Unending Work and Care: Managing Chronic Illness at Home appears to be the culmination of extensive research and work with chronically ill persons and their families. This book focuses on how these individuals manage the disease and their lives simultaneously, attempting to live a "normal life" in spite of the illness. The book is very current, well documented, and follows a rational course, looking at chronic illness from pre-diagnosis, through remissions and exacerbations and deterioration to death, blending research, theory and actual case studies.
The first half of the book is very heavy on theory. There are times when one must ask, "So what?' So what if there are illness trajectories, biographical work, etc.? How can that help the chronically ill person attempting to manage at home? This problem is remedied in the second half when the authors analyze actual case studies in great detail, applying the theory presented. The last chapter, "The Unending Work and Care Associated with Chronic Illness", was most useful. It presented an overview of the book, highlighting the signficance of each chapter and bringing the information into focus. If the authors had used this technique in some of the earlier chapters, the information would have had more impact.
This book is long overdue. For too long, health care practitioners and educators have focused on the acutely or terminally ill person. We have little information to help us meet the special needs of the chronically ill, other than to hear that they are "custodial" and need only "maintenance care". Through actual examples, this book proves that the chronically ill person does indeed need special "care and handling" to make the most of a life which is totally altered by a lingering disease. This does not come easy. It requires a different mind set and attitude which will build on the patient's and family's strengths while minimizing the effects of the illness. This is where this book will be most useful. If used as a textbook for health care practitioners (nurses, counselors, social workers, physicians, etc.) in a setting where the information can be applied to actual patient-family situations, the practitioners would develop some of the skills and insights needed to care for the chronically ill person and provide support to the family. Our educational system must focus on the special needs of the chronically ill and this book would serve as a great resource.
I have one relevant wish to end this review. We must educate the practition-