford,123 pages, 3495,ISBN 0 863 88312 5.

    At one level this is a useful, but expen-sive, manual for speech and languagetherapists working with people whohave dementia, many of whom willdevelop feeding and swallowing prob-lems. The publication is beautifully pre-sented, well written and concludes withspecimen assessment schedules whichmay be used for instructional purposes.The manual covers dementia and itscauses, the reasons behind the produc-tion of the manual and then covershistory taking and assessment.

    At another level, however, it is relat-ively easy to be critical of the manual.All of the background material and theassessment material are referenced.However, there is no indication of thestatus of this literature; it is all familiarto anyone in this field but how was itobtained for the present publication:presumably not by systematic review?Any list of references will be selectiveand used to back an argument but thislist does seem very selective. The authorargues that there may be a place fortube feeding in early dementia whileacknowledging authors who raisedoubts about its use in late dementia.However, my reading of this literatureis that tube feeding is a waste of timeacross the board in dementia. Finally(while this is a blatant example of areviewer blowing his own trumpet) Iwas glad to see some reference to myown writing in this area but astoundedthat there was no reference to my ownresearch: the development of the Ed-FED Scale. This remains the only val-idated instrument for the assessment offeeding difficulty in older people withdementia, yet it is not mentioned. Myoverall assessment is that this is an

    interesting and potentially useful, butlimited, manual.

    Roger WatsonUniversity of Hull, UK

    Dilemmas in UK Health Care,3rd editionby Carol Komaromy.Open University Press, 2002, 248 pages,1799, ISBN 0 335 20841 X.

    This clear, well argued and helpful textprovides material that gives an excellentintroduction to the contentious area ofhealth care dilemmas. Dilemmas arehotly debated throughout the UnitedKingdom as clinicians and managersstruggle to provide services in the faceof perceived difficulties.

    The main concepts required to under-stand basic issues relating to health caredilemmas are comprehensively coveredin the text. Such things as political andeconomic factors are clearly and logi-cally explained. The acute and primarycare sectors are discussed, helpfully, asare the labour market, the impact ofnew technology and disease prevention.The chapter on poverty, inequality andsocial exclusion is valuable in remindingreaders of the important socio-economicinfluences on health and well-being.

    Readers are given different perspec-tives on issues; this is welcome at a timewhen political edict seems too often topresuppose that there is only one way ofunderstanding anything. The text makesthis point well in discussing NHS fund-ing or the role of markets and manage-ment in modern British health careprovision. In most cases issues discussedrelate to the clinical context throughcase studies or scenarios. As this book islikely to be used by clinical professionalsthis technique is valuable. The texthighlights key points and then brieflyexplains them by using coloured bulletpoints. Questions are raised at the endof each chapter with outline answersavailable at the end of the book.

    This book is a good starting point foranyone wanting a critically balanceddiscourse on dilemmas, with sufficientinsight to challenge and enough refer-ences and background material to en-able the reader to further their studies.

    Mark DarleyCourse Director, South BankUniversity, UK

    Managing Projects in Healthand Social Careby Vivien Martin.Routledge, London, 2002, 208 pages,1699, ISBN 0 415 27620 9.

    In any service, such as UK health andsocial care, the change agenda hasspawned yet more projects. People cantake on project-type work, or the labelproject can be broadly applied. Thisbook will help anyone caught up in thisenthusiasm for modernity to thinkabout the role projects play and theirpotential to trigger long-term change.

    Not all change is, of course, improve-ment, and Martin warns that change inwelfare provision has the potential tocause anxiety among users and tounsettle service-providers. Projects,then, need to be well organized, andthose running them need to consider theimpacts on services and users once theyhave withdrawn from the setting. Mar-tin provides a step-by-step account ofthe stages of project management, andthese reflect these sensitivities. However,this book is also relevant to any of thoseparticipating in project work, not justmanaging it. This is because most pro-ject work is collaborative, and muchdepends on these front-line workers.

    Like many texts arising from theOpen Universitys extensive and impres-sive experience in distance learning, thisbook comes with a range of activitiesand case study illustrations. This makesit possible to use the book as a form ofinstruction or to dip in and out for spe-cific points. As an example, there is a

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  • helpful list of the general structure andcontents of a project report which wouldprove a useful aid. This is followed by aguide to presenting a projects findingsto an audience. Sensible points are madeabout preparation, practising and gain-ing feedback. For some this will beobvious but many of us may recognizethe need for such care in project work.This book is an excellent introductionto, and review of, the area.

    Jill ManthorpeUniversity of Hull, UK

    The Care Homes Legal Handbookby Jeremy Cooper.Jessica Kingsley Publishers, London,2002, 144 pages, 1595,ISBN 1 843 10064 9.

    In the regulated world of the 21stcentury a mass of new laws, regulations,standards, training requirements, policydocuments and new organizationalstructures have changed irreversibly thelandscape of care home management.The Care Standards Act (2000) isdesigned to bring about fundamentalchanges in the management of residen-tial care homes for older people, withthe creation of the National StandardsCommission and the Care StandardsTribunal. This handbook explains whatthe new legal framework requires of allindividuals involved, what it is designedto achieve, and how it is designed tooperate. Although written as a user-friendly guide for non-lawyers it is farfrom easy bedtime reading and requiresconsiderable concentration.

    Implementation may well prove to bea nightmare for the busy manager. Par-ticularly interesting to nurses will be thechapters covering the National MinimalStandards (which provide the bench-marks against which the registrationand inspection system operate) and theProvision of Nursing Care. Other usefulchapters cover staff employment andtraining, and the impact of the HumanRights Act (1998) on care homes. Theauthor provides a clear summary of therelevant legislation and comprehensiveinformation for those managing andworking in residential homes. As thenumber of residential care homes in theUK subject to external regulation is inexcess of 30 000, of which 20 000 are inthe private and voluntary sectors, so this

    indispensable book should deservedlyprove to be a best seller.

    William Whitfield(retired) University of Southampton,UK

    Muriel Powell Remembered: A Profileof Her Lifeby Elizabeth Scott.Published privately by the St GeorgesNurses League, London 2000, 165pages, 1250 plus 120 postage andpacking per copy.Copies are available from: St GeorgesNurses League c/o Chief Nurses Office,Room 32, 1st Floor, Grosvenor Wing, StGeorges Hospital, London SW17 0QT

    This text relates Dame Muriel Powellscontribution to nursing throughout hercareer as a nurse and as an ambassadorfor nursing. At the birth of the NationalHealth Service in 1948, Powell hadalready been appointed matron of StGeorges a year earlier at the very youngage of 32. From the inception of theNHS through Salmon in 1963 andBriggs in 1972, Powell was in a uniqueposition to be involved in the changestaking place in the NHS and to influencethe role of nursing within this structure.

    An impressive list of Muriel Powellsappointments and committee member-ships between 1948 and 1976 are illus-trated in Figure 1 on page 96, includingher involvement with the World HealthOrganization, the International Councilfor Nursing, the Ministry of Health,the Royal College of Nursing andmany other prestigious organizations.From a history of nursing perspective, Iwould have found it useful had thedates of these appointments been inclu-ded.

    The author has gathered anecdotalmaterial from Powells family, friends,former colleagues and students andsythesized these data to give an overallview of how she has been remembered.However, the sense of person is missing,only a tantalizing glimpse is observed ofa woman who knew how to influencethose around her including the media,and who had a penchant for hats.

    Powells illness and decline with whatwas then termed pre-senile dementiaand her death at the relatively youngage of 64 is dealt with sensitively inChapter 9 and demonstrates the way

    that mental illness was dealt with in the1970s. As a history of the developmentsin nursing and health care in the post-war era this is a useful text. As a story ofa persons life, the person is elusive.

    Anne StimpsonUniversity of Hull, UK

    A to Z British Medicines ResearchOverview, 3rd editionby Stephen Bartlett.The Association of the BritishPharmaceutical Industry, London,68 pages. This publication is notavailable for purchase. Visit for a PDF summarycopy.

    This short and beautifully producedbooklet in A4 format summarizes thecurrent state of pharmaceutical researchin the UK. Beginning with a foreword bythe President of the association that haspublished the book, there is an introduc-tion, a short section of medicines re-search outlining some general principlesand providing a timeline of this research,and a major section which comprises theA to Z. The book concludes with a list ofcompanies involved in medicines re-search and a glossary of terms.

    The timeline runs from 1948 and thedemonstration that pernicious anaemiawas due to Vitamin B12 deficiency tothe sequencing of the human genome.The link between research, developmentand introduction is outlined and themajor areas where UK research hascontributed to areas of research arelisted. The A to Z runs by diseases andsymptoms and not medicines, as mighthave been expected. Each entry providesa state of the art summary of knowledgein the field, covering a description of theproblems associated with the entry andthe drugs in use. The A to Z section isliberally illustrated by high quality todie for diagrams which, if copyrightpermission is granted and these can bedownloaded to power point, provideany teacher in this area with a gift. Thisbook will provide a useful resource forteachers but should also be available inclinical areas and students in health carewill find it an invaluable summary forcourse work and examinations.

    Roger WatsonUniversity of Hull, UK

    Media Reviews

    98 2003 Blackwell Publishing Ltd, Journal of Advanced Nursing, 42(1), 9799

  • Fragile Lives Death, Dying and Careby Beverley McNamara.Open University Press, Buckingham,2001, 171 pages, 1799,ISBN 0 335 20899 1.

    This book examines sociological per-spectives of death. It is written by ananthropologist and consists of 165 pagesdivided into 10 chapters. Issues such ashow people face death, the construc-tions of a good death, and the medical-ization of dying are explored.

    Demographic change has led us intothe 21st century expecting increasedlongevity, and yet of one thing we canall be certain: the end point of life is

    death; nobody is immortal. Life there-fore remains a fragile commodity, par-ticularly so for those who face apremature death. Life-supporting andlife-enhancing technology may strive toextend life but, in so doing may alsoextend the process of dying.

    McNamara challenges us to acknow-ledge the social and cultural contexts inwhich death takes place. By doing this,one is better able to deal with thequestions that complicate the dyingprocess, recognizing that in contempor-ary secular society the good deathmade plausible by religion is now lesspossible. A fascinating discussion is

    presented on the language of deathand disease. Cancer has become themetaphor for the feared death. Indi-viduals are expected to have hope andto fight against it; to despair or losehope is frowned upon. The text drawson a wide range of research methodsand on the personal stories of thoseexperiencing the process of dying. Over-all this is a most informative and inter-esting book for all involved in the careof individuals approaching the end oftheir lives.

    Hilary BrocklehurstUniversity of Hull, UK

    Media Reviews

    2003 Blackwell Publishing Ltd, Journal of Advanced Nursing, 42(1), 9799 99