This issue of Clinics in Geriatric Medicine focuses on the past, present, and future of home health care, a rapidly growing subspecialty of Geriatric Medicine. Guest Edited by Peter Boling, the issue describes the population in need (age range, numbers, projected growth), range of service needs, social vs. medical models of care, international and state-to-state comparisons to show the wide range of strategies that have been tried. It also includes a brief snapshot of the history of home care research, absence of integration of medical model home care and continuity of care for home-bound and function-limited persons in the US.

The need to sleep and obtain adequate rest is an essential bodily function from birth to death. Like eating and breathing, sleep is necessary for human survival. Sleep patterns evolve as one moves from infancy to childhood and into adulthood. It should be no surprise, then, that sleep parameters also evolve as the body enters the oldest decades of life. In this exciting new issue of Clinics in Geriatric Medicine, guest edited by Julie Gammack, a leader in her field, the spectrum of sleep-related changes and disease states is discussed. Evaluation of insomnia is summarized in the context of the elderly individual. Sleep disturbances are specifically reviewed in various care settings and disease states. Finally, this issue discusses both pharmacologic and nonpharmacologic management of sleep disorders to provide a multidimensional array of treatment options for the medical provider.

Over 4 million Americans suffer from Alzheimer's disease, which is an organic disorder that is progressive, debilitating, and irreversible. The economic cost of treating and providing care for those with Alzheimer's is over $40 billion a year. The emotional cost to the sufferers and their families is beyond estimation. Yet Alzheimer's is often misdiagnosed, mistreated, and mismanaged. The purpose of this book is to help physicians, health care administrators, graduate students and researchers better understand diagnostic procedures, treatment and management factors related to Alzheimer's disease and other dementias in the elderly.

Aging affects neurological function leading to neurological disease As society grows older, so do the neurological problems associated with aging. These can be new neurological deficits due to the aging process itself, or the effect of aging on already existing neurological conditions. Neurologists will spend increasing amounts of time managing patients with age-related neurological complications. Geriatric Neurology brings together the wisdom of world-leading experts. They have crafted a new textbook to define this emerging subspecialty from basic science through clinical assessment and medical management to social aspects of patient care. Geriatric Neurology covers: * The aging brain in neurology * Assessment of the geriatric neurology patient * Neurological conditions in the elderly * Therapeutics for the geriatric neurology patient * Management issues beyond therapeutics Comprehensive in scope but with practical focus for effective patient care, Geriatric Neurology provides top-of-class guidance for the management of elderly patients with neurological disorders.

This volume discusses the current state of research findings related to healthy brain aging by integrating human clinical studies and translational research in animal models. Several chapters offer a unique overview of successful aging, age-related cognitive decline and its associated structural and functional brain changes, as well as how these changes are influenced by reproductive aging. Insights provided by preclinical studies in mouse models and advanced neuroimaging techniques in humans are also presented.

This up-to-date bibliography of heretofore scattered references to nursing assistants includes literature pertinent to the construction of models to improve nursing assistant practice and emphasizes the psychosocial skills that are invaluable to the nursing assistant's work. Annotated reviews center on the tasks and context of nursing assistant work and ways to improve practice through training, organizational development, advocacy, and bargaining. Additional chapters present a tentative psychosocial model of nursing assistant practice, offer six intervention models, and investigate ways of further developing the nursing assistant occupation. Very highly recommended. Choice The role of the nursing home has expanded in the late twentieth century due to both the growing percentage of elderly in the U.S. population and to society's tendency to over-institutionalize people. In recent years, the kinds and quality of care given to the elderly in nursing homes have received intense scrutiny. This timely bibliography focuses on nursing assistants--the personnel who are with the elderly around the clock, doing a variety of tasks, ranging from helping them with basic functions to comforting them during periods of distress. Nursing assistants provide as much as 90 percent of the direct care received by the elderly in the nursing home setting. Emphasizing the psychosocial skills that make the nursing assistant's job so important to the well being of nursing home residents, Geriatric Nursing Assistants collects and annotates the heretofore scattered references to nursing assistants and includes literature pertinent to the construction of models that improve nursing-assistant practice. The first four chapters present the annotated reviews, which are organized in anticipation of the practice enhancement models discussed in Chapter Six. These reviews center on the tasks and context of the nursing assistant's work and on ways to improve practice through training, organizational development, advocacy, and bargaining. Chapter Five offers a tentative psychosocial concept of nursing-assistant practice that requires further development, detailing the various resident psychosocial circumstances to which the nursing assistant might respond helpfully and the kinds of interventions and techniques which the nursing assistant might attempt. In Chapter Six, intervention models--on inservice training, organizational development, advocacy, and bargaining--are presented in ideal-typical forms that recognize the limitations of daily practice; also, these models emphasize rigorous practice and its evaluation. Activities necessary to further develop the nursing-assistant occupation, including political action, are investigated in Chapter Seven, which also considers the moral aspects of a progressive agenda for nursing assistants. This reference seeks to improve services to nursing home residents and represents a valuable, practical contribution to the geriatric field. It will be useful to nursing home administrators and directors of nursing homes who must address ways to improve the working conditions of nursing assistants; to academicians in their research, training, and advocacy efforts; and to the training directors and supervisors in the field who can directly aid nursing assistants in the acquisition of needed knowledge and skills.

Demographics reveal that the proportion of elderly individuals in the population is growing at a significant rate. Advances in medicine have allowed populations to live longer than ever; however, ensuring that these individuals have the tools necessary to sustain a productive and happy lifestyle as they age remains a concern. Optimizing Assistive Technologies for Aging Populations focuses on the development and improvement of devices intended to assist elderly individuals in coping with various physical limitations and disabilities. Highlighting the available tools and technologies for supporting the mobility, agility, and self-sufficiency of the aging population as well as the challenges associated with the integration of these technologies into the everyday lives of elderly individuals, this publication is ideally designed for reference use by healthcare workers, medical students, gerontologists, and IT developers in the field of medicine.

This book focuses on extrapyramidal signs and symptoms of all types of dementia, and addresses the issue of the artificial boundary between dementias and Parkinsonism, which represent the two most common symptoms found in degenerative central nervous system diseases. In Movement Disorders in Dementias, movement disorder specialists from around the world write on topics generally restricted to dementia experts. Important motor issues related to either medication in demented patients (drug-induced movement disorders) or manifestations common to all forms of dementia, regardless of underlying cause (gait disorders, falls, fear of falling), is followed by analysis of the relationship between motor and cognitive symptoms, from their common pathogenesis to specific medical treatments. Movement Disorders in Dementias is aimed at general neurologists, dementia specialists, movement disorders specialists, neuropsychologists and geriatricians.

This book provides a unique analysis of provider-, environment-, client-, and societal-based obstacles to the empowerment of frail elderly persons in a philosophical framework of social values, as well as an applied framework wherein a variety of international case studies by a distinguished board of contributors provide concrete examples of the feasibility of achieving real empowerment. Empowerment means different things to different people in the context of housing, health, and social service delivery. This book analyzes the various definitions of the concept and practice of the empowerment of frail older persons and then discusses the definitions in a philosophical framework of social values regarding aging and the older person.

Each chapter demonstrates the feasibility of achieving increased empowerment of older persons, even those with severe physical or mental disability. True empowerment of older persons in every country requires time, energy, money, and commitment to the goal. This book will be of interest to academic as well as professional audiences in areas of Gerontology, Psychology, Sociology, and Family Studies. Caregivers and policymakers will also find this analysis useful.

This definitive guide encompasses past, present, and future issues of theory, research, and practice in areas of interest and specialization in aging, and represents current trends of thought on gerontology, the science of and associated practices with the elderly. This volume is a collection of articles dealing with the psychological, social, and cultural domains affecting older people and contains general biomedical understandings and practical/clinical applications. The contributors broadly outline some of the most relevant academic issues, including cross-cultural perspectives on age and aging; past and future trends in life expectancy with underlying explanations; innovations and advances in research design and methodology in the study of the aging process and the effects of age as a variable; and past and current theoretical perspectives on the psychology and sociology of aging. Some pertinent concerns for practitioners and clinicians are addressed, such as successful counseling therapies with older adults and changes in social work and rehabilitation practice with the elderly. The thought-provoking chapters provide a wide-sweeping, multidisciplinary review of a rapidly expanding field of interest and represent a definite desire among the contributors to evolve a theoretical apparatus and a related, applied arena of endeavor.

This important work on a significant and timely issue of concern will broaden our understanding and awareness of the rising number of positive efforts within gerontological studies now being derived from diverse disciplinary roots. The reader will find articles on subjects of particular interest, such as the Biology of Aging, the Psychology of Adult Development and Aging, Rehabilitation of the Elderly, and Social Work and Aging. An extraordinarily detailed reference, this work will be a valuable resource for gerontologists, social workers, psychologists, and doctors specializing in geriatrics.

With over 3.5 million copies sold, the bestselling guide to understanding and caring for people with dementia is now completely revised and updated! For 40 years, The 36-Hour Day has been the leading work in the field for caregivers of those with dementia. Written by experts with decades of experience caring for individuals with memory loss, Alzheimer's, and other dementias, the book is widely known for its authoritativeness and compassionate approach to care. Featuring everything from the causes of dementia to managing its early stages to advice on caring for those in the later stages of the disease, it is widely considered to be the most detailed and trusted book available. Highlighting useful takeaway messages and informed by recent research into the causes of dementia, this new edition has been completely updated. It features * brand-new content on everything from home care aides to useful apps to promising preventative techniques and therapies * practical advice for avoiding caregiver burnout-plus tips for when and how to get additional help * a completely new two-column design that allows readers to quickly access what they need The central idea underlying this indispensable book-that much can be done to improve the lives of people with dementia and of those caring for them-remains the same. The 36-Hour Day is the definitive dementia care guide.

Alterations in sleep are common manifestations of aging that can lead to significant health problems and contribute to behavioural problems associated with age-related neurodegenerative disorders such as Alzheimer's and Parkinson's diseases. Recent advances have revealed key cellular and molecular mechanisms involved in sleep regulation, and this knowledge is helping to advance an understanding of both the normal functions of sleep and the mechanisms responsible for abnormalities in sleep in various neurological conditions and during normal aging. This volume of Advances in Cell Aging and Gerontology brings together chapters by leaders in the fields of sleep research and the neurobiology of aging. The book starts with chapters describing fundamental aspects of the neurocircuitry involved in sleep, patterns of brain activity during the different stages of sleep and disturbances of sleep during aging. The links between depression, anxiety and insomnia are reviewed in regards to the underlying neurochemical alterations that appear to involve abnormalities in neurotransmitter and neurotrophic factor signalling. The evolutionary basis of sleep is reviewed and the emerging evidence supporting a major role for sleep in learning and memory is described. The bulk of the book focuses on specific sleep disorders associated with aging and age-related neurodegenerative disorders. A comprehensive consideration of this topic is woven through a number of chapters that address both basic research and clinical aspects of sleep abnormalities during aging and in disease. The impact of sleep on the immune system is described. The articles are written in a high level of detail and are comprehensive, thus providing valuable information for a range of scientists and other well-educated people. In particular, the book will be a valuable resource for graduate students, postdoctoral and senior scientists in the fields of sleep, aging, neurodegenerative disorders and learning and memory. In addition, clinicians will find this book valuable as it provides a bridge between basic research and the treatment of the patients with sleep disorders.
* Covers the fields of sleep in aging and age-related disease from neurochemistry to the clinic
* Includes detailed summary diagrams that depict key concepts
* Provides views of the future of research on sleep and aging, and the potential for prevention and treatment of various sleep disorders

De cibo quod superest nobis sufficit; oportet gratias agere. Some elders have accepted this proposition, although seldom with enthu- siasm. Gerontologists also have been burdened with the adage: "Leftovers are good enough for us, and we should be grateful for them." I remember how a clerk tried to palm off astale and cheap cigar to her octogenarian customer. He knew better and carne away with a far superior smoke. The clerk fumed, "What does he need a good cigar for? Who is he to be particular!" In this and in many other ways, elders often have labored under the sociocultural expectation that they should be well content with whatever scraps and shmattes happen to come their way. Gerontologists can identify with this situation. The systematic study of aging and the aged was a new enterprise at the midpoint of this century, but the concepts and methods were pretty much limited to those already on hand. What biological and sociobehavioral scientists had been doing for years was simply extended to the newly annexed territory. This as not only a convenient but also a cost-effective strategy. Data accumulated more rapidly by remaining within familiar frarnes of reference and relying on farniliar designs and mea- sures. The new gerontologists soon harvested a promising crop of descriptive findings. Within a decade after the establishment of the Gerontological Society of America (1947), it was possible to discern the outlines of a valuable new field of knowledge.

Kapp's annotated list of 617 titles, in 13 sections, focuses on sources that discuss the `identifiable body of law concerned with personal and institutional relationships, implicated by the delivery of health care for the elderly.' This work is meant for health professionals, attorneys, researchers, educators, and advanced students. The succinct yet informative annotations cover references from January 1, 1980, to August 31, 1987. . . . Highly recommended. Choice Legal questions relating to health care for the elderly have grown increasingly numerous and complex. While these issues have been dealt with extensively by researchers and professional specialists, the literature has grown so vast in the past decade that it is difficult to keep abreast of legal developments. This bibliography is designed to assist practicing health, human services, and legal professionals as well as researchers, teachers, and students in identifying and evaluating information sources that will provide essential guidance on the legal implications of health care for the elderly. Organized in thirteen subject sections, the volume contains more than six-hundred annotated references dealing with institutional regulations and standards of care, disability determinations, decisionmaking for critically ill patients, involuntary commitment, advocacy services for the older health care consumer, and many other topics. Citations consist of books, book chapters, journal articles, and reports published from 1980 onwards. Entries are cross-referenced systematically, and author and subject indexes are provided. This important new reference will be an invaluable working tool for professionals and students who need to understand and deal with some of the most difficult issues in the field of modern health care.

The lipids of cellular membranes not only serve roles in controlling the structure and fluidity of the membrane, but are increasingly recognized for their roles as signalling molecules and modifiers of membrane protein function. Recent studies described in this volume reveal striking changes in membrane lipids during aging and in age-related diseases such as cancer, cardiovascular disease and neurodegenerative disorders. Lipids including inositol phospholipids, cholesterol, sphingolipids and ceramides play important roles in signalling cellular responses to stress and specific stimuli such as growth factors, cytokines and neurotransmitters. One or more of these lipid mediators has been linked to the pathogenesis of age-related diseases.

This book provides a comprehensive review of specific membrane lipid mediators and their roles in aging and age-related disease.

This book provides the first comprehensive overview of a new scientific discipline termed Geroscience. Geroscience examines the molecular and cellular mechanisms that might explain why aging is the main risk factor for most chronic diseases affecting the elderly population. Over the past few decades, researchers have made impressive progress in understanding the genetics, biology and physiology of aging. This book presents vital research that can help readers to better understand how aging is a critical malleable risk factor in most chronic diseases, which, in turn, could lead to interventions that can help increase a healthy lifespan, or 'healthspan.' The book begins with an analysis of the Geroscience hypothesis, as well as the epidemiological underpinnings that define aging as a candidate main risk factor for most chronic diseases. Next, each chapter focuses on one particular disease, or group of diseases, with an emphasis on how basic molecular and cellular biology might explain why aging is a major risk factor for it. Coverage in the book includes: cancer, cardiovascular disease, dementias, stroke, Parkinson's and Alzheimer's diseases, osteoporosis, arthritis, diabetes asthma, emphysema, kidney disease, vision impairment, and AIDS/HIV. It finishes with a chapter on pain in the elderly and an overview of future steps needed to bring the newly acquired knowledge into the clinic and the public at large.

The prominence of dementia within the global aging population has undergone an increase in recent years. To improve the living conditions of patients, researchers must place more emphasis on early detection methods. Improving the Quality of Life for Dementia Patients through Progressive Detection, Treatment, and Care provides a thorough overview of emerging research on various neuroscience methods for the early diagnosis of dementia and focuses on the improvement of healthcare delivery to patients. Highlighting relevant issues on health information systems, behavioral indicators, and treatment methods, this book is a pivotal reference source for health professionals, neuroscientists, upper-level students, practitioners, and researchers interested in the latest developments within the field of dementia treatment.

A distinguished panel of internationally recognized neuroscientists comprehensively review the involvement of and changes in glial cells both during the normal aging process and in the major disorders of old age. Topics range from the cellular and molecular changes that occur with aging-especially aging-associated activation of astrocytes and microglia and its relation to neuronal injury and repair-to neuron-glia intercommunication. The contributors show how glial signals may be modulated by hormones, growth factors, neurotransmitters, intracellular metabolism, and intercellular exchanges, as well as by aging of the blood-brain barrier.

The sixth volume of the Handbook is devoted to topics related to aging and dementia. The volume is introduced by two chapters dealing with age-related cognitive and neurobiological alterations in animals, including a detailed review of data obtained with transgenic and knockout technology. The next chapter reviews the cognitive changes associated with normal aging. The gamut of symptoms that occur in Alzheimer's disease (AD) are then described and analyzed, they include effects on attention, language, memory, non-verbal functions with emphasis on spatial abilities, olfaction and the motor system. The discussion of dementia syndromes is presented in two sections. The first concerns AD, which is discussed from the points of view of epidemiology, neuropathology and neurochemistry and concludes with a review of current and future treatments. The other section deals with non-AD dementias including Fronto-temporal and Lewy body dementias and specific conditions such as Parkinson's and Huntington's disease, as well as HIV infection. The volume includes a review of brain imaging and cerebral metabolism findings in aging and dementia. The final chapters review the relations between culture and dementia and the special syndrome of severe dementia.

Not only is depression among the elderly treatable but, given its increase in incidence and a rapidly aging population, it is a critical issue for the mental-health and medical communities. The authors review the range of late-life depressive syndromes and the strategies for assessing and treating them, and illustrate the problems and principles with fourteen extended case studies-rare in the geropsychology literature and the core of the book. They also provide a guide to medications, screening tools, innovative models, and supplementary resources, invaluable tools for mental-health professionals and medical practitioners alike.

The risk of serious injury resulting from a fall increases with age as our eyesight, ability to react quickly, memory, and cognitive functions begin to decline. For the growing population of people over age 65, falls can lead to loss of dignity and independence, and they can cause serious injury or even death.

Preventing Falls is an essential guide for the elderly, caregivers, Parkinson's sufferers, and many others who face this health risk in their daily lives. As people age, knowing how to accommodate motor, sensory, and cognitive changes is important. While no single cause for a fall exists, the leading factors are environmental hazards, balance problems, muscle weakness, poor vision, and impaired judgment. Parkinson's patients as well as those with various neurological or muscular disorders are especially prone to falls because their motor skills are seriously compromised. This book addresses valuable skills and coping mechanisms as well as environmental changes and assistive devices that are needed to prevent falls.

Many elderly victims of a fall require the skilled care of a nursing home within a year of the incident, especially those elders who cannot care for themselves and whose family members are unable to provide adequate help. The editors place emphasis on "successful aging"-the ability to maintain mobility and remain independent. Preventing Falls is a handy guidebook for elders to decrease their risk of falls, develop personal confidence, and maintain their independence. This vital sourcebook is complemented with a valuable 60-minute videotape offering step-by-step instruction on the best methods for preventing falls.

In this volume of Reviews of Physiology, Biochemistry and Pharmacology there a contributions by M.D. Swope, E. Lolis, F.Hofmann, L. Lacinova, N. Klugbauer, M. Hermann, P. Berger, S.S. Shen, J.S. Kim, M.E. Weksler, M. Hirsch-Kauffmann and M.Schweiger.