In the 21st century, people in the developed world are living longer. They hope they will have a healthy longer life and then die relatively quickly and peacefully. But frequently that does not happen. While people are living healthy a little longer, they tend to live sick for a lot longer. And at the end of being sick before dying, they and their families are frequently faced with daunting decisions about whether to continue life prolonging medical treatments or whether to find meaningful and forthright ways to die more easily and quickly. In this context, some people are searching for more and better options to hasten death. They may be experiencing unacceptable suffering in the present or may fear it in the near future. But they do not know the full range of options legally available to them. Voluntary stopping eating and drinking (VSED), though relatively unknown and poorly understood, is a widely available option for hastening death. VSED is legally permitted in places where medical assistance in dying (MAID) is not. And unlike U.S. jurisdictions where MAID is legally permitted, VSED is not limited to terminal illness or to those with current decision-making capacity. VSED is a compassionate option that respects patient choice. Despite its strongly misleading image of starvation, death by VSED is typically peaceful and meaningful when accompanied by adequate clinician and/or caregiver support. Moreover, the practice is not limited to avoiding unbearable suffering, but may also be used by those who are determined to avoid living with unacceptable deterioration such as severe dementia. But VSED is "not for everyone." This volume provides a realistic, appropriately critical, yet supportive assessment of the practice. Eight illustrative, previously unpublished real cases are included, receiving pragmatic analysis in each chapter. The volume's integrated, multi-professional, multi-disciplinary character makes it useful for a wide range of readers: patients considering present or future end-of-life options and their families, clinicians of all kinds, ethicists, lawyers, and institutional administrators. Appendices include recommended elements of an advance directive for stopping eating and drinking in one's future if and when decision making capacity is lost, and what to record as cause of death on the death certificates of those who hasten death by VSED.

Ageing populations mean that palliative and end of life care for older people must assume greater priority. Indeed, there is an urgent need to improve the experiences of older people at the end of life, given that they have been identified as the 'disadvantaged dying'. To date, models of care are underpinned by the ideals of specialist palliative care which were developed to meet the needs of predominantly middle-aged and 'young old' people, and evidence suggests these may not be adequate for the older population group.
This book identifies ways forward for improving the end of life experiences of older people by taking an interdisciplinary and international approach. Providing a synergy between the currently disparate literature of gerontology and palliative care, a wide range of leading international experts contribute to discussions regarding priority areas in relation to ageing and end of life care. Some authors take a theoretical focus, others a very practical approach rooted in their clinical and research experience. The issues covered are diverse, as are the countries in which discussions are contextualised. Those working in both palliative care and gerontology will find the issues and advice discussed in this book hugely topical and of real practical value.

Reingard Lange beleuchtet vier Bereiche der sozialen Vernetzung bei Menschen mit beginnender Demenz: im engsten sozialen Umfeld, zusammen mit Profis bzw. Hilfeorganisationen, im Gemeinwesen und mit anderen gleichermassen Betroffenen. In Gruppengesprachen beschreiben Menschen mit beginnender Demenz und Angehoerige die Veranderungen, die die Erkrankung mit sich bringt und die Bedeutung der Vernetzung als Ressource. In der Auswertung der Gesprache werden Spannungsfelder und hilfreiche Differenzierungen erkennbar. Die Studie gibt praxistaugliche Handlungsempfehlungen, wie Vernetzung als Zusammenleben und Zusammenwirken von und fur Menschen mit Demenz und ihre Angehoerigen gestaltet werden kann.

The population is ageing, and most cardiovascular diseases are more common in older people. Older people often present atypically, have multiple co-morbidities, and are vulnerable to therapeutic delays or errors. The healthcare needs of the elderly differ from those of younger patients and are more complex, related to the physical and psychological changes associated with ageing and other disease processes in the elderly population. In addition, the response to treatment may alter with ageing, yet many elderly patients with cardiovascular disease are not looked after by specialists. Cardiovascular Disease in the Elderly provides user-friendly advice in a field that has limited evidence but contributes significantly to the workload not only of cardiologists but also of elderly care physicians and general practitioners. It reflects current UK and international guidelines and provides key evidence based references. Wherever possible, published guidelines are incorporated to ensure the book reflects current recommended management. It indicates where practice differs from that of younger adults, and provides guidance on the ethical and clinical dilemmas particular to the elderly. The handbook covers many aspects of cardiovascular disease in the elderly and focuses on common problems, including heart failure, atrial fibrillation and isolated systolic hypertension.

In the 7 years since the first edition of Clinical Manual of Geriatric Psychopharmacology was published, dozens of new drugs have been released, and older medications have been marketed in different formulations. In addition, research on pharmacokinetics, pharmacodynamics and mechanism of action, potential interactions, and other critical topics has proceeded apace, rendering much of the information in existing guides obsolete. This new volume is both comprehensive and completely up to date, offering information unavailable elsewhere.

- New drugs covered include asenapine, paliperidone, iloperidone, lurasidone, desvenlafaxine, vilazodone, long-acting trazodone, milnacipran, armodafinil, extended-release valproate, rotigotine transdermal, tetrabenazine, dextromethorphan, long-acting gabapentin, and transdermal buprenorphine.- Each chapter has a standardized format, with topics including pharmacokinetics, pharmacodynamics and mechanism of action, drug interactions, clinical use (which addresses choice of drug, alternative formulations/routes, pre-treatment evaluation, dose and dose titration, PRN use, monitoring treatment, drug levels, managing treatment resistance, switching drugs, duration of treatment, discontinuation, and overdose), adverse effects, and treatment of selected syndromes and disorders.- Dozens of tables, boxes, and figures organize and present complex material, such as practice guidelines, in a straightforward manner that is easy to understand and apply, and the concise, bulleted text facilitates reading and comprehension in the clinical setting.- "Specific Drug Summaries" -- one-page summaries of prescribing information for individual drugs -- provide fast access to critical information in a simple format.

Designed for residents, fellows, and all clinicians in psychiatry and medicine who diagnose and treat psychiatric and neuropsychiatric conditions affecting geriatric patients, this clinical reference can be used across all treatment settings (inpatient, outpatient, day hospital, consultation, and nursing home). Meticulously referenced and grounded in the latest research, Clinical Manual of Geriatric Psychopharmacology, Second Edition, is the definitive guide to psychotropic use in elderly patients. Clinicians can rely confidently on its up-to-date coverage and authoritative counsel.

Die Autoren stellen eine Untersuchung der Bedarfslagen von Menschen mit Demenz (MmD) vor, die eine umfangreiche Analyse von Behandlungsdokumenten gerontopsychiatrischer Patienten, Experteninterviews sowie eine Befragung von einweisenden Hausarzten umfasst. Haufig liegt der Schwerpunkt der sozialen, pflegerischen und/oder medizinischen Bedarfslagen an der ambulant-stationaren Schnittstelle. Die genannten Aspekte bilden in ihrer Komplexitat und ihrem Zusammenspiel das dynamische Konzept der Dementia Care Sensitive Demands (DCSD). Dieses Konzept kann Akteuren verschiedener Berufe, die an der Versorgung von MmD beteiligt sind, eine strukturierte Analyse der Bedarfe und ihres komplexen Zusammenwirkens ermoeglichen und eine multiprofessionelle Zusammenarbeit darstellbar machen.

This book describes the changes in the brain and in cognitive functions that occur with aging in the absence of a neurological, psychiatric, or medical disease. It discusses aging-related changes in many brain functions, including memory, language, sensory perception, motor function, creativity, attention, executive functions, emotions and mood. The neural mechanisms that may account for specific aging-related changes in cognition, perception and behavior are explored, as well as the means by which aging-related cognitive decrements can be managed and possibly ameliorated. Consequently, this book will be of value to clinicians, including neurologists, psychiatrists, geriatricians, primary care physicians, psychologists and speech-language pathologists. In addition, researchers and graduate students who want to learn about the aging brain will find this an indispensable guide.

Older people have complex and unique primary care needs. The frequent occurrence of co-morbidities, polypharmacy, psychological, social and functional impairments can impact on the way problems present making the diagnosis and treatment more challenging for the primary care physician. The provision of healthcare is becoming more community-based and national service frameworks have highlighted the special healthcare needs of older people. This means that treating older patients will become an even larger proportion of the daily work of the general practitioner. Packed full of practical and down to earth advice for clinicians specialising in the care of older people, this book examines real problems that present on a day-to-day basis in the primary care environment. It provides GPs with specific advice and guidance to help them in the management of the often complex conditions that present in older people. Written by practising clinicians who are experts in the field, this book covers a diverse range of subjects from stroke medicine to incontinence to the role that the voluntary sector plays in the care of older people. It includes clinical case scenarios throughout and colour photographs in chapters on areas such as ophthalmology and dermatology enable readers to effortlessly understand the points being made. Easy to read and with most chapters co-authored by a specialist and a general practitioner, this book provides GPs, community and practice nurses, and those specialising in the care of older patients with an indispensable resource they can use to find practical advice from specialists in the field, including tips on differential diagnosis and summaries of the existing evidence-base and guidelines on treatment.

Dementia can be a distressing condition, for the sufferer, and for families and other carers. Management of dementia is never easy, and involves facing some unpleasant problems and difficult choices. The right approach and expertise can minimise the unpleasantness and make dementia manageable, while inexperienced or inexpert management has the potential to cause unnecessary distress and disability, mis-directed resources, frustrated care staff, unduly long periods spent in hospital and premature care home placement.
Dementia Care is a practical manual for health and sociacare professionals in their encounters with people with dementia. It covers a wide range of information in a short, easily-accessible handbook format and broadly follows the journey of a person with dementia from first presentation to health or social services, through problems and their management, to the final stages of the illness. The book is rooted in the extensive experience of the authors in managing dementia in the community, in hospital and care homes and hopes to make the necessary expertise available and accessible in a form that will be useful to the whole range of medical, health and social care staff looking after people with dementia and their families.

Wie geht es dir - Wie geht es mir: Rat und Tat fur pflegende Angehoerige mit empathischen und leicht verstandlichen Antworten auf die wichtigsten Fragen. Die Autorin kennt die Probleme und Fragen durch ihre jahrelange Tatigkeit als Leiterin von Angehoerigenkursen. Praxisnah erlautert sie die pflegerischen Grundlagen wie Grundpflege, Ernahrung, Lagerung, Krankenbeobachtung, Vorbeugung vor Zweiterkrankungen, Dekubitus- und Wundversorgung etc. Zusatzlich gibt sie Tipps zur Pflege und zum Umgang mit dem MDK, ambulanten Pflegediensten und anderen Dienstleistern. Das Pflegewissen ist in kurzen Checklisten zusammengefasst. Im praktischen Anhang: Adressen von Selbsthilfegruppen, Formulare und ein Lexikon medizinischer und pflegerischer Fachbegriffe.

Martina Bogensberger rekonstruiert die Erfahrungsraume der Mitarbeiter und Mitarbeiterinnen in der mobilen Pflege mit Personen mit Demenz anhand der dokumentarischen Methode nach Ralf Bohnsack. In funf Gruppendiskussionen werden die Handlungspraktiken im Arbeitsalltag des Pflegepersonals dargestellt. Die Haupttypologie "Vom Phantom zur Mutter" zeigt die Interaktionsmuster der Pflegenden. Die Ergebnisse machen deutlich, dass die Arbeit mit Angehoerigen von Personen mit Demenz fur die betreuenden Personen eine UEberforderung darstellt und eine personelle Trennung von Pflegetatigkeiten und Angehoerigenarbeit erforderlich ist. Sowohl fur den Wissenstransfer von Fortbildungsinhalten in die alltagliche Arbeit als auch fur die Fursorge der betreuenden Mitarbeiter und Mitarbeiterinnen sollte eigenes Personal bereitgestellt werden.

Although the perceptions and realities of ageing have changed markedly over the last few decades, for practitioners working with older people, emotional problems remain a major factor of health and happiness in later life. This handbook provides a concise, authoritative and up to date guide to best practice in therapy for older people, for a wide range of mental health professionals.
The editors bring together chapters by experienced trainers and clinicians that cover all the significant problems and issues in the assessment and treatment of emotional disorders in later life. The introductory chapters examine the individual, social, cultural and physical experience of ageing, and provide an essential background for a caring and professional understanding of related emotional disorders and their effective treatment. Throughout the book, key research and clinical experience is reported as underlying evidence based treatment, but the emphasis is on practical guidance for assessment and interventions, rather than detailed discussion of methodological issues. With each chapter written by a specialist in their field, a range of expertise is provided in a single source, making this book an invaluable resource for anyone dealing with the mental health needs of older people.

Pain in later life is both quite common and disabling, and it differs significantly in terms of its aetiology, diagnosis and treatment from pain in the general adult population. Older people often have complicated co-morbidities, have a high prevalence of mental health problems (e.g. anxiety, cognitive impairment, and depression) and respond to treatment in different ways compared to younger people. Their specific needs are rarely discussed specifically in more general texts.
Part of the "Oxford Pain Management Library," this pocketbook will serve as a concise companion for healthcare professionals who manage older patients suffering with pain. Concise chapters will summarize up-to-date reserach literature in a practical style that will have direct relevance to busy clinicians. Introductory chapters will include the epidemiology of pain in older people as well as the proper assessment of older patients with pain conditions. Later chapters will focus on specific painful conditions common in the elderly, including arthritis and rheumatism, osteoporosis, abdominal pain, and cancer.
The book will appeal to a wide variety of health care professionals in both primary care and secondary care services such as geriatric medicine, rheumatology, orthopedics, surgery, pain management and palliative medicine. The book will also be of relevance to nurses, physiotherapists, occupational therapists, clinical psychologists, pharmacists and other health care providers.

Doris Eglseer untersucht den Zusammenhang zwischen Sarkopenie und dem Ernahrungszustand alterer Menschen (60+). Sarkopenie stellt mit Pravalenzzahlen von bis zu 85 % eines der bedeutendsten geriatrischen Syndrome und eine der haufigsten Ursachen fur verminderte Mobilitat, erhoehte Pflegebedurftigkeit und reduzierte Lebensqualitat bei alteren Menschen dar. Im Rahmen der vorliegenden Arbeit wurde eine systematische Literaturrecherche in Datenbanken und Suchmaschinen durchgefuhrt. Nach Auswertung der Literatur kann festgehalten werden, dass Sarkopenie und ein schlechter Ernahrungszustand - im Sinne von Mangel- und Unterernahrung - bei einem Grossteil der Betroffenen gleichzeitig vorliegen.

Die Gedachtnistrainerin Annemarie Frick-Salzmann beschreibt, wie unser Gedachtnis funktioniert und welche Gehirnregionen fur einzelne Gedachtnissysteme relevant sind. Sie beantwortet oft gestellte Fragen wie z.B. "Wie sehr koennen wir uns auf unsere Erinnerungen verlassen? Was koennen Ursachen fur falsche Erinnerungen sein? Warum haben Vergessen und Gedachtnispannen auch positive Seiten?" Gut nachvollziehbar widerlegt sie das Vorurteil uber die Vergesslichkeit alternder Menschen. Sie gibt dem Leser Hinweise zum Lernen und Informationen anhand ausgewahlter Texte zu Gehirnregionen und Funktionssystemen. Die Autorin stellt komplexe Sachverhalte einfach und verstandlich dar und zeigt, dass wir uns dank der Plastizitat unseres Gehirns neuen Situationen anpassen und bis ins hohe Alter lernen koennen.

This book aims to be a single point of reference for advances in the care of geriatric populations across medical and surgical specialties. The aging population is a unique demographic with its own health challenges. Geriatricians are specifically trained to address these challenges but few medical students or residents enter geriatrics, even as the demand for geriatric expertise increases. The practices of many medical and surgical specialists are dominated by older patients who may themselves see many specialists but rarely visit geriatricians. This updated edition elucidates the most common medical conditions seen in aging patients and translates approaches to those conditions for physicians across specialties. Divided into three sections that assemble crosscutting issues, medical specialties, and surgical and related specialties, this book serves as a guide for clinicians of all backgrounds who will work with older patients as the demographic ages further. This second edition of Geriatrics for Specialists expands the number of specialist chapters to reflect growth in research in aging and clinical care for older people in dermatology, plastic surgery, and behavioral neurology. All original chapters from the first edition are extensively revised and updated to reflect the rapid growth of new knowledge in the field.

Candidates can prepare with confidence for the Geriatric Medicine Specialty Certificate Examination with this revision guide designed specifically for the exam. Containing 300 Best of Five questions, the content is carefully mapped to the curriculum ensuring comprehensive preparation. The questions mirror the format of those candidates can expect to find in the exam, and cover all of the key topics, including dementia and delirium, palliative care, nutrition, and stroke. Explanatory answers include references to guidelines and other sources to enable further reading and study. The second edition addresses the latest clinical guidelines and supporting literature, Non-vitamin K Antagonist Oral Anticoagulants (NOACs), and changes in health and social care policy. This new edition is also suitable for candidates preparing for the Diploma in Geriatric Medicine exam. Providing a thorough assessment of the reader's geriatric medicine knowledge, this is the only revision guide candidates will need to pass the Geriatric Medicine Specialty Certificate Examination first time.

In an ageing world, the delivery of psychogeriatric services in an effective and efficient manner is an increasing concern for health service providers and administrators in both developed and developing countries. Despite awareness of the anticipated mental health needs of the ageing population, services for older people have been slow to develop in many places, and in some places do not exist at all. This volume brings together the theory and practice of psychogeriatric service delivery from an international perspective. It examines the range of different service models, perspectives and ideas with the evidence-base for each, providing a unique resource for those planning and administering psychogeriatric services. The first section of the book discusses the theory behind psychogeriatric service delivery, including its history, service delivery principles, needs analysis, population-based service planning, economics and funding, and evidence-based service delivery. Section two concentrates on practice, describing examples of service delivery from a number of European, American, African, Asian and Australasian settings. The third section focuses on solutions, evaluating the range of delivery settings and considering the needs of both consumers and carers.

Der vorliegende Themenband hat sich zum Ziel gesetzt, aktuelle wissenschaftliche Erkenntnisse zur Laufbahngestaltung in der Pflege zusammenzufuhren, Praxisentwicklungen zu dokumentieren und zu analysieren und weitergehende Perspektiven der Kompetenzentwicklung in der Pflege zu diskutieren. Das Entwicklungspotential von innerbetrieblichen Laufbahnpfaden, insbesondere in der Altenpflege, wird vor dem Hintergrund begrenzter Tatigkeitsdauern und des Nachwuchskraftemangels kritisch reflektiert und Gestaltungsoptionen auf der individuellen und der betrieblichen Ebene diskutiert.

Straffalligkeit alterer Menschen Das erste systematische und umfassende Buch ausschliesslich zur Straffalligkeit alterer Menschen im deutschsprachigen Raum. Zu aktuellen Fragen rund um das Thema "Seniorenkriminalitat" werden durch jeweils einschlagig tatige Experten verschiedener Forschungs- und Praxisbereiche Erkenntnisse, Analysen und Perspektiven vorgestellt. Die Beitrage bieten damit in knapper Form einen aktuellen und facettenreichen UEberblick zur Thematik. Das Buch eignet sich sowohl als Einstiegslekture fur eine ganzheitliche und vertiefte Auseinandersetzung mit dem Thema als auch als aussagekraftige Quelle zur gezielten Beschaftigung mit einzelnen Aspekten. Die Beitrage richten sich an ein breites Publikum: insbesondere an Wissenschaftler und Studierende der Fachrichtungen Soziologie, Kriminologie, Polizeiwissenschaft, Jura, Psychologie und (Geronto- sowie forensische) Psychiatrie, an Praktiker/Fachleute aus den Bereichen Soziale Arbeit und Kriminaljustiz (Polizisten, Juristen, JVA-Angestellte etc.) sowie an Journalisten und Publizisten. Aus dem Inhalt - Soziologische und kriminologische Aspekte - Juristische und kriminalpolitische Aspekte - Forensisch-psychiatrische Aspekte kriminellen Handelns von Senioren sowie Besonderheiten bei deren Schuldfahigkeitsbeurteilung Die Herausgeber Dr. Franziska Kunz, Institut fur Soziologie, Technische Universitat Dresden Prof. Dr. Hermann-Josef Gertz, Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Universitatsklinikum Leipzig