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As the largest generation in U.S. history - the population born in the two decades immediately following World War II - enters the age of risk for cognitive impairment, growing numbers of people will experience dementia (including Alzheimer's disease and related dementias). By one estimate, nearly 14 million people in the United States will be living with dementia by 2060. Like other hardships, the experience of living with dementia can bring unexpected moments of intimacy, growth, and compassion, but these diseases also affect people's capacity to work and carry out other activities and alter their relationships with loved ones, friends, and coworkers. Those who live with and care for individuals experiencing these diseases face challenges that include physical and emotional stress, difficult changes and losses in their relationships with life partners, loss of income, and interrupted connections to other activities and friends. From a societal perspective, these diseases place substantial demands on communities and on the institutions and government entities that support people living with dementia and their families, including the health care system, the providers of direct care, and others. Nevertheless, research in the social and behavioral sciences points to possibilities for preventing or slowing the development of dementia and for substantially reducing its social and economic impacts. At the request of the National Institute on Aging of the U.S. Department of Health and Human Services, Reducing the Impact of Dementia in America assesses the contributions of research in the social and behavioral sciences and identifies a research agenda for the coming decade. This report offers a blueprint for the next decade of behavioral and social science research to reduce the negative impact of dementia for America's diverse population. Reducing the Impact of Dementia in America calls for research that addresses the causes and solutions for disparities in both developing dementia and receiving adequate treatment and support. It calls for research that sets goals meaningful not just for scientists but for people living with dementia and those who support them as well. By 2030, an estimated 8.5 million Americans will have Alzheimer's disease and many more will have other forms of dementia. Through identifying priorities social and behavioral science research and recommending ways in which they can be pursued in a coordinated fashion, Reducing the Impact of Dementia in America will help produce research that improves the lives of all those affected by dementia.
This book provides an overview of the demographic, clinical, and psychosocial context of dementia care. With its focus on patient and family perspectives, this book describes evidence-based approaches towards prevention, detection, and treatment of dementia that is like any other book. The text presents memory clinics, care management, home-based interventions, palliative care, family caregiver programs, specific to dementia care. Additionally, the text examines strategies to support transitions to acute care and long-term care. The text also places a special emphasis on measures of quality, cultural sensitivity, and implications for health care policy. Written by experts in the field, Dementia Care: An Evidence-Based Approach is an excellent resource for clinicians, students, healthcare administrators, and policymakers who aim to improve the quality of life of both the person with dementia and their informal caregiver.
Rehabilitation helps individuals maintain and optimize independence. Historically, people with dementia have received little rehabilitation and the focus has been on care to replace lost function. Dementia Rehabilitation is a resource for health and social professionals, service planners, policy makers, and academics. The book makes a compelling case for rehabilitation for people with dementia, including the views of people with dementia and the research evidence. For each area of function, the research evidence and relevant theory is summarized, followed by practical information on clinical assessment, and delivery of therapies. Identifies rehabilitation as a human right for people with dementia. Reviews functions affected by dementia, including cognition, communication, and physical function. Outlines evidence-based strategies to maintain function and to delay decline. Describes how to maintain activities of daily living and leisure activities. Includes techniques to maintain self-identity and mood. Recognizes the importance of environment and care partners in supporting rehabilitation. Summarizes models of care for rehabilitation.
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.
Decades of research have demonstrated that normal aging is accompanied by cognitive change. Much of this change has been conceptualized as a decline in function. However, age-related changes are not universal, and decrements in older adult performance may be moderated by experience, genetics, and environmental factors. Cognitive aging research to date has also largely emphasized biological changes in the brain, with less evaluation of the range of external contributors to behavioral manifestations of age-related decrements in performance. This handbook provides a comprehensive overview of cutting-edge cognitive aging research through the lens of a life course perspective that takes into account both behavioral and neural changes. Focusing on the fundamental principles that characterize a life course approach - genetics, early life experiences, motivation, emotion, social contexts, and lifestyle interventions - this handbook is an essential resource for researchers in cognition, aging, and gerontology.
Vascular dementia is one of the most common forms of mental deterioration for the elderly, second only to Alzheimer's disease. It should not be defined as a single disease, but rather as a group of syndromes that relate to different vascular mechanisms. This is one of the first books to be solely dedicated to the specific class of vascular dementia known as subcortical vascular dementia. The strict focus of the chapters give an depth review that will clarify many different aspects and give an unprecedented amount of detail about this clinical problem. Considering that vascular dementia can be prevented with early diagnosis, the research presented in this book will be important for both students and specialists of this important field.
Health systems should function in such a way that the amount of inappropriate care is minimized, while at the same time stinting as little as possible on appropriate and necessary care. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" was developed in the 1980s. It has been further developed and refined in North America and, increasingly, in Europe. The rationale behind the method is that randomized clinical trials--the "gold standard" for evidence-based medicine--are generally either not available or cannot provide evidence at a level of detail sufficient to apply to the wide range of patients seen in everyday clinical practice. Although robust scientific evidence about the benefits of many procedures is lacking, physicians must nonetheless make decisions every day about when to use them. Consequently, a method was developed that combined the best available scientific evidence with the collective judgment of experts to yield a statement regarding the appropriateness of performing a procedure at the level of patient-specific symptoms, medical history, and test results. This manual presents step-by-step guidelines for conceptualising, designing, and carrying out a study of the appropriateness of medical or surgical procedures (for either diagnosis or treatment) using the RAND/UCLA Appropriateness Method. The manual distills the experience of many researchers in North America and Europe and presents current (as of the year 2000) thinking on the subject. Although the manual is self-contained and complete, the authors do not recommend that those unfamiliar with the RAND/UCLA Appropriateness Method independently conduct an appropriateness study; instead, they suggest "seeing one" before "doing one." To this end, contact information is provided to assist potential users of the method.
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.
Affordable, easy-to-use, and flexible transportation options are vital to older adults' quality of life. Community Mobility: Driving and Transportation Alternatives for Older Persons provides physical and occupational therapists with recent research findings on older driver assessment, remediation/rehabilitation, and the use of alternatives to the car in the event that older adults need to “retire” from driving. This unique book addresses changes in driving patterns over time, the impact of climate conditions on driving, mental and physical health issues, self-regulation by drivers, and driver safety. Community Mobility addresses changes in driving patterns over time, the impact of climate conditions on driving, mental and physical health issues, self-regulation by drivers, and driver safety. This unique book also includes summaries of recent consensus conferences held in the United States and Canada to determine the best approaches to therapist services and counseling. Community Mobility examines: the effect of alternative forms of transportation on drivers in declining mental and physical health safety interventions the relationship between chronic illness and an elderly driver’s “home range” road conditions versus driving patterns factors that can act as predictors in mobility patterns self-regulation and adaptation strategies effective remediation techniques a comprehensive driving evaluation (CDE) and much more! Community Mobility is an essential resource for anyone working with elderly drivers who face the loss of independence and the decreased access to social activities, medical services, and other basic needs that accompany “retirement” from the driver’s seat.