This issue of Clinics in Geriatric Medicine, Guest Edited by Drs. Frederick Luchette and Robert D. Barraco, is devoted to Surgery and the Geriatric Patient. Articles in this issue include: Changing Epidemiology of the American Population; Frailty and Prognostication in Geriatric Surgery and Trauma; Utilization of Geriatric Consultation and Team-Based Care; Palliative Care and Geriatric Surgery; Transitions of Care in Geriatric Medicine; Surgical Oncology and the Geriatric Patient; Orthopedic Surgery and the Geriatric Patient; Vascular Surgery and the Geriatric Patient; Elder Abuse; Falls in the Geriatric Population; Driving in the Geriatric Population; and Suicide and the Geriatric Population.

With the recent discovery that amyloid beta protein, the cause of plaques in Alzheimer's disease, is an antimicrobial peptide produced in response to infection, many researchers are focusing on the role infection plays in the development of Alzheimer's disease. Brain studies have also identified a number of different viruses, bacteria, fungi, and protozoa in the postmortem brain specimens of Alzheimer's patients. Infection (particularly chronic, latent and persistent infections) causes an immune response that leads to inflammation and brain cell degeneration, which are characteristic features of Alzheimer's disease. Sources of infection in Alzheimer's disease vary from childhood infections to gut microbes that find their way into the brain as a result of aging, leaky gut syndrome, and increased permeability of the blood brain barrier. Studies and ongoing clinical trials show that treatment of viral and bacterial infections, as well as restoring a healthy balance to the gut microbiome, can reduce disease risk and improve symptoms in patients with Alzheimer's disease. This book serves as an introduction to the human microbiome and the role that infection plays in the development of Alzheimer's disease.

This book is designed to present an overview of common geriatrics ethical issues that arise during patient care and research activities. Each chapter includes a case example and practical learning pearls that are useful in day-to-day patient care. Coverage includes a brief overview of geriatric epidemiology, highlighting the high rates of dementia, use of surrogate decisions makers at the end-of-life, relocation from home to long-term care facilities, and low health literacy in the geriatrics population. Sections are devoted to issues around capacity, surrogate decision making, end-of-life care, hemodialysis in the elderly, and futility as well as challenges presented by independence questions, such as dementia care, driving, feeding, and intimacy in nursing homes. The text also addresses questions around recognizing, reporting, and treating elder abuse and self-neglect, ethics related to research and technology in the geriatric population, and the use of e-mail, Facebook, and open notes. Written by experts in the field, Ethical Considerations and Challenges in Geriatrics is a valuable tool for trainees at a variety of levels including medical students, residents, and fellows. In addition, it provides practical guidance and a useful reference for practicing geriatricians, primary care physicians, geriatric nurses, social workers, nursing home workers, hospice care employees, and all medical health professionals working with the elderly.

This book provides a comprehensive view of rational suicide in the elderly, a group that has nearly twice the rate of suicide when chronically ill than any other demographic. Its frame of reference does not endorse a single point-of-view about the legitimacy of rational suicide, which is evolving across societies with little guidance for geriatric mental health professionals. Instead, it serves as a resource for both those clinicians who agree that older people may rationally commit suicide and those who believe that this wish may require further assessment and treatment. The first chapters of the book provides an overview of rational suicide in the elderly, examining it through history and across cultures also addressing the special case of baby boomers. This book takes an ethical and philosophical look at whether suicide can truly be rational and whether the nearness of death in late-life adults means that suicide should be considered differently than in younger adults. Clinical criteria for rational suicide in the elderly are proposed in this book for the first time, as well as a guidelines for the psychosocial profile of an older adult who wants to commit rational suicide. Unlike any other book, this text examines the existential, psychological, and psychodynamic perspectives. A chapter on terminal mental illness and a consideration of suicide in that context and proposed interventions even without a diagnosable mental illness also plays a vital role in this book as these are key issues in within the question of suicide among the elderly. This book is the first to consider all preventative measures, including the spiritual as well as the psychotherapeutic, and pharmacologic. A commentary on modern society, aging, and rational suicide that ties all of these elements together, making this the ultimate guide for addressing suicide among the elderly. Rational Suicide in the Elderly is an excellent resource for all medical professionals with potentially suicidal patients, including geriatricians, geriatric and general psychiatrists, geriatric nurses, social workers, and public health officials.

The leading reference in the field of geriatric care, Brocklehurst's Textbook of Geriatric Medicine and Gerontology, 8th Edition, by Drs. Howard M. Fillit, Kenneth Rockwood, and John B. Young, provides a contemporary, global perspective on topics of importance to today's gerontologists, internal medicine physicians, and family doctors. An increased focus on frailty, along with coverage of key issues in gerontology, disease-specific geriatrics, and complex syndromes specific to the elderly, makes this 8th Edition the reference you'll turn to in order to meet the unique challenges posed by this growing patient population. Consistent discussions of clinical manifestations, diagnosis, prevention, treatment, and more make reference quick and easy. More than 250 figures, including algorithms, photographs, and tables, complement the text and help you find what you need on a given condition. Clinical relevance of the latest scientific findings helps you easily apply the material to everyday practice. A new chapter on frailty, plus an emphasis on frailty throughout the book, addresses the complex medical and social issues that affect care, and the specific knowledge and skills essential for meeting your patients' complex needs. New content brings you up to date with information on gerontechnology, emergency and pre-hospital care, HIV and aging, intensive treatment of older adults, telemedicine, the built environment, and transcultural geriatrics. New editor Professor John Young brings a fresh perspective and unique expertise to this edition.

Evidence pertaining to continual violence throughout the life cycle coupled with the experience of growing old in a life permeated by intimate violence is scarce. And the focus is usually on the victims usually, the older, battered women and seldom on their aging partners or adult children who were part and parcel of the violent dynamics in the family system. With the increase in longevity and the older population's subsequent growth in size, the number of elderly couples living and aging in long-lasting conflictive relationships is on the rise. The relatively intense preoccupation with elder abuse in the gerontological literature in recent years has not specifically addressed long-term intimate violence among the old adults and its lasting consequences. Similarly, the literature on intimate intergenerational relationships in old age has usually focused on normative exchanges between partners and their extended family, including their adult children. Therefore, conflictive relationships, and particularly violent ones, have also fallen outside the scope of this body of research. This volume describes and analyzes the various perspectives of family members concerning life, and particularly old age, in the shadow of long-term intimate violence. It explores how people make sense out of living and aging in violence, how interpersonal, familial and cross-generational relationships are perceived and reconstructed and how "we-ness" is achieved, if at all, in such families.

This book presents a wealth of insights and new conceptualizations for the development of Assistive Technologies for the Interaction of the Elderly. The book arranges the chapters according to important aspects of maximizing the use value in innovation projects. Every chapter will include an executive summary reporting the main results, a storyline using everyday language, and scientific excursions, wherever useful. The book shows how an innovation project should be structured towards maximum use value and how a project should be structured in order to make a difference. It describes the useful categorization of the large group of the elderly to maximize the focus of the innovation and demonstrates the user involvement into innovation activities. Of course, the assessment of such innovative projects is discussed as well as the “lessons learned�. The book also explores the business opportunities and the financial evaluation of aspects of assistive technology.  

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.

Geriatric Trauma and Critical Care provides a multidisciplinary overview of the assessment and management of the elderly patient presenting with surgical pathology. By utilizing current literature and evidence-based resources, the textbook elucidates the unique nature of caring for the elderly population. The structure of the volume provides the reader with an overview of the physiologic and psychological changes, as well as the impact on the healthcare system, associated with the aging process. Emphasis is placed on the impact of aging, pre-existing medical problems, effects of polypharmacy, advanced directives and end-of-life wishes on acute surgical problems, including trauma and surgical critical care. Special attention is given to the ethical implications of management of the aged. The multidisciplinary contributors provide a unique point of view not common to surgical texts. The textbook is the definitive resource for practicing surgeons, emergency medicine physicians, intensivists, anesthesiologists, hospitalists, geriatricians, as well as surgical residents, nurses and therapists, all who care for elderly patients with surgical emergencies.

This book examines the social aspects of healthy ageing for older individuals. It features more than 15 papers that explore the relevance of the social environment for health on the micro, meso, and macro level. Overall, the book applies a comprehensive contextual approach that includes discussion of how family and friends, neighborhoods, nations, and welfare regimes influence health. The book first explores the issue on the individual level. It looks at the importance of social capital for health among older people, examines types of social networks and health among older Americans, as well as discusses dynamic social capital and mental health in late life. Next, the book looks at the issue through a neighborhood and societal context, which takes into account day-to-day interaction in the immediate environment as well as the social, health, and economic policies in place in different regions in the world, including America, Europe, Asia, and Africa. From there, the book goes on to offer implications and recommendations for research and practice, including the management of related concepts of research on well-being and health. It also offers a psychosocial approach to promoting social capital and mental health among older adults. This book provides health professionals as well as researchers and students in gerontology, sociology, social policy, psychology, and social work with vital insights into the social factors that increase healthy life years and promote well-being.

Disaster Public Health and Older People introduces professionals, students and fieldworkers to the science and art of promoting health and well-being among older people in the context of humanitarian emergencies, with a particular focus on low- and middle-income country settings. Older people face specific vulnerabilities in physical, mental and social well-being during disasters. They are likely to experience socio-economic marginalisation, isolation, inaccessible information and a lack of relevant post-emergency support services. Meanwhile, although older people can also significantly contribute to disaster preparedness, response and recovery, their capacities are often under-utilised. Drawing on a range of global case studies, this book provides readers with a theoretical underpinning, while suggesting actions at the individual, community and national levels to reduce the health risks to older people posed by the increasing frequency and intensity of disaster, in particular those resulting from natural hazards. Topics covered range from the health impact of disasters on older people and response to their post-disaster health needs, to disaster preparedness, disease prevention, healthy ageing, global policy developments and the contributions of older people in disaster contexts. This book draws on lessons learnt from previous disasters and targets students and professionals working in disaster medicine, disaster public health, humanitarian studies, gerontology and geriatrics.

This book will contain the proceedings of the XV International Symposium on Retinal Degeneration (RD2012). A majority of those who will speak and present posters at the meeting will contribute to this volume. The blinding diseases of inherited retinal degenerations have no treatments, and age-related macular degeneration has no cures, despite the fact that it is an epidemic among the elderly, with 1 in 3-4 affected by the age of 70. The RD Symposium will focus on the exciting new developments aimed at understanding these diseases and providing therapies for them. Since most major scientists in the field of retinal degenerations attend the biennial RD Symposia, they are known by most as the "best" and "most important" meetings in the field. The volume will present representative state-of-the-art research in almost all areas of retinal degenerations, ranging from cytopathologic, physiologic, diagnostic and clinical aspects; animal models; mechanisms of cell death; candidate genes, cloning, mapping and other aspects of molecular genetics; and developing potential therapeutic measures such as gene therapy and neuroprotective agents for potential pharmaceutical therapy. While advances in these areas of retinal degenerations will be described, there will be many new topics that either were in their infancy or did not exist at the time of the last RD Symposium, RD2010. These include the role of inflammation and immunity, as well as other basic mechanisms, in age-related macular degeneration, several new aspects of gene therapy, and revolutionary new imaging and functional testing that will have a huge impact on the diagnosis and following the course of retinal degenerations, as well as to provide new quantitative endpoints for clinical trials. The retina is an approachable part of the central nervous system (CNS), and there is a major interest in neuroprotective and gene therapy for CNS diseases and neurodegenerations, in general. It should be noted that with successful and exciting initial clinical trials in neuroprotective and gene therapy, including the restoration of sight in blind children, the retinal degeneration therapies are leading the way towards new therapeutic measures for neurodegenerations of the CNS. Many of the successes recently reported in these areas of retinal degeneration sprang from collaborations established at previous RD Symposia, and many of those will be reported at the RD2010 meeting and included in the proposed volume. We anticipate the excitement of those working in the field and those afflicted with retinal degenerations will be reflected in the volume.

This book constitutes the thoroughly refereed proceedings of the International Conference on Communication Technologies for Ageing Well and e-Health, ICT4AWE 2016, held in Rome, Italy, in April 2016. The 8 full papers presented were carefully reviewed and selected from 39 submissions. The papers present relevant trends of current research on ageing well and e-health, including: ambient assisted living, mobile assistive technology, lifestyle engineering and life quality, electronic health records, security and privacy in e-Health, smart environments, home care and remote monitoring.

Evidence Based Treatment with Older Adults: Theory, Practice, and Research provides a detailed examination of five research-supported psychosocial interventions for use with older adults: cognitive behavioral therapy, motivational interviewing, life review/reminiscence, problem solving therapy, and psychoeducational/social support approaches. These interventions address the diversity of mental health conditions and late-life challenges that older adults and their family members experience. Detailed explanations of the approaches, skills, and strategies employed in each intervention are provided, as are adaptions for use of the interventions with older adults. Vignettes are also used to demonstrate the use of specific practice skills and techniques with older clients. The theory undergirding each approach and the historical development of the interventions is explained, and provides the reader with a rich understanding of background and context of each therapy. In addition, the distinct issues such as depression, anxiety, substance abuse/misuse for which evidence exists are highlighted. Research support for application of the interventions in community-based, acute care, and long-term care settings and in individual and group formats is also discussed. Finally, implementation issues encountered in therapeutic work with older adults are described as are accommodations to enhance treatment efficacy. In sum, this book provides a comprehensive overview of evidence based psychosocial interventions for older adults; it is ideal for students and mental health professionals interested in clinical work with older adults and their families.

End-of-life issues in cardiology are becoming increasingly important in the management of patients in the cardiac unit, but there is frequently a lack of understanding regarding their impact on cardiology practice. The cardiac unit is increasingly becoming the location whereby a number of key clinical decisions relating to end-of-life care are being made, such as the decision to remove medications, the appropriate removal of cardiac devices, the management of do not resuscitate orders and the requirement for other cardiac procedures in light of the management of the terminally ill cardiac patients. Those working in palliative care need input from the cardiovascular team as the cardiologist is frequently still managing these patients until they are moved to the hospice. That this move into a hospice is often delayed until the very last moment, there is considerable onus on the cardiovascular management of these patients to be much broader in scope and take account of some of the more palliative medical decisions needed in this group of patients. This concise reference will detail the practical issues open to cardiovascular physicians and those medical professionals who manage patients reaching the end of their life from a cardiology perspective. It will detail the full management options open to them to ensure that their practice is in line with the requirements of the patient nearing the end of their life whether the cause be cardiovascular in origin or who need appropriate management of secondary cardiovascular symptoms. It will also include the various ethical, cultural and geographical issues that need to be considered when managing these patients.

This book examines the emergent and expanding role of technologies that hold both promise and possible peril for transforming the ageing process in this century. It discusses the points and counterpoints of technological advances that would influence a reconstruction of what it means to age when embedded in a post-human vision for a post-biological future. The book presents a provocative interdisciplinary meta-analysis that contrasts paradigms with inflection points, making the case that society has entered a new inflection point, provisionally labeled as Post Ageing. It goes on to discuss the moderate and radical versions of this inflection point and the philosophical issues that need to be addressed with the advent of post ageing activities: postponing and possibly ending ageing, primarily through technological advances. This book will be a valuable resource for professionals who wish to review the continuum of varied constructs and intersects of technologies ranging from those purporting to enhance the activities of daily living in older adults, to those that would enable the older worker to stay competitive in the labor market, to those that propose to extend longevity and ultimately, claim to transcend ageing itself-moving toward a transhumanistic domain and more specifically, a post-ageing inflection point.

Care of Older Adults is a comprehensive introduction to aged care for the nursing profession in clinical practice. By taking a strengths-based approach, the book encourages practice with a focus on individuals' potential and capacities rather than their limits. Theories of ageing are linked with the older individual's strengths to ensure the text is well framed from an evidence base, as well as a clinical orientation. The book presents the topic from a healthy ageing perspective through to chronic illness, frailty and end of life. Each chapter includes discussion and reflective questions, and concludes with a list of key points summarising the central content. Case studies combine evidence-based knowledge with practical examples in a number of aged-care settings. Written by internationally renowned authors with extensive practical experience in aged care, Care of Older Adults provides undergraduate students in Australia and New Zealand with local content with a nursing focus.

In recent years, the literature on the topic of ethnic and racial issues in Alzheimer's disease and other dementias has increased dramatically. At the same time, the need for cultural competence in all of geriatric care, including dementia care, is increasingly being acknowledged. Dementia is a large societal problem affecting all communities, regardless of race or ethnicity, and understanding dementia for specific groups is tremendously important for both clinical knowledge and for health planning as a nation. This third edition of Ethnicity and the Dementias offers invaluable background information in this area, while also examining how those suffering from dementia and their family members respond or adapt to the challenges that follow. Thoroughly updated and revised throughout, the book features contributions from leading clinicians and researchers in the field, with particular attention given to genetic and cultural factors related to dementia, effective prevention and treatment strategies, and issues in caregiving and family support. Chapters offer specific recommendations for dementia care in eleven ethnic/racial groups, as well as suggestions for working effectively with LGBTQ families. Providing a truly comprehensive resource on ethnicity and dementia, and including reflections on emerging trends and the future of caregiving, this new edition is ideal reading for clinicians, educators, researchers, policy makers, and families, in search of the most current ethnogeriatric findings.

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.

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 colorectal cancers 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.

Effective, meaningful caregiving requires a well-coordinated and informed effort guided by various highly skilled specialists across several interrelated professions, including psychologists, social workers, and occupational therapists. Multidisciplinary Coordinated Caregiving addresses the information needs of these interrelated professionals, contributing to the direct care of individuals and serving as an essential resource for those who ultimately create collaborative approaches to contemporary caregiving plans. In addition, the volume provides a wealth of evidence-based research findings to facilitate ongoing dialogue about multidisciplinary and interdisciplinary perspectives on and interventions for the complex challenge of caregiving in America. Key areas of coverage include: The status of professional caregiving in the United States. Nursing perspectives on the state of family caregiving. Psychological aspects of caregiving. A human development, lifespan perspective on caregiving during late life. Public health contributions to caregiving. Multidisciplinary Coordinated Caregiving offers a wealth of insights for those researchers, practitioners, and graduate students who seek to optimize the care of individuals across such fields as psychology, social work, public health, geriatrics and gerontology, and medicine as well as public and educational policy making.

This is the new and fully revised third edition of the well-received text that is the benchmark book in the field of nutrition and aging. The editors (specialists in geriatric nutrition, medical sociology, and clinical nutrition, respectively) and contributors (a panel of recognized academic nutritionists, geriatricians, clinicians, and other scientists) have added a number of new chapters and have thoroughly updated the widely acclaimed second edition. This third edition provides fresh perspectives and the latest scientific and clinical developments on the interaction of nutrition with age-associated disease and provides practical, evidence-based options to enhance this at-risk population's potential for optimal health and disease prevention. Chapters on a wide range of topics, such as the role of nutrition in physical and cognitive function, and coverage of an array of clinical conditions (obesity, diabetes, heart failure, cancer, kidney disease, osteoporosis), compliment chapters on food insecurity, anti-aging and nutritional supplements, making this third edition uniquely different from previous editions. Handbook of Clinical Nutrition and Aging, Third Edition, is a practical and comprehensive resource and an invaluable guide to nutritionists, physicians, nurses, social workers and others who provide health care for the ever-increasing aging population.

Primer of Geriatric Urology provides a review of the demographics of our aging urologic population and their unique needs. Chapters review alterations that must be considered in the initial evaluation of the aging patient, and follow with practical suggestions for development of the management plan, whether by counseling, medication, invasive procedure or foregoing procedures. Complications, especially likely in the elderly, are also discussed. The volume also provides a review of the use of necessary adjunctive services such as home care or hospice in the context of Medicare in the USA. An important chapter provides hints on urology practice in a nursing home. The volume concludes with analysis of specific geriatric entities seen in urology practice. Primer of Geriatric Urology will be of great value to urologists, residents, fellows and allied health professionals including physician's assistants and nurse practitioners who treat urologic patients. Additionally, this book will also be of interest to primary care providers who treat elderly patients with urologic problems.

This volume highlights research issues specific to geriatric oncology in the field of carcinogenesis and cancer prevention and treatment, based on the biologic interactions of cancer and age. It conveys a sustainable way of thinking about cancer and aging.

Through their scientific research and clinical practice, husband and wife team Gene D. Cohen and Wendy L. Miller uncovered new clues about how the aging mind can build resilience and continue growth, even during times of grave illness, thus setting aside the traditional paradigm of aging as a time of decline. Cohen, considered one of the founding fathers of geriatric psychiatry, describes what happens to the brain as it ages and the potential that is often overlooked. Miller, an expressive arts therapist and educator, highlights stories of creative growth in the midst of illness and loss encountered through her clinical practice. Together, Cohen and Miller show that with the right tools, the uncharted territory of aging and illness can, in fact, be navigated. In this book, the reader finds the real story of not only Cohen's belief in potential, but also how he and his family creatively used it in facing his own serous health challenges. With Miller's insights and expressive psychological writing, Sky Above Clouds tells the inside story of how attitude, community, creativity, and love shape a life, with or without health, even to our dying. Cohen and Miller draw deeply on their own lessons learned as they struggle through aging, illness, and loss within their own family and eventually Cohen's own untimely death. What happens when the expert on aging begins to age? And what happens when the therapist who helps others cope with illness and loss is forced to confront her own responses to these experiences? The result is a richly informative and emotional journey of growth.