Part of the Wiley Series in Clinical Geropsychology, Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention helps to familiarize you with the legal and social contexts for decision making in potentially impaired individuals. Editors Sara Qualls and Michael Smyer have brought together a notable team of international contributors to provide you with a unique framework of the legal, social, and psychological approaches to assessing the ability of older adults to make decisions.
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Possible new breakthroughs in understanding the aging mind that can be used to benefit older people are now emerging from research. This volume identifies the key scientific advances and the opportunities they bring. For example, science has learned that among older adults who do not suffer from Alzheimer's disease or other dementias, cognitive decline may depend less on loss of brain cells than on changes in the health of neurons and neural networks. Research on the processes that maintain neural health shows promise of revealing new ways to promote cognitive functioning in older people. Research is also showing how cognitive functioning depends on the conjunction of biology and culture. The ways older people adapt to changes in their nervous systems, and perhaps the changes themselves, are shaped by past life experiences, present living situations, changing motives, cultural expectations, and emerging technology, as well as by their physical health status and sensory-motor capabilities. Improved understanding of how physical and contextual factors interact can help explain why some cognitive functions are impaired in aging while others are spared and why cognitive capability is impaired in some older adults and spared in others. On the basis of these exciting findings, the report makes specific recommends that the U.S. government support three major new initiatives as the next steps for research.
"This book demonstrates how to address practical and ethical challenges when evaluating capacities of older adults with neurocognitive disorders, like dementia. The contributors are expert clinicians who draw upon real life experiences conducting clinical capacity assessments in civil matters, illustrating best practices based on the guidelines from the ABA/APA's Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists. Chapters cover complex and difficult issues in careful detail, including: * financial exploitation, * undue influence, * sexual consent, and * medical aid in dying. The author also provides guidance for negotiating family conflicts, working with surrogate decision makers who also have diminished capacity, coordinating with medical and legal professionals, and addressing other situations that involve multiple stakeholders with competing priorities. A recurring theme throughout the volume is the challenge of balancing a client's right to autonomy, while also protecting them from harm. The book offers careful, effective advice for keeping clients who lack decision making capacity involved in their healthcare choices and working to maintain their independence when daily living skills are impaired"--
By 2030 there will be about 70 million people in the United States who are older than 64. Approximately 26 percent of these will be racial and ethnic minorities. Overall, the older population will be more diverse and better educated than their earlier cohorts. The range of late-life outcomes is very dramatic with old age being a significantly different experience for financially secure and well-educated people than for poor and uneducated people. The early mission of behavioral science research focused on identifying problems of older adults, such as isolation, caregiving, and dementia. Today, the field of gerontology is more interdisciplinary. When I'm 64 examines how individual and social behavior play a role in understanding diverse outcomes in old age. It also explores the implications of an aging workforce on the economy. The book recommends that the National Institute on Aging focus its research support in social, personality, and life-span psychology in four areas: motivation and behavioral change; socioemotional influences on decision-making; the influence of social engagement on cognition; and the effects of stereotypes on self and others. When I'm 64 is a useful resource for policymakers, researchers and medical professionals.
For most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors.
Decisions large and small play a fundamental role in shaping life course trajectories of health and well-being: decisions draw upon an individual's capacity for self-regulation and self-control, their ability to keep long-term goals in mind, and their willingness to place appropriate value on their future well-being. Aging and Decision Making addresses the specific cognitive and affective processes that account for age-related changes in decision making, targeting interventions to compensate for vulnerabilities and leverage strengths in the aging individual. This book focuses on four dominant approaches that characterize the current state of decision-making science and aging - neuroscience, behavioral mechanisms, competence models, and applied perspectives. Underscoring that choice is a ubiquitous component of everyday functioning, Aging and Decision Making examines the implications of how we invest our limited social, temporal, psychological, financial, and physical resources, and lays essential groundwork for the design of decision supportive interventions for adaptive aging that take into account individual capacities and context variables. Divided into four dominant approaches that characterize the current state of decision-making science and aging neuroscience Explores the impact of aging on the linkages between cortical structures/functions and the behavioral indices of decision-making Examines the themes associated with behavioral approaches that attempt integrations of methods, models, and theories of general decision-making with those derived from the study of aging Details the changes in underlying competencies in later life and the two prevailing themes that have emerged—one, the general individual differences perspective, and two, a more clinical focus
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
