What real progress has been made in dementia training?

In this blog post, author Dr Shibley Rahman addresses the urge to recognise the needs of the workforce in dementia education and training by asking a simple, yet poignant, question: what real progress has been made in this direction over the past few years?

progress-dementia training

The current Prime Minister’s Dementia Challenge 2020 has successfully improved the awareness of dementia (and quality in other areas), but it also did produce a lot of other industrious contributions, such as courses and conferences, not always with a primary aim of educating the workforce.

But – “Knowledge is power.”

A lot has been made of the finding that people living with dementia are “core users” of the NHS and social care. And it has been said “dementia is everybody’s business”. But these tropes are too easy to trot out. Rather, the needs of people with dementia and their care partners often go unaddressed, despite much effort being publicly pumped into ‘dementia awareness’.

Just before Christmas last year, as a full time carer of a family relative with dementia, I had reason to experience at close quarters an English hospital admission. Although I am loath to extrapolate from what was essentially an anecdotal experience, I found the mismatch between reality and political rhetoric quite revealing.  Continue reading

Are you looking for books and resources to support your work with gender variant individuals?


We publish a range of books for therapists, counsellors and healthcare practitioners who work with gender variant individuals. From informative guides to personal memoirs, our books offer support and promote greater understanding of gender identity and expression. This collection includes books that address themes of gender identity, sexuality, relationships, transitioning and mental health. For more information on new books and to receive a copy of our new catalogue, join our mailing list here

The Voice Book for Trans and Non-Binary People

Matthew Mills and Gillie Stoneham

Written by two specialist speech and language therapists, this book explains how voice and communication therapy can help transgender and non-binary people to find their authentic voice. It gives a thorough account of the process, from understanding the vocal mechanism through to assimilating new vocal skills and new vocal identity into everyday situations, and includes exercises to change pitch, resonance and intonation. Each chapter features insider accounts from trans and gender diverse individuals who have explored or are exploring voice and communication related to their gender expression, describing key aspects of their experience of creating and maintaining a voice that feels true to them.

This pithy, practical guide is a treasure trove of rare and wonderful gems – particularly the exercises for trans men and non-binary people, often neglected but vulnerable to crippling self-consciousness and even phobia around speaking. Clinicians and clients alike, I unreservedly recommend The Voice Book to anyone looking to feminise, masculinise, neutralise or just explore the potential of voice.’ – Dr Stuart Lorimer, Consultant Psychiatrist

Who is this book for? Speech and language therapists, healthcare practitioners, counsellors, gender variant individuals


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Rethinking hospice chaplaincy: A spiritually motivated response to raw human need

Reverend Dr Steve Nolan is the chaplain at Princess Alice Hospice in Esher and the author of ‘Spiritual Care at the End of Life.

Here, he explores new ways of understanding the roles of hospice chaplains. 

I never met Dame Cicely Saunders. The nearest I came to her was when I visited the chaplain at St Christopher’s, the south London hospice she established. My tour of the hospice had reached the old chapel, and as I chatted with the chaplain, I caught a glimpse of her as she walked slowly passed the chapel door.

Whether Dame Cicely should be considered ‘the founder’ of modern hospice care could be debated. But her dynamism and drive had a significant hand in shaping the direction and values of the nascent movement. Yet she was not the only dynamic woman to have influenced the history of hospice care.

In 1843, Mme Jeanne Garnier opened a home for the dying in Lyon. In Dublin, Sister Mary Augustine inspired first Our Lady’s Hospice for the Dying, which opened in 1879, then further hospices in Australia and Great Britain. And in New York, Mother Alphonsa established St Rose’s Home in 1899. Working independently of each other, these women shared not only a common purpose but a motivation that was inspired by their spiritual beliefs.

Spirituality was clearly one of the key motivators that drove Dame Cicely. In the late 1940s, she converted from agnosticism to a deep evangelical Christian faith, which transformed the way she understood her work. Caring for the sick had always been a priority; following her conversion it became a religious calling.

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“Why Bother? Does it Even Matter?” Read an exclusive extract from Treating Body and Soul

In Peter Wells’ new book, Treating Body and Soul, various healthcare professionals reveal how they meet patients’ spiritual needs in medical settings.

Patients who are facing illness and uncertainty often find themselves reflecting on the bigger questions in life, and the core beliefs or principles they live by. These convictions, religious or otherwise, are integral to a patient’s identity, and consequently to their most fundamental emotional and spiritual needs. Perceptive clinicians have proved that, by recognising and working with their patients’ spiritual requirements, they have been able to significantly improve their patients’ experience in the medical setting.

In this extract, Peter Wells questions why we need to address the needs of the body and the soul in healthcare settings and why this shouldn’t just be the role of the hospital chaplain. He also explains how best to use this book.

Read the exclusive extract from Peter Wells here

For more information on this book, or to buy a copy, please follow this link.

Why healthcare practitioners must learn to self-care

Sarah Parry is a senior lecturer in Clinical and Counselling Psychology at Manchester Metropolitan University. Her new book, ‘Effective Self-Care in Clinical Practice,’ explores how compassion can enable clinical practitioners to foster hope and resilience for themselves and their clients. We talked to Sarah about her motivations behind the book and why it’s so important for healthcare practitioners to learn how to effectively self-care. 

Effective Self-Care and Resilience in Clinical Practice is a collection of essays from different practitioners, that explore the need for compassion in therapeutic work. Where did the idea for the book originate from?

Developing a personal compassionate framework for self-care has been an on-going endeavour of mine for some years. When I started working in healthcare settings that could, at times, present multiple challenges to my own well-being, I became increasingly curious as to how to overcome these emotional hurdles. I am also a great believer in the power of stories, both in terms of helping us see through the eyes of another, as well as giving us a mirror to hold up to our own experiences, helping us develop a deeper knowledge of ourselves. My motivation for this book came from my own experiences of struggling with competing demands and a realisation that working harder and harder isn’t always the answer. I wanted to understand more about how people developed effective self-care strategies based on compassionate teachings and practices, to enhance their own well-being, resilience and ability to maintain a hopeful outlook. Consequently, I started talking to colleagues who I knew managed their self-care well, as well as people I didn’t know at all at that stage but whose writings inspired me and encouraged me to think about how well I was looking after myself.

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Chaplains are worthwhile because….

Karen Murphy has worked in hospice chaplaincy for twenty years and has represented chaplaincy at national and international level. She is President of the Association of Hospice and Palliative Care Chaplains (AHPCC). Here, she argues the case for hospice chaplains. 

The Association of Hospice and Palliative Chaplains held our annual conference in May and considered the following statement: ‘chaplains are worth having because….’ As a group of skilled, trained and experienced chaplains, we had no problem in accounting for our role and purpose in a palliative care setting. There is a view, however, that in these secular days, the role of the chaplain is no longer valid or necessary. The daily conversations that chaplains share with patients and families soon render this argument redundant.

A patient shared with me recently that she had never had a religious faith, although she often thought it would be of value. Her long held view was ‘when you are gone, you are gone’. Now, facing her mortality having being diagnosed with terminal cancer, her thinking has shifted and for the first time, she is considering her life against an absence of faith. Our conversations are not concerned with my attempts to convert her to my way of thinking or persuade her to find a faith or belief, but to support her in this deeply challenging time. I can enable her to think through her questions and listen. At this point the value of chaplaincy becomes clearer as we offer spiritual listening, which is very different to counselling or social work listening. Chaplains have the capacity to instigate and support conversations that get to the root of someone’s spiritual distress and need. We are not afraid to ask the difficult questions about life’s meaning and purpose, and in my experience, patients seek out those with a belief in order to make sense of the spiritual disturbance and trauma experienced. A patient’s relative expressed this very clearly in a recent conversation, saying: ‘My mother, in her last weeks of life, wasn’t concerned with whether or not the chemotherapy had been successful, or what drugs she would need to be pain free. She trusted the doctors for this. What she valued was the time of the chaplain to help her think about life’s meaning and how to live and die well’.

There is a view that chaplaincy services are a waste of time and resources in a stretched and under –funded health service. The rationale for this view suggests that if patients identify spiritual need, they are likely to have religious faith, therefore will have the support of a local faith community. This view ignores the fact that patients faced with a terminal prognosis, while describing themselves as non-religious, will experience spiritual distress which is unfamiliar and frightening. Chaplains are an essential tool of our health care services which provide distinctive and relevant care for patients who are asking the big questions of life which have never been asked before. The positive impact of chaplaincy based on evidence and research is already emerging, with projects demonstrating the need for fewer GP appointments, reduced medication and a greater sense of well-being to live in the face of impending death. This body of research is growing and will offer to those cynical of chaplaincy, a quantitative and qualitative foundation for the chaplain’s continuing contribution to palliative care services.

For more information on Chaplaincy in Hospice and Palliative Care and to buy a copy of the book, follow this link

Why not follow us on Facebook @JKPReligion or on Twitter @JKPBooks for more content from our authors.  

Confused, Angry, Anxious? How to understand and tackle challenging behaviours in older people in care

challenging behaviours dementia

In this extract, the authors of Confused, Angry, Anxious? look at one of the many challenges healthcare professionals can face when working in older and dementia care. With an accessible and easy-to-read style, the authors offer advice on how to best handle challenging behaviours effectively, professionally and with confidence.

click here to read the free extract!


This book intends to create a link between person-centred care methods and what is described as the low arousal approach, a method which aims to manage challenging behaviours in a calm and positive manner to minimise conflict, stress and fear. With many examples of everyday challenges and how to deal with them, this book has the potential to change your (working) life.

 ‘It is not the people with dementia whose task should be to behave themselves, rather it is the caregivers whose task should be to create a context that allows these people’s everyday life to function’.

Click here to find out more about the book.

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Excerpt from Having Your Baby Through Egg Donation 2nd edition by Ellen Sarasohn Glazer and Evelina Weidman Sterling

The below article has been excerpted from the forthcoming book, Having Your Baby Through Egg Donation 2nd edition by Ellen Sarasohn Glazer and Evelina Weidman Sterling (June 2013), published by Jessica Kingsley Publishers.

Egg donation—how did it all begin? There are published records from as early as the late 1800s of experiments conducted on women who lost theirHaving Your Baby Through Egg Donation 2nd edition ovaries at young ages. However, it was not until the arrival of in vitro fertilization in 1978 that physicians had a means for enabling a woman to become pregnant with another woman’s eggs. The first child born through egg donation was born in Australia in 1983.

In its early years, egg donation, though possible, was not readily available. The first donors were either sisters or cousins (of their recipients) or they were infertile women who were undergoing IVF. Since cryopreservation of embryos was not available to all, some of these women had “extra eggs” for which they had only two options: discard or donate to other infertile women. Another group of early egg donors were women seeking tubal ligation who were invited to donate their eggs in exchange for the cost of their procedure. Either way, donated eggs were relatively few and far between and for the most part, came from women whose donation was based more on practicality or expediency than on an affirmative decision to help an infertile couple. The scarcity of eggs made the experience challenging for would be recipients who had little way of knowing if and when donated eggs would become available to them. One mother of a now 23-year-old through egg donation recalls taking medications over an extended period of time to ensure her uterus was ready for implantation should a donated egg come along. She was literally “on call” for news that an egg was available. When the call came, there was no asking about who the donor was or what her genetic history revealed. The recipient was instructed to go immediately to the fertility clinic, where she underwent a full laparatomy (a surgical incision in the abdominal area) and a gamete intrafallopian transfer (GIFT procedure). The donor’s eggs were mixed with the recipient’s husband’s sperm and placed in her tubes.

Much has changed. Not only has IVF fully replaced GIFT as a vehicle for egg donation, but beginning in the late 1980s, women were actively recruited for voluntary egg donation. This began in medical clinics, some of whom continue to recruit donors. However, in the United States, independent “Egg Donor Agencies” rapidly replaced medical programs as the main source of donated eggs. By the late 1990’s it was common to see adds like the following in college newspapers:

Make a dream come true. Help a childless couple become parents. If you are under 34, healthy, a non-smoker, please consider donating some of your eggs. You will be compensated for your time and effort.

The arrival of these programs transformed egg donation from something extremely difficult to arrange to something that, with financial/health insurance resources and access to medical treatment, can be launched with a few visits to internet web sites. One need simply type in “Egg donation” to be connected to agencies with names ranging from “Precious Wonders” to “Tiny Treasures” to “An Angel’s Gift” to “Peas in a Pod” and “Our Fairy Godmother.” As of this writing, there are 94 Egg Donor Agencies listed on the website of the American Society for Reproductive Medicine. Most have tantalizing websites that offer hope to infertile couples many of whose journey to parenthood as so far been filled with only disappointment and loss. They also offer the promise of financial and emotional reward to young women who are invited to undergo ovarian hyperstimulation and egg retrieval.

Just as there have been changes in the availability and accessibility of donors, so also have there been shifts in the way people think about egg donation. In the early years there was a real sense that the science was advancing far more rapidly than our understanding of what it means for a person to be physically born to three people. Instead of taking note of what a seismic shift this marked in human reproduction, physicians presented egg donation as a treatment for female infertility. In so doing, they missed the opportunity to examine, make sense of and ul†imately celebrate what egg donation means for identity formation and our understanding of kinship. Sadly, egg donation was pushed into the shadows, spoken of in hushed tones and burdened by secrecy.

The experiences of parents through egg donation, their children and their donors changed significantly with the arrival of the Donor Sibling Registry in 2000. This US based worldwide registry was founded in 2000 by Wendy Kramer and her son, Ryan, who was conceived via sperm donation. The registry helps people connect with donor relations.  In the 12 years since its founding, the DSR has helped connect over 9200 individuals with their donor relations. Wendy Kramer reports there are on average two new matches every day. For egg donation families, this has meant that parents have connected with donors, donors with offspring and as the name of the DSR suggests, offspring with other offspring.  As word of the DSR has grown and with it, people’s appreciation of the significance of genetic connections, families have been turning to the DSR in new ways. As of this writing, there are several egg donor agencies in the US that include the DSR in their donor-recipient contracts, making it possible for people who want anonymity (or at least to start out with no identifying information) to remain in touch and share photos and updated medical and social information.

Where Are We Today?

Looking at egg donation today we see a very different picture from what we saw even as recently when we prepared our 2005 edition of Having Your Baby Through Egg Donation.  In addition to the changes noted above, we see changes in the way ED parents feel about their path to parenthood. The secrecy that prevailed in the past has lifted and been replaced with honesty and privacy. True, there are some ED parents who still feel they have something to be secretive about, but increasing numbers are treating their child’s story as an open but private matter. They don’t go around saying “my egg donor baby” etc, but acknowledge donor conception when there is a reason to do so. In talking about it in a natural and appropriate way, most find that others are fully accepting of and comfortable with egg donation. Accompanying this more open approach to egg donation in general has been increased comfort with the donors.  As one mother through egg donation put it,

When I first heard about egg donation, I did not want to meet my donor because I thought that I would see her face in my child and it would upset me. Now I feel the opposite. I have twins and one looks just like the donor. I love it because it is a constant reminder of the remarkable woman who helped make us a family.

With increased comfort and familiarity with egg donation has come increase use of this option. Or perhaps it is the reverse—as more people have become parents through egg donation, more of them have become comfortable speaking openly about it. Either way, the use of egg donation is on the rise. In 2010, the most recent year for which the SART (Society for Assisted Reproductive Technology) statistics are available, there were 9, 321 transfers using donated eggs. Over 55% of these result in live births. This is the official SART number. Wendy Kramer of the DSR found, in surveying parents through egg donaton, that 42% were never asked to inform their clinic whether they had a live birth. Some did so voluntarily and others did not. If we add in the pregnancies that resulted from frozen embryo transfers, there were over 8,000 births in the US alone (in 2010) from donated eggs.

So egg donation in the US is accepted. It is also common. And it is available. All that said, it can still feel overwhelming to embark on a path to egg donation. Recipients must identify a medical program that they have confidence in, figure out how they will afford the medical treatment and often, donor and other fees and they must find and secure a donor.  All of this is do-able but it takes time, wherewithal, money, stamina and information.

Although egg donation has enjoyed widespread acceptance and relatively little scrutiny in the United States, this is not the case throughout the world. In Italy, for instance, a law was passed in 2004 completely banning oocyte donation, banning as well use of donor sperm and helping women past childbearing age becoming pregnant via ARTs. The road to this law started in 1994 when Italy made headlines when Dr. Severino Antinori used donor eggs to get 63 year old Rosana Della Cortes pregnant. Robin Marantz Henig’s New York Times article (2004) states,

We are learning the wrong lessons from our earlier misadventures. Things got a little out of hand, yes, but that is because governments around the world adopted a hands-off policy towards the whole affair. It was too complicated to reach consensus about what steps were too intrusive, about when human life begins, about what risks were worth taking for the sake of having one’s own biological child. So governments turned their backs on reproductive technology and allowed the field to be taken over by cowboys.”

Still, unable to come to a consensus about exactly what should be accepted and what should not as far as egg donation, countries like Italy, Austria, Norway, Sweden and Switzerland have also nearly eliminated ovum donation. While such strict laws serve to call everyone’s attention to the potential for ethical abuses in egg donation, they also create new social problems. There now exists what has been termed “fertility tourism”—people living in countries that ban oocyte donation are traveling to other countries to obtain eggs.

Visit our website to get additional information or to order a copy of Having Your Baby Through Egg Donation 2nd edition by Ellen Sarasohn Glazer and Evelina Weidman Sterling.