A powerful book not only about those dealing with dementia, but the ways that the condition in turn affects caregivers. Drawing on science, personal experience, and case studies, Kiper explores how the brain works, illuminating how common and superficially logical behaviors on the part of those caring for individuals with dementia can make their own lot even more difficult. Well-chosen references to literary classics by Chekhov, Kafka, and others deepen the conversation. Kiper frequently acknowledges her debt to the work of Oliver Sacks. Travelers to Unimaginable Lands admirably extends that tradition.

Many thanks to NetGalley and Random House for gifting me a digital ARC of this informative book by Dasha Kiper - 4.5 stars rounded up!

Dasha Kiper was getting her master's in clinical psychology and at the same time was a caregiver to an elderly gentleman with Alzheimer's. With that experience, and the experience of being a counselor for caretakers for over 10 years, she wrote this book which gives case studies and scientific knowledge and insight into the difficulties of caring for someone with dementia.

Some of these stories are so sad and difficult to listen to, but they also left me feeling grateful. I'm dealing with this issue now, as my mother moved in with us about 18 months ago and is dealing with mild/moderate cognitive impairment. I saw myself and my mom in these stories and it left me feeling validated and heard. It's difficult to separate the person from the disease and at these beginning stages, that is the biggest struggle. While Kiper stresses that caretakers need to forgive themselves, I wish she could have provided some more concrete examples and ways to handle some of the situations confronted

Dasha Kiper was once on track for a Ph.D. in psychology, but she became weary of the abstract and theoretical world of academia, finding herself to be more interested in grounded, real-world work with people. During her graduate-school years, she looked after an elderly Holocaust survivor who suffered from dementia, viewing this “as an opportunity to observe how a person fights to preserve his sense of self, even as a neurological disease was eroding it.” Kiper ended up becoming the consulting clinical director of support groups for an Alzheimer’s organization. She now facilitates meetings for family members and friends who care for dementia patients. Long an admirer of neurologist Oliver Sacks’s methods of clinical observation, emotional engagement with, and affection for his patients, she has modelled her approach to working with people on his.

In her professional role, Kiper regularly hears caregivers confess to feelings of guilt over the intense frustration and anger they feel dealing with their loved ones. These people know that the brain of a dementia patient doesn’t fire on all cylinders, yet almost all get sucked into arguments and power struggles with the impaired person, feeling compelled to present “the facts” to one who seldom comprehends and almost certainly won’t remember them, even if there is the occasional flicker of understanding. Caregivers are ashamed of their lack of composure—or what Oliver Sacks identified as the indispensable “compassionate detachment” one needs to assist the neurologically handicapped. Kiper began to wonder if the frustrating caregiver-patient interactions she kept hearing about might be due to something other than mere impatience.

In this excellent book, permeated by her warm intelligence, she focuses on the psychology of dementia caregivers, the “invisible victims of the disease,” who “unwittingly become part of the madness” and even mirror the irrationality and distortions of their charges. Based on cognitive and neuroscientific research, insights from literary fiction, and her own experience, Kiper proposes that much of the difficulty caregivers face in dealing with patients is due to the default setting of the healthy brain, which operates with a number of cognitive biases and philosophical intuitions. For one thing, we humans are wired to regard others as having the ability to learn, incorporate new information, be self-reflective, and maintain a continuous, essential core self. This perspective prevails even when we know we’re dealing with those whose cognitive faculties have been drastically diminished.

Kiper effectively uses case studies of caregivers she’s worked with to explain (among other things) why
(1) we cannot remember that dementia patients forget;
(2) family members take so long to recognize the disease;
and
(3) it’s so hard to change our knee-jerk, emotional reactions to the cognitively impaired person. She also explores the defenses that the mind uses to cope with the chaos and confusion that dementia wreaks.

As might be expected, a consideration of how memory works is a major focus of the book. Kiper points out that the distinction between the impaired and normal brain is not as clear-cut as one might think. Typically, functioning memory is not a one-to-one correspondence with reality, nor is it designed for accuracy. In fact, memory doesn’t actually exist to serve “objective” reality, but rather to create meaningful narratives about who we are. None of us can retain all the details about what we experience. Normal subjects have compensatory strategies to offset the memory loss that naturally occurs, relying on the employment of concepts, categorizations, and generalizations. In short, our minds summarize. Later, when we retrieve a memory, we’re not actually “summoning” a previous event but “reconstructing” past experience based on some elements of what happened, on a general sense of what might have happened, and on our current beliefs and feelings. The way normal memory works affects how we view and interact with Alzheimer’s patients.

Another basic principle about mental function that Kiper regularly returns to is that the brain’s objective isn’t “to be wise or right or even reasonable, but to conserve energy.” So much of how we think and behave is done on automatic pilot. Citing psychologist Daniel Kahneman’s book Thinking, Fast and Slow, Kiper says our usual effortless, automatic mode of “fast” thinking, which forms immediate impressions by recruiting intuitions, biases, and assumptions, gets us into trouble with the Alzheimer’s patient for whom many of these assumptions no longer apply. It’s difficult for a harried caregiver to switch in the moment to the “slow,” more deliberative thinking mode that dealing with a dementia patient requires.

Kiper’s book is a rich and fascinating one. I’ve barely scratched the surface here. While it’s not of the self-help genre, Travelers to Unimaginable Lands is certainly a helpful, instructive, and accessible book—not only for caregivers who can’t understand their erratic and irrational behaviour (never mind forgive themselves for it), but also for those interested in the unconscious brain processes that govern the ways we think and act.

An empathetic and well-researched book on dementia, what it's like for the patient and the caregiver. Helped me understand what my relatives with dementia have gone through.

Many thanks to NetGalley and Random House for gifting me a digital ARC of this informative book by Dasha Kiper - 4.5 stars rounded up!

Dasha Kiper was getting her master's in clinical psychology and at the same time was a caregiver to an elderly gentleman with Alzheimer's. With that experience, and the experience of being a counselor for caretakers for over 10 years, she wrote this book which gives case studies and scientific knowledge and insight into the difficulties of caring for someone with dementia.

Some of these stories are so sad and difficult to listen to, but they also left me feeling grateful. I'm dealing with this issue now, as my mother moved in with us about 18 months ago and is dealing with mild/moderate cognitive impairment. I saw myself and my mom in these stories and it left me feeling validated and heard. It's difficult to separate the person from the disease and at these beginning stages, that is the biggest struggle. While Kiper stresses that caretakers need to forgive themselves, I wish she could have provided some more concrete examples and ways to handle some of the situations confronted. However, I will be rereading this one to let some of the lessons sink in.

I received an invite to review Dasha Kiper's Travelers to Unimaginable Lands because I had previously reviewed Amy Bloom's In Love, a memoir of her husband's dementia. And Travelers is about dementia and the toll it takes on caregivers, primarily family members trying to care for their loved one and having a hard time separating the person from the disease.

This is an intriguing read, mainly if you are currently a caregiver for someone with Alzheimer's. The book goes through different obstacles that arise as family members become primary caretakers, explaining the differences between our healthy brains and their diseased brains and how alike the brains can be.

The author writes from her personal experience as a caretaker and as someone who leads therapy groups for caretakers. She shares stories from her clients that show how difficult it can be, but also how that difficulty is not uncommon.

I think the biggest takeaway from this book is that caretakers are not alone - in the way they feel, in the way they sometimes treat their loved one, and in not fully understanding this devastating disease. If you are currently caring for someone who has Alzheimer's, then you might find this book helpful and hopeful.

Travelers to Unimaginable Lands is published by Random House and is available to purchase now. I received a free e-ARC.

An important but, to be honest, tough and a tad ponderous read, Thanks to Netgalley for the ARC. Regrettably, I found myself turning away from it because of the subject matter but kudos for the writing and to Kiper for taking on a rough one.

Thank you for providing me the opportunity to review "Travelers to Unimaginable Lands" prior to publication. I am appreciative and leave my sincerity review voluntarily.