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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.
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.
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.
The number of older subjects is rapidly increasingly worldwide. As a consequence, the nature of clinical conditions is also changing. Traditional medicine and models of care have been based on the evaluation and treatment of single and usually acute conditions occurring in relatively young individuals. Today, the usual clinical manifestation of diseases is characterized by multiple and often chronic conditions affecting older people. In this scenario, frailty and dementia have been triggering special interest both in research and clinical settings due to their high prevalence, impact on the individual’s quality of life, and consequences for public health worldwide. These conditions aptly reflect the complexity of age-related pathological conditions, finding as causal factor a myriad of heterogeneous, interacting, and often still unclear pathophysiological processes. Indeed, their study is strongly affected by the difficulty to differentiate the effects of a normal aging process from eventual pathological deviations of the underlying systems. Their occurrence and trajectories over time are strongly affected by a wide array of factors and determinants that can be hardly attributed to the deficit/involvement of single biological systems and/or health domains. Moreover, environment and social factors also play a key role in the determination of phenotypes. The present Research Topic is aimed at widening our understanding of the frailty and dementia phenomena occurring with aging, in order to improve the clinical and public health approaches to these burdening conditions.
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.
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.
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.
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 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.
The conceptualization of dementia has changed dramatically in recent years with the claim that, through early detection and by controlling several risk factors, a prevention of dementia is possible. Although encouraging and providing hope against this feared condition, this claim is open to scrutiny. This volume looks at how this new conceptualization ignores many of the factors which influence a dementia sufferers’ prognosis, including their history with education, food and exercise as well as their living in different epistemic cultures. The central aim is to question the concept of prevention and analyze its impact on aging people and aging societies.