Transition From Pediatric To Adult Medical Care

This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.

Transitioning youth with chronic medical conditions (also known as Youth with Special Health Care Needs--YSHCN) to adult services is a complex issue in clinical practice. It is estimated that about 10.2 million children and youth, ages 017 years, in the United States alone have special health care needs and while this group constitutes only about 14% of the childhood population, they account for 40% or more of medical expenditures for children. As reflected in this book there are a growing number of programs and projects from around the world that are developing and implementing innovative approaches to promoting successful health care transitions. The authors hope that the information and discussions provided will stimulate your interest and encourage you to take action to improve health care transition related services and supports for adolescents and young adults with special health care needs.

Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large. Investing in The Health and Well-Being of Young Adults describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. Investing in The Health and Well-Being of Young Adults makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions. What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. Investing in The Health and Well-Being of Young Adults will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.

Over the course of the last two decades, improved practices in child and adolescent mental healthcare have led to a decreased environment of stigma, which also led to an increased identification and treatment of mental health disorders in children and youth. Considering that treatment and outcomes are improved with early intervention, this is good news. However, the success gained in the field of child and adolescent psychiatry leads to a new challenge: transitioning from adolescent care to adult care. It has been known for some time that children, adult, and geriatric patients all have unique needs where it comes to mental healthcare, yet limited work has been done where it comes to the shifting of the lifespan. Where it comes to the child-adult transition—defined as those in their late teens and early/mid-20s—there can be multiple barriers in seeking mental healthcare that stem from age-appropriate developmental approaches as well as include systems of care needs. Apart from increasing childhood intervention, the problem is exacerbated by the changing social dynamics: more youths are attending college rather than diving straight into the workforce, but for various reasons these youths can be more dependent on their parents more than previous generations. Technology has improved the daily lives of many, but it has also created a new layer of complications in the mental health world. The quality and amount of access to care between those with a certain level of privilege and those who do not have this privilege is sharp, creating more complicating factors for people in this age range. Such societal change has unfolded so rapidly that training programs have not had an opportunity to catch up, which has created a crisis for care. Efforts to modernize the approach to this unique age group are still young, and so no resource exists for any clinicians at any phase in their career. This book aims to serve as the first concise guide to fill this gap in the literature. The book will be edited by two leading figures in transition age youth, both of whom are at institutions that have been at the forefront of this clinical work and research. This proposed mid-sized guide is therefore intended to be a collaborative effort, written primarily by child and adolescent psychiatrists, and also with adult psychiatrists. The aim is to discuss the developmental presentation of many common mental health diagnoses and topics in chapters, with each chapter containing clinically-relevant “bullet points” and/or salient features that receiving providers, who are generally, adult-trained, should keep in mind when continuing mental health treatment from the child and adolescent system. Chapters will cover a wide range of challenges that are unique to transition-age youths, including their unique developmental needs, anxiety, mood, and personality disorders at the interface of this development, trauma and adjustment disorders, special populations, and a wide range of other topics. Each chapter will begin with a clinical pearl about each topic before delving into the specifics.

This book offers essential information on interventions and actions that enable and promote transition experiences for adolescents and young adults. It provides guidance on appropriate strategies that bring together these groups and caregivers in the context of transition preparation, and those which optimize adolescents’ and young adults’ ability to self-manage their healthcare. The health care transition for adolescents and young adults has gained more attention given the improved survival rates, including for those with long-term conditions. It is now estimated that more than 90% of children diagnosed with a long-term condition will survive into adulthood. The significant change in survival requires concomitant services to facilitate adolescents’ and young adults’ successful transition to adult health care, therefore providers need education, knowledge and skills to support healthcare transition services. A recent US national survey demonstrated only 10% of parents/caregivers reported that their children received transition preparation services. This book is targeted at nurses and pediatric and adult health care providers of different disciplines seeking guidance on which interventions are available, how they can be used, advantages and challenges, and how best to promote a seamless transition for all adolescents and young adults with long-term conditions. It provides several examples of transition programmes and initiatives worldwide. There is an increasing focus on how nurses can support transition but little guidance on what is effective and what has been tried. This book will fill a gap by addressing all of these issues outlined above and by providing worked examples from leading nurse researchers and academics worldwide.

This book addresses the unique healthcare needs of adults with chronic childhood illnesses. It presents a model of primary and secondary prevention for emerging adulthood—primary prevention in which all young adults are screened for high-risk behaviors and health needs and secondary prevention in which young adults with chronic childhood conditions are optimized through coordinated care, connections to community resources and social/family support. This book is organized in five parts. Part I provides a detailed overview of the health care transition from pediatrics to adult medicine from both a policy and practice perspective. In Part II, the concept of emerging adulthood as a developmental period is explored and strategies for providing improved comprehensive care for this age group are discussed. Part III reviews specific chronic childhood conditions, such as attention-deficit/hyperactivity disorder, autism, cystic fibrosis, and diabetes mellitus, and offers clinical cases and summary reports that can be used as a quick guides to each condition. In Part IV, additional clinical considerations that are not necessarily condition-specific but are highly relevant to the care of young adults with chronic childhood conditions are examined. Part V describes the socio-legal issues involved in caring for this population. Care of Adults with Chronic Childhood Conditions provides primary care providers with a new framework for the care of young adults and identifies opportunities to influence patient health outcomes over a life trajectory.

Pediatricians face many questions and challenges during patients’ transition from childhood to adulthood. Chronic diseases justify long-term medical, psychological, educational, and social management. The establishment of networks with adult endocrinologists is, therefore, very important to achieving optimal conditions for a successful transition period. In this book, leading experts discuss major public health issues such as diabetes and obesity. They also review genetic diseases, including Turner syndrome and congenital adrenal hyperplasia. All clinical cases are presented in a focused way to highlight any issues which might be discussed by the doctor with patients and family. Psychological approaches are debated as are proposals for defining specific tools to encourage autonomy during this life period. This book is a valuable tool and will be helpful in answering many questions for endocrinologists, adult and pediatric, dedicated to the long-term management of patients with chronic diseases.