Since the first edition of this book was published there have been considerable changes in continuing care. NHS nursing homes have been created, enthusiasts have developed new initiatives, and attempts have been made to improve attitudes. The recent White Paper on Community Care is likely to accelerate the transfer of large numbers of elderly patients from long-stay hospital beds to private-sector accommodation: a move often accompanied by much anxiety about standards of care. Although Health Authorities visit private nursing homes and apply the National Association of Health Authorities' standards to them, anxieties continue. Unfortunately for the patients who remain in hospital, many Health Authorities seem reluctant to apply these same standards to their own long-stay departments, since many would fail abysmally. The 1987 annual report of the Health Advisory Service (see Chapter 3) presents a damning indictment of the care given to old people: A recent review of twelve consecutive HAS Reports on services for older people in hospitals shows that long-stay wards consistently offered environments which were unable to offer privacy, homely surroundings, personal space and possessions or adequate furniture. In the twelve districts there was not one comprehensive personalised clothing service. Half of the reports commented on the lack of effec- tive management of continence. Catering was often provided according to the needs of the institution rather than those of the resident patients.

In 2009 jahrt sich die Wiedergrundung der Heidelberger Akademie der Wissenschaften zum hundertsten Mal. Aus diesem Anlass veranstaltet die Landesakademie jeweils gemeinsam mit den acht Universitaten des Landes Baden-Wurttemberg Tagungen oder Vortragsreihen. Das Symposium "Altern gestalten - Medizin, Technik, Umwelt", dessen systematisch geordnete Beitrage diesen Band fullen, wird so gemeinsam mit der Universitat Stuttgart und der Robert Bosch Stiftung geplant und durchgefuhrt. Themenfelder sind: Biologische Plastizitat des Alternsprozesses, moegliche molekulare, zellulare und biochemische Regenerationsprozesse. Auf der mikro- und makrotechnologischen Ebene werden verfugbare Assistenz- und Ersatzsysteme demonstriert, einschliesslich der vielfaltigen Methoden von Gelenkrekonstruktion oder -ersatz, und die Unterstutzungs- und Ersatzsysteme fur defekte Sinnesorgane. Die damit eroeffneten Moeglichkeiten, ungleiches Altern von wichtigen Funktionstragern des Koerpers auszugleichen, werden von fuhrenden Wissenschaftlern der jeweiligen Disziplinen demonstriert. Auch das aktuelle Wissen um die altersgerechte Gestaltung der Umwelt und der Wissensstand uber Assistenzsysteme im Automobil, die auch bei altersbedingten Einschrankungen von Beweglichkeit, Kraft, Sicht und Reaktionsgeschwindigkeit mehr Bedienungskomfort und Fahrsicherheit gewahren, wird vermittelt.

A high-level text on the molecular and genetic aspects of human ageing with reference to cognitive functions and age-related diseases."

Neurotransmitter changes taking place in the brain of patients with dementia disorders, mainly Alzheimer type dementia, are reported. Their role in the pathogenesis of Alzheimer's disease is discussed; and the neurochemical changes are considered as a base for formulating treatment strategies. By studying markers in the cerebrospinal fluid, diagnostic methods may be achieved that will aid in diagnosing subgroups of dememtia.

This volume presents a clear, concise overview of the current state of knowledge about the biology of aging - serving as both an invaluable graduate-level text and a key reference for practicing professionals. Over a dozen distinguished contributors probe the latest developments in our knowledge of why people age and how the process works. These authoritative chapters are not just written for biologists - but for gerontologists in general. Marks the tenth anniversary of the Annual Review of Gerontology and Geriatrics.

The shifting demographic toward a "graying" population -- coupled with today's reality of managed care -- makes the need for high-quality, cost-effective psychiatric services within the nursing care setting more urgent than ever. As we increase the number of our years, it is also imperative that we enhance the quality of those years.

The product of the American Psychiatric Association's (APA's) Council on Aging and its Committee on Long-Term Care and of the Elderly, the Manual of Nursing Home Practice for Psychiatrists stands out because it focuses on the "how" -- not the "why" -- of nursing home care. Of exceptional importance is its detailed discussion of the Minimum Data Set (MDS), a structured assessment required by both Medicare and Medicaid for all residents of skilled nursing facilities.

Divided into six sections, this "how to" volume contains practical information readers can use right away, from getting reimbursed by insurance companies to handling nursing facility politics: - Clinical -- History; evaluation and management of psychiatric problems in long-term care patients; an overview of the MDS; sexuality within the nursing home care setting- Regulatory -- Introduction to the Nursing Home Reform Act of 1987 (part of OBRA-87) and its implications for psychiatric care; details about the Resident Assessment Instrument (RAI), which includes the MDS, the Resident Assessment Protocols (RAPs), and Utilization Guides specified in the State Operations Manual (SOP)- Financial -- Documentation, reimbursement, and coding; what to look for when contracting with nursing homes- Legal and ethical -- The dehumanizing effect of diagnostic labels and the ethical issues inherent in regulating daily schedules (e.g., bed, meal, and bath times); nursing home placement; competence and decision-making ability; comfort care for end-stage dementia; coping with Alzheimer's disease; and the role of caregivers- Summary and Future Perspectives -- A detailed vision about how psychiatrists can improve the diagnosis and treatment of nursing home patients- Appendixes and bibliography -- Staffing recommendations and assessment instruments

Edited by a distinguished authority and former chair of the APA's Committee on Long-Term Care and Treatment of the Elderly, this comprehensive volume will appeal to a wide audience of professionals: from general psychiatrists, nurse practitioners, and clinical nurse specialists, to primary care physicians and residents.

The number of diabetics in the elderly population is increasing rapidly, not merely because of the increasing size of the elderly population itself. In elderly people diabetes is often poorly diagnosed and occurs as a consequence of, or in addition to, some other condition. Although diabetes may manifest itself less dramatically in the elderly there is evidence to suggest that diabetes-related complications do arise more rapidly in this group. It is therefore extremely important that doctors and health professionals can spot the symptoms of diabetes at an early stage. This book provides a concise description of diabetes in the elderly as well as discussing related complications and should be useful to all health workers dealing with elderly people.;This book should be of interest to all health professionals working with elderly people.

The study of "the end of life" has become a major focus on medicine, the social sciences, ethics, and religion. This volume brings together the latest research on issues around death and dying, life's attributes as it nears death, planning and preparation for death, and care and intervetion-related issues. This evidence-based finding of this volume will help shape how we approach the topic for years to come.

Traditional methods in the clinical practice of neurology have dominated clinical teaching in this specialty for about 100 years. Essentially these methods involve meticulous attention to detail and the recording of clinical facts. Thus the clinical history must be recorded chronologically, preferably in the patient's own words, and of the nervous sys followed by a carefully structured examination tem set out in such a way as to allow the precise localisation of the lesion or system involved. Clinical neurology taught and practised in this way has bred generations of neurologists throughout the world and raised the standards in the specialty to a level where clinical skills are probably unexcelled in any other specialty. With increasing availability and reliance upon non-invasive imaging techniques, the need for these skills in large areas of neurological practice has diminished. But perhaps more importantly, the classical clinical methods in neurology were developed when the elderly population was much smaller and when the specialty of geriatrics did not exist. As a result, much of the methodology is irrelevant or unreliable in of geriatrics will frequently the elderly population and the student find himself searching in vain in the textbooks of neurology for help in assessing an elderly patient with an atypical presentation (for example disturbance of balance or recurrent confusional episodes) of some common neurological disorder."

Illness in old age is characterised by vague and atypical presenting features which are often missed and wrongly attributed to the ageing process. This is particularly true of endocrine disorders where hypothyroidism may mas querade as dementia, where electrolyte imbalance may cause lassitude, and where diabetes mellitus may produce a wide range of complications com monly associated with ageing. It is our intention that our book provide straightforward practical guidance in this difficult area by delineating the effects of ageing on endocrine function and the clinical consequences of these; and by describing in detail the wide range of presenting clinical fea tures of endocrine disease in the elderly. Physicians are also often baffled and misled by the effects of ageing and disease on laboratory tests used in the investigation of endocrine disease. Our book describes these changes in detail, and gives guidance on which tests are most appropriate. Ageing and disease also produce subtle changes in the response of patients to drugs and replacement, and this is also dis cussed in detail. Subjects included separately and in depth include thyroid disease, the clinical features and treatment of diabetes, postmenopausal changes, bone disease, fluid and electrolyte imbalance, energy imbalance, and drugs caus ing endocrine and metabolic disorders. These have been chosen because we consider that they present problems which are particularly relevant to the elderly. Many other issues are covered in general textbooks of endocrin ology and have been omitted."

The concept of dementia has itself been the subject of increasing refinement and precision in definition and diagnosis. Two important sub-types have been identified: Alzheimer's disease and multiple-infarct dementia. Alzheimer's disease or Senile Dementia of the Alzheimer Type (SDA T), arises out of changes in the brain which are as yet poorly understood and identifiable with certainty only at post mortem examination. This type of dementia has been named after Alois Alzheimer, who first identified these changes, in the earliest years of this century. Alzheimer's is the commonest type of identified dementia. The second commonest type is multi-infarct dementia (MID), which follows a stroke or strokes affecting the relevant part of the brain. Like SDA T, it can be diagnosed with certainty only after death, although Jorm (1987, Ch. 8) reviews progress in using various types of tests which can suggest, if not confirm, its presence during the sufferer's lifetime. As will be shown in Chapter 2, some populations appear to reverse the general picture and exhibit more MID than SDAT. Many dementia sufferers cannot, even after a post-mortem examination, be neatly categorized as one or the other of these sub-types. A considerable uncertain 'grey area' of dementia remains at present very poorly understood. Some elderly people develop dementia as a side-effect of known physical disease. Some of these conditions are curable. Care of the demented person has traditionally taken place in the community: hospitalization is a fairly recent innovation.

Elderly patients are major consumers of antidepressant drugs, yet this subject is under-researched. The elderly are particularly sensitive to the adverse affects of psychotrophic drugs, and they are often given a variety of drugs simultaneously. It is therefore vital that doctors should be well informed about this subject.;The aim of this book is to provide comprehensive guidance on the drug therapy for depression in old age to the clinicians involved in the health care of elderly people.;The book starts be discussing the epidemiology, presentations and assessments of depression in old age. The main part of the book deals with problems of antidepressant drug therapy, such as which antidepressant to prescribe, how to monitor side effects, what is the adequate dose, how long to treat a single episode of depression and who requires long-term medication.;This book should be useful reading for all doctors who care for elderly people.;This book should be of interest to general physicians, psychiatrists, psychopharmacologists and physicians in geriatric medicine.

Incontinence is still a subject which is rarely discussed. But, since this very common condition can severely impair a person's lifestyle, information about it needs to be made more widely available, both to health professionals and to lay people.;This text describes the nature of incontinence, how it can be managed, and gives information about the aids, equipment and services available to help those affected by this problem. It is a revised version of a book originally published in 1977 under the title - "Incontinence: A Guide to Understanding and Management of a Very Common Complaint". Since the earlier publication the services available to people with incontinence have increased significantly. More doctors and Incontinence Advisers (usually nurses) have expertise in the field, and manufacturers have improved their products. Incontinence can severly affect a person's self-esteem, family relationships and mobility. It is hoped that this book will help educate lay and professional readers about incontinence and how sufferers can be helped.;This book should be of interest to health professionals (doctors, nurses, physiotherapists), social workers, volunteers working with disabled people, lay people.

The study of "the end of life" has become a major focus on medicine, the social sciences, ethics, and religion. This volume brings together the latest research on issues around death and dying, life's attributes as it nears death, planning and preparation for death, and care and intervetion-related issues. This evidence-based finding of this volume will help shape how we approach the topic for years to come.

As our population continues to age, health professionals are being called on to care for an ever-increasing number of elderly patients. A thorough understanding of what constitutes normal aging versus age-prevalent illness is essential. In addition, the atypical and nonspecific presentation of illness commonly encountered when caring for an older patient must be expected and watched for carefully. In recent years, the health professional has been exposed to an exponentially increasing number of publications attempting to teach geriatric principles. To date, few publications lend themselves to use by the busy practitioner, student, or nurse in search of immediate facts, flow sheets, and clinically applicable data. It was felt that the health professional would benefit greatly from a book based on the concept of a ready-reference "hand book," with chapters filled with tables, flow sheets, and listings similar in scope to those in a well-presented lecture series. Our goal was to create a geriatrics handbook that would have value at the bedside as well as in the classroom. It is to this end that the contributors dedicated their efforts."

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.

How do digital technologies shape both how people care for each other and, through that, who they are? With technological innovation is on the rise and increasing migration introducing vast distances between family members--a situation additionally complicated by the COVID-19 pandemic and the requirements of physical distancing, especially for the most vulnerable – older adults--this is a pertinent question. Through ethnographic fieldwork among families of migrating nurses from Kerala, India, Tanja Ahlin explores how digital technologies shape elder care when adult children and their aging parents live far apart. Coming from a country in which appropriate elder care is closely associated with co-residence, these families tinker with smartphones and social media to establish how care at a distance can and should be done to be considered good. Through the notion of transnational care collectives, Calling Family uncovers the subtle workings of digital technologies on care across countries and continents when being physically together is not feasible. Calling Family provides a better understanding of technological relationality that can only be expected to further intensify in the future.

For much of the developed world, health care for a surging elderly population looms as one of the most daunting problems of the coming decade. In this book, contributors from diverse disciplinary backgrounds and countries discuss resource allocation for the elderly and debate plans for the years ahead. Essays focus on five general issues: the meaning of old age, the goals of medicine and health care for the elderly, the balance between the needs of the young and old, the pressures of other social priorities, and the role of families, especially the burden on women, in long-term care.

In consideration of the difficult moral and practical issues involved, the editors conclude the volume with a special report containing policy recommendations from representatives of eight countries (the United States, Belgium, the Czech Republic, Germany, Hungary, the Netherlands, Sweden, and the United Kingdom). This important volume will be of interest to policymakers and a broad spectrum of health care professionals, as well as to anyone interested in the fate of the elderly or in coming health care challenges.

A history of aging in America surveys and compares actualities and attitudes in the eighteenth, nineteenth, and twentieth centuries and suggests practical improvements on the current inadequate system of pensions, social security, medicare, and other programs.

Increasingly, scholars from many disciplines have begun to incorporate various modalities from the humanities and arts - novels, films, artwork, and other forms of expression - to help connect students with the experience of aging in deeply meaningful and person-centered ways. This collection examines how these approaches are incorporated into gerontology and geriatrics education. Rather than focusing solely on measurable outcomes, such as changes in learning over time - which is the purview of empirical pedagogy - chapters focus on strategies for successfully incorporating a specific work into the classroom, descriptions of humanities and/or arts exercises with students or older adults, and other ways that explore how the humanities and arts can be applied successfully and meaningfully in educational settings. This book was originally published as a special issue of Geronotology & Geriatrics Education.