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Books > Medicine > Clinical & internal medicine > Geriatric medicine
For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of ""successful aging"" and ""long life,"" as if both are commodities. In Rethinking Aging , Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making. Over the past decade, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging , Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace. |Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of ""successful aging"" and ""long life,"" as if both are commodities. Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life.
Through their scientific research and clinical practice, husband and wife team Gene D. Cohen and Wendy L. Miller uncovered new clues about how the aging mind can build resilience and continue growth, even during times of grave illness, thus setting aside the traditional paradigm of aging as a time of decline. Cohen, considered one of the founding fathers of geriatric psychiatry, describes what happens to the brain as it ages and the potential that is often overlooked. Miller, an expressive arts therapist and educator, highlights stories of creative growth in the midst of illness and loss encountered through her clinical practice. Together, Cohen and Miller show that with the right tools, the uncharted territory of aging and illness can, in fact, be navigated. In this book, the reader finds the real story of not only Cohen's belief in potential, but also how he and his family creatively used it in facing his own serous health challenges. With Miller's insights and expressive psychological writing, Sky Above Clouds tells the inside story of how attitude, community, creativity, and love shape a life, with or without health, even to our dying. Cohen and Miller draw deeply on their own lessons learned as they struggle through aging, illness, and loss within their own family and eventually Cohen's own untimely death. What happens when the expert on aging begins to age? And what happens when the therapist who helps others cope with illness and loss is forced to confront her own responses to these experiences? The result is a richly informative and emotional journey of growth.
The latest addition to the Evidence-Based Book series, "Evidence-Based Geriatric Medicine" provides non-geriatrician clinicians an overview of key topics central to the care of the older patient. This guide focuses on the management of common problems in the elderly taking into account their life situations as well as treatment of specific conditions. Leading geriatricians with expertise in evidence-based medicine utilize the best available evidence and present this information in a concise, easy-to-use, question-based format. "Evidence-Based Geriatric Medicine" is a unique guide to the optimum management of older patients.
This book offers focused and concise coverage of all issues relating to malnutrition in the field of neurology, and in particular addresses practical aspects of nutritional support from a neurology perspective. In addition to providing basic knowledge on important nutritional concepts (body metabolism, assessment and diagnosis of malnutrition, epidemiology, enteral/parenteral nutrition), detailed information is presented on nutritional support for various neurologic disorders handled in a variety of settings, including the neurointensive care unit. Much consideration is also given to the diagnosis and management of dysphagia, which is a common and highly critical cause of malnutrition in these patients. Finally, the newly developing concept of neuronutrition (or brain foods) - the use of certain nutrients for treatment of neurologic disorders - is discussed. By providing practical solutions to commonly encountered challenges in the nutritional management of neurologic patients, this book will prove a valuable resource for practicing neurologists in a wide variety of fields. It will also be very useful for medical personnel from other specialties such as clinical nutrition, critical care, and geriatric medicine.
This guide is structured to assist physicians in the management of those hypertensive patients who present with specific comorbidities, such as diabetes, systolic dysfunction, obesity, renal disease, or previous cardiac events, often associated with hypertension. The clinical cases contained in this book have been selected to provide a paradigmatic set of scenarios frequently encountered in daily clinical practice, and will serve as an easy-to-access tool in applying general guidelines to individual patients, particularly in the choice of the most appropriate antihypertensive therapy. Treatment of hypertension with associated clinical conditions require specific therapies and combinations of drugs, which are necessarily different from one comorbidity to another. By discussing exemplary cases that may better represent clinical practice in a "real world" setting, and analyzing step by step the diagnostic and therapeutic process, this book will assist cardiologists and physicians in selecting the diagnostic tools and forms of treatment best suited to the individual patient and the particular cardiovascular risk profile.
Geriatric Medicine at a Glance logically presents the core principles of geriatric medicine, including mechanisms of ageing, changes in physiology commonly seen in older adults, and the clinical management and treatment of the key medical presentations affecting older patients. It provides a thorough overview of the essential required core knowledge, mapped to the British Geriatrics Society undergraduate curriculum on ageing. Geriatric Medicine at a Glance: - Is fully aligned with the newly developed British Geriatric Society curriculum on ageing for undergraduate medical students - Explains the relevant concepts associated with ageing in addition to the common medical presentations seen in older adults - Includes the perspective of nurses and other allied health professionals - Features 'best of five' MCQ self-assessment questions Geriatric Medicine at a Glance will help address the uncertainty often experienced by medical students and junior doctors when dealing with older patients.
Life changes dramatically for the entire family when the decision is made to move a person who has dementia from home to community care. Rachael Wonderlin, a gerontologist, dementia care expert, and popular dementia care blogger, helps caregivers cope with the difficult behaviors, emotions, and anxieties that both they and their loved one may experience. Writing from her own practice and drawing on the latest research in gerontology and dementia, Wonderlin explains the different kinds of dementia, details the wide range of care communities available for people who have dementia, and speaks empathetically to the worry and guilt many families feel. "Do not let anyone make you feel like you have taken the 'easy way out' by choosing a dementia care community," she writes. "You are still going to deal with a lot of challenging behaviors, concerns, and questions regarding your loved one's care." When Someone You Know Is Living in a Dementia Care Community is an accessible guide offering answers to such questions as: * How do I choose a place for my loved one to live?* What can I find out by visiting a candidate memory-care community twice?* What do I do if my loved one asks about going home?* How can I improve the quality of my visits?* What is the best way to handle conflict between residents, or between the resident and staff?* How can I cope with my loved one's sundowning?* What do I do if my loved one starts a romantic relationship with another resident? An indispensable book for family members and friends of people with dementia, When Someone You Know is Living in a Dementia Care Community touches the heart while explaining how to make a difficult situation better.
Stroke care has been revolutionised by better prevention, treatment, and more widely available rehabilitation. Nonetheless, stroke remains the second most common cause of death worldwide. This fully-updated new edition provides clear facts and practical advice as to why strokes occur and how they can be prevented in the future. Concise in style but comprehensive in approach, Stroke: The Facts describes the myriad of symptoms, varied presentations, and longer-term consequences of this disabling condition. The journey from treatment through to rehabilitation and preventing a further stroke is made easy by the author, a stroke doctor and researcher involved in many of the studies that have advanced care. Supplemented with case studies, this guide concentrates on developments in treatment, providing an important update on the first edition. It is essential reading for those who have had a stroke or Transient Ischaemic Attack and their families, and will also be of interest to medical professionals working within stroke care.
It's no secret that our population is aging. In fact, it won't be long before one in four drivers will be over the age of 65. Research suggests we'll outlive our ability to drive by almost ten years--but knowing when to stop or limit driving isn't always clear. "The Driving Dilemma" is a comprehensive resource for older drivers and their families facing questions about driving safety. Dr. Dugan provides clear, useful information about the effects of age, medical conditions, and medications on driving. She offers practical advice on how to discuss this issue with loved ones. Such talks can be difficult, and the book provides not only the facts, but also a research-based approach to communication, with useful sample dialogue scripts that will help you discuss driving with your loved ones. Also included are state-by-state listings of available resources, making this book a total information source for families.
For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of ""successful aging"" and ""long life,"" as if both are commodities. In Rethinking Aging, Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making. Over the past decade, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging, Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace.
This clinically focused book provides the essential modalities for managing pain in older patients. Chapters cover a variety of topics important for clinicians, including effective approaches, evaluation, acute and chronic pain, interventional strategies, and addiction issues. Complexities in assessing and treating pain when presented with multiple comorbidities and the unique physical, cognitive, and sensory changes that occur in the elderly are discussed in detail. Practical, concise and authored by leaders in pain medicine, this will serve as an invaluable guide to practitioners that care for older people.
This book discusses all important aspects of emergency medicine in older people, identifying the particular care needs of this population, which all too often remain unmet. The up-to-date and in-depth coverage will assist emergency physicians in identifying patients at risk for adverse outcomes, in conducting appropriate assessment,and in providing timely and adequate care. Particular attention is paid to the commonpitfalls in emergency management andmeans of avoiding them. Between 1980 and 2013, the number of older patients in emergency departmentsworldwide doubled. Compared with younger patients, older people suffer from more comorbidities, a higher mortality rate, require more complex assessment and diagnostic testing, and tend to stay longer in the emergency department. This book, written by internationally recognized experts in emergency medicine and geriatrics, not only presents the state of the art in the care of this population but also underlines the increasing need for adequate training and development in the field.
Preventive Medicine and the disappearance of random causes of death in developed countries have led to ageing populations and the consequent need for radical change in health service provision. This book comes at an opportune time as the old-fashioned National Health Service is reformulated to accord better with medical need, most of which concerns the elderly population that is projected to grow until 2025. Dr Thompsons book offers the modern concept of age change to be due to human development, rather than 'decline' or 'degeneration'. The outmoded idea that a disease is something that you either have or dont have is replaced by the modern concept of homoeostatic disturbance producing changes that are at first insidious and indistinguishable from good health arE one end of the scale, but which later advance across the clinical threshold and produce gross organic disturbance. The main function of the GP lies in his longitudinal relationship with parents, requiring understanding of the diseases of ageing and reducing the rate of pathological change, so preventing as far as possible the need for rehabilitation, the function of the hospital officer.
While modern Americans strive to control nearly every aspect of their lives, many of us abandon control of life's final passage. But the realities of twenty-first-century medicine will allow most of us to have a say in how, when, and where we die, so we need to make decisions surrounding death, too. Or those decisions may be made for us. Threading compelling real-life stories and practical guidance throughout, this book helps readers navigate end-of-life care for themselves and their loved ones. In this practical guidebook, Dr. Dan Morhaim and Shelley Morhaim offer readers hope, empowerment, and inspiration. What we choose for our end-of-life care, they assert, depends on accurate information and on our personal values. We need these not only to understand new medical advances but also to appreciate the wisdom of humanity's past and present. Dan Morhaim, an emergency medicine physician and former Maryland state legislator, guides readers through the medical, legal, and financial maze of end-of-life care. He details the care choices available to patients and explains why living wills and advance directives are a necessity for every American. He tells readers where to find free and readily available living wills and advance directives and why it is so important for everyone-young and old-to complete them. Meanwhile, Shelley Morhaim draws on her experience as a therapeutic music practitioner for hospice and hospital patients to offer compassion to readers facing hard decisions. The authors reflect on a number of timely topics, including * what doctors-including Dr. Morhaim specifically-want for themselves in terms of end-of-life care * how legislative initiatives on assisted dying vary by state * how to obtain medical orders for life-sustaining treatment (MOLST/POLST) * how to deal with dementia * what to expect from palliative and hospice care * how to cope with pain at the end of life, including with medical cannabis and narcotics * how organ donation and body disposition work * how to communicate individual needs to lawyers, physicians, and family members * how to make decisions when selecting the best care for yourself and others and more. Organized as a roadmap that people should follow when they plan end-of-life care and contingencies, this book helps readers keep decisions in their own hands and spare their families the uncertainty and trauma of guessing about their end-of-life wishes. Breaking down the barriers to a difficult but essential topic, Preparing for a Better End helps readers open this often-avoided discussion with their loved ones while providing the information and guidance needed to ensure that deeply held values are reflected and honored. Praise for the Author "In The Better End, Dr. Morhaim helps the reader to see that while death does have its sting, it need not be bitter, and each of us can prepare for the end in better ways."-Maya Angelou "Dan Morhaim's message is a must read for anyone who is facing end-of-life crisis issues and concerns, whether it be for themselves or for a family member or loved one. When so many others shun away from the topic, Dan Morhaim addresses the situation with clarity, insight, and sensitivity."-Montel Williams
Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease quality of life. Unfortunately, Medicare's payment structure and rules deprive the elderly of the chance to pursue less aggressive care, which often yields the most humane and effective results. Medicare encourages and will pay more readily for hospitalization than for palliative and home care. It encourages and pays for high-tech assaults on disease rather than for the primary care that can make a real difference in the lives of the elderly.Lazris offers straightforward solutions to ensure Medicare's solvency through sensible cost-effective plans that do not restrict patient choice or negate the doctor-patient relationship. Using both data and personal stories, he shows how Medicare needs to change in structure and purpose as the population ages, the physician pool becomes more specialized, and new medical technology becomes available. Curing Medicare demonstrates which medical interventions (medicines, tests, procedures) work and which can be harmful in many common conditions in the elderly; the harms and benefits of hospitalization; the current culture of long-term care; and how Medicare often promotes care that is ineffective, expensive, and contrary to what many elderly patients and their families really want.
This state-of-the-art review on longevity focuses on centenarians, studied as a model of positive biology. The extraordinary rise in the elderly population in developed countries underscores the importance of studies on ageing and longevity in order to decrease the medical, economic and social problems associated with the increased number of non-autonomous individuals affected by invalidating pathologies. Centenarians have reached the extreme limits of human life span. Those in relatively good health, who are able to perform their routine daily tasks, are the best examples of extreme longevity, representing selected individuals in which the appearance of major age-related diseases - including cancer and cardiovascular diseases - has been consistently delayed or avoided. The relationship between causality and chance is an open discussion topic in many disciplines. In particular, ageing, the related diseases, and longevity are difficult to define as a consequence of causality, chance or both. Discussing the relevance of these different factors in the attainment of longevity, the book gathers contributions on genetic, epigenetic and phenotypic aspects of centenarians. The "positive biology" approach is applied to clarify the causes of positive phenotypes, as well as to explain the biological mechanisms of health and well-being with the aim of preventing and/or reducing frailty and disability in the elderly.
This comprehensive book presents the latest information on all aspects of the aging skin, including a broad spectrum of the relevant basic science, malignant and non-malignant age-associated diseases and conditions, techniques and methods, toxicological and safety considerations in the elderly, psychological and social issues, ethnicity and gender differences and marketing to the aged. Since the first edition the book has been extensively updated and revised, with the inclusion of many additional chapters that describe the most recent advances in scientific, medical and technical understanding of the aging phenomenon. There is, for example, extended coverage of physiology, description of novel bioengineering methods and tools, detailed consideration of developments in genomics research, and information on new ingredients and products. Textbook of Aging Skin is written by global experts and thought leaders and is intended to serve as the single and complete reference on the subject. It will be of value for dermatologists, gerontologists, toxicologists, biologists and a range of other professionals.
The field of geriatric urology continues to evolve and expand since the publication of the first edition of this book. The second edition of this book builds upon the previous addition and provides an introductory overview of the demographics of our aging population and their unique needs. It also provides an in depth review of urologic conditions and their treatment in the elderly patient population. The second edition also includes new and updated information with regard to management of the geriatric urology patient. Chapters were written by members of the faculty of the University of Pennsylvania. Each faculty member included has specific areas of expertise related to their topics. Primer of Geriatric Urology, Second Edition will be of interest to urologists, residents, fellows and allied health professionals including physician's assistants and nurse practitioners who treat urologic patients. Additionally, this book will also be of interest to primary care providers treating elderly patients.
This book provides a comprehensive and practical guide to orthostatic hypotension (OH) for doctors and nurses involved in the care of older adults, together with a state-of-the-art update on OH, covering its epidemiology, pathophysiology, assessment, diagnosis, causes, prevention, management, and relevance for geriatric practice. In addition, it addresses mechanisms of orthostatic tolerance and other orthostasis related conditions, as well as drugs, comorbidities and geriatric syndromes related to OH. The homeostatic ability to maintain blood pressure while standing requires an adequate blood volume and the integrity of the nervous system, heart, blood vessels and muscle pump. However, in older adults, some age-related factors can contribute to the development of OH. For example, decreased baroreflex sensitivity, -1-adrenergic vasoconstrictor response to sympathetic stimuli, parasympathetic activity, renal salt and water conservation, increased vascular stiffness and decreased ventricular diastolic filling, as well as concentrated capacities of the kidney may be associated with changes in postural blood pressure. It has also been shown that OH is associated with falls, cardiac events, heart failure, stroke, reduced quality of life, and increased risk of overall mortality in these patients. "Orthostatic Hypotension in Older Adults" will be of considerable interest to all professionals working in the fields of geriatrics, geriatric psychiatry, neurology, internal medicine, cardiology, and emergency medicine, or working with older people in hospitals or in their community.
"Lifestyle Matters" is a practical CD-Rom resource that contains a wealth of ideas and activities for occupational therapists, support workers, students and other professionals working with older people in the community. Taking a holistic approach, the Lifestyle Matters programme challenges participants to examine their lifestyle and to make positive changes which promote good physical and emotional health. Themes include: "'The relationship between activity and health " Maintaining mental well-being'; 'Maintaining physical well-being'; Safety in the home and community'; and, Personal circumstances. Each theme is divided into a number of sessions with ideas for introductory activities, group discussion topics and group activity ideas. There are also 64 photocopiable handouts in the book and on the accompanying CD-Rom that can be used within the group sessions. The book is divided into four parts: 'The Lifestyle Matters programme and the principles behind it'; 'How to implement the programme - including who can benefit from it, how long it should last and the resources required'; 'Delivering the programme - looking at session structure, selecting a session and keeping a record of group and individual sessions'; and, 'The Lifestyle Matters manual - each section containing a combination of group sessions, individual sessions and visits or outings'. Inspired by research by Florence Clark and her colleagues at the University of Southern California, this Lifestyle Matters programme has been developed through consultation with older people at every stage, making it a welcome and invaluable resource. As one member of a group exclaimed, 'You didn't give me a new lease of life, you gave me back my life!'. "Lifestyle Matters" is now referred to in the NICE guidelines (2009) where it is identified as the intervention of choice for therapists and professionals responding to the guidance by this professional body.
This CD has been especially compiled from the BBC Sound Archives and contains excerpts of famous radio programme theme tunes from the 1940s and 1950s. Designed to be used as a trigger for reminiscence work with older people, this CD provides a valuable stimulus for conversation. It can also be used for group or individual quiz sessions. These packs provide memorable listening material covering the 1940s and 1950s. Ideal for work on a one-to-one basis, as a starting point for discussion groups and with those with visual disability. Each pack contains a CD and notes for guidance in a storage wallet.
Update your knowledge of mental health services delivery in long-term care settings! Authored by experts in the field of psychology practice in long-term care (LTC), this valuable book is designed to update psychologists and educators on developments in the evolving field of geriatric mental health in LTC settings. The editors and chapter authors are scientist-practitioners who use their expertise to cover applied topics while maintaining high scientific and scholarly standards. The first section of Emerging Trends in Psychological Practice in Long-Term Care examines modifications to traditional psychotherapy techniques that make them more appropriate for long-term care patients, with chapters reviewing: group therapy in long-term care brief psychotherapy for treating depression in patients with dementia the use of autobiographical memory techniques in cognitive-behavioral treatment for depression the treatment of disruptive behaviors in LTC residents The second section covers systematic therapy approaches in LTC settings, with chapters discussing: distinctive family therapy issues in LTC an LTC systems application of behavioral treatment for depression using pleasant events a comparison of patient and staff perceptions of characteristics that contribute to the quality of LTC facilities a multidisciplinary team approach to the treatment of dementia training LTC caregivers in behavioral techniques The third section of this remarkable volume addresses the thorny ethical and legal issues unique to LTC residents, including legal definitions, requirements for obtaining informed consent from LTC patients, and confidentiality dilemmas that are unique to clinical services in long-term care. With helpful charts, tables, and fascinating case studies that illustrate clinical issues, this user-friendly text belongs on the reference shelf of everyone involved in providing mental health services to people in long-term care settings!
Now on CD, you can play tracks in random order and easily repeat each track. This is an easy-to-play game: simply listen to the first few bars of each song and then name that tune! There are 80 different melodies designed to bring back memories and perhaps change the quiz session into a sing-along session.
This book provides basic knowledge and skills for non-dental healthcare practitioners, helping them recognize the importance of oral health, perform initial oral health assessments, consult dentists when necessary, and offer preventive advice and counseling. As people age, they tend to refrain from routine dental care, while the number of consultations with non-dental healthcare providers (physicians, nurses, pharmacists, physician assistants, physical therapists, occupational therapists etc.) increases. However, few healthcare providers are adequately trained to assess oral problems. The relevance of this book is underscored by the recently published European policy recommendations on oral health in older adults by the European College of Gerodontology and the European Geriatric Medicine Society, which highlight the importance of the active involvement of non-dental primary care practitioners in oral health assessment and promotion. These two respected European Societies have identified a significant gap in education, practice and health policies and described the necessary action plans. This book helps to fill the educational gap identified in the recommendations and will be an invaluable tool for all healthcare providers working with older people.
A practical approach for professionals working with people suffering from dementias, this book focuses on dementias, including Alzheimer's disease, from a multi-cultural perspective. |
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