Medical and other professionals with organizations that deal with and fight Alzheimer's disease, as well as authors, editors, and fellow caregivers, all agree that Breaking the Silence is a major source of inspiration and advice. Whether you are a caregiver, a professional dealing with the disease, or just someone who knows a caregiver or who may someday be in this position yourself, Breaking the Silence will provide you with great comfort and wisdom.

"In the busy world of healthcare, one might think that stopping for a time to read a book of poetry might be time better spent 'catching up.' However, among all of the other gems of wisdom found in this book, Frances Kakugawa reminds us of the Japanese saying 'Iso geba maware,' words spoken amazingly on point by a person with advanced Alzheimer's disease, in overhearing a woman tell of spilling a carefully prepared cup of coffee onto her clothes while suddenly rushing to do something else. "Iso geba maware" translates to the equivalent of "when rushing to do something, one travels in a circle, not a straight line." What wonderful advice to give to a busy health care professional. Slow the rush, take the time to hear your patient, reconnect to the healing art of a person-to-person connection, read a section of this book, be reminded of the person inside the patient."

— Patricia Lanoie Blanchette, MD, MPH.
   Professor of Geriatric Medicine
   John A. Burns School of Medicine
   University of Hawai´i at Manoa

"Frances Kakugawa's Breaking the Silence: A Caregiver's Voice is a powerful literary contribution and teaching tool to the field of gerontology. While our Center provides practical training for family caregivers in the mechanics of caregiving - basics in nursing skill-sets, an overview of community services, key definitions and even how to deal with our parents' stuff, there is so much more regarding the burdens, grief, memories and joys that helps us understand and to mend in time. Kakugawa has been among a few (to the best of my knowledge) who have tried to capture the humanities of our afflicted parents suffering from Alzheimer's and ourselves as caregivers in a literary format. I strongly recommend this book to read, laugh, cry and reflect. I would also encourage the promotion of more courses on writing as therapy based upon her work. Her detailed guidelines and recommendations for instructors may hopefully springboard more activity in this still uncharted waters of the humanity of caregiving."

— Cullen T. Hayashida, Ph.D.
   Director, Kupuna (Elder) Education Center
   Kapiolani Community College
   Honolulu, Hawai´i

"If you are not familiar with Johann Sebastian Bach's classical piece 'Air On The G String' then I wholly suggest searching it out, or if you have it find a few moments to settle down, close your eyes, and let the music surround and penetrate you. The piece possesses a sonic beauty that tugs ever so gently upon the heart, satin-soft in its melancholy yet inescapably lifting in its hope and depth. An identical stir from within happens throughout Frances Kakugawa's Breaking the Silence: A Caregiver's Voice.

"A writer can use words to connect with the reader, to attempt to place the proper words in the perfect order, but often the best stories tell themselves and the writer becomes less a presenter and more of a companion, a guide with a gentle hand upon the shoulder. Kakugawa does dignified service to those who have sacrificed years of their lives to take care of loved ones which Alzheimer's disease has attempted to steal. Through poetic example and personal stories imbued with gravitas she captures the struggle for both patients and caregivers.

"I have been blessed—thus far—to not have had any family ensnared by Alzheimer's. I had casual knowledge of it, of what ravages it performs on the human brain. But I never had the slightest notion of what its tendrils do to those closest to the host. Ms. Kakugawa draws distinctly with her pen images from her own experience with her mother, then introduces us to several others who share with us their own raw, intimate experiences as caregivers for their own family members. I could scarcely say that I would have understood the behavior of someone so afflicted before reading Breaking the Silence. Now I understand the profoundly important need for both parties to retain their dignity in the face of such adversity.

"The book's true power comes from Kakugawa and her contributors as they divest themselves of shadows and grief long held from view, and through their own stories and poetry bravely stepping into the light to justly show the rest of us what caring for another person is genuinely about. From their examples and words come the same satin soft ripples upon the soul, joyful even in their melancholy, hopeful in their remembrance, respectful and dignified for posterity and for all mortals with a heart."

— J. W. Nicklaus
The Light, The Dark, and Ember Between

"ADI is the umbrella of all the patient and caregiver associations around the world and that we aim for an improved quality of life of people with dementia and their families. Frances' book is written from the same perspective and therefore I'd like to recommend it."

— Marc Wortmann
   Executive Director of Alzheimer's Disease International

"In our aging society, care is the most necessary resource, and the most precious. Will we find—among us as a society and within us as individuals—sufficient capacity to provide the care that will be increasingly needed by our parents, our spouses, our loved ones? And will we find caregivers for ourselves, privileged as we are to live in a time when dying of chronic, degenerative disease is the norm? Cancer, heart and lung disease, and dementia—these are the main story lines in the last chapter of our lives.

"Poet and teacher Frances H. Kakugawa answers these questions with an echoing, Yes! Breaking the Silence: A Caregiver's Voice is a book of enormous hope and transformation. In it we listen to women and men who have mined the vein of care that lies under the surface of our seemingly narcissistic society. They know that dying, illness, and caregiving are very hard work, and they have discovered that such work can be affirmed by keen observation, self-reflection, and creative written expression. The terrible reality of Alzheimer disease is a crucible where this wisdom is hard won, and Breaking the Silence shows how resilient Alzheimer caregivers quietly are and how far our system of long-term care still has yet to go in order to support both patients and caregivers in a decent and just way.

"The texts in this book are poems, notes, journal entries, and brief commentaries by Kakugawa and five others who have been guided by her in a writing support group process. These texts are intimate, but not idiosyncratic. In them we find facets of a universal human significance—molded by the particular personality, culture, imagination, and sensibility of different individuals. This is a book about what fundamentally matters—the humanity of caring in the face of dependency and mortality, loss and change, holding on and letting go. This book does more than simply ask us to read; it calls us to reflect."

— Bruce Jennings
    Director of Bioethics
   Center for Humans and Nature
   New York, NY

"I was never a fan of poetry; but when I opened Frances Kakugawa's earlier book, Mosaic Moon, and turned randomly to three or four pages, I was drawn in immediately.

Here, in poetry and anecdotes written with five of her fellow caregivers, Frances once again draws the reader in - with sometimes spellbinding honesty, sorrows, and even humor. An old friend and mentor once told me that truly emotionally powerful writing is born only through isolation and great pain. My friend's own great writing seemed to have arisen from being a young man isolated by polio during the London blitz. When my father was fighting a cancer that threatened to move into his brain, he died suddenly one night from heart failure. My friend and teacher comforted me with the words, 'Charlie! That's how I want to go.' My teacher was then at the beginning of his own battle against Alzheimers-like symptoms. He was glad that my father would never know the path on which he was embarking.

"These writers know that path—all of it. However, a reader no more needs to have actually known Alzheimer's in his family than to have lived through the sinking of the Titanic to appreciate Walter Lord, or studied the stars and designed spacecraft to learn from Arthur C. Clarke.

"Among the stand-outs in this book are, 'Symphony of Truth'... 'A Dream'... 'Lesson #2'... 'Option Three'... 'Isogaba Maware'... 'Chocolates for Doris'... 'A Reading Specialist'... 'Nightbook #2'... 'The Ink and the Fury'...

"These are among the nuggets - the truly golden nuggets of insight - you will encounter, and remember."

— Charles Pellegrino
The Last Train from Hiroshima