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This book offers practical age-adjusted recommendations to treat the most common psychiatric symptoms and syndromes in the geriatric patient. The principles described here are not new; advice for prescribing to the aging patient has always been to "start low, go slow." This book fleshes out that dictum based on research evidence, clinical experience, and trends in the literature. An age-adjusted approach endorses medication interventions when needed as part of a comprehensive treatment plan. A combination of psychotherapeutic interventions, non-pharmacological modalities, and judiciously managed medications can improve quality of life and minimize risks inherent in pharmacotherapy applied to aging physiology. Age-Adjusted Psychiatric Treatment for the Older Patient is divided into five sections, covering the foundations of evaluation and treatment, neurocognitive disorders, psychiatric syndromes, therapeutics and interventions, and special topics. Each chapter begins with a complex case example that illustrates the topic. It then reviews current evidence-based evaluation and treatments. Age-adjusted recommendations, distilled from the literature, are offered at the end of each chapter. The intent is to provide actionable advice to supplement, but not supplant, good clinical judgement, which can improve quality of life by managing psychiatric symptomatology while averting untoward results. This volume is an essential guide for experienced clinicians as well as trainees across many health care disciplines, both generalists and geriatric specialists, who all see increasing numbers of aged patients with psychiatric symptomatology.
This open access book provides a comprehensive perspective on the concept of ageism, its origins, the manifestation and consequences of ageism, as well as ways to respond to and research ageism. The book represents a collaborative effort of researchers from over 20 countries and a variety of disciplines, including, psychology, sociology, gerontology, geriatrics, pharmacology, law, geography, design, engineering, policy and media studies. The contributors have collaborated to produce a truly stimulating and educating book on ageism which brings a clear overview of the state of the art in the field. The book serves as a catalyst to generate research, policy and public interest in the field of ageism and to reconstruct the image of old age and will be of interest to researchers and students in gerontology and geriatrics.
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. - Identifies factors influencing mental health in older adults - Includes biological, sociological, and psychological factors - Reviews epidemiology of different mental health disorders - Supplies separate chapters on grief, schizophrenia, mood, anxiety, and sleep disorders - Discusses biomarkers and genetics of mental health and aging - Provides assessment and treatment approaches
This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
Late-life Mood Disorders provides a comprehensive review of the current research advances in neurobiology and psychosocial origins of geriatric mood disorders. The review of the latest developments and "gold standards" of care is provided by an international group of leading experts.
Cognitive Behaviour Therapy (CBT) is now well established as an effective treatment for a range of mental health problems, but for clinicians working with older clients, there are particular issues that need to be addressed. Topics covered include the need to build a therapeutic relationship, dealing with stereotypical thinking about ageing, setting realistic expectations in the face of deteriorating medical conditions, maintaining hope when faced with difficult life events such as the loss of a spouse, disability, etc., and dealing with the therapist's own fears about ageing. Illustrated throughout with case studies, practical solutions and with a troubleshooting section, this is essential reading for all clinical psychologists, psychiatrists and related health professionals who work with older people. * Authors are world authorities on depression and psychotherapy with older people * First book to be published on CBT with older people * Case studies and examples used throughout to illustrate the method and the problems of older people
At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
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.