Dementia is an illness that raises important questions about our own attitudes to illness and aging. It also raises very important issues beyond the bounds of dementia to do with how we think of ourselves as people--fundamental questions about personal identity. Is the person with dementia the same person he or she was before? Is the individual with dementia a person at all? In a striking way, dementia seems to threaten the very existence of the self.
This book brings together philosophers and practitioners to explore the conceptual issues that arise in connection with this increasingly common illness. Drawing on a variety of philosophers such as Descartes, Lock, Hume, Wittgenstein, the authors explore the nature of personal identity in dementia. They also show how the lives and selfhood of people with dementia can be enhanced by attention to their psychological and spiritual environment. Throughout, the book conveys a strong ethical message, arguing in favor of treating people with dementia with all the dignity they deserve as human beings. The book covers a range of topics, stretching from talk of basic biology to talk of a spiritual understanding of people with dementia. Accessibly written by leading figures in psychiatry and philosophy, the book presents a unique and long overdue examination of an illness that features in so many of our lives.

Fortschritte in der Medizin, vor allem aber Veranderungen in der Einstellung zur Stellung alterer Menschen in unserer Gesellschaft haben die Ziele der Behandlung verandert. Die Zahl alterer Patienten, an welchen chirurgische Eingriffe vorgenommen werden, ist seit vielen Jahren im Steigen, daruber hinaus werden immer groessere und schwerere Operationen vorgenommen. Nicht mehr das blosse UEberleben, sondern die Mobilisierung, die Selbststandigkeit und die Integration in die Gesellschaft ist das Ziel. Fur den langfristigen Erfolg einer chirurgischen Intervention spielen die Operationsvorbereitung und die postoperative Kontrolle eine grosse Rolle. Vor allem die Beitrage der Anasthesisten, der Internisten und der Psychiater sind neben jenen der Chirurgen fur den Erfolg einer Operation entscheidend, wobei der engen Kommunikation zwischen diesen Fachern groesste Bedeutung zukommt. Der Anasthesist sollte uber die Wahl des Narkosevorganges, des Narkosemittels und auch uber die Tiefe der Narkose entscheiden. Die betreuenden Internisten sollen das Risiko fur den Patienten abschatzen und auf der Basis ihrer Erhebungen gemeinsam mit den Anasthesisten die Operationsvorbereitung durchfuhren. Nicht zuletzt kommt den Internisten auch die postoperative Betreuung zu. Die Psychiater mussen die zerebrale Belastung durch die Narkose und durch die Operation zu beurteilen mit dem Ziel, eine postoperative zerebrale Dekompensation mit Verwirrtheit und Delirium zu verhindern.

This case-based approach to geriatric medicine is suitable for all health professionals and trainees who provide care for the elderly, including interns, residents, geriatric fellows, physicians in practice, and nurse practitioners. Illustrated with more than 40 cases based on the authors' experience in clinical practice, the examples range from the healthy elderly to those with advanced cognitive or physical impairments. Discussions are evidence based with extensive references, emphasizing differential diagnosis, atypical presentations in late life, age-appropriate medical management, interdisciplinary methods, and care in the context of different health care settings. The authors have distilled a wealth of practical and clinical experience in this area to produce a user-friendly guide to geriatric medicine. This is the ideal study guide for certifying examinations and highly suitable as a textbook for courses in geriatric medicine and gerontology.

This textbook presents hands-on training material for medical students. The style reflects the need for practice-based teaching with a modern edge in daily clinical routine; accordingly, it also employs online material and pocket cards. Each chapter begins with specific learning objectives, which are cross-referenced with the European curriculum for undergraduate medical education released by the European Union of Medical Specialists (UEMS) together with the European Union Geriatric Medicine Society (EUGMS), as well as the minimum geriatric competences for medical students established by the American Geriatrics Society (AGS). World-renowned European experts in practicing and teaching the interdisciplinary field of Geriatrics contributed to this work, with the aim of offering the new generation of health professionals a global perspective on one of the greatest public health challenges of our time: the management of the steadily increasing number of older, multimorbid, and vulnerable persons. The major strength of this book - published under the auspices of the EUGMS - is its pragmatic, goal-oriented approach, which makes it suitable for bedside learning and patient-centered medicine; further, all of the chapters are firmly based on the pillars of the ageing process in all of its biological aspects, helping readers understand the pathophysiology of and rationale behind interventions for the main geriatric syndromes and disorders.

Die AufklArung des autonomen Patienten stellt den Kern jeder medizinischen Behandlung dar. Da zahlreiche Konzepte, welche die Kommunikation mit dem Kranken im Rahmen der gebrAuchlichen AufklArung verbessern wollten, im Alltag keine nachhaltigen Auswirkungen zeigten, bedarf es grundsAtzlicher VerAnderungen hinsichtlich der GesprAchsintentionen und Strukturen der Kommunikation. Die im Buch behandelten ethischen Aspekte sollen dazu beitragen, eine Verbesserung der Intentionen zu erreichen. Der Autor plAdiert fA1/4r einen umfassenden, wertorientierten AufklArungsprozess, der auch einen ethisch argumentierbaren Umgang mit den PatientenwA1/4nschen einschlieAt. Er wird so zum Ausdruck einer nahezu symmetrischen Therapiebeziehung, die sich an der Autonomie beider Partner orientiert. Aoeberlegungen, wie der Patient aktiver an der Gestaltung des Kommunikationsprozesses mitwirken kann, wodurch die Gesundheitsberufe verstArkt partnerschaftlich eingebunden werden, geben Ausblick auf zukA1/4nftige Entwicklungen.

The newly retired are entering a time of life that is virtually uncharted, a time in which they are free from social expectations and, to a large extent, from obligations to others. Life's meanings are no longer provided by work and family. Instead, men and women have the freedom, and the need, to find new activities that they can imbue with meaning. The term, "Third Age" has been given to this time of life during which for most there is relatively good health, financial stability, and reduced family obligations. The problems and possibilities of this "Third Age" serve as the material for this book. How do older people decide how to deploy their continued vitality, now that they are free from the demands of work and children? How do they find meaning in daily life? In this book, scholars from several disciplines consider the way in which meaning can be found in this important stage of later life. They discuss sociological, psychological, and religious determinants of responses to the challenges of finding meaningful activity after retirement.

Wir werden alle langer leben - das prophezeit uns die demographische Entwicklung. Wie wir dabei mit alten und pflegebedurftigen Menschen umgehen, wird zu einer immer grosseren Herausforderung unserer Gesellschaft. Die Versorgung von alten Menschen kann sowohl in stationaren Einrichtungen als auch zu Hause erfolgen und ist sowohl fur betreute als auch betreuende Personen ein wichtiger Teil ihrer Lebens- und Arbeitswelt. In diesem Buch werden alle pflegerischen Handlungen und Begriffe in einzelnen abgeschlossenen Kapiteln praxisrelevant aufbereitet. Erfahrungsberichte, ein Glossar sowie Stimmungsbilder von in der Langzeitpflege tatigen Personen komplettieren das Werk. Es ist daher unverzichtbar fur alle Personen, die in der Pflege von alten oder chronisch erkrankten Personen tatig sind. Das Handbuch ist sicher ein weiterer und wichtiger Schritt, um professionelles Handeln beschreibbar zu machen.

To reveal the concrete threats to personal autonomy in long-term care, George Agich's book offers a framework for developing an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. Previously published as Autonomy and Long-term Care (Oxford, 1993), this revised edition in paperback has wide appeal among bioethicists and health care professionals.

Every day ten thousand baby boomers turn 65, and by 2030 more than 20% of US residents will be 65 or older. Mental health professionals must become familiar with the unique needs of this growing population. Using the APA Guidelines for Psychological Practice With Older Adults and the Pikes Peak Model for Training in Professional Geropsychology, this book shows mental health providers how to expand their practice in order to treat older adults. Chapters describe tools and techniques for assessing and treating common conditions that practitioners encounter when working with older adults, including depression, anxiety, cognitive impairment, and prescription drug misuse. Clinical case examples demonstrate how to deliver interventions while avoiding common interactional pitfalls. Includes expert recommendations for assessment tools, additional readings, and online resources.

Warum eine EinfA1/4hrung in die geriatrische Rehabilitation? Weil sich die typischen Alterserkrankungen in Art, Verlauf, Regenerations- und RehabilitationsmAglichkeiten erheblich von den Erkrankungen jA1/4ngerer Menschen unterscheiden. Als professioneller Betreuer finden Sie hier alle wichtigen Informationen A1/4ber: - Symptombilder der in der Rehabilitation hAufigen chronischen Erkrankungen und Behinderungen; - medizinisch-therapeutische BehandlungsmAglichkeiten in der rehabilitativen und ambulanten Versorgung mit Zielfindung, Therapieplanung und praktischer DurchfA1/4hrung; - die Schnittstellen zwischen Klinik, Reha-Einrichtung und ambulanter Therapie; - AdaptationsmAglichkeiten fA1/4r selbstAndiges Wohnen im Alter; - Hilfs- und Pflegemittelversorgung, vor allem im ambulanten Bereich; - soziale Hilfen (Konzept einer auf den alten Menschen zugehenden Sozialarbeit) mit ausfA1/4hrlichen Infos A1/4ber Organisationen, Hilfsdienste, gesetzliche Regelungen.

Offering a comprehensive look at physical therapy science and practice, Guccione's Geriatric Physical Therapy, 4th Edition is a perfect resource for both students and practitioners alike. Year after year, this text is recommended as the primary preparatory resource for the Geriatric Physical Therapy Specialization exam. And this new fourth edition only gets better. Content has been thoroughly revised to keep you up to date on the latest geriatric physical therapy protocols and conditions. Five new chapters have also been added to this edition to help you learn how to better manage common orthopedic, cardiopulmonary, and neurologic conditions; become familiar with functional outcomes and assessments; and better understand the psychosocial aspects of aging. In all, you can rely on Guccione's Geriatric Physical Therapy to help you effectively care for today's aging patient population. Comprehensive coverage of geriatric physical therapy prepares students and clinicians to provide thoughtful, evidence-based care for aging patients. Combination of foundational knowledge and clinically relevant information provides a meaningful background in how to effectively manage geriatric disorders Updated information reflects the most recent and relevant information on the Geriatric Clinical Specialty Exam. Standard APTA terminology prepares students for terms they will hear in practice. Expert authorship ensures all information is authoritative, current, and clinically accurate. NEW! Thoroughly revised and updated content across all chapters keeps students up to date with the latest geriatric physical therapy protocols and conditions. NEW! References located at the end of each chapter point students toward credible external sources for further information. NEW! Treatment chapters guide students in managing common conditions in orthopedics, cardiopulmonary, and neurology. NEW! Chapter on functional outcomes and assessment lists relevant scores for the most frequently used tests. NEW! Chapter on psychosocial aspects of aging provides a well-rounded view of the social and mental conditions commonly affecting geriatric patients. NEW! Chapter on frailty covers a wide variety of interventions to optimize treatment. NEW! Enhanced eBook version is included with print purchase, allowing students to access all of the text, figures, and references from the book on a variety of devices.

Die Beitrage stellen das Thema "Veralterung der deutschen Gesellschaft" in den Kontext der Alltagsforschung. Alte Menschen leben in einer besonderen Umwelt. Sie haben besondere Wohnverhaltnisse und Einkaufsgewohnheiten etc."

Tipps fur eine abgestimmte Behandlung von geriatrisch urologischen Patienten Das Praxisbuch zur Urogeriatrie. Als erster Professor fur Urogeriatrie Deutschlands schafft der Autor den Transfer von hilfreichen Erkenntnissen aus der Geriatrie in die Urologie und umgekehrt. Die Zunahme alterer, multimorbider Patienten ist in der Urologie besonders stark. Inkontinenz ist eines der fuhrenden Leiden im hoeheren Lebensalter. Fachubergreifend, auf der Basis der aktuellen Wissenschaft und einer jahrelangen Erfahrung aus Klinikpraxis und Forschung, werden relevante Aspekte der Geriatrie, die bei der Behandlung multimorbider, urologischer Patienten berucksichtigt werden sollten, ubersichtlich und praxisnah erlautert. Dazu zahlen Themen wie: Einbinden geriatrischer Assessments in die urologische Diagnostik Einbeziehung der geistigen und koerperlichen Ressourcen in die Therapieentscheidung Nebenwirkungen und Wechselwirkungen urologischer Praparate Polypharmazie Demenz und andere Komorbiditaten Kognitive Veranderungen nach einer urologischen Operation Jedes Kapitel enthalt Tabellen und Entscheidungshilfen, die es dem Leser erlauben, schnell die wichtigsten Punkte fur den geriatrischen Patienten zu prufen. Fur alle Urologen, aber auch Allgemeinmediziner, Internisten, Geriater, die diese Patientengruppe, die eine ganzheitliche Behandlung verfolgen. Das Buch entstand in Zusammenarbeit mit dem Arbeitskreis Geriatrische Urologie. Es moechte durch den fachubergreifenden, interdisziplinaren Blick, ein UEberdenken standardisierter Therapien anregen.

Das Buch behandelt den Themenbereich "Partnerschaft und SexualitAt im hAheren Lebensalter" unter medizinischen, psychologischen und sozialen Aspekten und beruht auf den BeitrAgen einer 1996 in MA1/4nchen abgehaltenen Arbeitstagung im Rahmen der Veranstaltungsreihe "Verhaltenstherapie im Alter." Im ersten Teil des Buches liegt der Schwerpunkt auf normalen altersbedingten VerAnderungen im kArperlichen, seelischen und sozialen Bereich. Damit soll einiges von dem Hintergrundwissen vermittelt werden, das jeder benAtigt, der mit alten Menschen therapeutisch arbeitet. Die BeitrAge des zweiten Teils befassen sich mit Diagnostik und Behandlung von StArungen im Bereich von SexualitAt und Partnerschaft. Das bewuAt interdisziplinAr ausgerichtete Buch wendet sich an AngehArige aller in diesem Bereich tAtigen Berufsgruppen wie A"rzte, Psychologen, Sozialarbeiter und Pflegepersonal.

Im vorliegenden Band macht die 'Forsehergruppe Soziale Gerontologie' der Westfalischen Wilhelms-Universitat und der Fachhochschule Munster der Fachoffentlichkeit im Gesundheits- und Sozialwesen, Lesem aus Wissenschaft und Praxis der Altenpflege, Forschungsergebnisse zuganglich, die in den letzten drei Jahren gewonnen wurden. Die interdisziplinar zusammengesetzte Forschergruppe arbeitet bereits seit Jahren in Munster erfolgreich zusammen. Ihren Ausgang hat sie in thematisch abgestimmten Lehrveranstaltungen fur Studierende beider Hochschulen ge nommen. Beteiligt sind Vertreter der Soziologie, Psychologie, Erziehungs wissenschaft und Medizin. DaB Universitat und Fachhochschule an einem Hochschulort in Lehre und Forschung kooperieren, gehort keineswegs zu den Selbstverstandlichkeiten in der deutschen Hochschullandschaft. Die Forschergruppe hat mehrfach aktuelle Themen zu 'Alter und Altem' aufgegriffen, bearbeitet und ihre Resultate publiziert. Da nicht alle alles gleich zeitig tun konnten, haben einige Kollegen von uns die Forschung, andere mehr die Lehre und Weiterbildung betrieben. Ein Schwerpunktthema der Forschung waren subjektive Alterstheorien bei Ehrenamtlichen und Professionellen in der Altenhilfe bzw. Altenpflege. Parallel zu den Aktivitaten der Forschergruppe entwickelte sich vor rund 10 1ahren das 'Studium im Alter' an der Universitat Munster, ein im Lehrangebot nicht mehr wegzudenkender institutionalisierter Teil. MaBgeblich etabliert wurde dieses Lehrangebot fur Altere durch einen Vertreter der Forschergruppe. An der Fachhochschule Munster gehort das Lehrgebiet 'Psychologie des Altems' seit Jahren zum Standardlehrprogramm in den Studiengangen Sozialarbeit und Sozialpadagogik."

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.

Qigong is the centuries-old practice of moving vital energy (Qi) through the channels of the body, known as meridians, to promote vitality and health. Stephen Rath details current research and Traditional Chinese Medicine theory to show how Qigong practice can support cognitive functioning, as well as emotional and physical wellbeing, in people with dementia. Qigong for Wellbeing in Dementia and Aging presents a set of accessible Qigong exercises and breathing techniques adapted specifically for older people who may be frail or have limited mobility, which address specific symptoms associated with dementia. These include exercises for the hands and feet, exercises for releasing emotions through the Five Animal Sounds, seated exercises, and facial exercises. The exercises, contributed by the Natural Healing Research Foundation from their Senior Exercise Class in Hawaii, are presented with clear explanatory illustrations. The final part of the book describes the Chinese understanding of nutrition as an essential underpinning of good health into old age, and provides health-giving food and drink recipes for people with dementia based on these principles. There is also a helpful chapter on practicing Qigong to protect against caregiver burnout. This will be an invaluable book for care professionals, nurses, activity coordinators, and physical therapists, as well as people with dementia and their families.

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.