Practical, essential advice about making tough decisions for people with end-stage dementia. Each year, more than 500,000 people are diagnosed with dementia in the United States. As stunning as that figure is, countless family members and caregivers are also affected by each diagnosis. Families are faced with the need to make vital end-of-life decisions about medical treatment, legal and financial matters, and living situations for those who no longer can; no one is prepared for this process. And many caregivers grapple with sadness, confusion, guilt, anger, and physical and mental exhaustion as dementia enters its final stage. In Making Tough Decisions about End-of-Life Care in Dementia, Dr. Anne Kenny, a skilled palliative care physician, describes how to navigate the difficult journey of late-stage dementia with sensitivity, compassion, and common sense. Combining her personal experience caring for a mother with dementia with her medical expertise in both dementia and end-of-life care, Dr. Kenny helps the reader prepare for a family member's death while managing their own emotional health. Drawing on stories of families that Dr. Kenny has worked with to illustrate common issues, concerns, and situations that occurs in late-stage dementia, this book includes practical advice about * making life-altering decisions while preparing for a loved one's inevitable death * medical care, pain, insomnia, medication, and eating * caring for the caregiver * having conversations about difficult topics with other family members and with health care, legal, and financial professionals Concrete to-do lists and lists of important points provide information at a glance for busy caregivers. Each chapter concludes with a list of additional resources for more information and help. Making Tough Decisions about End-of-Life Care in Dementia is a lifeline, an invaluable guide to assist in the late stage of dementia.

This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults.

Applied gerontology and geriatrics always entail a multidisciplinary perspective and usually demand an interdisciplinary treatment approach. Providing a unique combination of perspectives, treatment approaches, and expertise, The Practical Handbook of Clinical Gerontology explores issues relevant to practitioners who work with the elderly. A leading cast of contributors--representing the fields of psychology, medicine, neuropsychology, nursing, and law--examines what is known about specific disorders and discusses treatment techniques and the development of intervention plans. This comprehensive volume begins with an overview of several broad topics pertinent to the treatment of older adults and discusses special considerations in assessment. It then presents up-to-date information on treatment of specific psychological and behavioral disorders of older adults. The final section covers interdisciplinary issues, including information about common medical problems, rehabilitation, and the psychopharmacological treatment of mental health problems. Written in a language that is accessible to a general health care audience, this extensive volume will be a valuable resource for mental health care providers, medical students, researchers, and graduate students in such fields as geriatrics, gerontology, nursing, psychology, and social work. **Please note the following three quotes are from the same person** "This handbook has a variety of attributes that make it a highly desirable desk reference for today's mental health practitioners in geriatrics and gerontology. Few stones have been left unturned in the 22 reader-friendly chapters that comprise the handbook. Not only are general treatment issues addressed in great detail but assessment procedures, the treatment of specialized psychological and behavioral problems, and even issues in effective collaboration with medical geriatricians are considered. The scope and breadth of clinical knowledge and wisdom found within the covers of this volume are certainly impressive." --Lenard W. Kaye, Professor, Bryn Mawr College "The authors have succeeded in drawing on the expertise of a broad range of recognized authorities in clinical gerontology who have the capacity to communicate to the reader with considerable clarity both current information and best-practice strategies of mental health intervention with older adults." --Lenard W. Kaye, Professor, Bryn Mawr College "It would be difficult to find another reference source in clinical gerontological practice that is able to deal with the challenges of practice in this area with greater comprehensiveness and authority. The multidisciplinary perspective of the handbook ensures it being a valuable addition to the clinical practice collections of psychologists, social workers, nurses, gerontologists, and other allied health professionals. And, once obtained it should not gather dust given the currency and utility of the information." --Lenard W. Kaye, Professor, Bryn Mawr College

"A remarkable addition to the literature of the science of the mind…Shenk has drawn together neurobiology, art history and psychology into a literary portrait of Alzheimer's perfectly balanced between sorrow and wonder, devastation and awe."
'LA Times'

Jonathan Swift once pointed to a diseased elm and declared 'I shall be like that tree, I shall die first at the top'. And, as our lifespans continue to expand, the illness he so dreaded has reached epidemic proportions. Today Alzheimer's afflicts on in twenty over the age of sixty-five. There are currently around twelve million sufferers worldwide, and this number is rising fast. Poignant and hopeful, 'The Forgetting' is the first book to record the history and explain the future of this difficult, frightening disease.

"[An] absorbing and enlightening book…and an engrossing story."
'TLS'

"A lucid, often moving book with an excellent preface from Adam Phillips…Shenk is a wonderful writer…His prose zings with apt metaphors. He has an eye for the social and financial forces that shape scientific interests and he brings key players, whether proteins or people, to dramatic life."
'Independent'

"'The Forgetting' is completely absorbing, fascinating, the best of writing, thought-provoking, socially important and imperative to read – with the narrative pull of a well-written murder mystery."
AMY TAN, author of 'The Bonesetter's Daughter'

For caregivers of deeply forgetful people: a book that combines new ethics guidelines with an innovative program on how to communicate and connect with people with Alzheimer's. How do we approach a "deeply forgetful" loved one so as to notice and affirm their continuing self-identity? For three decades, Stephen G. Post has worked around the world encouraging caregivers to become more aware of-and find renewed hope in-surprising expressions of selfhood despite the challenges of cognitive decline. In this book, Post offers new perspectives on the worth and dignity of people with Alzheimer's and related disorders despite the negative influence of "hypercognitive" values that place an ethically unacceptable emphasis on human dignity as based on linear rationality and strength of memory. This bias, Post argues, is responsible for the abusive exclusion of this population from our shared humanity. With vignettes and narratives, he argues for a deeper dignity grounded in consciousness, emotional presence, creativity, interdependence, music, and a self that is not "gone" but "differently abled." Post covers key practical topics such as: * understanding the experience of dementia * noticing subtle expressions of continuing selfhood, including "paradoxical lucidity" * perspectives on ethical quandaries from diagnosis to terminal care and everything in between, as gleaned from the voices of caregivers * how to communicate optimally and use language effectively * the value of art, poetry, symbols, personalized music, and nature in revealing self-identity * the value of trained "dementia companion" dogs At a time when medical advances to cure these conditions are still out of reach and the most recent drugs have shown limited effectiveness, Post argues that focusing discussion and resources on the relational dignity of these individuals and the respite needs of their caregivers is vital. Grounding ethics on the equal worth of all conscious human beings, he provides a cautionary perspective on preemptive assisted suicide based on cases that he has witnessed. He affirms vulnerability and interdependence as the core of the human condition and celebrates caregivers as advocates seeking social and economic justice in an American system where they and their loved ones receive only leftover scraps. Racially inclusive and grounded in diversity, Dignity for Deeply Forgetful People also includes a workshop appendix focused on communication and connection, "A Caregiver Resilience Program," by Rev. Dr. Jade C. Angelica.

A one-of-a-kind guide to active, engaging learning strategies for aging studies. Harnessing the proven benefits of active learning strategies, this is the first activity book created for a broad spectrum of courses in aging-related higher education. It features 32 classroom and community-based educational activities for instructors seeking to introduce and/or enhance aging content in their courses. Underscoring the interdisciplinary nature of aging studies, the book encompasses teaching strategies for instructors in such disciplines as Counseling, Family Studies, Gerontology, Geriatrics, Medicine, Psychology, Public Administration, Public Health, Nursing, Social Work, Sociology, Speech Pathology, and others. This peer-reviewed collection of hands-on activities is designed by noted educators in aging and incorporates AGHE competencies. It offers clear, step-by-step procedures for implementing each activity including preparation, introduction, the activity itself, discussion/reflection, wrap-up, and assessment. The book also addresses learning outcomes and includes recommendations for number of participants, settings, materials, and time required. Encompassing key, impactful issues affecting older individuals, the text examines Ageism and Aging in the Media, Dementia, Demography, Health Care, Housing, Physical Aging, Policy and Politics of Aging, Positive Interactions with Older Adults, and Spirituality. In addition to its value to students, the book's activities are also beneficial to professionals instructing or participating in staff trainings, in-services, and continuing education. Key Features: Contains 32 experiential learning activities for students in a great variety of aging-related disciplines Designed for activities in the classroom, in the community, on line, and take- home Provides clear, step-by-step procedures for each activity from implementation through assessment Addresses student learning outcomes and includes a glossary Incorporates AGHE competencies

As the average age of the population rises, mental health professionals have become increasingly aware of the critical importance of personality in mediating successful adaptation in later life. Personality disorders were once thought to "age out," and accordingly to have an inconsequential impact on the lives of the elderly. But recent clinical experience and studies underscore not only the prevalence of personality disorders in older people, but the pivotal roles they play in the onset, course, and treatment outcomes of other emotional and cognitive problems and physical problems as well. Clearly, mental health professionals must further develop research methods, assessment techniques, and intervention strategies targeting these disorders; and they must more effectively integrate what is being learned from advances in research and theory into clinical practice. Inspired by these needs, the editors have brought together a distinguished group of behavioral scientists and clinicians dedicated to understanding the interaction of personality and aging. Offering a rich array of theoretical perspectives (intrapsychic, interpersonal, neuropsychological, and systems), they summarize the empirical literature, present phenomenological case reports, and review psychodynamic, cognitive-behavioral, and pharmacological treatment approaches. This comprehensive state-of-the-art guide will be welcomed by all those who must confront the complexity and the challenge of working with this population.

Frail older people now contribute the majority of the acute emergency take both medical and surgical. Despite this there is often a lack of confidence and knowledge among doctors and nurses in treating older people in the Emergency Department and on Emergency Assessment Units. -- From the Preface Emergency care of frail older people is challenging but very rewarding. Older patients tend to be complex and therefore their assessment needs to be more extensive and include comprehensive geriatric assessment. It is the extras in their assessment that are not usually needed in younger patients, such as cognitive, functional and social evaluations that make the difference in achieving a better outcome. This book describes the key features of high quality care for frail elderly patients in acute hospital settings. With chapters on assessment and the characteristic non-specific ways that patients tend to present (such as 'confusion', 'collapse query cause' and 'off legs'), this practical guide is ideal to have on-hand. As well as common medical and surgical conditions, it also covers medication management, elder abuse, pressure ulcers and hypothermia, including the physiological changes seen in ageing and ways to define frail patients. Tables, diagrams and images are ideal for quick reference, and key points are summarised throughout the text to aid comprehension, providing doctors, nurses and therapists with both background and essential information to provide the excellent acute care older people deserve.

Today, approximately 1.6 million American children live in what social scientists call "grandfamilies"-households in which children are being raised by their grandparents. In You've Always Been There for Me, Rachel Dunifon uses data gathered from grandfamilies in New York to analyze their unique strengths and distinct needs. Though grandfamilies can benefit from the accumulated wisdom of mature adults raising children for a second time, Dunifon notes, such families also face high rates of health problems as well as parenting challenges related to a large generation gap. Grandfamilies are also largely hidden in American society, flying under the radar of social service agencies, policymakers, and family researchers. This book gives family researchers a greater understanding of a unique family form, and also offers service providers, policymakers and the general public important information about the lives of an important group of American families.

One of the problems geriatricians are confronted with in everyday clinical practice is differentiating disease from the process of old age. The challenges of ageing require a better understanding of the essential biology of ageing in order to separate ageing from disease, and indeed ageing made worse by disease. Although the topic is large and diverse, this practical and easy-to-read reference book contains vital information on the biology of ageing. It provides a concise understanding of the changes that occur and focuses on the clinical implications of ageing. MCQs are featured throughout for revision and examination practice. The Biology of Ageing provides the reader with: . a learning guide on the biology of ageing through an overview of the changes that occur at both cellular and system levels . knowledge of how biological changes of ageing impact on physiology and the clinical relevance in medical practice . a practical consideration of these changes in disease presentations and how these changes may impact on disease management. This full-colour guide featuring slides, MRIs, figures and photographs is ideal for doctors training in geriatric medicine, practising geriatricians and those with an interest in management of older people.

The risk of cancer increases with age, and the number of older adults seeking treatment is increasing dramatically in line with the aging population. The care of older patients differs from that of younger adults because of differences in the biology of the tumor, age-related differences in host physiology, co-morbidity burden and psychosocial issues, which might impact the efficacy and side effects of cancer therapy. This book focuses on the management of hematological cancer and provides guidance on the management issues specific to older patients, spanning background and epidemiology, special considerations in the management of older people, therapeutics and psychosocial considerations.

In this timely and important work, expert gerontologists review what has been learned about the aged and the process of aging and link this knowledge to interventions for improving the quality of life.

This volume highlights the development of preventive, therapeutic, and rehabilitative interventions designed to assist older people maintain their independence and quality of life. In addition to the editors, chapter authors include Robert N. Butler, Matilda White Riley, Carroll Estes, and a foreword by James O. Mason.

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.

The ability to effectively assess cognitive and other behavioral functions is an essential skill for neurologists, psychiatrists, geriatricians, nurses, and other clinicians who perform clinic and bedside examinations. Unique in the field, The Mental Status Examination Handbook is a user-friendly, comprehensive resource that provides practical guidance on cognitive assessment, clarifies mental status testing procedures, and assists with decision making for neuropsychological referrals. This detailed manual draws from the full history of behavioral neurology testing, making the complex and challenging area of cognitive assessment accessible for both students and practitioners. Offers guidance on how to choose and perform a large number of mental status tests, with information on selected test materials and normative values. Covers the bedside evaluation of arousal, attention, memory, language, perception, executive abilities, and other cognitive and behavioral areas. Provides an authoritative assessment and compendium of commonly used mental status scales, inventories and questionnaires. Describes relevant correlations with formal neuropsychological testing, neuroimaging, and neuropsychiatric disease. Explains how to weigh, use, and understand mental status scales and neuropsychological instruments. Discusses the meaning of cognitive symptoms and signs, and their neuroanatomical and neuropathological correlations. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

This state-of-the-art volume will focus on the evidence base, but practical nature of the optimizing physical activity and function, and the real world recommendations provided by experts in the field. In addition, the book will be written by a wide variety of national and international experts across multiple disciplines including nursing, medicine, physical therapy, and exercise physiology.

The mental health needs of older people are all too often overlooked or put down to the inevitable consequences of ageing. This textbook will make it much easier for health, social care and third sector workers to identify, treat and support the needs of this population. The book takes an interdisciplinary team approach and sets the scene by looking at different practice contexts in the United Kingdom and the increasingly important role played by social care in addressing the mental health needs of older people. A number of more clinically focused chapters then cover: mental health promotion anxiety and depression ageing and psychosis alcohol and dual diagnosis dementia later life liaison services complex and enduring mood disorders. Each clinical chapter makes use of extended and detailed case studies which illuminate the team's role in the assessment-intervention-evaluation cycle and ensure the text's application to practice. Service user and family perspectives are drawn on throughout and current practice exemplars outlined. The final chapter distils key messages from the book and sets a number of key challenges. Mental Health and Later Life highlights the rewards and complexity of working with older people with mental health needs and their families. It is invaluable reading for all those learning about, or working with, this population.

Age-Related Macular Degeneration: Diagnosis and Treatment is written by two leading experts from Wills Eye Hospital. Covering the latest therapies and treatments developed in the last few years, this is a concise yet highly illustrated andpractical text that guides the clinician through diagnosis and treatment of the leading cause of blindness in older Americans."

In the past decade, evidence based practice (EBP) has emerged as one of the most important movements to improve the effectiveness of clinical care. As the number of older adults continues to grow, it is essential that practitioners have knowledge of effective strategies to improve both the medical and the psychosocial aspects of older persons' lives. The purpose of this work is to present systematic reviews of research-based psychosocial interventions for older adults and their caregivers.

The interventions presented focus on a variety of critical issues facing older adults today including medical illnesses (cardiac disease, diabetes, arthritis/pain, cancer, and HIV/AIDS), mental health/cognitive disorders (depression/anxiety, dementia, substance abuse), and social functioning (developmental disabilities, end-of-life, dementia caregivers, grandparent caregivers). For each of these areas the prevalence of the problem, the demographics of those affected, and the nature and consequences of the problem are discussed. The empirical literature is then reviewed. A treatment summary highlights the type and nature of research supporting the interventions reviewed and is followed by a conclusion section that summarizes the status of intervention research for the specified issue. A Treatment Resource Appendix for each area is included. These appendices highlight manuals, books, articles and web resources that detail the treatment approaches and methodologies discussed.

This book was previously published as a special issue of the Journal of Gerontological Social Work.

This book discusses the intersections between culture, context, and aging. It adopts a socio-cultural lens and highlights emotional, social, and psychological issues of the older adults in urban India. It is set in multiple sites such as Ahmedabad, Delhi, Kolkata, and Saskatoon to indicate how different cultural practices and contextual factors play an integral role in determining the course of aging. It also focuses on different narratives such as older adults living with adult children, older adults living with spouse, and older adults living alone to demonstrate the intricate process of growing old. Drawing from various sites and living arrangements of older adults, it sheds light on cultural constructions of growing old, ideas of belonging, the inevitability of death, everyday processes of aging, perceptions associated with growing old in India, acceptance of the aging body, and intergenerational ties in later lives. Given its scope, the book is essential reading for students and researchers in the fields of sociology, demography, and social scientists studying aging.

Geared toward sleep specialists, neurologists, geriatricians, and psychiatrists, Geriatric Sleep Medicine presents the most current medical research for the diagnosis and management of sleep disorders in the older patient.
Focused on the prevention of chronic geriatric sleep disorders, this text examines:

• the most recent and up-to-date classification information of sleep disorders from the American Academy of Sleep Medicine
• current algorithms for the evaluation and management of sleep disorders (e.g., insomnia, sleep apnea, parasomnia, hypersomnia, restless legs syndrome) in older adults
• both pharmacological and nonpharmacological treatments

Geriatric Sleep Medicine also explores special topics of interest to clinicians, including sleep problems post-menopause, in the nursing home setting, and at the end stages of life.

This book provides concrete scientific basis that we can conceive the possibility of modifying or even completely canceling aging process, despite the fact that aging is commonly regarded as the result of the overall effects of many uncontrollable degenerative phenomena. The authors illustrate in detail the mechanisms by which cells and the whole organism age. Actions by which it is possible, or will be possible within a limited time, to operate for modifying aging are also debated. The discussion is conducted within the frame and the concepts of evolutionary medicine, which is also indispensable for distinguishing between the manifestations of aging and: (i) diseases that worsen with age, and (ii) acceleration of normal aging rates, caused by unhealthy lifestyle habits and other avoidable factors. The book also discusses the impact of aging on overall mortality and the strange situation that, according to official statistics, aging does not exist as cause of death. This book is a turning point between a gerontology and geriatrics conceived as the study and vain treatment of an incurable condition and one in which these disciplines examine the how and why of a physiological phenomenon that can be modified up to a possible total control. This means transforming the medical prevention and treatment of physiological aging from the greatest failure to the greatest success of medicine.

Psychological, social, and spiritual care is as important as physical care at the end of life. Yet caregivers often feel ill-equipped to give that nonphysical care. This book shows how to do it. The book addresses all caregivers who attend dying patients: doctors, nurses, chaplains, clergy in the pastorate, social workers, clinical psychologists, family caregivers, and others. It covers such topics as the functional and emotional trajectories of dying; the varied approaches of patients and caregivers to end-of-life decisions; culturally based beliefs about dying; the differences between depression and grief; and people's views about the right time to die, the death experience itself, and the afterlife. For each topic the book introduces core concepts and summarizes recent research about them. The book presents much of its material in readable tables for easy reference; applies the material to real-life cases; lists the main "take home" points for each chapter; and gives references for additional reading. The book helps caregivers anticipate the reactions of patients and survivors to end-of-life traumas and suggests how caregivers can respond insightfully and compassionately. At the same time the book challenges caregivers to think through their own views about death and dying. This book, therefore, is a must-read for all caregivers professional and nonprofessional alike who strive to give their patients comprehensive, high-quality end-of-life care.