Demographics show a growing number of elderly persons in the United States, many of whom have active connections to communities of faith. Some do not need or want formal long-term care, nevertheless many cannot care adequately for themselves in the home setting. Available health care dollars and support services increasingly fall short in meeting the needs this population represents. The community is placed in a position to take up the slack. The ministry of parish nursing is a partial solution to the problem, addressing both the physical and spiritual needs of the population served. Sybil Smith and her contributors have done a service by collecting in one volume a compendium of the field. Included are the history of this "evolving specialty" (32), its current and future role, and some practical suggestions for implemention and ongoing quality improvement of such a program. The book explores such essential issues as fund raising, the variety of challenging situations in which the parish nurse must operate, and the care giver's role at life's end.

The book will appeal to the academic, with index, bibliography, charts and summaries will be useful to someone who might wish to begin a parish nurse program or to explore the topics further. The authors draw upon contemporary research in the social sciences and ground their ideas in good pedagogy. The text is user-friendly, including what might be considered homey touches: short biographies and photographs of the contributors, personal anecdotes which illustrate the points the authors wish to stress, and an abundance of poster-esque black and white artwork drawn from presentations for the parish nursing training program. The final chapters on end-of-life care from the perspective of the parish nurse offer some insight into the growing demands posed by persons who are near death, but who will experience the dying process outside of the hospital setting.

Much of the book details personal accounts connected with a parish nurse program. The reality-based stories are on target to illustrate the authors' points, especially the challenges presented by the diverse "cultures" in which parish nurses must function. Parish nursing is not a one program fits all enterprise, but must be tailored to the unique setting of each faith community. The book suggests several models which might be utilized in constructing a program.

All in all, this will be a helpful resource. It can be used by those already in the field of parish nursing to enhance their work and to reassure them that the challenges they face are not unique. It would certainly be an excellent source of information for pastoral administrators who may be reluctant to invest time and particularly funds into what seems a redundant and potentially costly venture. It is a much needed addition to the sometimes uneven literature on the subject.