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The Erosion of Autonomy in Long-Term Care. - book reviews

Age and Ageing, May, 1994 by Tom Arie

Edited by Charles W. Lidz, Lynn Fischer and Robert M. Arnold

Oxford: Oxford University Press for OUP USA. 1992. 195 pp. Price [pound]35.00 (hardback).

This is a fascinating book on a sad subject. Based on observational studies, it reviews the topic of long-term care, beginning with a historical introduction ('How did we get here?'). This book's contents are mostly all too familiar, though it is none the less worthwhile to bring them together here.

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Chapters deal, among other things, with the implied value systems of those concerned with long-stay care; with relationships between those cared for and different types of staff and relatives, and with each other; with restrictions, routines, choices and lack of choices; privacy; physical direction and restraint. A summary relates the findings to the still vivid formulations of Erving Goffman in the 1960s. Any geriatrician or gerontologist who is not familiar with Goffman's writings on 'total institutions' would do well to read them. They are brilliantly written, and remain classics.

This is a useful compendium on one of society's persistent and pervasive ills, which brings little comfort, but there are constructive suggestions and some glimmers of light in a dark scene. This is a book for departmental libraries, though to be read by all--whereas Goffman (e.g. Asylums, Anchor Paperbacks, 1961) should continue to live, well-thumbed, on everyone's personal shelf.

TOM ARIE Psychiatrist, Nottingham

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The Erosion of Autonomy in Long-Term Care. - book reviews

Age and Ageing, May, 1994 by Tom Arie

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