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Books > Medicine > Clinical & internal medicine > Geriatric medicine
Some of the most serious consequences of aging are its effects on skeletal muscle. 'Sarcopenia', the progressive age-related loss of muscle mass and associated muscle weakness, renders frail elders susceptible to serious injury from sudden falls and fractures and at risk for losing their functional independence. Not surprisingly, sarcopenia is a significant public health problem throughout the developed world. There is an urgent need to better understand the neuromuscular mechanisms underlying age-related muscle wasting and to develop therapeutic strategies that can attenuate, prevent, or ultimately reverse sarcopenia. Significant research and development in academic and research institutions and in pharmaceutical companies is being directed to sarcopenia and to related health issues in order to develop and evaluate novel therapeutics. This book provides the latest information on sarcopenia from leading international researchers studying the cellular and molecular mechanisms underlying age-related changes in skeletal muscle and identifies strategies to combat sarcopenia and related muscle wasting conditions and neuromuscular disorders. The book provides a vital resource for researchers and practitioners alike, with information relevant to gerontologists, geriatricians, sports medicine physicians, physiologists, neuroscientists, cell biologists, endocrinologists, physical therapists, allied health and musculoskeletal practitioners, strength and conditioning specialists, athletic trainers, and students of the medical and biomedical sciences.
This book aims to provide an up-to-date review of the literature in each of the major areas relating to the management of older urological cancer patients, and makes recommendations for best practice and future research. The authors come from a broad geographic spread including the UK, mainland Europe and North America to ensure a worldwide relevance.
Healthcare Changes Reach Main Street: A Call to Action for Physicians provides guidance, examples, and information on processes and time lines for physicians based on the implementation of The Affordable Care Act (ACA) that was established in 2010. This volume focuses on how geriatricians and other healthcare professionals can be engaged in responding to the roll-out of the ACA in their communities, and through this engagement assume leadership roles in local hospitals, healthcare organizations, and medical societies to advance quality improvement and new models of care for older adults. In-depth chapters provide an update on quality improvement efforts at the state level, as well as changes in Medicaid financing and the significant impact this will have for older adults, particularly dual-eligibles. Many elements of the ACA are yet to be rolled out and many healthcare decisions are yet to be made. Healthcare Changes Reach Main Street: A Call to Action for Physicians will guide healthcare decision makers and help them to play a leadership role in advancing quality care for older adults in our changing healthcare environment.
Over the last two decades, many changes have happened to the social welfare policies of various industrial countries. Citizens have seen their pensions, unemployment benefits, and general healthcare policies shrink as "belt tightening" measures are enforced. But in contrast, long-term care has seen a general growth in public financing, an expansion of beneficiaries, and, more generally, an attempt to define larger social responsibilities and related social rights. The aim of this book is to describe and interpret the changes introduced in long-term care policies in Western Europe. The volume argues that recent reforms have brought about an increasing convergence in LTC policies. Most of the new programs have developed a new general approach to long-term care, based on a better integration of social care and health care. The book explores increasing public support given to family care work (in the past, the family would take care of the elderly or infirm) and increasing growth and recognition of a extended social care market (by which care has shifted from a moral obligation based on family reciprocity to a paid, professional activity). A new social care arrangement has therefore been developing in Western countries, based on a new mix of family obligations, market provision, and public support. In order to understand such changes, this analysis will take into account the social and economical impact of these reforms.
A ground-breaking new volume and the first of its kind to concisely outline and explicate the emerging field of whole person care process, Whole Person Care: A New Paradigm for the 21st Century organizes the disparate strains of literature on the topic. It does so by clarifying the concept of 'whole person' and also by outlining the challenges and opportunities that death anxiety poses to the practice of whole person care. Whole person care seeks to study, understand and promote the role of health care in relieving suffering and promoting healing in acute and chronic illness as a complement to the disease focus of biomedicine. The focus is on the whole person -- physical, emotional, social, and spiritual. Using concise, easy-to-read language, the early chapters offer practitioners a thorough understanding of the concepts, skills and tools necessary for the practice of whole person care from a clinician-patient interaction standpoint, while the last two chapters review the myriad implications of whole person care for medical practice. An invaluable resource for all areas of medical practice and for practitioners at all stages of development, from medical students to physicians and allied health providers with many years of experience, Whole Person Care: A New Paradigm for the 21st Century will have a profound impact on western medical practice in North America and elsewhere.
That precursors of adult coronary artery disease, hypertension, and type II diabetes begin in childhood have been clearly established by the Bogalusa Heart Study. This unique research program has been able to follow a biracial (black/white) population over 35 years from childhood through mid-adulthood to provide perspectives on the natural history of adult heart diseases. Not only do these observations describe trajectories of cardio-metabolic risk variables leading to these diseases but provide a rationale for the need to begin prevention beginning in childhood. The trajectories of the burden of cardio-metabolic risk variables in the context of their fetal origin and chromosome telomere dynamics provide some insight into the metabolic imprinting in utero and aging process. The observed racial contrasts on cardio-metabolic risk variables implicate various biologic pathways interacting with environment contributing to the high morbidity and mortality from related diseases in our population. To address the seriousness of the onset of cardiovascular disease in youth, approaches to primordial prevention are described focussing on childhood health education as an important aspect of Preventive Cardiology.
This book investigates the experiences of older people who remain at home with care. It examines the transition points for the important life changes faced by family members who take on a greater care-giving role. The book draws on demographic analyses and qualitative fieldwork to explore the shift from independence to increasing dependence, and suggests that this transition constitutes movement into a new stage of life, that of an Age of Supported Independence. Applying the anthropological concept of rites of passage in their analysis, the authors focus on the changes in everyday living within the spatial environment of the home, the temporal organization of daily life, and the reshaping of relationships. They suggest that many older people - as well as the family members who become carers - remain in a state of 'liminality': unable to make sense of their new situation and experience and, despite assumptions that ageing-in-place sustains social connectedness, excluded from their communities.
Drug-related problems in the elderly is intended to serve as a source of information and clinical support in geriatric pharmacotherapy for students as well as all health care professionals, e.g. physicians, nurses and pharmacists. Pharmacotherapy is of great importance to all mankind. Drugs are however powerful and must be handled appropriately. This is especially important for elderly patients. Drug-related problem is not a major subject in most university programmes in medicine or pharmacy. When there is no speci c course, there is often no book covering the topic. In our view, as teachers at various university courses, there has been a shortage of literature that re ects the most important aspects of drug-related problems in the elderly. Medical practitioners, nurses and pharmacists, need to have this knowledge to be able to serve their patients in the best way. This book covers most aspects of drug-related problems in the elderly. With b- ter knowledge of drug-related dif culties and risks we hope that elderly will have fewer drug-related problems and bene t more from their pharmacotherapy.
Food or calorie restriction has been shown in many short-lived animals and the rhesus monkey to prolong life-span. Life-long nutrition studies are not possible in humans because of their long survival. Studies over two to six years in healthy adult humans have, however, shown that a 20% reduction in food or calorie intake slows many indices of normal and disease-related aging. Thus, it is widely believed that long-term reduction in calorie or food intake will delay the onset of age-related diseases such as heart disease, diabetes and cancer, and so prolong life. Over the last 20 or more years there has been a progressive rise in food intake in many countries of the world, accompanied by a rising incidence of obesity. Thus our increasing food and calorie intake has been linked to the rising incidence of cardiovascular disease and diabetes in early adult life. It is accepted that overeating, accompanied by reduced physical exercise, will lead to more age-related diseases and shortening of life-span. The answer is to reduce our calorie intake, improve our diet, and exercise more. But calorie restriction is extremely difficult to maintain for long periods. How then can we solve this problem? Edited by a team of highly distinguished academics, this book provides the latest information on the beneficial effects of calorie restriction on health and life-span. This book brings us closer to an understanding at the molecular, cellular and whole organism level of the way forward.
This volume will be a reliable source on the management of the elderly with renal disease. There is an ever-increasing proportion of the aging population affected by renal disease and hypertension, and physicians are faced with atypical clinical presentations of renal disease in the aged as compared to younger people. This volume combines the fields of nephrology and geriatrics and presents a multidisciplinary approach to the topic.
For many, caring for a chronically ill family member is "the right thing to do", but it is also often a source of emotional hardship, physical stress, and social isolation. In response, skill-building, coping, and psychoeducational programs have emerged to help caregivers meet the changes and challenges in their - as well as the patients' - lives. Education and Support Programs for Caregivers reveals the diversity of the caregiver population as well as their experiences and needs, and it introduces an empirically solid framework for planning, implementing, and evaluating caregiver programs. The book synthesizes current trends, exploring the effectiveness of different types of programs (e.g., clinic, community, home based) and groups (e.g., peer, professional, self-help), and how supportive programs lead to improved care. Coverage includes: Improving service delivery of education and support programs to underserved caregivers. Cultural, ethnic, and gender issues in conducting caregiver education and support groups. Utilization patterns (e.g., a key to understanding service needs). E-health, telehealth, and other technological developments in caregiver services. Evaluating the effectiveness and sustainability of programs. Recommendations for future practice, training, policy, and advocacy. Education and Support Programs for Caregivers offers a wealth of insights and ideas for researchers, practitioners, and graduate students across the caregiving fields, including psychology, social work, public health, geriatrics and gerontology, and medicine as well as public and education policy makers.
As the population ages, clinicians are facing an increasing number of elderly patients with colorectal cancer. These patients pose unique challenges as they have more comorbidities and lower functional reserves. In addition, the treatment goals may differ from those in younger patients. This book discusses in depth the different aspects of management of colorectal cancer in the elderly. After the provision of pertinent background information on the normal physiology of aging, screening and diagnosis are discussed. Subsequent chapters focus on a range of issues associated with the surgical and perioperative care of these patients and with adjuvant treatment and palliative care. Each chapter provides helpful take-home messages in bullet point form, and numerous informative figures and tables are also included. The authors are surgeons, physicians, anesthetists, geriatricians, oncologists, and allied health professionals with extensive experience in the field.
Measurement of Wound Healing will update the knowledge base and promote the use of measurements in order to improve both understanding of wounds and their management. This book will feature well used vascular measurements, pathological measurements, imaging measurements and so on. There will be chapters on techniques/measurements that have much promise. This book is led by 3 experienced clinician scientists from different backgrounds who have successfully worked together on projects.
This book provides a comprehensive but practical understanding of the clinical approach to evaluating and caring for older people with bipolar disorder. Aspects of aging that impact the diagnosis, clinical course, and management of bipolar disorder are explained; in particular, attention is drawn to the implications of comorbidities and medical complexity for the psychiatric care of older individuals with the disorder. On the other hand, similarities to treatment in younger patients are also identified. The coverage includes thorough review of current research in the field. Clinical case vignettes are used throughout to highlight practical points, and each chapter includes "clinical pearls" that summarize key points for the clinician. The book closes by examining anticipated research directions and the future needs of this patient population. Bipolar Disorder in Older Age Patients will be an ideal update for the practicing community or geriatric psychiatrist working with older patients with bipolar disorder.
This is the first work to take a comprehensive look at the application of Magnetic Resonance (MR) techniques in the diagnosis, follow-up and therapy monitoring of dementing illnesses. The authors present an overview of MR findings in neurodegenerative and vascular disorders leading to dementia. In doing so, they also discuss other diseases that lead to cognitive and/or behavioural deterioration, such as infectious inflammatory disorders, toxic encephalopathies, inborn errors of metabolism of adult onset and post-traumatic, post-radiotherapy and post-chemotherapy conditions. This authoritative, well-written and richly illustrated reference work is indispensable for anybody working in the field.
Cardiothoracic Surgery in the Elderly: Evidence Based Practice is an important and timely book that reflects the thoughtful work of pioneers in geriatric surgery. It encompasses their knowledge related to geriatric surgery, and their reflections and guidance on the rapidly accumulating knowledge related to improving the health and surgical care of seniors. This book provides a scholarly review of the constantly expanding knowledge base about cardiovascular and thoracic surgery in seniors. The book follows a logical sequence covering general aspects of care, cardiac surgery and thoracic surgery. Chapters are focused on common, devastating and often missed complications of surgical care in the seniors. These include delirium, depression, pressure sores, functional losses, incontinence, volume depletion and asymptomatic or atypical complications -myocardial infarction, post-operative diarrhea, urinary track infections and pneumonia. Each is expertly reviewed. Strategies to help the surgeons and the surgical team anticipate, recognize and effectively prevent or manage such problems are discussed and the evidence basis for such strategies is provided. Cardiothoracic Surgery in the Elderly: Evidence Based Practice is particularly timely and the first to review the substantial body of knowledge that has been developed in recent years related to geriatric cardiothoracic surgical problems. It catalogs well the expanding knowledge basis for achieving successful surgical outcomes in the very old. It provides a most useful resources for cardiovascular thoracic surgeons in training and those already in practice.
Caring for people with disabilities often becomes an all-encompassing responsibility for one or more family members. To manage the multifaceted demands, caregivers must possess strong multitasking skills, including the ability to assist with daily life tasks; provide emotional support; help with financial affairs; mediate and advocate with health care providers. Maintaining balance within their own lives can become incredibly challenging for caregivers. More often than not, providing care for family members or loved ones occurs at the expense of the caregivers' well-being. And for caregivers who themselves have disabilities, it further complicates matters. Multiple Dimensions of Caregiving and Disability addresses concerns that have been long familiar to the caregiver population and examines the current state of family care for individuals with disabilities. With a lifespan perspective, this concise reference reviews the literature on specific problems of caregivers and explores which care strategies are effective, promising, or lacking in available resources and support interventions. Contributors also explore the more fluid and subjective aspects of caregiving, such as feelings, spirituality, and family roles. Suggestions for future policy improvements, particularly within the public health sector, are discussed as well. Topics covered include: * Family dynamics and caregiving for people with disabilities. * Parent caregiving of children with disabilities. * Race, ethnicity, socioeconomic status, and caregiving. * Educational, training, and support programs for caregivers. * Emerging technologies to aid caregivers. * Developing partnerships between caregivers and health care providers. Multiple Dimensions of Caregiving and Disability is a must-have resource for researchers, scientist-practitioners, policy makers, and graduate students across such disciplines as clinical psychology, nursing, social work, public health, medicine, and social and education policy.
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."
"Aging, Health, and Longevityin the Mexican-Origin Population"creates a foundation for an interdisciplinary discussion of the trajectory of disability and long-term care for older people of Mexican-origin from a bi-national perspective. Although the literature on Latino elders in the United States is growing, few of these studies or publications offer the breadth and depth contained in this book. "
A quick yet comprehensive guide for anyone considering hip replacement surgery. Each year, more than 300,000 adults in the United States undergo hip replacement surgery. What can the many people experiencing hip pain in this country expect before, during, and after surgery? Hip Replacement-part of a new series of Johns Hopkins University Press books on specific surgical procedures-is designed to provide quick answers to all of the most common questions individuals have about hip surgery and the recovery process. Focusing on the patient experience, this frank and easy-to-use book highlights real patient experiences with hip pain, diagnosis, and treatment. The book * discusses basic hip anatomy * describes the symptoms of hip arthritis * explores alternative treatments, including lifestyle changes, medications, and surgical treatments other than hip replacement * reviews the entire recovery process, including preferred exercises to help speed your recovery and how quickly you can return to certain activities * features a glossary of key terms and a list of frequently asked questions * contains numerous sidebars touching on important points to consider, questions to ask your doctor, red flags, and risks * is supplemented with useful illustrations and photographs The book's concise format allows readers to peruse the content quickly in the days leading up to surgery and then refer to it during the recovery period. Written by experts in the field, Hip Replacement is destined to become the most trusted book on this topic. Contributors: Roy K. Aaron, MD, Valentin Antoci, Jr., MD, PhD, Travis Blood, MD, Eric Cohen, MD, Matthew E. Deren, MD, John Froehlich, MD, MBA, Derek R. Jenkins, MD, Dominic T. Kleinhenz, MD, Scott Ritterman, MD, Lee E. Rubin, MD
As more of us live longer, the fear of an old age devastated by brain diseases like dementia is growing. Many people are already facing the challenges posed by these progressive and terminal conditions, whether in person or because they are caring for loved ones. Dementia is now the fifth most common cause of death across the world. It is small wonder that understanding, preventing, and finally curing these illnesses is now a global priority. Recent advances in brain research have given scientists a better chance than ever of finding ways to help patients, carers, and clinicians dealing with dementia. Yet there is still no effective treatment. Why has progress been so slow? And what can we all do to reduce our chances of getting the disease? In this Very Short Introduction Kathleen Taylor offers a guide to the science of dementia and brain ageing. Never forgetting the human costs of brain disorders - movingly illustrated throughout the book - she also discusses their costs to society. Clearly explaining the research, she sets out the main ideas which have driven dementia science, and the new contenders hoping to make a breakthrough. Taylor also looks at risk factors, and how to lower our chances of succumbing to dementia. Assessing current and potential treatments, including both drugs and other approaches, she explains, clearly and gently, what help is available for someone who is diagnosed with dementia, and how to boost the chances of living well with the condition. ABOUT THE SERIES: The Very Short Introductions series from Oxford University Press contains hundreds of titles in almost every subject area. These pocket-sized books are the perfect way to get ahead in a new subject quickly. Our expert authors combine facts, analysis, perspective, new ideas, and enthusiasm to make interesting and challenging topics highly readable.
Elderly Care Medicine Lecture Notes provides all the necessary information, within one short volume, for a sound introduction to the particular characteristics and needs of elderly patients. Presented in a user-friendly format, combining readability with high-quality illustrations, this eighth edition has been thoroughly revised to reflect advances in knowledge on how disease presents in elderly people, and changes in management practice, particularly regarding stroke, dementia, delirium, and cancer. New for this edition, Elderly Care Medicine Lecture Notes also features: * More treatment tables and boxes throughout for rapid access and revision * Expansion of material on polypharmacy and prescribing * Discussion of emotional support, counselling and spirituality * Advice for doctors on breaking bad news and end-of-life care * Consideration of ethical and legal issues A companion website at www.lecturenoteseries.com/elderlycaremed features appendices which can be used as guidelines in a clinical setting, key revision points for each chapter, further reading suggestions, and extended content for specialty training in geriatrics. Not only is this book a great starting point to support initial teaching on the topic, but it is also easy to dip in and out of for reference or revision at the end of a module, rotation or final exams. Whether you need to develop or refresh your knowledge of geriatrics, Elderly Care Medicine Lecture Notes presents 'need to know' information for all those involved in treating elderly people.
Part exploration, part knowledge building, and part narration, Work and the Older Person: Increasing Longevity and Well-Being draws on the latest research from a variety of disciplines and resources to paint a complete picture of productivity in old age. Dr. Linda A. Hunt and Caroline E. Wolverson, along with 11 contributors, discuss the relationship between work and aging and highlight the importance of working into old age. Each chapter of Work and the Older Person focuses on narratives from older workers that support the evidence presented with personal stories. These stories illustrate the opportunities, challenges, frustrations, and choices that older people face in maintaining a productive lifestyle. Simultaneously, the text highlights current events and the economy largely within Western societies and discusses the struggle some countries have supplying the financial benefits paid to retirees. Overall, the text shows how working into old age can contribute to longevity and greater quality of life. Occupational therapists, occupational therapy assistants, gerontologists, social workers, psychologists, and those working with older people in the health and social care sector will appreciate the inspiring accounts from older workers discussing how work contributes to their self-identity, quality of life, health, and well-being. Work and the Older Person: Increasing Longevity and Well-Being shows how engaging in occupations brings purpose to people’s lives. The text will be of value to all professionals working with older adults, as well as older adults themselves looking to maintain a productive lifestyle.
Ageing population poses a set of complex policy and dilemmas for social security systems, intensifying the concerns about rising expenditures in health care and long-term care for elderly. In this context, ageing societies has many valuable lessons to learn by studying Japan's experience dealing with its hyper-aged society and particularly from its strategies to ensure the financial sustainability of the Long-Term Care Insurance (LTCI) system. Based on an exhaustive literature review, and the results from six original researches on long-term care expenditures in Japan (LTCE) conducted during a doctoral program, the book provides a comprehensive view in analyzing trends and factors associated with increasing expenditures in the Long-Term Care Insurance system in Japan. The book address relevant topics such as; the main socio-demographic changes experienced by the Japanese society during the last three decades, predictors of the LTCE, measuring efficiency in nursing homes, the impact of the LTCI 2005-reform to contain expenditures, cost-effectiveness of the in-home and community based services and institutional LTCE in the last year of life. The book end with a discussion on futures challenges and strategies oriented to contribute with the sustainability of LTCI system in Japan." |
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