Advanced Age Geriatric Care

As the Baby Boomers age, concerns over healthcare systems' abilities to accommodate geriatric patients grow increasingly challenging. This is especially true with the population deemed to be “the oldest of the old,” specifically those over the age of 85. Unlike any other time in history, this demographic is the fastest growing segment of most developed countries. In the United States the oldest old is projected to double from 4.3 million to 9.6 million by 2030. The increased life expectancy of the population since the early 1900s has been built on the improvement of living conditions, diet, public health and advancement in medical care. With this we have seen a steady decline in the age-specific prevalence of vascular and heart diseases, stroke and even dementia. Older persons are healthier today than their counterparts decades ago. More importantly than in any other age group, the care of the oldest old must be individualized; management decisions should be made taking into consideration the older persons’ expressed wishes, quality of life, function and mental capacity. The inevitable consequence is that there will be an increase in the prevalence of older persons with chronic diseases, multiple co-existing pathologies and neuro-degenerative diseases. The oldest of the aging population are often excluded from drug trials and their treatments are largely based on findings extrapolated from that of the younger old. Furthermore, among the oldest old, physiologically they are more diverse than other segments of the population. Their demographic characteristics are unparalleled and different compared to that of the younger old. Several studies have drawn attention to the differing attitudes among health professionals towards elderly people and many show prejudice because they are old. As a result, the use of age as a criteria in determining the appropriateness of treatment is of very limited validity, yet there are limited resources that guide physicians through these challenges. This book creates a greater awareness of these challenges and offers practical guidelines for working within the infrastructures vital to this demographic. This book is designed for geriatricians, primary care physicians, junior medical officers, specialty geriatrics nurses, and gerontologists. It is divided into 3 sections: General Considerations, Chronic diseases and Geriatric Syndromes. Each chapter provides a summary of important and essential information under the heading of Key Points. Case studies are included in some of the chapters to highlight the principles of management.

With the appearance of a textbook as comprehensive as this one, it is clear that the field of geriatrics is coming of age. The broad scope of these volumes shapes a substantial answer to the question, "What is geriatrics and why should we be interested in it?" As I see it, there are at least five reasons. First, the scientific or intellectual reason: gerontology is the study of aging from the biologic, psychological, and social perspectives. There is increasing interest in the fascinating insights into the biologic mechanisms of aging, errors in protein synthesis, DNA repair mechanisms, alterations of the neuroendocrine system, changes in the immune system, genetic controls, and somatic mutations. Second, the demographic reason: this is the century of old age. There has been a 26-year gain in the average life expectancy. This gain compares with that acquired from 3,000 years B.C. (the Bronze Age) to the year 1900, which was about 29 years. Therefore, in one century, there has been a gain in the average life expectancy almost equal to 5,000 previous years of human history. In 1830, one of three newborn infants survived beyond 60 years of age.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

This book distills the wealth of knowledge contained in the classic text, Geriatric Medicine: An Evidence-Based Approach, 4/e into a practical guide for primary care, family medicine, and internal medicine residents. Written by top experts in the field, the book offers a detailed, compact overview of geriatric care. It addresses geriatric pharmacology, Medicare and Medicaid, and numerous other subjects unique to older adults. The case-based instructional approach helps readers navigate the complexity of prevention, presentation, and treatment for conditions such as depression, dementia, and hypertension. Graphs and tables aid the reader in determining the proper courses of treatment.

Falling is one of the most common causes of disability in later life and is also one of the most preventable. This book provides an enormous body of fall-related research that has been organized by the author into easy, digestible information for geriatric health professionals. Extensively updated and revised for its second edition, the book has direct clinical applications and strategies for preventing and managing falls. It also contains new information on the physical, psychological, and social complications of falling. For physicians, nurses, administrators, and staff in long-term and other geriatric care settings, this book will be an essential resource.

Society, as a whole is getting older. Thanks to the extraordinary advances in technology and medicine, humans are now living longer than ever before, and are shifting the demographic make-up on a worldwide scale. As a result, more and more of us are living and engaging with an aging population in both our personal and professional lives, and there's a heightened demand for concrete research and advice on how to effectively provide care for this growing demographic. The Care of the Older brings together some of today's most experienced geriatric researchers to provide concrete answers for care providers of all kinds-doctors, nurses, therapists, nursing home workers, and spouses and children of elderly-who are spending more and more time working with our aging population.The Care for the Older Person is broken up into 23 chapters written by an esteemed group of doctors and researchers, each covering a different aspect of elder care.

Originally published in 1981 and edited by a pioneer in psychogeriatric services, this book spans medicine, psychiatry, social work and organisation of services of the elderly, written by eminent authors from several different professions. Chapters include those on stroke rehabilitation, dementia, neurosis, psychotherapy for the elderly and institutional care, among others. The book discusses many issues which remain as pertinent today as when it was first published, not least the problems of providing health services for ageing populations.