Senility

Cultural responses to most illnesses differ; dementia is no exception. These responses, together with a society's attitudes toward its elderly population, affect the frequency of dementia-related diagnoses and the nature of treatment. Bringing together essays by nineteen respected scholars, this unique volume approaches the subject from a variety of angles, exploring the historical, psychological, and philosophical implications of dementia. Based on solid ethnographic fieldwork, the essays employ a cross-cultural perspective and focus on questions of age, mind, voice, self, loss, temporality, memory, and affect. Taken together, the essays make four important and interrelated contributions to our understanding of the mental status of the elderly. First, cross-cultural data show the extent to which the aging process, while biologically influenced, is also very much culturally constructed. Second, detailed ethnographic reports raise questions about the behavioral criteria used by health care professionals and laymen for defining the elderly as demented. Third, case studies show how a diagnosis affects a patient's treatment in both clinical and familial settings.; Finally, the collection highlights the gap that separates current biological understandings of aging from its cultural meanings. As Alzheimer's disease and other forms of dementia continue to command an ever-increasing amount of attention in medicine and psychology, this book will be essential reading for anthropologists, social scientists, and health care professionals.

Ballenger's work contributes to our understanding of the emergence and significance of dementia as a major health issue.

Senile dementia is one of the major health problems confronting mankind in this century. To some extent the problem has, of course, always existed. The condition was sufficiently troubling to classical philosophers and jurists to have apparently provoked comments by Solon in approximately 500 B. C. and Plato in the fourth century B. C. (Plutarch 1967 translation; Plato 1921 translation). Medical recognition can be traced at least as far back as the second century A. D. (Adams 1861). However, several factors have converged in this century to extend the absolute dimensions of the problem of senile dementia and to increase societal, medical, and scientific recogni tion of the magnitude of the condition. Perhaps the most important factor relating to the present importance of senile dementia is demographic. Although the human population has been increasing since the mid-eighteenth century, it has only been since the advent of the twentieth century that a decrease in mortality has been noted for those over the age of 45 (McKeown 1976). Consequently, the absolute number of aged persons and the proportion of increasingly aged persons in the populations of the world's industrial nations have been steadily increasing. For example, in the United States, 4% ofthe population was over the age of 65 in 1900. In the 1970 census, this proportion had grown to 10%.

nly two things are certain in life, one is that all of us will inevita Obly grow older, the other is that at some point during or at the end of this process we shall die. Inherent to the passage of time is a deterio ration in the structural and functional integrity of our bodies, this pro gressing to such an extent that one or more organ systems will eventu ally begin to fail with the continued health and well-being of the individual coming under threat. Age-associated deficiencies in the musculo-skeletal, cardiovascular, or endocrine systems producing arthri tis, hypertension, stroke or diabetes are all too apparent in our elderly population yet internally caused failures in the function of the nervous system provide the common, and mostly intractable, problems of memory and intellect or locomotion that face and frustrate clinicians. Perhaps the most important factor which can decide the outcome of research studies professing to examine the effects of the passage of time (i. e. the 'process of aging') on the function of the nervous system, or indeed any other organ system, is the selection of appropriate or repre sentative subjects for investigation. The heart of this problem lies in defining what might be considered as 'normal' aging as distinct from age-associated disease; setting the 'goal posts of normality' continues to 1 be a matter of considerable debate.

This manual gives step-by-step guidance on the evaluation and treatment of geriatric diseases and disorders. It covers incidence of disorders, diagnostic tests, associated diagnoses, clinical implications for mobility, and rehabilitation techniques. It offers a broad overview of the effects of aging on all body systems. Special geriatric considerations for laboratory assessment, thermoregulations, and pharmacology are also discussed. This manual is a resource for all training clinicians in geriatric care and is a quick-reference guide for students and practitioners in this field.

Historian Jesse F. Ballenger traces the emergence of senility as a cultural category from the late nineteenth century to the 1980s, a period in which Alzheimer's disease became increasingly associated with the terrifying prospect of losing one's self. Changes in American society and culture have complicated the notion of selfhood, Ballenger finds. No longer an ascribed status, selfhood must be carefully and willfully constructed. Thus, losing one's ability to sustain a coherent self-narrative is considered one of life's most dreadful losses. As Ballenger writes "senility haunts the landscape of the self-made man." Stereotypes of senility and Alzheimer's disease are related to anxiety about the coherence, stability, and agency of the self—stereotypes that are transforming perceptions of old age in modern America. Drawing on scientific, clinical, policy, and popular discourses on aging and dementia, Ballenger explores early twentieth-century concepts of aging and the emergence of gerontology to understand and distinguish normal aging from disease. In addition, he examines American psychiatry's approaches to the treatment of senility and scientific attempts to understand the brain pathology of dementia. Ballenger's work contributes to our understanding of the emergence and significance of dementia as a major health issue.

A biting satire of a particular despot and a deeply human allegory of the fragility of goodness and the contagion of unchecked power. Set twenty-odd years from now, it opens on Patient Number One—Vladimir Putin, largely forgotten in his presidential dacha, serviced by a small coterie of house staff, drifting in and out of his memories of the past. His nurse, charged with the twenty-four-hour care of his patient, is blissfully unaware that his colleagues are using their various positions to skim money, in extraordinarily creative ways, from the top of their employer’s seemingly inexhaustible riches. But when a family tragedy means that the nurse suddenly needs to find a fantastical sum of money fast, the dacha’s chef lets him in on the secret world of backhanders and bribes going on around him, and opens his eyes to a brewing war between the staff and the new housekeeper, the ruthless new sheriff in town. A brilliantly cast modern-day Animal Farm, The Senility of Vladimir P. is a coruscating political fable that shows, through an honest man slipping his ethical moorings, how Putin has not only bankrupted his nation economically, but has also diminished it culturally and spiritually.