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This innovative and informative new text bridges the fields of gerontology and thanatology.
When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."
This book provides a comprehensive view of rational suicide in the elderly, a group that has nearly twice the rate of suicide when chronically ill than any other demographic. Its frame of reference does not endorse a single point-of-view about the legitimacy of rational suicide, which is evolving across societies with little guidance for geriatric mental health professionals. Instead, it serves as a resource for both those clinicians who agree that older people may rationally commit suicide and those who believe that this wish may require further assessment and treatment. The first chapters of the book provides an overview of rational suicide in the elderly, examining it through history and across cultures also addressing the special case of baby boomers. This book takes an ethical and philosophical look at whether suicide can truly be rational and whether the nearness of death in late-life adults means that suicide should be considered differently than in younger adults. Clinical criteria for rational suicide in the elderly are proposed in this book for the first time, as well as a guidelines for the psychosocial profile of an older adult who wants to commit rational suicide. Unlike any other book, this text examines the existential, psychological, and psychodynamic perspectives. A chapter on terminal mental illness and a consideration of suicide in that context and proposed interventions even without a diagnosable mental illness also plays a vital role in this book as these are key issues in within the question of suicide among the elderly. This book is the first to consider all preventative measures, including the spiritual as well as the psychotherapeutic, and pharmacologic. A commentary on modern society, aging, and rational suicide that ties all of these elements together, making this the ultimate guide for addressing suicide among the elderly. Rational Suicide in the Elderly is an excellent resource for all medical professionals with potentially suicidal patients, including geriatricians, geriatric and general psychiatrists, geriatric nurses, social workers, and public health officials.
Every year, about 30,000 people die by suicide in the U.S., and some 650,000 receive emergency treatment after a suicide attempt. Often, those most at risk are the least able to access professional help. Reducing Suicide provides a blueprint for addressing this tragic and costly problem: how we can build an appropriate infrastructure, conduct needed research, and improve our ability to recognize suicide risk and effectively intervene. Rich in data, the book also strikes an intensely personal chord, featuring compelling quotes about people's experience with suicide. The book explores the factors that raise a person's risk of suicide: psychological and biological factors including substance abuse, the link between childhood trauma and later suicide, and the impact of family life, economic status, religion, and other social and cultural conditions. The authors review the effectiveness of existing interventions, including mental health practitioners' ability to assess suicide risk among patients. They present lessons learned from the Air Force suicide prevention program and other prevention initiatives. And they identify barriers to effective research and treatment. This new volume will be of special interest to policy makers, administrators, researchers, practitioners, and journalists working in the field of mental health.
Presenting a broad coverage of this major area of studies on death and dying, this book provides a systematic presentation of the six most widely used and best validated measures of death anxiety, threat and fear. These chapters consider the available data on the psychometric properties of each instrument and summarize research using them, and also supply a copy of the instrument with scoring keys - to facilitate their use. In addition, other chapters make use of the instrumentation by pursuing questions of applied significance in various health care settings nursing homes, psychotherapy, death education, near death experiences, persons with AIDS, experiences of bereaved young adults.; An introductory chapter introduces the major philosophical and psychological theories of the causes and consequences of death anxiety in adult life, and a closing chapter gives an overview of death education and how this affects attitudes towards death and dying.
The first book of its kind, Resilience and Palliative Care - Achievement in adversity takes the increasing international literature on resilience and applies it to palliative and end-of-life care. The book offers an overview of all key aspects of palliative care, presented through a resilience perspective. Why do some patients and families break down while others surmounts the challenges facing them? What interventions strengthen individual, family and community coping?This book aims to facilitate change with people facing the crisis of death, dying and bereavement. Much of the existing literature has focused on risk, problems and vulnerability; the emerging concept of resilience focuses on strengths and possibilities.The 'total pain'/'total care' approach pioneered by Dame Cicely Saunders and St Christopher's Hospice now needs reinterpreting in the light of changing contexts and challenges. The realities of demographic change and resource-constrained health and social care environments have generated an increasingly risk focused approach to service delivery. A narrowly medicalised approach has inevitable limitations; professional care alone will be unable to meet need and demand in the face of ageingpopulations, changing patterns of illness and the need for equity. The resilience approach offers a counterbalance that harnesses the strengths of individuals and the communities in which they live and in which most of their dying will take place. Resilience thinking emphasises the importance of publichealth and creates a partnership between patients, professionals and community structures, seeking to build community capacity and to deliver a preventive health care that will leave future generations less afraid of the dying and bereavement that will confront all of us.This book offers insights into how, at all levels of planning and delivering palliative care, there is the opportunity to maximise coping, build an infrastructure for self-help, and increase the capacity of strengthened teams and organisations.
Part of the authoritative Oxford Textbooks in Psychiatry series, the new edition of the Oxford Textbook of Suicidology and Suicide Prevention remains a key text in the field of suicidology, fully updated with new chapters devoted to major psychiatric disorders and their relation to suicide.
Covers all facets of geriatric forensic medicine and pathology, from natural changes, trauma and dementias, to toxicology and scene investigation.
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
Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993.