Living With Frailty

Increasingly, we question ‘what makes us healthy?’, as well as ‘what makes us ill?’. What does this shift mean for frailty? Almost wholly defined in negative terms, the term ‘frail’ tends to refer to a group of older people who are at highest risk of adverse outcomes such as falls, infections, disability, admission to hospital or the need for long-term care. This ground-breaking book takes a holistic approach to frailty. It connects the medical literature with the wider social science discourse on ageing, and focuses on promoting wellbeing and the building up of strengths. Living with Frailty draws together the latest biomedical evidence and good practice in this emerging area and explores ideas about assets and resilience, the role of society and the social model of disability in relation to frailty, arguing that insufficient attention is paid to positive action such as developing bone strength, maintaining good nutrition and exercising. Chapters look at: existing models of frailty person-centred care assessing frailty and quality of life how falls, and fear of falls, relate to discussions of frailty delirium and frailty the environment and frailty sarcopenia. Living with Frailty is an important introduction and reference for all practitioners, researchers and students with an interest in frailty, wellbeing and social approaches to health. Forewords by Professors Ken Rockwood, Dalhousie University, and Adam Gordon, Nottingham University.

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.

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 open access book takes a multidisciplinary approach to provide a holistic understanding of late old age, and situates the aged person within the context of family, caregivers, clinical and other institutions. All through the book, the author discusses preparedness for an aging individual as well as the society in the Indian context. The book highlights inevitable but mostly neglected health issues like depression, dementia, fall, and frailty and provides detailed analyses of solutions that are practicable in low resource settings. It also brings up intergenerational differences and harmony in the context of holistic care of older Indians. Alongside clinical perspectives, the book uses narratives of elderly patients to dwell on the myriad of problems and issues that constitute old age healthcare. Demonstrating cases that range from the most influential to the most underprivileged elderly in India, the book enlightens multiple caregivers—doctors, nurses, and professional caregivers as well as family members—about the dynamic approach required in dealing with complex issues related to late old age. The narratives make the book relatable and interesting to non-academic readers, with important lessons for gerontological and geriatric caregiving. It is also of use to older adults in preparing for active aging.

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.

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.

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.