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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.
This open access book investigates psychiatry in Uganda during the years of decolonisation. It examines the challenges facing a new generation of psychiatrists as they took over responsibility for psychiatry at the end of empire, and explores the ways psychiatric practices were tied to shifting political and development priorities, periods of instability, and a broader context of transnational and international exchange. At its heart is a question that has concerned psychiatrists globally since the mid-twentieth century: how to bridge the social and cultural gap between psychiatry and its patients? Bringing together archival research with oral histories, Yolana Pringle traces how this question came to dominate both national and international discussions on mental health care reform, including at the World Health Organization, and helped spur a culture of experimentation and creativity globally. As Pringle shows, however, the history of psychiatry during the years of decolonisation remained one of marginality, and ultimately, in the context of war and violence, the decolonisation of psychiatry was incomplete.
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.
Human migration is a global phenomenon and is on the increase. It occurs as a result of 'push' factors (asylum, natural disaster), or as a result of 'pull' factors (seeking economic or educational improvement). Whatever the cause of the relocation, the outcome requires individuals to adjust to their new surroundings and cope with the stresses involved, and as a result, there is considerable potential for disruption to mental health. This volume explores all aspects of migration, on all scales, and its effect on mental health. It covers migration in the widest sense and does not limit itself to refugee studies. It covers issues specific to the elderly and the young, as well as providing practical tips for clinicians on how to improve their own cultural competence in the work setting. The book will be of interest to all mental health professionals and those involved in establishing health and social policy.
The Government recognises that many lifestyle-driven health problems are at alarming levels: obesity; high rates of sexually transmitted infections; a relatively large population of drug users; rising levels of harm from alcohol; 80,000 deaths a year from smoking; poor mental health; health inequalities between rich and poor. This white paper outlines the Government's proposals to protect the population from serious health threats; help people live longer, healthier and more fulfilling lives; and improve the health of the poorest. It aims to empower individuals to make healthy choices and give communities and local government the freedom, responsibility and funding to innovate and develop ways of improving public health in their area. The paper responds to Sir Michael Marmot's strategic review of health inequalities in England post 2010 - "Fair society, healthy lives" (available at http://www.marmotreview.org/AssetLibrary/pdfs/Reports/FairSocietyHealthyLives.pdf) and adopts its life course framework for tackling the wider social determinants of health. A new dedicated public health service - Public Health England - will be created to ensure excellence, expertise and responsiveness, particularly on health protection where a national response is vital. The paper gives a timetable showing how the proposals will be implemented and an annex sets out a vision of the role of the Director of Public Health. The Department is also publishing a fuller story on the health of England in "Our health and wellbeing today" (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_122238.pdf), detailing the challenges and opportunities, and in 2011 will issue documents on major public health issues.
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
The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult's risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child's social development, academic achievement, and better health across the lifespan. The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health. Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
This is the definitive textbook on global mental health, an emerging priority discipline within global health, which places priority on improving mental health and achieving equity in mental health for all people worldwide.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.