The Family Guide to Surviving Stroke and Communication Disorders (1999).  By Dennis C. Tanner. Allyn & Bacon, 160 Gould St., Needham Heights, MA 02494. 273 pages, $23. Reviewed by Sarah C. Petrik, Louisville, KY.

This book for stroke patients and their families is intended to provide "current and meaningful information to progress from being victims to victors." The guide begins with a story about a stroke patient' s experiences, followed by three chapters on speech and language disorders theory. Subsequently, Tanner describes associated disorders and cognitive problems resulting from strokes. Another two chapters tackle the stroke patients' psychological issues of depression and anxiety. Then, a 15-page chapter focuses on what family members can do to help the patient adjust and communicate. The next chapter deals with the process of accepting the unwelcome changes after a stroke with an emphasis on the Kubler-Ross stages of denial, anger, bargaining, depression, and acceptance. The author details the speech-language rehabilitation process and offers answers to common questions in the next chapters. A glossary, brief reference list, appendices with agencies, associations, and community groups, and an index complete the book.

This guide offers a lengthy description of speech, language, associated cognitive disorders theory, and psychological problems common in stroke patients. Practical suggestions for optimal interaction are found primarily in Chapter 9. The realistic patient scenarios effectively humanized the plight of stroke survivors. Families may find the glossary and resource material, including Web sites, helpful in their effort to learn about stroke survival. The eight-item reference list is regrettably short, including four previous publications by Tanner. The section on dysphagia omits the fact that most aspiration pneumonias are caused by pathogenic oral secretions getting into the lungs or aspiration of refluxed stomach contents (MMWR, 1997). Also, the instrumental examination used by speech-language pathologists to assess swallowing problems is labeled a "barium esophagram" or a "barium swallow" in this book. While this terminology may be used in some facilities, the term "modified barium swallow" would be more accurate since the barium esophagram is a completely different examination conducted by radiologists.

In short, the guide may be useful to family laypeople wishing to learn a great deal about the nature of strokes.

Reference:
Centers for Disease Control and Prevention. Guidelines for prevention of nosocomial pneumonia. MMWR 1997;46 (No. RR-1).