Nursing home reform, Professor Farmer asserts, calls for increased emphasis upon issues related to life rather than care. Organizational climate, which reflects the nursing home's unique position to impact life issues, provides a conceptual framework for effective interventions, evaluations, and ultimately meaningful reform.

The general atmosphere of most nursing homes remains overwhelmingly negative in spite of those few homes that are credited with excellence. Professor Farmer believes that the concept of organizational climate holds promise for better understanding the complexities and impact of atmosphere in any one nursing home. At the same time, organizational climate as a concept is poorly understood. There is a need to rethink the concept and return to the original notion of weather as its metaphor. Farmer attempts this in her case study by describing organizational climate where it can best be captured.

Practitioners of long-term care, from the fields of administration, geronotology, nursing, nutrition, policy makers, occupational and physical therapy, social work, and therapeutic recreation will find the insights of this study of great value, as will graduate students, scholars, and others concerned with organizational studies and issues in gerontology.

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 volume brings together noted scientists who study presbycusis from the perspective of complementary disciplines, for a review of the current state of knowledge on the aging auditory system. Age-related hearing loss (ARHL) is one of the top three most common chronic health conditions affecting individuals aged 65 years and older. The high prevalence of age-related hearing loss compels audiologists, otolaryngologists, and auditory neuroscientists alike to understand the neural, genetic and molecular mechanisms underlying this disorder. A comprehensive understanding of these factors is needed so that effective prevention, intervention, and rehabilitative strategies can be developed to ameliorate the myriad of behavioral manifestations.

The aim is to provide students and researchers in auditory science and aging with a understanding of the various effects of aging on the auditory system.

Contents:

• Introduction and Overview Sandra Gordon-Salant and Robert D. Frisina
• The Physiology of Cochlear Presbyacusis Richard A. Schmiedt
• The Cell Biology and Physiology of the Aging Central Auditory Pathway Barbara Canlon, Robert Benjamin Illing, and Joseph Walton
  
• Closing the Gap between Neurobiology and Human Presbycusis: Behavioral and Evoked Potential Studies of Age-related Hearing Loss in Animal Models and in Humans James R. Ison, Kelly L. Tremblay, and Paul D. Allen
• Behavioral Studies with Aging Humans: Hearing Sensitivity and Psychoacoustics Peter J. Fitzgibbons and Sandra Gordon-Salant.
• Binaural Processing and Auditory Asymmetries David A. Eddins and Joseph W. Hall III

• The Effects of Senescent Changes in Audition and Cognition on Spoken Language Comprehension Bruce A. Schneider, Kathy Pichora-Fuller, and Meredyth Daneman
• Factors Affecting Speech Understanding in Older Adults Larry E. Humes and Judy R. Dubno
• Epidemiology of Age-related Hearing Impairment Karen J. Cruickshanks, Weihai Zhan, and Wenjun Zhong
• Interventions and Future Therapies: Lessons from Animal Models James F. Willott and Jochen Schacht

Sandra Gordon-Salant is Professor and Director of the Doctoral Program in Clinical Audiology in the Department of Hearing and Speech Sciences at the University of Maryland, College Park. Robert D. Frisina is Professor of Otolaryngology, Neurobiology & Anatomy, and Biomedical Engineering, and Associate Chair of Otolaryngology at the University of Rochester Medical School. Arthur N. Popper is Professor in the Department of Biology and Co-Director of the Center for Comparative and Evolutionary Biology of Hearing at the University of Maryland, College Park. Richard R. Fay is Director of the Parmly Hearing Institute and Professor of Psychology at Loyola University of Chicago.

About the series:

The Springer Handbook of Auditory Research presents a series of synthetic reviews of fundamental topics dealing with auditory systems. Each volume is independent and authoritative; taken as a set, this series is the definitive resource in the field.

Immunosenescence is a unique, multi-disciplinary approach to the understanding of immune aging. It addresses the topic from the biological, as well as the psychological, social and behavioral perspectives. It is, thus, a valuable and timely addition to the literature in this area. Contributors include experts in the field, reviewing the state of the art in research.

This important handbook addresses technologies targeted at the assessment, early detection and the mitigation of common geriatric conditions. These include decline in functional abilities, gait, mobility, sleep disturbance, vision impairment, hearing loss, falls, and cognitive decline. This book not only describes the state of both embedded and wearable technologies, but also focuses on research showing the potential utility of these technologies in the field.

Over 4 million Americans suffer from Alzheimer's disease, which is an organic disorder that is progressive, debilitating, and irreversible. The economic cost of treating and providing care for those with Alzheimer's is over $40 billion a year. The emotional cost to the sufferers and their families is beyond estimation. Yet Alzheimer's is often misdiagnosed, mistreated, and mismanaged. The purpose of this book is to help physicians, health care administrators, graduate students and researchers better understand diagnostic procedures, treatment and management factors related to Alzheimer's disease and other dementias in the elderly.

This book synthesizes the major research advances in molecular, biochemical and translational aspects of aging and heart failure over the last four decades and addresses future directions in management and drug discovery. It presents clinical issues and molecular mechanisms related to heart failure, including the changing demographics in the aging population with heart failure; hypertension and prevention of diastolic heart failure in the aging population; polypharmacy and adverse drug reactions in the aging population with heart failure; changes in the heart that accompany advancing age from humans to molecules; aging-associated alterations in myocardial inflammation and fibrosis and aging-related changes in mitochondrial function and implications for heart failure therapy. The book succinctly summarizes the large volume of data on these key topics and highlights novel pathways that need to be explored. Featuring contributions from leading clinician-scientists, Aging and Heart Failure: Mechanisms and Management is an authoritative resource on the major clinical issues in heart failure therapy in the elderly for cardiologists, gerontologists and internists.

This up-to-date bibliography of heretofore scattered references to nursing assistants includes literature pertinent to the construction of models to improve nursing assistant practice and emphasizes the psychosocial skills that are invaluable to the nursing assistant's work. Annotated reviews center on the tasks and context of nursing assistant work and ways to improve practice through training, organizational development, advocacy, and bargaining. Additional chapters present a tentative psychosocial model of nursing assistant practice, offer six intervention models, and investigate ways of further developing the nursing assistant occupation. Very highly recommended. Choice The role of the nursing home has expanded in the late twentieth century due to both the growing percentage of elderly in the U.S. population and to society's tendency to over-institutionalize people. In recent years, the kinds and quality of care given to the elderly in nursing homes have received intense scrutiny. This timely bibliography focuses on nursing assistants--the personnel who are with the elderly around the clock, doing a variety of tasks, ranging from helping them with basic functions to comforting them during periods of distress. Nursing assistants provide as much as 90 percent of the direct care received by the elderly in the nursing home setting. Emphasizing the psychosocial skills that make the nursing assistant's job so important to the well being of nursing home residents, Geriatric Nursing Assistants collects and annotates the heretofore scattered references to nursing assistants and includes literature pertinent to the construction of models that improve nursing-assistant practice. The first four chapters present the annotated reviews, which are organized in anticipation of the practice enhancement models discussed in Chapter Six. These reviews center on the tasks and context of the nursing assistant's work and on ways to improve practice through training, organizational development, advocacy, and bargaining. Chapter Five offers a tentative psychosocial concept of nursing-assistant practice that requires further development, detailing the various resident psychosocial circumstances to which the nursing assistant might respond helpfully and the kinds of interventions and techniques which the nursing assistant might attempt. In Chapter Six, intervention models--on inservice training, organizational development, advocacy, and bargaining--are presented in ideal-typical forms that recognize the limitations of daily practice; also, these models emphasize rigorous practice and its evaluation. Activities necessary to further develop the nursing-assistant occupation, including political action, are investigated in Chapter Seven, which also considers the moral aspects of a progressive agenda for nursing assistants. This reference seeks to improve services to nursing home residents and represents a valuable, practical contribution to the geriatric field. It will be useful to nursing home administrators and directors of nursing homes who must address ways to improve the working conditions of nursing assistants; to academicians in their research, training, and advocacy efforts; and to the training directors and supervisors in the field who can directly aid nursing assistants in the acquisition of needed knowledge and skills.

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.

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.

Demographics reveal that the proportion of elderly individuals in the population is growing at a significant rate. Advances in medicine have allowed populations to live longer than ever; however, ensuring that these individuals have the tools necessary to sustain a productive and happy lifestyle as they age remains a concern. Optimizing Assistive Technologies for Aging Populations focuses on the development and improvement of devices intended to assist elderly individuals in coping with various physical limitations and disabilities. Highlighting the available tools and technologies for supporting the mobility, agility, and self-sufficiency of the aging population as well as the challenges associated with the integration of these technologies into the everyday lives of elderly individuals, this publication is ideally designed for reference use by healthcare workers, medical students, gerontologists, and IT developers in the field of medicine.

This fifth edition of Autonomic Failure covers the many recent advances made in our understanding of the autonomic nervous system. There are numerous new chapters and extensive revisions of all other contributions. This book makes diagnosis increasingly precise by fully evaluating the underlying anatomical and functional deficits, thereby allowing more effective treatment. This new edition continues to provide a rational guide to aid in the recognition and management of autonomic disorders for practitioners from a variety of fields, including neurology, cardiology, geriatric medicine, diabetology and internal medicine.

This book discusses theoretical issues, standards, and professional considerations arising when legal and health practitioners undertake legal capacity assessments in the context of wills, enduring powers of attorney and advance health directives. The potential loss of cognition can erode autonomy as individuals lose the ability to make their own legally recognised decisions. This is an inescapable problem with significant legal, social, health and policy repercussions. This work synthesises and critically analyses the existing literature, including some of the best assessment models and guiding principles internationally, to generate a new methodology and understanding of what capacity assessment best practice means. This includes the impact of assessments on individual autonomy - the ideal method building upon respect for both autonomy as well as fundamental human rights. The triggers to assess capacity, who to involve in the assessment process, as well as how to conduct that assessment process are discussed. The crucial relationship between the legal and health professionals involved in assessments, including growing concerns around practitioner liability, is also explored. This analysis is undertaken through the innovative use of a therapeutic jurisprudence lens, the effect of which is to contribute new knowledge to this complex field.

This book provides a unique analysis of provider-, environment-, client-, and societal-based obstacles to the empowerment of frail elderly persons in a philosophical framework of social values, as well as an applied framework wherein a variety of international case studies by a distinguished board of contributors provide concrete examples of the feasibility of achieving real empowerment. Empowerment means different things to different people in the context of housing, health, and social service delivery. This book analyzes the various definitions of the concept and practice of the empowerment of frail older persons and then discusses the definitions in a philosophical framework of social values regarding aging and the older person.

Each chapter demonstrates the feasibility of achieving increased empowerment of older persons, even those with severe physical or mental disability. True empowerment of older persons in every country requires time, energy, money, and commitment to the goal. This book will be of interest to academic as well as professional audiences in areas of Gerontology, Psychology, Sociology, and Family Studies. Caregivers and policymakers will also find this analysis useful.

This book investigates sociological, demographic and geographic aspects of aging in rural and nonmetropolitan areas of the United States. Population aging is one of the most important trends of the 20th and 21st centuries, and it is occurring worldwide, especially in more developed countries such as the United States. Population aging is more rapid in rural than urban areas of the U.S. In 2010, 15 percent of the nonmetropolitan compared to 12 percent of the metropolitan population were 65 years of age and older. By definition rural communities have smaller sized populations, and more limited healthcare, transportation and other aging-relevant services than do urban areas. It is thus especially important to study and understand aging in rural environments. "Rural Aging in 21st Century America" contributes evidence-based, policy-relevant information on rural aging in the U.S. A primary objective of the book is to improve understanding of what makes the experience of rural aging different from aging in urban areas and to increase understanding of the aged change the nature of rural places. The book addresses unique features of rural aging across economic, racial/ethnic, migration and other structures and patterns, all with a focus on debunking myths about rural aging and to emphasize opportunities and challenges that rural places and older people experience."""

This definitive guide encompasses past, present, and future issues of theory, research, and practice in areas of interest and specialization in aging, and represents current trends of thought on gerontology, the science of and associated practices with the elderly. This volume is a collection of articles dealing with the psychological, social, and cultural domains affecting older people and contains general biomedical understandings and practical/clinical applications. The contributors broadly outline some of the most relevant academic issues, including cross-cultural perspectives on age and aging; past and future trends in life expectancy with underlying explanations; innovations and advances in research design and methodology in the study of the aging process and the effects of age as a variable; and past and current theoretical perspectives on the psychology and sociology of aging. Some pertinent concerns for practitioners and clinicians are addressed, such as successful counseling therapies with older adults and changes in social work and rehabilitation practice with the elderly. The thought-provoking chapters provide a wide-sweeping, multidisciplinary review of a rapidly expanding field of interest and represent a definite desire among the contributors to evolve a theoretical apparatus and a related, applied arena of endeavor.

This important work on a significant and timely issue of concern will broaden our understanding and awareness of the rising number of positive efforts within gerontological studies now being derived from diverse disciplinary roots. The reader will find articles on subjects of particular interest, such as the Biology of Aging, the Psychology of Adult Development and Aging, Rehabilitation of the Elderly, and Social Work and Aging. An extraordinarily detailed reference, this work will be a valuable resource for gerontologists, social workers, psychologists, and doctors specializing in geriatrics.

This book aims to clarify the potential association between frailty and cardiovascular disease in older people. Covering the biological as well as the clinical point of view, it allows researchers and clinicians to discover the significance of this topic. The contributions cover the most important aspects in the potential relationship between frailty and cardiovascular disease. In particular, authoritative authors in this field have clarified the definition and the epidemiology of frailty and cardiovascular disease in older people. A large part of the volume is dedicated to the biological mechanisms of frailty and cardiovascular disease, trying to find those in common between these two conditions. Since this book is dedicated to both researchers and clinicians, we have proposed some chapters to the importance of comprehensive geriatric assessment in the evaluation and treatment of cardiovascular diseases and frailty. In this regard, the importance of geriatric evaluation in cardiac surgery for older people is well covered. Finally, the importance of cardiac rehabilitation and physical exercise is summarized, being, actually, the most important treatments for both frailty and cardiovascular disease. Written by many well-known and widely published experts in their respective fields, this book will appeal to a wide readership such as researchers in the field and clinicians, especially suited in geriatric medicine and cardiology who, every day, face frail older patients.

An encouraging and compassionate guide for dementia caregivers. Caring for someone with dementia means devotedly and patiently doing a hundred little things each day. But few care providers are trained to meet the challenges of dementia-despite the fact that millions of people will struggle with it as they grow older. In A Loving Approach to Dementia Care, Laura Wayman, who is known professionally as the Dementia Whisperer, offers practical, compassionate advice on overcoming caregiving obstacles and maintaining meaningful relationships with loved ones who have dementia and memory loss. In this thoroughly revised third edition, Wayman includes * answers to common caregiver questions, such as "What is dementia?" * a detailed explanation of how to cope with and care for a spouse with dementia symptoms, including advice about communication * a new chapter on caring for someone who has dementia along with other health problems * recommendations about how to handle challenging situations and behaviors * dementia-aware activities that work for both family caregivers and professional care staff * fresh caregiving insights that emphasize the importance of taking time to care for oneself Each chapter contains two sections-"Lessons Learned" and "Perceptions and Approaches"-which provide details about how readers can apply lessons from the stories Wayman tells to their own caregiving practice. Providing support for the numerous difficulties and disruptions that all caregivers face along the way, A Loving Approach to Dementia Care is an empathetic guide filled with respect, calm, and creativity. It will leave readers feeling empowered and inspired.

The prominence of dementia within the global aging population has undergone an increase in recent years. To improve the living conditions of patients, researchers must place more emphasis on early detection methods. Improving the Quality of Life for Dementia Patients through Progressive Detection, Treatment, and Care provides a thorough overview of emerging research on various neuroscience methods for the early diagnosis of dementia and focuses on the improvement of healthcare delivery to patients. Highlighting relevant issues on health information systems, behavioral indicators, and treatment methods, this book is a pivotal reference source for health professionals, neuroscientists, upper-level students, practitioners, and researchers interested in the latest developments within the field of dementia treatment.

The average age of the world's population is increasing at an unprecedented rate and this increase is changing the world. This "Silver tsunami" emphasizes the need to provide advanced training in epidemiology and increase the cadre of experts in the study of aging. This book is designed to summarize unique methodological issues relevant to the study of aging, biomarkers of aging and the biology/physiology of aging and in-depth discussions of the etiology and epidemiology of common geriatric syndromes and diseases. Contributing authors in the book represent many disciplines, not only epidemiology and clinical geriatrics, but also demography, health services, research, cardiovascular disease, diabetes, psychiatry, neurology, social services, musculoskeletal diseases and cancer. The aim of the book is to provide a broad multidisciplinary background for any student/researcher interested in aging. The material in the book is organized and comprehensive. It represents the most up-to-date information on the scientific issues in aging research written by academics who specialize in research and training in the broad field of aging. The structure and organization of the book reflects our course series in the Epidemiology of Aging starting with the broad issues of demography and methodology, and then addressing specific health conditions and geriatric conditions common to older persons.

Kapp's annotated list of 617 titles, in 13 sections, focuses on sources that discuss the `identifiable body of law concerned with personal and institutional relationships, implicated by the delivery of health care for the elderly.' This work is meant for health professionals, attorneys, researchers, educators, and advanced students. The succinct yet informative annotations cover references from January 1, 1980, to August 31, 1987. . . . Highly recommended. Choice Legal questions relating to health care for the elderly have grown increasingly numerous and complex. While these issues have been dealt with extensively by researchers and professional specialists, the literature has grown so vast in the past decade that it is difficult to keep abreast of legal developments. This bibliography is designed to assist practicing health, human services, and legal professionals as well as researchers, teachers, and students in identifying and evaluating information sources that will provide essential guidance on the legal implications of health care for the elderly. Organized in thirteen subject sections, the volume contains more than six-hundred annotated references dealing with institutional regulations and standards of care, disability determinations, decisionmaking for critically ill patients, involuntary commitment, advocacy services for the older health care consumer, and many other topics. Citations consist of books, book chapters, journal articles, and reports published from 1980 onwards. Entries are cross-referenced systematically, and author and subject indexes are provided. This important new reference will be an invaluable working tool for professionals and students who need to understand and deal with some of the most difficult issues in the field of modern health care.

De cibo quod superest nobis sufficit; oportet gratias agere. Some elders have accepted this proposition, although seldom with enthu- siasm. Gerontologists also have been burdened with the adage: "Leftovers are good enough for us, and we should be grateful for them." I remember how a clerk tried to palm off astale and cheap cigar to her octogenarian customer. He knew better and carne away with a far superior smoke. The clerk fumed, "What does he need a good cigar for? Who is he to be particular!" In this and in many other ways, elders often have labored under the sociocultural expectation that they should be well content with whatever scraps and shmattes happen to come their way. Gerontologists can identify with this situation. The systematic study of aging and the aged was a new enterprise at the midpoint of this century, but the concepts and methods were pretty much limited to those already on hand. What biological and sociobehavioral scientists had been doing for years was simply extended to the newly annexed territory. This as not only a convenient but also a cost-effective strategy. Data accumulated more rapidly by remaining within familiar frarnes of reference and relying on farniliar designs and mea- sures. The new gerontologists soon harvested a promising crop of descriptive findings. Within a decade after the establishment of the Gerontological Society of America (1947), it was possible to discern the outlines of a valuable new field of knowledge.

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."