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Delirium is a cognitive disorder consisting of deficits of attention, arousal, consciousness, memory, orientation, perception, speech and language. It is a prevalent, although relatively misunderstood and often mis-diagnosed, disorder of old age. This book provides a comprehensive, critical overview of the current state of international delirium theory and research.
The fully updated second edition of this popular handbook concisely summarises all current knowledge about delirium in critically ill patients and describes simple tools the bedside clinician can use to prevent, diagnose and manage delirium. Chapters discuss new developments in assessing risk and diagnosis, crucial discoveries regarding delirium and long-term cognitive outcomes, and dangers of sedation and death. Updated management advice reflects new evidence about antipsychotics and delirium. This book explains how to minimise the risks of delirium, drugs to avoid, drugs to use and when to use them, as well as current theories regarding pathophysiology, different motoric subtypes leading to missed diagnosis, and the adverse impact of delirium on patient outcomes. While there are still unanswered questions, this edition contains all the available answers. Illustrated with real-life case reports, Delirium in Critical Care is essential reading for trainees, consultants and nurses in the ICU and emergency department.
This book provides a comprehensive, scholarly, and practical account of delirium that will be of value for all doctors and nurses involved in the care of the elderly. It not only offers a state of the art update on delirium, covering its history, epidemiology, pathophysiology, assessment, diagnosis, causes, prevention, and management, but also presents evidence-based and practical information relevant to daily clinical routine. Owing to the complex multifactorial causes of delirium, different aspects of delirium in the elderly are discussed from a variety of perspectives. The book closes by presenting a series of case vignettes, delirium assessment tools and screening scales, and a list of those drugs highly associated with delirium. Delirium is a cognitive disorder characterized by deficits in attention, arousal, consciousness, memory, orientation, perception, speech, and language. It is a common and serious problem among older persons at every healthcare interface. Although it occurs in 10–60% of the older hospitalized population, delirium remains a relatively misunderstood and misdiagnosed condition. This book will be of interest to professionals working in geriatrics, geriatric psychiatry, general psychiatry, or neurology, internists, intensive care unit specialists, and all who care for the elderly in hospitals or the community.
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Intro -- Foreword -- Acknowledgements -- Contents -- Part I: Nutritional Care in Geriatrics -- 1: Overview of Nutrition Care in Geriatrics and Orthogeriatrics -- 1.1 Defining Malnutrition -- 1.2 Nutrition Care in Older Adults: A Complex and Necessary Challenge -- 1.3 Malnutrition: A Truly Wicked Problem -- 1.4 Building the Rationale for Integrated Nutrition Care -- 1.5 Managing the Wicked Nutrition Problems with a SIMPLE Approach (or Other Tailored Models) -- 1.5.1 Keep It SIMPLE When Appropriate -- 1.5.2 A SIMPLE Case Example -- 1.5.2.1 S-Screen for Malnutrition -- 1.5.2.2 I-Interdisciplinary Assessment -- 1.5.2.3 M-Make the Diagnosis (es) -- 1.5.2.4 P-Plan with the Older Adult -- 1.5.2.5 L-Implement Interventions -- 1.5.2.6 E-Evaluate Ongoing Care Requirements -- 1.6 Bringing It All Together: Integrated Nutrition Care Across the Four Pillars of (Ortho) Geriatric Care -- 1.7 Summary: Finishing Off with a List of New Questions -- References -- Recommended Reading -- 2: Nutritional Requirements in Geriatrics -- 2.1 Nutritional Recommendations for Older Adults, Geriatric and Orthogeriatric Patients -- 2.2 Nutritional Recommendations for Older Adults -- 2.2.1 Energy Requirement and Recommended Intake -- 2.2.2 Protein Requirement and Recommended Intake -- 2.2.3 Micronutrients and Dietary Fibers -- 2.3 Nutritional Risk Factors in Older Adults -- 2.4 Estimating Intake in Older Adults -- 2.5 Nutritional Status of Older Adults, Geriatric and Orthogeriatric Patients -- 2.6 Summary -- References -- Recommended Reading -- 3: Nutritional Assessment, Diagnosis, and Treatment in Geriatrics -- 3.1 The Nutrition Care Process -- 3.2 Nutritional Screening/Risk Detection -- 3.3 Nutritional Assessment and Diagnosis -- 3.3.1 Nutrition Impact Symptoms -- 3.3.2 Nutritional Diagnosis -- 3.3.3 Etiologic Criteria.
This book provides a comprehensive, scholarly, and practical account of delirium for all doctors involved in the care of the elderly. Delirium is defined as an acute or subacute non-specific response of the brain to a wide variety of physical and psychological causes that are nearly always treatable. However, problems arise if the underlying trauma is not identified and corrected, or if the delirious state itself is badly managed or misdiagnosed. In some cases, elderly people may be rendered delirious by their own doctors through haphazard prescribing, inappropriate admission to the hospital, or as a result of surgery. Since our population is aging, the proper identification, assessment, management, and prevention of delirium is essential for the efficient use of health resources. This book will be an invaluable sourcebook for psychologists, gerontologists, psychiatrists, and physicians.
This book provides both the evidence and the guidance to enable doctors to improve their assessment and management of the psychological and behavioural aspects of the most common problems presenting in general medical care. It summarises the recent research evidence and provides common sense guidance on how psychological and psychiatric aspects of illness can be addressed within the medical consultation.
A practical guide to perioperative cognitive disorders, the most common complications of anesthesia and surgery in older people.
The pathophysiology of sepsis can be regarded as a series of steps, beginning with the invasion of normally sterile tissue by microbes and the elaboration of various pro-inflammatory mediators. The final common pathway is often the development of the multiple organ dysfunction syndrome (MODS). Whereas a great deal has been learned during the past quarter century about the inflammatory processes associated with sepsis (and other related conditions, such as ischemia/reperfusion injury), our understanding is far less developed with respect to the pathophysiological events that lead to organ dysfunction under these conditions. Nevertheless, efforts by both clinical and laboratory scientists are leading to new knowledge in this area. The chapters in this volume provide a state-of-the-art overview of many aspects of the pathophysiology of organ dysfunction in critical illness.