Understanding socially disruptive behavior in dementia is never easy. Most explanations offer neither solace nor solutions for families and carers, and treatment is often characterized by policies of control and containment. The result of Graham Stokes' 15 years of clinical work with people who are challenging, this book: disputes the traditional medical model of dementia and asserts that if we reach behind the barrier of cognitive devastation and decipher the cryptic messages, it can be shown that much behavior is not meaningless but meaningful. It contrasts the medical interpretation that sees anti-social behavior as mere symptoms of disease with a person-centered interpretation that resonates change and resolution. It offers a radical and innovative interpretation of challenging behavior consistent with the new culture of dementia care, focusing on needs to be met rather than problems to be managed.

This text assembles together advances in knowledge about dementia, Alzheimers disease and related disorders as they affect persons with intellectual disabilities. Diagnosis, assessment, treatment, management and care practices are detailed in a practical manner for both students and professionals.

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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.

Mental Health Practice in Geriatric Health Care Settings emphasizes the major research and clinical findings realized in five years of research on mental health issues in older urban medical patients, many of whom represent minority groups. Chapters cover the high comorbidity of health and mental health problems in geriatric patients, neuropsychological (or cognitive) assessment, depression, alcohol abuse in health care settings, emerging behavioral medicine issues, and family relations and their tie to medical settings. As a practitioner, you'll find this book helps your practice by representing the first assessment and treatment techniques normed and validated on minority elderly. If you're a professional working in the mental health system, you'll see how to expand your services to health care markets.Mental Health Practice in Geriatric Health Care Settings devotes three chapters to neuropsychological assessment--first, a review of major principles; second, a new test battery for minorities; and third, extensive review on how to use test results in clinical decision making. Other chapters provide valuable information on: the analysis of outcomes for one thousand 60--103-year-olds a new validated behavioral treatment method for depression methods of detection and treatment of alcohol abuse emerging issues in behavioral medicine, including competency assessments; anxiety and pain disorders; and shaping the referral process family relations and health care, including caregiving and nursing home placement nursing home consultation and survival strategies in health care systemsAs Author Peter A. Lichtenberg describes in the Introduction, each chapter in Mental Health Practice in Geriatric Health Care Settings is multidisciplinary, empirically and statistically investigated, and focused upon urban elderly. "In addition, the major objectives are to provide clinicians with new understandings and new assessment and treatment knowledge to utilize in their practices. Finally, this book is hoped to provide clinicians [with] information about emerging trends in the field, and effective strategies for practice in healthcare settings."

Mental Health Practice in Geriatric Health Care Settings emphasizes the major research and clinical findings realized in five years of research on mental health issues in older urban medical patients, many of whom represent minority groups. Chapters cover the high comorbidity of health and mental health problems in geriatric patients, neuropsychological (or cognitive) assessment, depression, alcohol abuse in health care settings, emerging behavioral medicine issues, and family relations and their tie to medical settings. As a practitioner, you ll find this book helps your practice by representing the first assessment and treatment techniques normed and validated on minority elderly. If you re a professional working in the mental health system, you ll see how to expand your services to health care markets.Mental Health Practice in Geriatric Health Care Settings devotes three chapters to neuropsychological assessment--first, a review of major principles; second, a new test battery for minorities; and third, extensive review on how to use test results in clinical decision making. Other chapters provide valuable information on: the analysis of outcomes for one thousand 60--103-year-olds a new validated behavioral treatment method for depression methods of detection and treatment of alcohol abuse emerging issues in behavioral medicine, including competency assessments; anxiety and pain disorders; and shaping the referral process family relations and health care, including caregiving and nursing home placement nursing home consultation and survival strategies in health care systemsAs Author Peter A. Lichtenberg describes in the Introduction, each chapter in Mental Health Practice in Geriatric Health Care Settings is multidisciplinary, empirically and statistically investigated, and focused upon urban elderly. "In addition, the major objectives are to provide clinicians with new understandings and new assessment and treatment knowledge to utilize in their practices. Finally, this book is hoped to provide clinicians with] information about emerging trends in the field, and effective strategies for practice in healthcare settings.""

This comprehensive book gives an up-to-date profile of all aspects of the care of older people in the community, with particular emphasis on the importance of maintaining function and independence as well as health. In a uniquely broad approach, the book is edited by two family doctors with a particular interest in the elderly and a consultant geriatrician, and the varied subjects are each presented by experts in their field. This accessible book enables primary care teams to produce optimal standards of care in old age, and is helpful in the organization of preventive care programmes. Emphasizing the need for joint working, the book draws together practical knowledge and skills to produce an essential source of reference and advice for all those involved in delivering a co-ordinated service. It is essential reading for all doctors in general practice and in public health, medical students and all other professionals whose work brings them into contact with elderly people. It is particularly useful for general practice teams, allied professionals such as nurses and physiotherapists, as well as patients and carers seeking an understanding of good practice. It also contains much practical information vital to the work of voluntary agencies, social service departments and specialists in geriatric medicine.

People with mid-stage dementia are served by special care units in long-term care facilities, although as these residents deteriorate, they are transferred out of the unit and into a general nursing home unit. These nursing homes are not equipped to deal with palliative needs of end-stage dementia care. The book addresses those needs. With this in mind, Part One examines the stages of dementia (end-stage in particular). Other chapters in this section provide background on the hospice movement and hospice concepts; the idea of maintaining personhood; and administration of a late-stage care unit. Part Two focuses on treatment approaches for common needs in end-stage dementia - medical and physical care; a supportive environment; the fundamentals of care; psychopharmacology; and therapeutic activities. Part 3 contains chapters on family-centred care; legal and ethical issues; programme evaluation; and future opportunities.

Contents:
Part 1 Foundations and options for programme development: stages of dementia - an overview; palliative care for late-stage dementia; maintaining personhood - philosophy, goals, programme development and staff education; administration of a late-stage dementia programme in the nursing home setting. Part 2 Treatment approaches for common needs: medical care during late-stage dementia; treatment approaches to common physical care needs; strategies for eating, swallowing and dysphagia; a supportive environment for people with late-stage dementia; communications and fundamentals of care - bathing, grooming and dressing; behaviours associated with late-stage dementia; psychopharmacology and late-stage dementia behaviours; therapeutic activities for low- functioning older adults with dementia. Part 3 Special issues in care: working with the family; making change work - understanding concepts and strategies; legal and ethical issues; programme evaluation; future challenges and considerations.

Approved by the Dietary Managers Association for 9 CEUs through September 1998 Here is a useful guide that helps both administrators and food service workers understand the daily functions of their dietary departments. Dietetic Service Operation Handbook enhances extended caregivers'knowledge of basic food service and clinical dietetics operations and serves as a functional tool they can use to initiate effective organization of dietetic services. It explains proper techniques and tips for everything from how to plan a menu and care for equipment to special adaptive eating devices and modifying texture for swallowing disorders. Packed with general and specific guidelines, this book also teaches food service employees how to allocate time more wisely, making them effective members of the interdisciplinary medical team--and saving their facility time and money as well. Administrators who wish to understand the functions of their dietary department so they can communicate more effectively with its staff will find this book a most useful resource, full of meaningful interpretations of routine tasks found in the daily operation of a food service.The author, registered with the American Dietetic Association, has prioritized the topics in the book to assist the systematic organization of any dietary department. Chapters cover both administrative and clinical topics, including food purchasing and production, the policy and procedure manual, quality assurance, current trends in geriatric nutrition, the effects of medicine on diet, enteral feeding, and documentation of the medical record. Dietetic Service Operation Handbook includes a wide variety of standardized recipes for the pureed diet, a resource list, handy calculations, and many useful forms for record-keeping which are compatible with OBRA laws. Beginning dietitians and dietary managers will find this book to be an extremely helpful and practical guide in their day-to-day work. Beginning or expert administrators and nursing directors will discover it improves their understanding of and communication with their food service operations.

This eighth edition of Dr Reichel's formative text remains the go-to guide for practicing physicians and allied health staff confronted with the unique problems of an increasing elderly population. Fully updated and revised, it provides a practical guide for all health specialists, emphasizing the clinical management of the elderly patient with simple to complex problems. Featuring four new chapters and the incorporation of geriatric emergency medicine into chapters. The book begins with a general approach to the management of older adults, followed by a review of common geriatric syndromes, and proceeding to an organ-based review of care. The final section addresses principles of care, including care in special situations, psychosocial aspects of our aging society, and organization of care. Particular emphasis is placed on cost-effective, patient-centered care, including a discussion of the Choosing Wisely campaign. A must-read for all practitioners seeking practical and relevant information in a comprehensive format.

Focusing on the need for developing new service delivery models for the aged, Health Care of the Aged examines fiscal, political, and social criteria influencing this challenge of the 1990s. The aged are caught in the sweeping changes currently occuring in the financing, organizing, and delivery of human and health care services. From various perspectives, this new book will help shape the direction for elderly health care program development and implementation. With an emphasis on greater long-term care in either home, community, or institutional settings, this important book will increase the understanding for a comprehensive, effective policy designed to carry the growing number of elderly through this decade and into the next. As roles and issues change, this valuable book will become increasingly important to those involved in providing services and care to the elderly. Health care administrators, policymakers, social workers, physical and occupational therapists, and caregivers will benefit from the expertise presented in Health Care of the Aged.

Addressing the early clinical diagnosis of Alzheimer disease, this book was written to evaluate the relevance of current research on the subject. It uncovers the present lack of clinical utility in research methodologies such as neuro-imaging, drug challenges, electro-encephalographic studies and brain biopsy. The essays addressing each of these issues will provide the reader with a perspective on the role of each technology in clinical practice and an in-depth introduction to the technologies and research findings in each of the areas reviewed.

"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'

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.

A collection of easy-to-follow activities, organized by seasons of the year, to help family members and caregivers engage with memory-challenged adults. Dementia and related disorders impact the lives of those affected in countless ways, making it difficult to remain independent at work, at home, and in the wider world. But recent studies have shown that structured activities can make a significant, positive difference by stimulating mental engagement while improving interactions between caregivers and memory-challenged adults. Fun and easy to use, this large-format, full-color picture book is divided into themes representing the four seasons. Each section describes several multisensory experiences-such as walking on the beach, making ice cream, or planting flowers-along with related topics for discussion and activities to elicit memories and encourage new positive associations. The topics and activities incorporate all five senses to facilitate connections and conversations. The book adopts a compassionate, person-centered approach and is designed so that two people can easily look together while sitting side by side. This latest edition, which has been thoroughly revised, * takes a multicultural approach * includes all-new images, as well as 14 completely new highlighted activities * integrates modern wellness concepts * features a new introduction and an updated resource section * offers guidance about activity planning and optimizing interactions between care partners and the individual with dementia Helping you and your loved one make cherished new memories, Through the Seasons is an indispensable solution to the question of what to do together to maintain well-being and connection.

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.

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.

Historically, clinicians and researchers have focused on depression and dementia in older people, paying little attention to anxiety except as a complication of these disorders. However, increased research into late-life anxiety has seen a growth in scientific literature and clinical interest. This important book brings together international experts to provide a comprehensive overview of current knowledge in relation to anxiety in older people, highlighting gaps in both theory and practice, and pointing towards the future. Early chapters cover the broader aspects of anxiety disorders, including epidemiology, risk factors, diagnostic issues, association with insomnia, impaired daily functioning, suicidality, and increased use of healthcare services. The book then explores cross-cultural issues, clinical assessment, and pharmacological and psychological interventions across a variety of settings. An invaluable resource for mental health professionals caring for older people including researchers, psychiatrists, psychologists, specialist geriatric nurses and social workers.

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.

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.

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.

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 has two main purposes: formative case analysis and self-assessment of medicine in old age. It presents clinicians with a series of cases on which to base discussion of the investigation and management of patients. It also provides the trainee, or established doctor, with a medium to help prepare for post-graduate examinations and clinical practice. The authors have chosen 109 cases, a total of 250 questions/answers, illustrated by color photographs, diagrams, and tables. The cases cover the main modes of presentation of acute illness in old age, such as fall, confusion, incontinence, weight loss and immobility, with examples from all the major systems. These illustrate the complexity of diagnosis and treatment of medical illness in frail older people and the need to think widely and laterally when caring for such patients. The questions are mostly in best-of-five format to reflect the current style of multiple choice questions used in examination, though some are open questions as the basis for tutorials. Many of the clinical stems have been expanded to improve the educational function of the book and to test more rigorously the reader's deductive thinking.

"Lifestyle Matters" is a practical resource that contains a wealth of ideas and activities for occupational therapists, support workers, students and other professionals working with older people in the community. Taking a holistic approach, the Lifestyle Matters programme challenges participants to examine their lifestyle and to make positive changes which promote good physical and emotional health. Themes include: "'The relationship between activity and health " Maintaining mental well-being'; 'Maintaining physical well-being'; Safety in the home and community'; and, Personal circumstances. Each theme is divided into a number of sessions with ideas for introductory activities, group discussion topics and group activity ideas. There are also 64 photocopiable handouts in the book and on the downloadable resources that can be used within the group sessions. The book is divided into four parts: 'The Lifestyle Matters programme and the principles behind it'; 'How to implement the programme - including who can benefit from it, how long it should last and the resources required'; 'Delivering the programme - looking at session structure, selecting a session and keeping a record of group and individual sessions'; and, 'The Lifestyle Matters manual - each section containing a combination of group sessions, individual sessions and visits or outings'. Inspired by research by Florence Clark and her colleagues at the University of Southern California, this Lifestyle Matters programme has been developed through consultation with older people at every stage, making it a welcome and invaluable resource. As one member of a group exclaimed, 'You didn't give me a new lease of life, you gave me back my life!'. "Lifestyle Matters" is now referred to in the NICE guidelines (2009) where it is identified as the intervention of choice for therapists and professionals responding to the guidance by this professional body.

Up-to-date information on pain managementincluding options to consider when conventional treatment is ineffective Providing effective treatment for pain-especially to elderly clients-can be a vexing problem for even the most knowledgeable clinician. In Clinical Management of the Elderly Patient in Pain, some of the world's leading authorities describe the unique difficulties that arise when trying to provide pain relief to elderly patients. They examine conventional treatment with opioid and non-steroidal anti-inflammatory drugs along with a broad range of alternatives to consider when frontline drugs fail. Non-drug options for pain relief from the fields of physical medicine and psychology are also explored. Essential topics addressed in Clinical Management of the Elderly Patient in Pain include: pain as an aspect of advancing age how pharmacology differs in elderly patients available therapeutic options, including opioids, non-steroidal anti-inflammatory drugs, anti-epileptic drugs, tricyclic antidepressants, membrane stabilizers, and topical agents physical medicine approaches psychological approaches to pain in the elderly Most publications on this subject focus on the use of opioids, non-steroidal drugs, and other commonly prescribed analgesics. Clinical Management of the Elderly Patient in Pain takes a different approach. Editor Gary McCleane, MD, says, Our need, with elderly patients, is to provide treatment that is both effective and easily tolerated. This is not a book devoted to opioids and non-steroidals, although they are addressed. Nor is it about those analgesics used in younger patients being used in smaller doses with the elderly. Rather, it contains practical options for treating pain when other simple remedies fail to help. At times this will involve using conventional analgesics in scaled-down doses, but at others it will involve using substances not yet fully recognized as possessing analgesic properties because they fit the bill in terms of possible analgesic actions, side-effect profiles, and lack of drug/drug interactionsand because practical experience suggests they may be useful in the scenario described. Clinical Management of the Elderly Patient in Pain is designed as a point of interface between the specialist pain practitioner and the clinician faced with all the problems of satisfactorily managing pain in elderly patients. It presents commonsense, practical, patient-oriented options that make it a useful resource for busy clinicians.