Confused Angry Anxious?

Why working with older people in care can be really difficult and what to do about it

Bo Hejlskov Elven, Charlotte Agger and Iben Ljungmann

Jessica Kingsley Publishers 2017 192pp ISBN: 9781785922152

Positive Communication

Activities to reduce isolation and improve the well-being of older adults

Robin Dynes

Jessica Kingsley Publishers 2017

200pp ISBN: 9781785921810



A part of each one of us fears getting older because we see some of the consequences of age in our neighbours, friends and loved ones. This week I came across an older woman in my local shop who was completely lost – unaware of why she was in the shop and what brought her into this part of the town. Amidst the activity of those of us who were shopping few noticed her intense isolation, anxiety and frustration.

Another friend and colleague is struggling with older parents at a distance knowing that their quality of life continues to deteriorate partly as a result of their isolation. Of course this is not to argue that all old age is problematic – an inexorable and irreversible process of diminishment, decline and death. Some enjoy a good old age with health and vitality supported by family and community.

Recent initiatives in raising our awareness of dementia and its consequences has perhaps enabled us to realise some of the challenges that face us all as we befriend age in ourselves and others. It could be argued that what we need is a revolution in the care of older people similar to those who initiated a radical change in the culture of pain control for people living with cancer. This change will only come about if we open ourselves up to a more emotionally and spiritually informed understanding of old age and indeed a readiness to adapt and respond to different approaches to social care.

As ever Jessica Kingsley publishers demonstrate their commitment to innovative and ground-breaking narratives in our approaches to the care of older people.

I was especially interested to read the first book, Confused, Angry, Anxious? which emerges in part out of the experience of engaging older people in Denmark. I was especially impressed with the entrepreneurial approach to housing solutions for older people when I visited Copenhagen about 10 years ago. With characteristic care great attention had been given to design, independence, safety and sense of freedom in this particular community of older people. With similar care these authors explain why it is that older people in care, especially those living with dementia, can become difficult and therefore test our patience. The book aspires to a high aspiration of both longing for kindness and patience that can solve problems both for the older person and those who seek to care. Grounded in psychological theory the authors seek to offer a very wide variety of practical solutions to irrational, aggressive or unreasonably repetitive behaviour. Grounded in the real experience of individuals there is a quality to the organisation of each of these 17 chapters.

Part one sets out some principles. We are led firmly into the arena of identifying the problem alongside an affirmation that we must hold on to the belief that people behave well if they can. Carers must develop self-control for cooperation with the community of care holding onto the possibilities of maintaining self-control.

Part two offers a range of cases and action plans reminding the reader and practitioner that there are a range of social needs to be met and that the older person must be seen within the context of their family unit.

Part three explains with some admirable clarity types of dementia, person centred care and finally offer some study material indicating that the book is clearly informed by a grasp of the range of literature in this area.



Positive Communication is a working handbook designed for facilitators and older adults who want to explore how we might develop self-esteem and encourage personal expression and independence. The activities are all ready to use, practical and to my mind clearly tested out in practice.

A number of areas are tackled. The subheadings of each of the activities are: identifying strengths, interests, hopes and dreams; difficult topics; creativity; communication; memory; spirituality; social communication; writing; remaining active; building confidence and reminiscence. These will give you some indication of the range and scope of each of the 100 exercises.

The author is to be commended for such clear and systematic organisation and the publishers for printing this book with a careful eye to detail, typeface and design. I shall certainly be using some of these exercises in my work as a theological educator in the area of raising consciousness about age awareness and importance of moving beyond information overload in our digitalised age to good human connectivity.


James Woodward

Sarum College

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