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The progressive growth in the number of older adults worldwide has led to a modification of the current healthcare scenario and a parallel increase in the use of public resources. In this book, we propose a conceptual framework within which aging, frailty, and care are analyzed through the lens of complexity medicine. Therefore, we present a multidimensional perspective that takes into account biomedical, (neuro)psychological, and socio-ecological vulnerability. The theses presented are the result of an inductive approach, based on many years of experience in the field, which has made it possible to identify strategies for frailty recognition and effective responses even in complicated clinical settings. The book is intended to be a tool of concrete and easy consultation, rich in reflections and suggestions.
People are living longer and the population over the age of 60 is burgeoning, with repercussions for health services and healthcare expenditure in developed countries. Crucially, disease aetiology, diagnosis, and treatment in older people differ from the general adult population. Older people often have complicated co-morbidities and respond to treatment in different ways compared to younger people. Evidence of efficacy of different treatments is often lacking because older people are under-represented in clinical trials, and the specific needs of older people are rarely discussed specifically in more general texts. Geriatric medicine: an evidence based approach is a clinical reference for health care professionals who manage older patients, and summarizes up-to-date research literature in a style that can be directly applied by busy healthcare professionals and provide a useful resource for reference.
The most complete, authoritative guide available on the diagnosis and treatment of disorders affecting the elderly -- updated with a new global perspective A Doody's Core Title for 2011! "In addition to serving as a timely, comprehensive, state-of-the-art textbook of geriatric medicine anchored in science, evidence-based medicine, and patient-centered practice, the book also is intended to meet the learning needs of fellows in geriatric medicine. The authors succeed in modeling a textbook of geriatric medicine on textbooks of internal medicine. 3 Stars."--Doody's Review Service The undisputed leader on the subject of geriatrics, this comprehensive guide combines gerontology principles with clinical geriatrics offering unmatched coverage of this area of medicine. Written by some of the world's most respected geriatricians, Hazzard's Principles of Geriatric Medicine and Gerontology presents the most up-to-date, evidence-based medical information available -- in a revamped 2-color design that makes finding the answers to your questions faster and easier than ever. Features: A greater emphasis on evidence-based medicine through the expanded use of Clinical Practice Guidelines and references to systematic reviews and critically appraised topics A new international advisory board of 12 global authorities and an increased number of international contributors for a greater global perspective Important new chapters on the cultural aspects of geriatrics, emergency geriatrics, hospital geriatrics, international geriatric care, and rural geriatric care Information integrated with additional online resources Tables, drawings, and clinical algorithms made even more effective by a new two-color design 300 illustrations (including 64 in a full-color insert)
This book summarizes evidence on frailty and ageing, how this may impact patient outcomes and how frailty can be assessed, managed and incorporated in the decision-making process for older patients with cancer. The book aims to: empower clinical teams to assess and support older cancer patients with frailty, ideally within a multidisciplinary setting; and to improve the selection of older cancer patients to the most appropriate management/treatment strategies in order to improve the outcomes of this group of patients often underrepresented in research. The reader will learn the methods available for assessing frailty, such as screening tools, but also how to perform different geriatric assessments covering the different key components (physical, nutritional, social, psychological, etc.). The book also provides information on how to manage and intervene on frailty with the role of pre-habilitation and re-habilitation, how to set-up specialised teams and pathways within one’s hospital and community for these older cancer patients with frailty. Finally, the management of this challenging group of patients according to the cancer type is discussed in detail, alongside with mapping the unmet research needs and future directions in this field.
This supplement to the journal, International Psychogeriatrics introduces the Canadian Study of Health and Aging, one of the largest epidemiologic studies of dementia conducted to date. A comprehensive description of the study methods and data sets as well as selected results are discussed.
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.
This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.
This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
Designed to help in the understanding of the causes & course of disability in older women. Offers an excellent overview of diseases & disability & their impact on older women. Covers: adaptation to disability, physical performance measures, the daily lives of disabled older women, utilization of health services, mental health & general well-being, pulmonary diseases & conditions, musculoskeletal disease, neurological conditions, vision & hearing, medication use, instrumental & emotional support, adaptation to disability, & much more.
This book discusses all important aspects of emergency medicine in older people, identifying the particular care needs of this population, which all too often remain unmet. The up-to-date and in-depth coverage will assist emergency physicians in identifying patients at risk for adverse outcomes, in conducting appropriate assessment,and in providing timely and adequate care. Particular attention is paid to the commonpitfalls in emergency management andmeans of avoiding them. Between 1980 and 2013, the number of older patients in emergency departmentsworldwide doubled. Compared with younger patients, older people suffer from more comorbidities, a higher mortality rate, require more complex assessment and diagnostic testing, and tend to stay longer in the emergency department. This book, written by internationally recognized experts in emergency medicine and geriatrics, not only presents the state of the art in the care of this population but also underlines the increasing need for adequate training and development in the field.