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Books > Medicine > Clinical & internal medicine > Geriatric medicine
"The first lesson is that success looks like whatever your patient describes it as ... Some want to be pain free, to breathe a little easier, to make it to their grand-daughter's wedding ... to be with their cats. Some want me to do everything I can to cure them, while others want to die soon." Geriatric care and the frailty of old age can sometimes be reduced to a pain score chart rather than an inevitability that needs to be approached with humanity and empathy. Dr Riaz Dharamshi combines his expertise knowledge as a nationally recognised geriatrician with the relatable, deeply empathetic stories of his patients in order to reframe the way we approach care for our elderly population. This empowering and socio-politically conscious book delves into theoretical discussions around death and old age, drawing light on how many issues arise from social and political factors that take root decades earlier. It presents practical details of an integrated model of care allowing for expert, personalised healthcare to be delivered within our communities and outside of the hospital. This is a book that encourages the question 'Who is the person to whom this is happening?' rather than just 'What is the medical problem?'. It is ultimately this approach that imbues meaning, purpose, and justice into the work of geriatric medicine and care.
Auf die Bedurfnisse der taglichen Praxis abgestimmt Umfassende Information, inklusive NEU u.a. Nach den Leitlinien/Richtlinien Interdisziplinar, topaktuell. Von den fuhrenden Experten aus Deutschland, Osterreich, Schweiz. Wissen fur das optimale Diabetes-Management gerade heute besonders wichtig."
Aging is associated with morphologic and functional alterations of organ systems including the genitourinary tract. Aging of the bladder leads to urgency, frequency, dysuria, recurrent urinary tract infections and incontinence both in the aging men and women. These symptoms occur frequently, are very distressing and influence daily life of the aging person. Besides patients symptoms, medications and incontinence devices are a tremendous financial burden on health care systems. Understanding the morphologic and functional processes of the aging bladder may decrease symptoms, costs and develop new, preventive strategies for the treatment of the aging bladder. This book reviews present knowledge of morphologic and functional alterations of the aging bladder both in men and women adding new insights in order to optimize therapeutic options for the treatment of aging bladder in daily practice and improve patients quality of life.
A wide variety of ambitions and measures to slow, stop, and reverse
phenomena associated with aging have been part of human culture
since early civilization. From alchemy to cell injections to
dietary supplements, the list of techniques aimed at altering the
processes of aging continues to expand. Charlatans, quacks, and
entrpreneurs proffering anti-aging products and practices have
always exploited uniformed customers and instilled doubt and
apprehension toward practices intended to extend life. Recently,
however, the pursuit of longevity has developed into a respectable
scientific activity. Many biologists are substantially funded by
the government and the private sector to conduct research that they
believe will lead to effective anti-aging interventions.
The global burden of geriatric hip fractures is enormous. From both the patient's and physician's perspective, the injury is complex. A hip fracture often changes a patient's life and/or the life of the patient's family permanently. From the physician's perspective, care of geriatric hip fracture patients requires a multidisciplinary team, which is led by the surgeon and which includes internists and other subspecialists within internal medicine, anesthesiologists, nurses, operating room technicians, social workers, physical therapists, and rehabilitation center coordinators and staff. Nowhere in the orthopedic literature is there a text that guides care for these complex patients from injury through recovery. This text is the first to do so by organizing and synthesizing a large body of literature. Its main themes include pre-operative, operative, and post-operative care of the patient who sustains a geriatric hip fracture. Its main objective is to organize the current body of literature into a cohesive whole so that the busy orthopedic surgeon does not have to undertake a literature search each time he or she wants an answer to the myriad questions that characterize a patient's injury, treatment, and recovery course. With regard to pedagogy, because orthopedic surgeons in training will utilize this book, and because the case study is the central pedagogical tool in the field of orthopedic surgery, this book includes case studies within each chapter, with the author's preferred treatment and decision-making rationale for each case. Selected video supplements reinforce real-world application of knowledge. Practicing orthopedic surgeons, as well as orthopedic residents and fellows in training, will find Geriatric Hip Fractures: A Practical Approach a highly useful and informative resource.
La "cultura geriatrica" - intesa come conoscenza e dominio dei processi di invecchiamento - non ha avuto ancora piena affermazione in campo medico-sanitario. Questo comporta che il piu delle volte non si sappia distinguere a pieno il limite tra il fisiologico e il patologico che distinge l'anziano sano con gli inevitabili "acciacchi" dovuti all'invecchiamento da quello abbisognevole di supporti sanitari e/o assistenziali. Finora si e spesso trattato l'anziano con la cultura dell'adulto, molto diversa da quella geriatrica, con il risultato di considerare malato anche chi ha solo il torto di dimostrare i propri anni. In sostanza, mentre le eta della crescita e della piena efficienza sono ben conosciute nei loro aspetti normali e patologici, non altrettanto avviene per l'eta della decadenza, per la quale ci si avvale impropriamente di un altro metro di valutazione. Il risultato inevitabile di tutto questo e che gli interventi di supporto per la terza eta possono essere scorretti, cosi come l'impiego delle risorse umane e finanziare ad essa destinate. I vincoli economici sempre piu stretti da un lato e il progressivo allargamento della popolazione anziana dall'altro rendono ormai ineludibile l'affermarsi di una vera e propria "cultura geriatrica" non solo in campo diagnostico radiologico ma anche in tutte le altre discipline specialistiche. Quest'opera vuole andare in questa direzione."
This best-seller in geriatrics is even better in an updated and completely revised new edition. Geriatric Secrets provides a substantial knowledge base in geriatric medicine and provides a wealth of insights into the art and practice of geriatrics, featuring all the most important "need to know" questions and answers in the proven format of the Secrets Series (R). Thought-provoking questions that provide succinct answers Presentation of a vast amount of information, but not overly simplistic The most important "need-to-know" questions-and-answers in the proven format of the highly acclaimed Secrets Series (R) Concise answers that include the author's pearls, tips, memory aids, and "secrets" Bulleted lists, algorithms, and illustrations for quick review Thorough, highly detailed index
Gerontology did not emerge as a scientific field of inquiry in the United States until the twentieth century. By tracing intellectual networks and analyzing institutional patterns, Crossing Frontiers shows how old age became a "problem" worth investigating and how a multidisciplinary orientation took shape. Gerontology remains a marginal intellectual enterprise, but its very strengths and weaknesses illuminate the politics of specialization and academic turf-fighting in U.S. higher education.
Although philosophers, physicians, and others have long pondered the meanings and experiences of growing older, gerontology did not emerge as a scientific field of inquiry in the United States until the twentieth century. The study of aging borrows from a variety of other disciplines, including medicine, psychology, sociology and anthropology, but its own scientific basis is still developing. Despite dozens of aging-related journals, and a notable increase in state, regional, national and international networks, there are no widely shared techniques or distinctive methods. Theories of aging remain partial and tentative. By tracing intellectual networks and analyzing institutional patterns, Crossing Frontiers shows how old age became a 'problem' worth investigating and how a multidisciplinary orientation took shape. Gerontology is a marginal intellectual enterprise but its very strengths and weaknesses illuminate the politics of specialization and academic turf-fighting in U.S. higher education.
Why do we age? Is aging inevitable? Will advances in medical knowledge allow us to extend the human lifespan beyond its present limits? Because growing old has long been the one irreducible reality of human existence, these intriguing questions arise more often in the context of science fiction than science fact. But recent discoveries in the fields of cell biology and molecular genetics are seriously challenging the assumption that human lifespans are beyond our control. With such discoveries in mind, noted cell biologist William R. Clark clearly and skillfully describes how senescence begins at the level of individual cells and how cellular replication may be bound up with aging of the entire organism. He explores the evolutionary origin and function of aging, the cellular connections between aging and cancer, the parallels between cellular senescence and Alzheimer's disease, and the insights gained through studying human genetic disorders--such as Werner's syndrome--that mimic the symptoms of aging. Clark also explains how reduction in caloric intake may actually help increase lifespan, and how the destructive effects of oxidative elements in the body may be limited by the consumption of antioxidants found in fruits and vegetables. In a final chapter, Clark considers the social and economic aspects of living longer, the implications of gene therapy on senescence, and what we might learn about aging from experiments in cloning. This is a highly readable, provocative account of some of the most far-reaching and controversial questions we are likely to ask in the next century.
This book presents an interactional sociolinguistic approach to the progressive communicative breakdowns typical of Alzheimer's disease. The language used in open-ended, naturally occurring conversations between the author and one elderly female Alzheimer's patient over four-and-a-half years is investigated in an attempt to understand how the patient's communicative abilities and disabilities are related, how they change, and how they are influenced by the behavior of the healthy interlocutor.
This book examines the concepts of preventive care and health promotion specifically in the context of the elderly. It adopts a broad concept of health and defines a number of goals around this theme. Thereafter it provides a succinct, up-to-the-minute critique of the worth, risks and costs of preventive care and health promotional strategies for older people. A broad range of such strategies are considered including cancer prevention, the prevention of non-cancer health problems and strategies aimed at enhancing functional status and strengthening the social support network. Principles for tailoring these strategies to the varied needs and wishes of elderly people are outlined. Likewise, practical measures are discussed for integrating these preventive strategies into the existing health care system. In particular, the role of screening, case-finding and targeting strategies in primary care are reviewed in detail. The book concludes with a wider look at the cost implications of preventive care for the purchasers of health and health care services.
This thoughtful and compassionate account addresses some of the difficult ethical and medical issues raised in the provision of health care for the dependent elderly patient. Care of the dependent elderly is subject to conflicting priorities arising from the demands of patients, their relatives, the fair allocation of medical and financial resources, and the medical ethos to prolong life. A distinguished team of contributors, selected from the fields of medicine, philosophy, ethics, and law, discuss and critically evaluate these issues. This volume will provide a focus for further debate and interest in this important subject.
The latest addition to the Evidence-Based Book series, "Evidence-Based Geriatric Medicine" provides non-geriatrician clinicians an overview of key topics central to the care of the older patient. This guide focuses on the management of common problems in the elderly taking into account their life situations as well as treatment of specific conditions. Leading geriatricians with expertise in evidence-based medicine utilize the best available evidence and present this information in a concise, easy-to-use, question-based format. "Evidence-Based Geriatric Medicine" is a unique guide to the optimum management of older patients.
This volume presents a series of case narratives, following individual patients and families throughout the course of illness and death in the context of hospice and palliative care. Using a variety of qualitative research methods, including participant-observation, interviews, and journal-keeping, the experiences, perceptions, and feelings of the patient, the family and a range of caregivers are recorded, providing the reader with rich, multi-textured narratives. Going beyond conventional case reports in Medicine, typically concentrating on symptoms and treatment, these narratives depict how individuals find personal meaning in illness, and how this influences the experience and outcome of care.
We live in an ageing society, where people are living longer, and where decreases in the birth rate mean that the proportion of the population above retirement age is steadily increasing. An ageing population has considerable implications for health services and care provision. Consequently there is a growing interest among researchers, medical practitioners, and policy makers in older adults, their capabilities, and the changes in their cognitive functioning. This book offers an up-to-the-minute account of the latest methodological and theoretical issues in cognitive ageing. Part of the Debates in Psychology series, it sets out the arguments surrounding the currently controversial questions in cognitive ageing. What is the appropriate methodology for understanding cognitive change? How many factors are necessary to understand the patterns of age-related change? What might these factors be? The topics and arguments are explored in a series of chapters by the leading researchers in the field. Each contributor offers their view of how cognitive ageing can be best understood, and together they cover a broad range of cognitive functions including language use, cognitive slowing, and memory loss. Each of the chapters stands alone as the latest review of work in the area. Taken together, the chapters form a coherent theoretical debate through which the reader will learn about the dynamic nature of cognitive ageing research, and about the direction this research will be taking in the future. Models of Cognitive Aging will be an invaluable resource for anyone with an interest in the elderly, and in their cognitive abilities.
To a certain extent the dementias have been forgotten diseases until just recen tly when they were brought to the attention of the general public and health authorities as a result of the increasing number of cases in the aging popula tion, especially among famous people, and because of the efforts of private foundations. The goals of the present volume are to present the dementias to health prac titioners, to provide some basic information on their epidemiology and biolo gical basis and to discuss the diagnostic and clinical problems that physicians and institutions face when caring for demented patients. This book explores the various types of dementias and is not limited to Alzheimer's disease although, as expected, more information is available and presented on this pathology. On the other hand, a few fundamental questions on dementia can only be answe red through a comparison of the various forms. Examples of such questions are the following: Is the loss of cerebral tissue sufficient to cause dementia? Are there thresholds or is there a continuous progression toward the irreversible development of dementia? Are there common pathways in the dementing pro cess? Are there common risk factors? Comparative analysis allows the common and distinctive patterns of the various dementias to be defined, ultimately lea ding to more focused therapeutic interventions."
Comprehensive overview of literary works that illuminate the experiences of aging. Bibliographical essays analyze the ideas or themes relating to over 70 topics. Lengthy critical annotations accompany the more than 350 literary works, across various genres, on the different topics. An introduction, how to use the work section, careful cross-referencing, and author and subject indexes make this a useful research tool for gerontologists, health-care professionals, and general readers concerned with aging. Selective, annotated bibliography aimed at providing gerontologists, health care professionals, and general readers interested in the aging process, a useful tool for identifying and utilizing literary works that provide insight into various topics in gerontology. Part One contains bibliographical essays on more than 70 topics in gerontology. Each essay analyzes the ideas or themes that a number of literary works provide on a specific topic. The essays illustrate the relevance of literary works to gerontology study, introducing readers to a variety of works whose characters, plots, themes, or images bear on current topics in gerontology. Part Two includes detailed critical annotations of more than 350 literary works, including anthologies, autobiographies, novels, plays, poems, and stories. Annotations are detailed and draw out specific issues related to characterization, plot, conflicts, themes, imagery, and metaphors. This comprehensive overview includes an introduction, a chapter about how to use the guide, and author and subject indexes.
The proportion of elderly people continues to increase in the western world-nearly a quarter of the population will be over 65 years by the year 2050. Since aging is accompanied by an increase in diseases and by a deterioration in well-being, finding solutions to these social, medical and psychological problems is necessarily a major goal for society. Scientists and medical practitioners are therefore faced with the urgent task of increasing basic knowledge of the biological processes that cause aging. More resources must be put into this research in order to achieve better understanding of the cellular mechanisms that underlie the differences in life span between species and to answer the difficult questions of why some individuals age more quickly than others, and why some develop liver problems, some have heart problems, and others brain problems. The results of such a wide program of research will provide important information about the causes of many life-threatening and/ or debilitating diseases of old age; it will help find ways to prevent some of the ailments that result from aging, and it may well lead to discoveries enabling the prolongation of human life.
The second edition of PROTOCOLS IN PRIMARY CARE GERIATRICS continues its mission of improving practical, clinical knowledge among physicians and others caring for elderly people, while providing updated information on several major areas in the field. Reflecting current practice trends, a new chapter on home care has been added as well as one on comprehensive geriatric assessment. Revised guidelines for falls, incontinence, and drug treatment are also featured. Designed to provide both quick reference to clinical problem-solving schemes and lists, as well as a lucid, readable discussion of basic topics in geriatrics, the book's value lies in its combination of brief, readable chapters, a section of notes in outline form, staightforward clinical approaches, didactic exercises, and new updated case studies. Family physicians, primary care internists, and other primary specialists caring for elderly people will find this book of great value. It is also not to be missed by residents, as well as nursing homes, hospitals, and indiviual health care professionals, other than physicians, who will benefit from its use as a clinical reference guide.
"Public Health and Aging" was published to critical acclaim almost fifteen years ago. Much has changed in public health since then. Thomas R. Prohaska, Lynda A. Anderson, and Robert H. Binstock now offer a completely new and updated overview of the field in "Public Health for an Aging Society". This comprehensive survey discusses research, policy, and practice; managing and preventing diseases; promoting mental and physical health; and maintaining quality of life for an aging society. The fields of public health and aging have grown increasingly complex. Given the interdependency of issues posed by an aging society, the editors of this volume expand the traditional scope and treatments of public health and aging by adopting a social-ecological perspective that incorporates individual, family, community, societal, and environmental concerns. Chapters address the most critical public health issues facing an aging society, including Medicare and family caregiving, and introduce many new and emerging concepts, such as emergency preparedness, technology in aging, translational research, genomics, and environmental influences on health and health practices. The emergence of an aging society in the United States has far-reaching consequences for every generation. This book provides the latest information and future directions for the public health of this growing population. Students and practitioners will find "Public Health for an Aging Society" an invaluable resource both in the workplace and the classroom.
The appropriate and rational use of drugs by the elderly is a matter of growing medical and social concern. Persons aged 65 years and older constitute about 12%-15% of the population in the Western world, and the total number of the elderly will increase significantly in the coming years. This population accounts for 30% of all the prescription drugs used. Aging, specifically the transition from middle to old age, is a complex process. From the perspective of clinical pharmacology, these pathophysiological changes may reasonably be expected to alter responsiveness to drugs. The age-related differences in response to drugs can arise from alterations in pharmacokinetics or pharmacodynamics. This makes it mandatory that clinical pharma cological studies be carried out in the elderly during extended phase I studies. The older the population likely to use the drug, the more important it is to include the very old. It is also important not to exclude ....: ''lecessarily patients with concomitant illnesses; it is only by observing, such patients that drug-disease interactions can be detected. Reports from surveillance systems have greatly increased our awareness of problems associated with drug therapy in old age."
As the life expectancy of patients with arterial hypertension increases, hypertension in the elderly is becoming a relevant medical and social problem. Indeed, epidemiological trials have shown that the cardiovascular risk in elderly hypertensives is significantly higher than in normotensive subjects of comparable age. However, many characteristics of hypertension in the elderly, such as the haemodynamic pattern, do differ greatly from those of younger hypertensives and therefore the results obtained in younger patients cannot be extrapolated to older hypertensives. In this book, experts on hypertension have examined different aspects of hypertension in the elderly: from the changes in the cardiovascular system associated with ageing, to the role of ambulatory blood pressure measurement in the diagnosis of hypertension and the results of the recent clinical trials into the efficacy and tolerability of antihypertensive drugs. This book covers all the clinical aspects of hypertension in the elderly in such a way that it will become a valuable tool for medical students, general practitioners and specialists in hypertension alike.
Although age has been recognized as a risk factor for late-onset dementia of Alzheimer type, its etiology is unknown as yet. Several age-related metabolic abnormalities may thus become important for the pathogenesis of the late-onset form. Studies at the cellular/molecular level in brain tissue are possible post mortem, but lack information on the beginning of the disorder. In this supplement, different approaches are dealt with how to induce structural and/or metabolic abnormalities in relevant cell cultures, in brain slices and in experimental animals, and how behavioral changes parallel the metabolic variations.
The Handbook of Mental Health and Aging, Third Edition provides a foundational background for practitioners and researchers to understand mental health care in older adults as presented by leading experts in the field. Wherever possible, chapters integrate research into clinical practice. The book opens with conceptual factors, such as the epidemiology of mental health disorders in aging and cultural factors that impact mental health. The book transitions into neurobiological-based topics such as biomarkers, age-related structural changes in the brain, and current models of accelerated aging in mental health. Clinical topics include dementia, neuropsychology, psychotherapy, psychopharmacology, mood disorders, anxiety, schizophrenia, sleep disorders, and substance abuse. The book closes with current and future trends in geriatric mental health, including the brain functional connectome, repetitive transcranial magnetic stimulation (rTMS), technology-based interventions, and treatment innovations. |
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