Reading as an Occupation…What I read in November.

This month’s books tackled some worthy subjects: Early Onset Alzheimer’s Disease and raising a transgender child, both books that can provide a perspective that can positively impact occupational therapy services. There were also a couple of new mysteries, my preferred genre, from two of my favorite authors.

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Still Alice by Lisa Genova *

Reading a fictional novel about Alzheimer’s Disease written by a neuroscientist was a learning experience.  This is the story of Alice, a professor at Harvard University who is diagnosed with Early Onset Alzheimer’s Disease (EOAD). The novel starts with Alice prior to her diagnosis and the presentation of a life filled with lectures, travelling to speak to large audiences on linguistics research, and publishing research with a variety of professionals, including her husband. She had the respect and admiration of her family, colleagues and students.

At the age of 50, Alice was diagnosed with EOAD, and Genova presents Alice’s journey with this diagnosis. This journey starts with the general, neurological, and genetic testing that is involved with diagnosis of EOAD, which provides some insight into the layers that occurs when this diagnosis is revealed.

The novel presents the events from Alice’s perspective and it is enlightening to get a glimpse of this view. With this being a well-known degenerative disease, there is little expectation of Alice’s mental ability to thwart the cognitive decline that occurs. The magic of this novel is appreciating Alice’s view of the events that surround her through the lens of this condition. As the story unfolds, there are the instances of the expectations with this diagnosis, which includes wandering, forgetting names, and changes in life roles due to changes in functional skills due to the neurological degeneration. This also provides insight into the impact of dementia on caregivers with Alice’s husband and 3 children as instrumental parts to this story.

Having the perspective of Alice during her devolution provides the reader with the ability to empathize with clients with dementia. Many times, there is lack of understanding of what occurs neurologically, behaviorally, and the level of processing of information with this diagnosis. Genova brings the reader into the mind of Alice and how she thinks, views her environment, and processes information. The insight into this processing cements how to approach individuals with dementia such as how to provide directions (simple, concrete), methods to speak to a client (less pronouns and more names), and services to support engagement in their environment (support groups of both client and caregivers).

This is a book that can be dissected from many perspectives to influence occupational therapy services:

  1. What are the standard assessments that are used to diagnosis AD?
  2. What is the genetic marker that can be used to determine the likelihood of developing AD?
  3. Throughout the novel, there are many examples that focus on ADLs. Thinking of where Alice had issues with ADLS and IADLs, how can occupational therapy support the client and the caregiver with ADLs to ensure safety and independence?
  4. What is the impact of role loss on the individual with AD?
  5. What strategies can be used when working with a client with AD?
  6. Based on Alice’s progression, what is the role of occupational therapy during the early, mid, and late stages of AD?

Ratings: 4/4 stars. Highly recommend this book. Genova is an excellent writer. Her writing style is fluid, and she uses clear imagery to bring the story to life. She intermittently presents neuroscience concepts in this novel, but the information adds to the story and is not overwhelming. This novel is both a learning experience that helps the reader better understand AD and an opportunity to digest a well-written story about likeable characters.

This is How It Always Is by Laurie Frankel *

This is a fictional novel that tells the story of husband and wife, Penn and Rosie, and their five boys—a number that is based on their desire to have a girl. When their 5th son Claude was born, the couple decided that their family was complete and a girl in the family was not in the cards for them. However, it becomes clear early on that Claude does not see herself as a boy, but rather as a girl.

The way the Penn and Rosie handle this revelation is poignant to say the least. Rather than question Claude’s declaration, they support her to become Poppy. Following the journey of Penn, Rosie, and Poppy is one that provides insight into many issues that families encounter when addressing gender identity. Frankel does an excellent job presenting this story, the characters, and the unfolding of Poppy’s life.

Poppy encounters bullying in school, the consternation of her brothers who are grappling with Poppy’s journey and their need to both protect and understand her, family and friends who find the situation perplexing, and her own conflict with living in a body with which she does not feel aligned. Though this a work of fiction, this novel provides good insight into what families deal with and how occupational therapy practitioners can support families that are addressing this in their household or understanding the journey or needs of a transgender individual.

While many occupational therapy practitioners may not deal with gender identity issues directly during practice, there are time when skills will be needed to address some of what is encountered. One understanding individual can have a positive impact on the mental health of a child dealing with gender identity issues. Therefore, what can occupational therapy practitioners do to support students or adults?

  1. In the academic, medical, or community setting, what are ways to determine the individual’s lived experience to determine if supports are needed?
  2. If support is needed, what level of supports can be provided with this individual in their community?
  3. Looking at the OTPF-4, how does gender identity fit into the Framework and how can our understanding impact service provision?
  4. Looking at Poppy’s evolution and the role of Rosie with Poppy’s evolution, what is the takeaway for parents that are struggling with a child that requires support with gender identity?

Rating: 4/4. Highly recommend this book. Frankel presents this family’s story in a manner that captures the issues in a candid and poignant manner. This is an excellent recommendation for parents who have a child dealing with gender identity issues for considerations to best address the needs of their child.

One by One by Ruth Ware *

In the interest of full disclosure, I must confess that I listen to all Ruth Ware books for the British accents. With that confession out in the open, I can continue. Ask any mystery lover to list their top 10 authors, without a doubt, Ruth Ware will be on that list. The name alone evokes mystery, especially when said with an, ahem, British accent.

One by One is a story of the staff of Snoop (Snoopers), a music platform where subscribers can listen to the same music of their favorite stars, in real time. Other characters in this story, Erin and Danny, the staff at the snow resort in the French Alps where the Snoopers are staying. At this ski resort, one of the founding members of Snoopers, shares with the group that Snoop will be sold. The problem with this announcement is no one knew about this sale prior to the announcement at the desolate, ski resort. This announcement triggers an unfortunate event, and the story progresses into quite the mystery.

I have to say that listening to this as an audiobook, at the beginning of each chapter, the name of the Snoop subscriber and who they are listening too and who is listening to them is announced and it kind of made me think that was pivotal to the story. This information was not pivotal to the story and I am not sure why this was done. If anyone has ideas why this was done, feel free to reach out to solve this mystery. Other than this component of the story, this was a good read.

Rating: 3.5/4. Highly recommend this book. Ruth Ware is a great mystery writer that brings the reader into the story. She uses all the elements of suspense in her stories (picture darkness, macabre imagery, and just a hint of psychosis) and at many points, you are actually scared to continue reading!

Piece of My Heart by Mary Higgins Clark and Alafair Burke *

Unfortunately, Mary Higgins Clark passed away in January 2020, prior to the November 2020 release of this book. Higgins Clark has been one of my favorite authors since I was in high school. Alafair Burke is another one of my favorite authors after reading  The Wife *  and  The Ex * , both books I highly recommend. When I saw the two authors were writing a series of stories about Laurie Moran, I didn’t think twice about giving their collaboration a read.

This series of books lay out the story of Laurie Moran, the executive producer of Under Suspicion, a show that solves cold case mysteries. The characters are likeable, and the storylines are easy to follow. Think Hallmark movie meets mystery, but the mystery is a bit more in-depth than a Hallmark Mystery. Does that make sense? Yes? Good.

Piece of My Heart is the story of Laurie’s fiancé’s nephew kidnapping. The story is multi-layered and involves an adoption and much, much more. With this being a mystery, I will not provide spoilers. I can say that this is an easy and light read, think being done with this book in one weekend or even one very laid-back day. What I like most about this novel series is though the stories are short, all loose ends are tied up relatively well. There is also incredibly good character development. The plot is well rounded, and the mystery and suspense are palpable. Each story I have read in this series has left me satisfied with the overall plot and the ending.

Rating: 3.5/4. Highly recommend this series of books for a good, quick read. The characters are likeable, and the storylines are well-done and believable. I have been satisfied with each story in this series.

Overall, November was a good month! Did you read any of these books? What are your thoughts? What are you reading? Any recommendations for my December TBR pile?

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