Alzheimer's is swiftly on the rise: it is estimated that every 67 seconds, someone develops the disease. For many, the words 'Alzheimer's disease' or 'dementia' immediately denote severe mental loss and, perhaps, madness. Indeed, the vast majority of media coverage of Alzheimer's disease (AD) and other types of dementia focuses primarily on the losses experienced by people diagnosed and the terrible burden felt by care partners yearning for a "magic bullet" drug cure. Providing an accessible, question-and-answer-format primer on what touches so many lives, and yet so few of us understand, Alzheimer's Disease and Dementia: What Everyone Needs to Know (R) contributes what is urgently missing from public knowledge: unsparing investigation of their causes and manifestations, and focus on the strengths possessed by people diagnosed. Steven R. Sabat mines a large body of research to convey the genetic and biological aspects of Alzheimer's disease, its clinical history, and, most significantly, to reveal the subjective experience of those with Alzheimer's or dementia. By clarifying the terms surrounding dementia and Alzheimer's, which are two distinct conditions, Sabat corrects dangerous misconceptions that plague our understanding of memory dysfunction. People diagnosed with AD retain awareness, thinking ability, and sense of self; crucially, Sabat demonstrates that there are ways to facilitate communication even when the person with AD has great difficulty finding the words he or she wants to use. From years spent exploring and observing the points of view and experiences of people diagnosed, Sabat strives to inform as well as to remind readers of the respect and empathy owed to those diagnosed and living with dementia. Alzheimer's Disease and Dementia conveys this type of information and more, which, when applied by family and professional caregivers, will help improve the quality of life of those diagnosed as well as of those who provide support and care.

Population aging often provokes fears of impending social security deficits, uncontrollable medical expenditures, and transformations in living arrangements, but public policy could also stimulate social innovations. These issues are typically studied at the national level; yet they must be resolved where most people live--in diverse neighborhoods in cities.

New York, London, Paris, and Tokyo are the four largest cities among the wealthiest, most developed nations of the world. The essays commissioned for this volume compare what it is like to grow older in these cities with respect to health care, quality of life, housing, and long-term care. The contributors look beyond aggregate national data to highlight the importance of how local authorities implement policies.

Population aging often provokes fears of impending social security deficits, uncontrollable medical expenditures, and transformations in living arrangements, but public policy could also stimulate social innovations. These issues are typically studied at the national level; yet they must be resolved where most people live--in diverse neighborhoods in cities.

New York, London, Paris, and Tokyo are the four largest cities among the wealthiest, most developed nations of the world. The essays commissioned for this volume compare what it is like to grow older in these cities with respect to health care, quality of life, housing, and long-term care. The contributors look beyond aggregate national data to highlight the importance of how local authorities implement policies.

A practicing psychoanalyst offers one of the first books to help navigate the profound emotional challenges of caring for elderly parents in a strained parent-child relationship.

The failure of long-term care is the country's best-kept embarrassing secret. Almost every adult in the United States will either enter a nursing home or have to deal with a parent or other relative who does. Studies show that 40 percent of all adults who live to age sixty-five will enter a nursing home before they die, while even more will use another form of long-term care.

Part memoir, part practical guide, part prescription for change, "It Shouldn't Be This Way" is a unique look at the problems of long-term care. Robert L. Kane, a highly experienced physician and gerontologist, and his sister, Joan C. West, tell the painful story of what happened to their mother after she suffered a debilitating stroke and spent the last years of her life in rehabilitation, assisted-living facilities, and finally a nursing home. Along the way, her adult children encountered some professionals who were kind and considerate but also many frustrations--inadequate care and the need to hire private duty aides, as well as poor communication and lack of coordination throughout the system. The situation, they found, proved far more difficult than it needed to be.

As the authors recount their mother's story, they impart various lessons they learned from each phase of the experience. They alert those who are confronting such situations for the first time about what they will likely face and how to approach the problems. Closing with a broader look at why long-term care is the way it is, they propose steps to make necessary reforms, including the development of national organizations to work for change. Their message to families, care professionals, and policy-makers could not be more urgent.

"At present nursing homes are designed . . . like outmoded zoos. Residents are kept in small rooms, emotionally isolated. Occasionally they are visited by family members who reach through the bars and offer them treats. Aides keep their bodies clean and presentable. . . . America invests huge amounts of money to maintain the body while leaving the person to languish, cut off from all they love." From Nobody's Home

After caring for his mother at the end of her life, Thomas Edward Gass felt drawn to serve the elderly. He took a job as a nursing home aide but was not prepared for the reality that he found at his new place of employment, a for-profit long-term-care facility. In a book that is by turns chilling and graphic, poignant and funny, Gass describes America s system of warehousing its oldest citizens.

Gass brings the reader into the sterile home with its flat metal roof and concrete block walls. Like an industrial park complex, it is clean, efficient, and functional. He is blunt about the institution s goal: keep those faint hearts pumping and the life savings and Medicaid dollars rolling in. With 130 beds in the facility, the owner grosses about three million dollars annually. As a relatively well-paid aide, Gass made $6.90 an hour.

Seventeen of the twenty-six residents on Gass s hall were incontinent, and much of his initiation to the work was learning to care for them in the most intimate ways. One of the many challenges was the limited time that he had available for each of his charges 17.3 minutes per day by his calculation. Even as he learned to ignore all but the most pressing demands of the residents, he discovered the remarkable lengths to which aides and their patients will go to relieve the constant ache of loneliness at the nursing home.

With Americans living longer than ever before, elder care is among the fastest growing occupations. This book makes clear that there is a systemic conflict between profit and extent of care. Instead of controlling costs and maximizing profits, what if long-term care focused on our basic need to lead meaningful and connected lives until our deaths? What if staff members dropped the feigned hope of forestalling the inevitable and concentrated on making their charges comfortable and respected? These and other questions raised by this powerful book will cause Americans to rethink how nursing homes are run, staffed, and financed as well as the circumstances under which we hope to meet our end."

Ronald Reagan's daughter writes with a moving openness about losing her father to Alzheimer's disease. The simplicity with which she reveals the intensity, the rush, the flow of her feelings encompasses all the surprises and complexities that ambush us when death gradually, unstoppably invades life.
In "The Long Goodbye, Patti Davis describes losing her father to Alzheimer's disease, saying goodbye in stages, helpless against the onslaught of a disease that steals what is most precious-a person's memory. "Alzheimer's," she writes, "snips away at the threads, a slow unraveling, a steady retreat; as a witness all you can do is watch, cry, and whisper a soft stream of goodbyes."
She writes of needing to be reunited at forty-two with her mother ("she had wept as much as I over our long, embittered war"), of regaining what they had spent decades demolishing; a truce was necessary to bring together a splintered family, a few weeks before her father released his letter telling the country and the world of his illness . . .
The author delves into her memories to touch her father again, to hear his voice, to keep alive the years she had with him.
She writes as if past and present were coming together, of her memories as a child, holding her father's hand, and as a young woman whose hand is being given away in marriage by her father . . . of her father teaching her to ride a bicycle, of the moment when he let her go and she went off on her own . . . of his teaching her the difference between a hawk and a buzzard . . . of the family summer vacations at a rented beach house-each of them tan, her father looking like the athlete he was, with a swimmer's broad shoulders and lean torso.. . . She writes of how her father never resisted solitude, in fact was born for it, of that strange reserve that made people reach for him. . . . She recalls him sitting at his desk, writing, staring out the window . . . and she writes about the toll of the disease itself, the look in her father's eyes, and her efforts to reel him back to her.
Moving . . . honest . . . an illuminating portrait of grief, of a man, a disease, and a woman and her father.

The failure of long-term care is the country's best-kept embarrassing secret. Almost every adult in the United States will either enter a nursing home or have to deal with a parent or other relative who does. Studies show that 40 percent of all adults who live to age sixty-five will enter a nursing home before they die, while even more will use another form of long-term care.

Part memoir, part practical guide, part prescription for change, "It Shouldn't Be This Way" is a unique look at the problems of long-term care. Robert L. Kane, a highly experienced physician and gerontologist, and his sister, Joan C. West, tell the painful story of what happened to their mother after she suffered a debilitating stroke and spent the last years of her life in rehabilitation, assisted-living facilities, and finally a nursing home. Along the way, her adult children encountered some professionals who were kind and considerate but also many frustrations--inadequate care and the need to hire private duty aides, as well as poor communication and lack of coordination throughout the system. The situation, they found, proved far more difficult than it needed to be.

As the authors recount their mother's story, they impart various lessons they learned from each phase of the experience. They alert those who are confronting such situations for the first time about what they will likely face and how to approach the problems. Closing with a broader look at why long-term care is the way it is, they propose steps to make necessary reforms, including the development of national organizations to work for change. Their message to families, care professionals, and policy-makers could not be more urgent.

Ten percent of the Texas population is 65 and older. The state has a large, rapidly growing elderly population, estimated to reach 4.4 million, or 16.1% of the state's total population in 2025. Medicaid spending for long-term care in FY2001 was $3.3 billion -- 28.5% of all Medicaid spending. Medicaid spending for institutions was more than 70% of Medicaid long-term care spending and more than 20% of all Medicaid spending in F Y2001. Spending for home and community-based services has increased rapidly in recent years and represented 29.2% of Texas long-term care spending in FY2001, primarily due to increased use of the Medicaid Section 1915(c) home and community based waiver program. From FY1990 to FY2001 spending for this program increased from less than 1% to over 21% of all Medicaid long-term care spending in Texas. Texas provides a wide range of services in the home and community to about 100,000 adults with disabilities. Despite this, the state has significant overcapacity in its nursing home industry. As a result, the nursing home occupancy rate is quite low -- 68.5% in 2000. The state continues to serve many persons with developmental disabilities in large state institutions and has no plans to close any facilities in the foreseeable future. Interviews with state officials and a review of state reports highlighted a number of issues including: an imbalance in Medicaid financing favoring institutional care, rather than home and community-based care; a shortage of frontline long-term care workers; and waiting lists for home and community-based services.

Health promotion makes an important contribution to the knowledge and understanding of the health and well-being of older people. This new book focuses on a range of issues which underpin older people's health and identifies ways health can be promoted. It reviews lifestyles, psychological well-being, a creative look at citizenship, grief, sexuality and travel health. Other specific areas include accident prevention, residential homes and productive ageing. Promoting the Health of Older People includes a helpful summary of the steps that can be taken to promote older peoples' health and well-being. It is recommended reading for advanced undergraduate and postgraduate students of medical sociology, social work, nursing and health studies. Its focus on practical health promotion also makes it relevant to health and social welfare professionals working with older people.

Intermediate care has become a buzzword within health and social care over the last few years. Seen as the panacea for a number of woes, particularly for older people, intermediate care has been held up as a way forward within contemporary health and social care.

This text explores in detail what is understood by the concept of intermediate care and, in particular, ways in which the needs of older people can be best met by this new range of services. Initial discussion centres on the concept of intermediate care and the motives for its development. This is followed by a summary of the range of intermediate care services that have been developed, with a discussion of some of the confusion that surrounds the concept.

The debate then moves on to centre on older people, discussing first why older people have come to be perceived as one of the main client groups that may benefit from intermediate care, and then how intermediate care could be developed to better serve their needs. An overview of ageing and the uniqueness of older people is then provided, followed by an exploration of some of the challenges faced by older people within society - and how this has extended into the delivery of health and social care.

TThe recent growth of "assisted living" facilities and programs has shaken the foundations of the system of long-term care for the elderly in the United States. Fueled by consumer frustrations with the available options, notably nursing homes, the assisted living model emerged during the 1990s to promise shelter, health care, control of one's own life, less government involvement, and a "real home." But how well have the advocates and developers of assisted living delivered on such promises? And what are the model's implications for public policy and the future of caregiving?

In "Reinventing Care," David Barton Smith offers brilliant insights into those questions by examining the realities of assisted living in New York City. Encompassing the largest, most concentrated population of elderly in the United States, New York spends more per person caring for its seniors than any other urban center. Yet, while the size of the city's care system boggles the mind, it nevertheless contains the same elements that exist in other metropolitan areas and thus provides valuable lessons for the nation as a whole.

Smith's study draws on twenty-five years of research, including hundreds of interviews and visits to representative facilities. He provides a succinct overview of how care is presently organized for New York's aging population and traces the history of the system up to the present. Among the key issues he addresses are the role of market forces and government regulation, the impact of class differences on access to quality care, and the ways in which perceptions of community affect the creation and management of assisted living programs. At the heart of the book are ten fascinating case studies, half of them focused on private-pay facilities and the other half on public-pay institutions.

While finding that the actualities of assisted living rarely match the rhetoric of its proponents, Smith sees much to admire in its goals. He suggests tactics and strategies--such as promoting family- and community-based models of assisted living and adopting a standard of licensure for certain facilities--that could point the way to a better future.

The recent growth of "assisted living" facilities and programs has shaken the foundations of the system of long-term care for the elderly in the United States. Fueled by consumer frustrations with the available options, notably nursing homes, the assisted living model emerged during the 1990s to promise shelter, health care, control of one's own life, less government involvement, and a "real home." But how well have the advocates and developers of assisted living delivered on such promises? And what are the model's implications for public policy and the future of caregiving?

In "Reinventing Care," David Barton Smith offers brilliant insights into those questions by examining the realities of assisted living in New York City. Encompassing the largest, most concentrated population of elderly in the United States, New York spends more per person caring for its seniors than any other urban center. Yet, while the size of the city's care system boggles the mind, it nevertheless contains the same elements that exist in other metropolitan areas and thus provides valuable lessons for the nation as a whole.

Smith's study draws on twenty-five years of research, including hundreds of interviews and visits to representative facilities. He provides a succinct overview of how care is presently organized for New York's aging population and traces the history of the system up to the present. Among the key issues he addresses are the role of market forces and government regulation, the impact of class differences on access to quality care, and the ways in which perceptions of community affect the creation and management of assisted living programs. At the heart of the book are ten fascinating case studies, half of them focused on private-pay facilities and the other half on public-pay institutions.

While finding that the actualities of assisted living rarely match the rhetoric of its proponents, Smith sees much to admire in its goals. He suggests tactics and strategies--such as promoting family- and community-based models of assisted living and adopting a standard of licensure for certain facilities--that could point the way to a better future.

Given the impact that good nutrition and keeping fit have on health and well-being in later life, WHO, in collaboration with the Tufts University USDA Human Nutrition Research Center on Aging, organized a consultation to review the scientific evidence linking diet and other factors - especially exercise - affecting nutritional status, disease prevention and health promotion for older persons. The consultation focused primarily on practical issues, including the establishment of explicit recommendations to improve the health and nutritional status of older persons in a wide variety of socioeconomic and cultural settings. During the production of a comprehensive report, representing the outcome both of the preparatory work and of the consultation itself, it was recognized that new information emerging in several key areas should also be included. The combined results presented here are intended as an authoritative source of information for nutritionists, general practitioners, gerontologists, medical faculties, nurses, care providers, schools of public health and social workers.The specific recommendations concerning nutrient intakes, food-based dietary guidelines, and exercise and physical activity should also interest a larger audience, including the general reader. The main body discusses the epidemiological and social aspects of ageing, health and functional changes experienced with ageing, the impact of physical activity, assessment of the nutritional status of older persons, and nutritional guidelines for healthy ageing. Additional material covers food-based dietary guidelines for older adults - with particular emphasis on healthy ageing and prevention of chronic noncommunicable diseases - and guidelines for promoting physical activity among older persons. "...This report is significant, representing an authoritative consensus related to the epidemiological and social aspects of ageing, health and functional changes experienced with age, and the impact of physical activity. This valuable source of information is relevant to a wide range of health professionals; the clear and specific recommendations concerning food/nutrient consumption and physical activity for older adults should also interest a larger audience."- The Journal of the Royal Society for the Promotion of Health "...The book is a timely publication, which provides an exhaustive review of studies...This publication will certainly serve as a reference manual for all those involved in nutrition, gerontology and geriatrics. " - Indian Journal of Medical Research

The government's NHS Plan emphasises the importance of services based on users' views. This highly topical report provides practical guidance on how to ensure that older people's views are heard and acted on, and their views monitored, in relation to service quality. Quality at home for older people: provides new information on the definition of quality in home care services by service users both under and over 80 years of age; identifies users' priorities for the first time; shows the differences and similarities in the perceptions of quality between white and minority ethnic service users; compares different methods of obtaining service users' views; makes recommendations for ways of ensuring that listening to older people's views on quality becomes part of the mainstream process of purchasing and providing quality home care services. This report will be invaluable for policy makers, home care service managers and providers, and service users and voluntary organisations concerned with ensuring that service users' voices are listened to. It will also be of interest to academics and students on nursing, social care, social work and social policy courses.

Easing the Way to a New Stage in Life..

Placing a loved one in a nursing home is a difficult thing to face. In addition to choosing a home, figuring out finances, and dealing with the actual moving, you may also be struggling with deeper conflicts. The emotions you may feel—of guilt, sadness, anger, and even relief—are never predictable, and can sometimes cause confusion. This invaluable book helps to ease this process, opening the channels of communication for all concerned. By examining the experience of nursing home care from all perspectives, including those of families, caregivers, and the residents themselves, everyone can learn to cope with this new situation. The Nursing Home Decision offers effective advice and empathic reassurance for managing one of life's most difficult transitions, allowing everyone to learn and grow from this new experience.

* If most older people want to remain in their own homes, then why does residential care persist? The authors of this timely book set out to answer this pressing question and offer an explanation as to what makes older people give up their homes. Residential care homes provide accommodation for over 300,000 older people in the UK, the majority of whom are in their mid eighties. More than a quarter of the population over eighty five live in institutional settings, most of them in residential care homes. This book offers readers a comprehensive review of the history of residential care, current provision, current practice and an analysis of its future role. Re-Evaluating Residential Care will be invaluable to a wide range of practitioners involved in residential care, as well as students of nursing, social work, gerontology and social policy.

*Why do many older people rate their health as good when 'objective' evidence suggests that old age is a time of inevitable decline and disease? *How do different perspectives on health inform our understanding of health in old age? *What are the policy implications for ensuring a healthy future for old age? This book addresses important questions which existing literature on health and old age has largely ignored. By juxtaposing detailed case histories and first person accounts from older people with 'official statistics' on the health of 'the elderly' it explores the myths and tries to unpick the mysteries which surround the subject of health in later life. It goes on to explore the implications of these myths and mysteries for the way individual older people manage their health. It looks at the resources and social support available to them as well as the implications for public policy provision. The book ends by exploring the problems and possibilities of ensuring a healthy future for old age. It will be essential reading for reflective practitioners and for anyone concerned with new developments in the fields of ageing, social policy and health.

What are the issues underpinning the trend towards innovation in the community care of older people? What is the nature of the innovation: how is it experienced by older people and their carers? "Changing services for older people" sets out to address these pressing questions. It presents the findings of a major research project evaluating the outcomes of the Neighbourhood Support Units innovation in Sheffield. Key issues raised include the goal to create more flexible 'tailor made' services and the promotion of user-and carer-responsive forms of provision, shifts which are occurring in many other European countries.;The aims of the book are two-fold. First, it reports on the outcomes of the initiative for older people and their carers placing these findings in the context of current debates about community care. Second, it discusses the process of innovation in the social services, drawing on evidence gathered from policy-makers, managers and front-line workers to illustrate both the barriers to change and the ways in which successful innovation can be accomplished.; "Changing services for older people" will be invaluable to personnel in the health and social services who are consi

Given medical advances and greater understanding of healthful living habits, people are living longer lives. Proportionally speaking, a greater percentage of the population is elderly. Despite medical advances, there is still no cure for dementia, and as elderly individuals succumb to Alzheimer's Disease or related dementia, more and more people are having to care their elderly parents and /or siblings. Profiles in Caregiving is practical source of information for anyone who teaches caregiving, acts as a caregiver, or studies caregiving.
This book discusses recent research on stress factors associated with caregiving, and what factors impact on successful versus non-successful adaptation to the care-giving role. This is an expanding field in gerontology, and is also of interest to personality and social psychologists studying stress and interpersonal relations. Although there are many books on the cause and treatment of dementia, there has been a book that provides a research investigation into the factors associated with effective caregiving to dementia patients.
Key Features
* Conceptualizes caregiving as a multistage career whose impact on the caregiver continues to be felt after in-home care has ceased
* Based upon a longitudinal survey of a demographically diverse sample of principal caregivers over a three-year period
* Identifies caregivers who are most at-risk for adverse adaptation to the role
* Describes preventative and clinical intervention strategies
* Identifies post-care risk and issues
* Identifies antecedents to successful adaptation
* State of the art analytic techniques
* Graphic presentation of empirical findings
* Renowned multidisciplinary research team

Ageing has traditionally been seen as ubiquitous decline - all 'doom and gloom'. The Psychology of Growing Old challenges this view and shows how our own attitudes and values may serve to perpetuate it. The book uses the research literature of gerontology - the multidisciplinary study of ageing and later life - to involve the reader in considering his or her own future and that of others. It examines the potential that ageing and later life have to be a rewarding experience - something to look forward to - rather than something to be denied and rejected. Unlike other books in the area, The Psychology of Growing Old places the reader centre stage as someone who can influence the future of ageing. It will be of interest to a wide range of professionals in health and social services who work with older people; and relevant to many student courses with ageing as a focus, whether in psychology, sociology, nursing, gerontology, social work or the medical professions.

OVER 1,000 SOURCES OF FREE DOLLARS AND ASSISTANCE FOR SENIORS

Millions of dollars of services are available to help seniors and their caregivers get the top quality care they need for free or at a minimal cost. Many people with needs just like yours are already receiving free money and services for medical treatment, meals, long-term specialized care, and at-home assistance. But in order to get these benefits, you have to locate and tap into the government, community, and private agencies that offer them.

Leading free money expert Laurie Blum shows you how to navigate the bureaucratic maze. She provides:

• Over 1,000 sources of free financial aid, complete with contact names, addresses, and phone and fax numbers
• Listings of hundreds of government, community, and private organizations that provide nonfinancial assistance
• Clear step-by-step instructions for assessing your needs, evaluating services, working with caregivers, and making legal arrangements
• Smart ways to choose at-home and alternative housing for self-sufficient seniors or those needing special care

In the first geographic and environmental analysis of the recreational and retirement community industry, Hubert B. Stroud shows how and why certain communities had positive impacts on the surrounding region while others did not. Focusing on well-known developments in Arizona, New Mexico, Florida, Arkansas, and Tennessee, he finds that most developments were poorly planned, resulting in environmental damage, overtaxing of public services, and social and economic problems. Yet Stroud acknowledges that future development is inevitable, as recreational and retirement communities continue to lure urban America with the promise of paradise.