_LauFinalBR Book Review Review of Douglas Wornell. Sexuality & Dementia: Compassionate and Practical Strategies for Dealing with Unexpected or Inappropriate Behaviors. Demos Medical Publishing: 2014. pp. 200. Price $17.95. Janice Y C Lau The Chinese University of Hong Kong Anthropology & Aging, Vol 39, No 1 (2018), pp. 117-118 ISSN 2374-2267 (online) DOI 10.5195/aa.2018.188 This work is licensed under a Creative Commons Attribution 4.0 United States License. This journal is published by the University Library System of the University of Pittsburgh as part of its D-Scribe Digital Publishing Program, and is cosponsored by the University of Pittsburgh Press. Anthropology & Aging Vol 39, No 1 (2018) ISSN 2374-2267 (online) DOI 10.5195/aa.2018.188. http://anthro-age.pitt.edu Lau | Book Review 117 Book Review Review of Douglas Wornell. Sexuality & Dementia: Compassionate and Practical Strategies for Dealing with Unexpected or Inappropriate Behaviors. Demos Medical Publishing: 2014. pp. 200. Price $17.95. Janice Y C Lau The Chinese University of Hong Kong The purpose of this monograph is a comprehensive guide for generating understanding, and more importantly, provoking insights into and awareness of providing compassionate strategies regarding sexuality of demented patients in the context of care. The volume begins with an overview of sexual behaviors in connection with different dementias. It then discusses issues and challenges confronting families, nursing home staff and primary care doctors in dealing with unexpected sexual behaviors, and ways to support both patients and the people around them, both medically and psychosocially in the subsequent chapters. The book, divided into two parts, starts with five chapters exploring the breadth of sexuality of patients living with dementia, and the relationship dynamics created with the people around. The introduction points out the common occurrence of sexual behaviors among these patients that exemplifies Wornell’s reason for choosing the topic. In Chapter 2, Wornell brings together a range of patient stories that are examined in depth, while suggesting ways to support patients and families who are disturbed by the changed intimate relationships. Chapter 3 addresses the effects of neurobiological changes on sexuality. What follows is an illustration of how stronger bonds are built between families and patients as the healthy family members come to better understand the complex changes that have led to the behavioral challenges. Chapter 5 presents the impacts of sexuality and dementia on others, which is more relevant to nursing care settings and highlights the difficulties, dilemmas and ethical issues confronting families and care providers in dealing with sexual expressions. The remaining chapters (6-10) offer a medical perspective on current approaches in managing inappropriate sexual behaviors in people affected by dementia. Chapter 6 begins with an outline of a spectrum of age-related dementias that focuses on their risk factors, symptoms, treatment and prevention. Chapter 7 discusses genetics, toxin, brain injuries or infection as contributing factors for young-onset dementias, as well as how they affect one’s sexuality. Chapter 8 further widens the readers’ horizons towards an understanding of how factors such as delirium, drugs and other substances can bring about uncontrolled sexual behaviors, which must be considered during the process of evaluation. Chapter 9 proposes some practical steps to support nursing care staff in managing sexual inappropriateness in long- term care dementia residents, as well as a detailed summary of treatments across various domains of medical knowledge and therapies, which are useful tools to prepare someone for advancement of their professional practice. In conclusion, Wornell raises his concern of how the best interests of these patients, who lack decision-making capacity, can be served in face of personal interests of others and changed moral beliefs. Anthropology & Aging Vol 39, No 1 (2018) ISSN 2374-2267 (online) DOI 10.5195/aa.2018.188. http://anthro-age.pitt.edu Lau | Book Review 118 Authored by Dr. Douglas Wornell, a geriatric neuropsychiatrist with profound expertise in supporting geriatric and neuropsychiatric services in long-term care facilities in the US, the greatest strength of this book is an attempt to emphasize the use of humanistic approach where compassion in care may serve the new and positive direction. Wornell grounds its theme in the real world through his clinical experiences, medical knowledge, research and storytelling. The facts, stories, reflections and strategies are neatly interwoven together that successfully engage and communicate with his readers. Wornell is able to re-create the scenes of stories and bring them to life, where multiple perspectives from different people resembles a coherent narrative. These stories are short yet thought-provoking and emotionally inspiring. Wornell intents on reassuring readers that having sexual symptoms among this population is not uncommon, and that it is possibly supported by available treatments and therapies. This volume contributes to promoting a taboo-free discussion on sexuality and dementia in the community, and developing positive, supportive, and proactive attitudes among carers. By treating everyone as individuals and each situation as unique, the sharing of his consultation experiences also contributes to raising awareness among healthcare professionals about the need for prioritizing patient-centeredness. The short stories perfectly display the qualities that health providers should have, i.e., to observe, to actively listen and to ask the right questions in order to formulate appropriate strategies to support care. Considering the demographic makeup in the US though, the work lacks a discussion of impacts of cultural values on carers in coping with the situations, practices in nursing homes, and policies. Given that the lay readers may not be familiar with the scientific jargon, Wornell writes with clarity and uses life examples to relate them to the scientific context. The scholarly work is therefore readable for both the professionals and the general public; family carers, nursing home staff, social workers, physicians, nurses, and sex therapists can all gain great insights from it. In all, this volume shows Wornell’s immense care towards his patients, fueling his readers a desire for positive changes.