Enhancing Primary Care Of Elderly People

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

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.

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.

Taking a unique look at health promotion and aging in Canada, this edited collection uses the action framework in the Ottawa Charter for Health Promotion to explore the factors and issues related to the health of older adults. The book is organized around the five action areas for health promotion: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health and social services. Adhering to the holistic approach that health in older age involves physical, mental, emotional, and social well-being, this comprehensive collection covers a wide range of interventions that are designed to benefit and protect the aging population’s health, quality of life, rights, and dignity, while building intergenerational solidarity and collaboration. Readers will learn about aging from a health promotion perspective; the context, environment, and issues related to older adults in Canada; as well as best practices in health promotion, public health, and the care of older adults. Promoting the Health of Older Adults is an invaluable resource for both graduate and undergraduate students in gerontology, health promotion, nursing, social work, and related fields. FEATURES - Considers the implications of the COVID-19 pandemic for health promotion and aging - Provides an up-to-date profile of older adults in Canada and current/future trends in aging and health, including the use of new technologies and policies and practices in health promotion, public health, and other disciplines - Includes a wealth of pedagogical features, such as learning objectives, critical thinking questions, a glossary, and online supplementary materials

This book is a practical resource that will support the delivery of holistic mental health interventions in the primary and community care setting for older people. Primary care delivery is discussed in relation to both functional mental health problems, such as anxiety, depression, and psychotic and personality disorders, and acquired organic mental disorders of old age, such as dementia, cognitive impairments, and delirium. Careful consideration is paid to the complex relationship between mental and somatic health problems, as well as the impacts of multimorbidity and polypharmacy. Further topics include, for example, epidemiology, wider determinants of health, different care models, history taking, neurocognitive and capacity assessment, and pharmacological, psychological, and physical interventions. The wider goals of the book are to support the development of community resilience and self-care in older people; to promote universal access and equity for older people in order to enable them to achieve or recover the highest attainable standard of health, regardless of age, gender, or social position; and to promote pathways to care for older people with mental health problems respecting their autonomy, independence, human rights, and the importance of the life-course approach. This book will be an invaluable resource for all professionals who work with older adults with mental health problems and those training in these fields including physicians, psychiatrists, family doctors, geriatricians, general practitioners, nurses, psychologists, neurologists, occupational therapists, social workers, support workers and community health and social care workers.

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice. After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed. Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients. This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.

This book provides a comprehensive and systematic state-of-the science review of major primary care delivery models, how they address specific needs of older adults, and available evidence for their efficacy. Written by experts in the field, this book explores the patient-centered medical home model (PCMH) in depth and dives into the complexities of the “medical neighborhood”. It describes and analyzes primary care specifically directed toward special, complex populations, such as the Health Home for safety net patients with mental health needs, and intensive primary care for older adults. It reviews an array of primary care models related to dual eligible patients including the GRACE primary care consultation model and PACE models. It describes primary care with Advanced Practice Nurses and Physician Assistants and explores in-depth the massive effort within the VA to develop the Patient Activated Care Team (PACT), a VA form of the PCMH that also has several offshoots that address complex older veterans and veterans with severe mental illness. Finally, it illuminates rarely discussed primary care that occurs within the home and within long-term care. Throughout the entire book, experts navigate the workforce, care quality, and financing challenges of primary care for older adults. Primary Care for Older Adults is a valuable resource for clinicians, researchers, patients, caregivers and their advocates, and policy makers who have an interest in designing, promoting, and implementing high quality primary care for older adults.