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LEARNING TO WORK WITH AN
INCREASINGLY AGED SOCIETY
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 for how to effectively provide care for this growing demographic.
The Care of the Older Person brings together some of today’s most experienced professionals to provide concrete answers for care providers of all kinds—doctors, nurses, therapists, pharmacists—those who build, run, and staff the facilities and housing for all of the aging population, as well as spouses and children of the elderly. Most importantly, this information is for seniors themselves, who want to feel empowered in their stage of life.
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EXPLORING A BROAD ARRAY OF ISSUES FOR ELDER CARE
The Care of the Older Person is broken up into chapters written by an esteemed group of doctors and other professionals, each covering a different aspect of elder care:
Overview of the Field (by Jose Morais, MD) presents an in-depth overview of the current state of geriatric medicine, including the unique challenges and opportunities characterizing this growing field today.
Caring for the Older Person (by Abraham Fuks, MD) focuses “attention to chronic illnesses and the needs of the older person whose ailments need a more deliberate, longer-term horizon with different goals and aspirations.”
Frailty (by Sathya Karunananthan, PhD and Howard Bergman, MD) explores the increasing vulnerability of our bodies and organs as we age and what care providers can do to diagnose and treat individuals.
Physical Activity as a Countermeasure to Frailty (by Guy Hajj Boutros, MSc and Antony D. Karelis, Phd) makes a compelling case for avoiding the sedentary state when possible, and demonstrates interventions that can potentially reverse frailty.
“Doctor, My Wife is Getting Forgetful” (by Serge Gauthier, MD) explores the natural decline in memory, and how to diagnose and address dementia in your patients, clients, or family.
Update on Alzheimer’s Disease Diagnosis and Management (by Serge Gauthier, MD) is a synopsis of the diagnosis and management of AD, as well as its natural history and progression, by one of the acknowledged leaders in the field.
Navigating the Journey of Dementia as a Caregiver (by Claire Webster, CPCA) identifies who caregivers are, their demanding roles, and the toll the caregiving may take on them.
How to Diagnose and Manage Delirium (by Haibin Yin, MD). Among elderly patients who come into the ER, 15% suffer from delirium or “acute brain failure.” This chapter explores the signs and treatments.
Why Does My Patient Have Gait & Balance Disorders? (by Olivier Beauchet, MD, PhD) explores the main causes and best treatments for the broad category of walking and balance problems.
Could My Patient Be Malnourished? (by Jose Morais, MD) explores the prevalence of malnutrition in older populations, how to diagnose it, and how to treat it.
Are the Immunizations of My Patient Up to Date? (by Dominique Tessier, MD) stresses the importance of immunizations in our vulnerable older population, with details of the various immunizations that may be necessary.
Management of Older Patients in the Emergency Department (By Cyrille Launay, MD, PhD) provides an overview of the unique challenges facing ER staff in diagnosing and working with older patients.
Critical Care of the Older Person (by Astrid F. Pilgrim, MD, and Michael R. Pinsky, MD) is a comprehensive look at the important differences seen in the critically ill older person, and how to efficiently respond to these issues and counteract them.
COVID19 in Long-Term Care (by Julia Chabot, MD, Philippe Desmarais, MD, and Michael Stiffel, MD) addresses the particularly onerous effects of the global pandemic on older persons, particularly those in long-term care facilities.
Stroke Prevention in the Elderly (by Liam Durcan, MD) emphasizes the need to identify predisposing causes of this major cause of death and disability, and to modify those risks before serious harm occurs.
Advances in Cardiac Care for Older Persons (by P. David Myerowitz, MD) is a detailed chronicle of medical problems encountered with the aging heart, and state of the art measures to deal with each of those problems.
How to Manage Type 2 Diabetes in Frail Elderly Patients (by Young-Sang Kim, MD, PhD, and Jose A. Morais, MD) explores this important disease condition that is highly prevalent in older adults, and stresses the differences in treatment and approach that are necessary in the older population.
Cancer in Older Adults (by Doreen Wan-Chow-Wah, MD) brings the relatively young subspecialty of Geriatric Oncology to the forefront. Particularities of older persons with cancer are noted, including fitness for treatment. Life expectancy is factored in.
Cancer Screening in the Older Adult (by Catalina Hernandez-Torres, MD, and Tina Hsu, MD) discusses the sometimes controversial role of cancer screening in older adults. Screening recommendations are covered in the light of treatment options and patient preference.
Psycho oncology: Living with the Fear of Death (by Norman Straker, MD) is a discussion of the emotional and psychiatric care of cancer patients and their families by one of the originators of the subspecialty. The relationship between various psychiatric disorders and cancer is examined.
Incontinence in Older Adults (by Samer Shamout MD and Lysanne Campeau, MD) explores the risks, diagnosis, and treatment of urinary incontinence.
Polypharmacy and Deprescribing in the Elderly (by Louise Mallet, Pharm.D). Polypharmacy is taking multiple medicines for chronic issues at the same time and is common among the elderly. This chapter explores the risks of polypharmacy and how to “deprescribe” unnecessary medications.
After the Menopause (by Ronald M. Caplan, MD) brings to the fore the fact that, with dramatically increasing lifespan, the postmenopausal years represent a very significant proportion of a woman’s productive life. Physiologic changes, screening for possible problems, prevention and possible treatments are discussed.
Skin Care of the Older Person: The Skin and its Associated Changes (by Hao Feng, MD, and Aziz Khan, MD) comprehensively details disorders of the skin in older persons and the management of those conditions.
Elder Abuse (by Mark J. Yaffe, MD). Unfortunately, elder abuse is far too common in our society, and takes on many forms. This chapter helps care providers to identify elder abuse and learn how to address it.
Late-Life Anxiety (by Jess Friedland, MD, Paulina Bajsarowicz, MD, and Philippe Desmarais, MD) describes the risk and predisposing factors for the development of anxiety disorders in older persons and the treatments of those disorders.
An Overview of Late-Life Depression (By Artin Mahdanian, MD, and Silvia Monti De Flores, MD) explores the importance of understanding late-life depression for care professionals, including tools for diagnosis and treatment.
Assessment of Decision-Making Capacity (By Catherine Ferrier, MD) provides an important analysis of how to determine a patient’s ability to make key decisions about their medical treatment, living situation, finances, and more.
How Do I Protect My Patient? (By Randy S. Perskin, Esq., JD) explores the important legal issues facing elderly patients and how care providers can best support them.
Financial Guidance for Seniors (by Karen C. Altfest, PhD, CFP) recognizes that, among the paramount concerns of older persons is financial stability. Financial concerns can affect mental and physical health, wellbeing, and even lifespan. Advice is offered to caregivers, including family, and to the older individual on how to anticipate and overcome these problems.
The Role of Religious Belief in the End-of-Life Care of Older Persons (by A. Mark Clarfield, MD,) compassionately shows that we cannot treat older persons near the end of life, and their families, without an understanding of their religious beliefs, and appropriately responding to their needs and concerns in ways that respect those beliefs.
Medical Glossary (by Ronald M. Caplan, MD). A highly researched glossary of medical definitions that will help you to understand what you’re reading and navigate the often-confusing world of scientific terminology. Includes forward-looking research that gives you a sense of where the advances in medicine are going in the future.
EDITORS & CONTRIBUTORS
Karen Caplan Altfest, PhD, CFP
“We are living in an age of rapidly advancing technology. We are undergoing a revolution in communication and information availability. The human genome is known, disease is understood at a metabolic level, and drugs are created to target the mechanisms of disease. All these factors complement one another so that in our industrialized, computerized and linked world people have the ability to live much longer.”
“It takes one minute to prescribe a medication but years to discontinue it.”
“Individuals are complex systems with a biopsychosocial nexus within which multiple functions are interconnected and socially embedded.”
“….the aging of the population is an unprecedented phenomenon in human history….it is in fact a triumph of humankind over the adversities of the environment.”
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