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      • The Role of Nutrition in Maintaining Health in the Nation's Elderly
        Geriatric medicine
        May 2000

        The Role of Nutrition in Maintaining Health in the Nation's Elderly

        Evaluating Coverage of Nutrition Services for the Medicare Population

        by Committee on Nutrition Services for Medicare Beneficiaries, Food and Nutrition Board

        Malnutrition and obesity are both common among Americans over age 65. There are also a host of other medical conditions from which older people and other Medicare beneficiaries suffer that could be improved with appropriate nutritional intervention. Despite that, access to a nutrition professional is very limited. Do nutrition services benefit older people in terms of morbidity, mortality, or quality of life? Which health professionals are best qualified to provide such services? What would be the cost to Medicare of such services? Would the cost be offset by reduced illness in this population? This book addresses these questions, provides recommendations for nutrition services for the elderly, and considers how the coverage policy should be approached and practiced. The book discusses the role of nutrition therapy in the management of a number of diseases. It also examines what the elderly receive in the way of nutrition services along the continuum of care settings and addresses the areas of expertise needed by health professionals to provide appropriate nutrition services and therapy.

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      • The National Academies Keck Futures Initiative: The Future of Human Healthspan
        Geriatric medicine
        April 2008

        The National Academies Keck Futures Initiative: The Future of Human Healthspan

        Demography, Evolution, Medicine, and Bioengineering, Task Group Summaries

        by Conference, Arnold and Mabel Beckman Center, Irvine, California, November 14-16, 2007, The National Academies Keck Futures Initiative Healthspan Steering Committee, The National Academies

        An individual's healthspan can be defined as the length of time an individual is able to maintain good health. In 2007, over one hundred experts and researchers from public and private institutions across the nation convened to find new ways of addressing the human healthspan and the elusive nature of aging. Experts in public health, bioengineering, neuroscience and gerontology discussed how stress and lifestyle influence the decline of health at older ages. Other discussions focused on the integration of technology in the quality of life, gerontology, regenerative medicine and life expectancy with regard to social and behavioral traits. Still, other groups explored topics such as the cellular and molecular mechanisms of biological aging, the effects of exercise on the human healthspan, and changes in social context to enhance functional status of the elderly. Most importantly, experts agreed that it was imperative to ensure that the elderly have access to medical services by establishing relationships with health care and insurance providers.

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      • Retooling for an Aging America
        Geriatric medicine
        August 2008

        Retooling for an Aging America

        Building the Health Care Workforce

        by Committee on the Future Health Care Workforce for Older Americans, Institute of Medicine

        As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

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      • Hearing Loss and Healthy Aging
        Geriatric medicine
        July 2014

        Hearing Loss and Healthy Aging

        Workshop Summary

        by Tracy A. Lustig and Steve Olson, Rapporteurs; Forum on Aging, Disability, and Independence; Board on Health Sciences Policy; Division on Behavioral and Social Sciences and Education; Institute of Medicine; National Research Council

        Being able to communicate is a cornerstone of healthy aging. People need to make themselves understood and to understand others to remain cognitively and socially engaged with families, friends, and other individuals. When they are unable to communicate, people with hearing impairments can become socially isolated, and social isolation can be an important driver of morbidity and mortality in older adults. Despite the critical importance of communication, many older adults have hearing loss that interferes with their social interactions and enjoyment of life. People may turn up the volume on their televisions or stereos, miss words in a conversation, go to fewer public places where it is difficult to hear, or worry about missing an alarm or notification. In other cases, hearing loss is much more severe, and people may retreat into a hard-to-reach shell. Yet fewer than one in seven older Americans with hearing loss use hearing aids, despite rapidly advancing technologies and innovative approaches to hearing health care. In addition, there may not be an adequate number of professionals trained to address the growing need for hearing health care for older adults. Further, Medicare does not cover routine hearing exams, hearing aids, or exams for fitting hearing aids, which can be prohibitively expensive for many older adults. Hearing Loss and Healthy Aging is the summary of a workshop convened by the Forum on Aging, Disability, and Independence in January 2014 on age-related hearing loss. Researchers, advocates, policy makers, entrepreneurs, regulators, and others discussed this pressing social and public health issue. This report examines the ways in which age-related hearing loss affects healthy aging, and how the spectrum of public and private stakeholders can work together to address hearing loss in older adults as a public health issue.

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      • Care of the Elderly Patient
        Geriatric medicine
        January 1989

        Care of the Elderly Patient

        Policy Issues and Research Opportunities

        by Council on Health Care Technology, Institute of Medicine

        A guiding principle of the Council on Health Care Technology is a special focus on medical technology assessment measures that coincide with patient well-being, quality of health care, and quality of life. Of particular concern is care of the elderly, which constitutes a special and vulnerable patient population. This comprehensive book discusses the appropriate use of technology to minimize risks posed to the elderly patient in the delivery of health care services. It covers home and community care as well as acute hospital care, and system resources and constraints.

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      • The Second Fifty Years
        Geriatric medicine
        February 1992

        The Second Fifty Years

        Promoting Health and Preventing Disability

        by Division of Health Promotion and Disease Prevention, Institute of Medicine

        Taking its title from the second 50 years of the human life span of about 100 years, this book presents wide-ranging and practical recommendations for health care providers, policymakers, and other sectors of society. These recommendations range from setting new national policies to changing the way elderly patients are interviewed in the doctor's office and from what exercises older persons should do to how city planners should design our urban environment. The bulk of this volume presents the latest research on 13 major health threats to the elderly, covering prevalence, impact on the older person's life, cost, and intervention. In addition, the authors provide a detailed analysis of why older people often do not receive the benefit of prevention programs.

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      • The Aging Population in the Twenty-First Century
        Geriatric medicine
        January 1988

        The Aging Population in the Twenty-First Century

        Statistics for Health Policy

        by Panel on Statistics for an Aging Population; Committee on National Statistics; National Research Council

        It is not news that each of us grows old. What is relatively new, however, is that the average age of the American population is increasing. More and better information is required to assess, plan for, and meet the needs of a graying population. The Aging Population in the Twenty-First Century examines social, economic, and demographic changes among the aged, as well as many health-related topics: health promotion and disease prevention; quality of life; health care system financing and use; and the quality of care--especially long-term care. Recommendations for increasing and improving the data available--as well as for ensuring timely access to them--are also included.

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      • Health Outcomes for Older People
        Geriatric medicine
        November 1996

        Health Outcomes for Older People

        Questions for the Coming Decade

        by Jill C. Feasley, Editor; Committee to Develop an Agenda for Health Outcomes Research for Elderly People, National Research Council

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      • Policy and Research Needs to Maximize Independence and Support Community Living
        Geriatric medicine
        September 2016

        Policy and Research Needs to Maximize Independence and Support Community Living

        Workshop Summary

        by Joe Alper and Sarah Domnitz, Rapporteurs; Forum on Aging, Disability, and Independence; Board on Health Sciences Policy; Institute of Medicine; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine

        Living independently and participating in one’s community are priorities for many people. In many regions across the United States, there are programs that support and enable people with disabilities and older adults to live where they choose and with whom they choose and to participate fully in their communities. Tremendous progress has been made. However, in many cases, the programs themselves â€" and access to them â€" vary not only between states but also within states. Many programs are small, and even when they prove to be successful they are still not scaled up to meet the needs of the many people who would benefit from them. The challenges can include insufficient workforce, insufficient funding, and lack of evidence demonstrating effectiveness or value. To get a better understanding of the policies needed to maximize independence and support community living and of the research needed to support implementation of those policies, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in October 2015. Participants explored policies in place that promote independence and community living for older adults and people with physical disabilities, and identified policies and gaps in policies that can be barriers to independence and the research needed to support changing those policies. This report summarizes the presentations and discussions from the workshop.

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      • Pharmacokinetics and Drug Interactions in the Elderly and Special Issues in Elderly African-American Populations
        Geriatric medicine
        August 1997

        Pharmacokinetics and Drug Interactions in the Elderly and Special Issues in Elderly African-American Populations

        Workshop Summary

        by Committee on Pharmacokinetics and Drug Interaction in the Elderly, Institute of Medicine

        Reports in the popular press about the increasing longevity of Americans and the aging of the baby boom generation are constant reminders that the American population is becoming older. Consequently, an issue of growing medical, health policy, and social concern is the appropriate and rational use of medications by the elderly. Although becoming older does not necessarily correlate with increasing illness, aging is associated with anatomical and physiological changes that affect how medications are metabolized by the body. Furthermore, aging is often related to an increased frequency of chronic illness (often combined with multiple health problems) and an increased use of medications. Thus, a better understanding of the absorption, distribution, metabolism, and excretion of drugs; of the physiologic responses to those medications; as well as of the interactions among multiple medications is crucial for improving the health of older people.

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      • HIV and Aging
        Medicine
        November 2016

        HIV and Aging

        by Brennan-Ing, M., Fulop, T., DeMarco, R.F.

        Despite decades of attention on building a global HIV research and programming agenda, HIV in older populations has generally been neglected until recently. This new book focuses on HIV and aging in the context of ageism with regard to prevention, treatment guidelines, funding, and the engagement of communities and health and social service organizations. The lack of perceived HIV risk in late adulthood among older people themselves, as well on the part of providers and society in general, has led to a lack of investment in education, testing, and programmatic responses. Ageism perpetuates the invisibility of older adults and, in turn, renders current medical and social service systems unprepared to respond to patients’ needs. While ageism may lead to some advantages – discounts for services, for example – it is the negative aspects that must be addressed when determining the appropriate community-level response to the epidemic.

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      • Families Caring for an Aging America
        Geriatric medicine
        March 2017

        Families Caring for an Aging America

        by Richard Schulz and Jill Eden, Editors; Committee on Family Caregiving for Older Adults; Board on Health Care Services; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine

        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.

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      • Strengthening the Workforce to Support Community Living and Participation for Older Adults and Individuals with Disabilities
        Medicine
        May 2017

        Strengthening the Workforce to Support Community Living and Participation for Older Adults and Individuals with Disabilities

        Proceedings of a Workshop

        by National Academies of Sciences, Engineering, and Medicine, Division of Behavioral and Social Sciences and Education, Health and Medicine Division, Board on Health Sciences Policy, Forum on Aging, Disability, and Independence, Sarah Domnitz, Joe Alper

        As the demographics of the United States shift toward a population that is made up of an increasing percentage of older adults and people with disabilities, the workforce that supports and enables these individuals is also shifting to meet the demands of this population. For many older adults and people with disabilities, their priorities include maximizing their independence, living in their own homes, and participating in their communities. In order to meet this population’s demands, the workforce is adapting by modifying its training, by determining how to coordinate among the range of different professionals who might play a role in supporting any one older adult or individual with disabilities, and by identifying the ways in which technology might be helpful. To better understand how the increasing demand for supports and services will affect the nation’s workforce, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in June 2016, in Washington, DC. Participants aimed to identify how the health care workforce can be strengthened to support both community living and community participation for adults with disabilities and older adults. This publication summarizes the presentations and discussions from the workshop.

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      • Health Literacy and Palliative Care
        Geriatric medicine
        June 2016

        Health Literacy and Palliative Care

        Workshop Summary

        by Joe Alper, Rapporteur; Roundtable on Health Literacy; Board on Population Health and Public Health Practice; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine

        The Institute of Medicine Roundtable on Health Literacy convened a 1-day public workshop to explore the relationship between palliative care and health literacy, and the importance of health literate communication in providing high-quality delivery of palliative care. Health Literacy and Palliative Care summarizes the discussions that occurred throughout the workshop and highlights the key lessons presented, practical strategies, and the needs and opportunities for improving health literacy in the United States.

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      • Nutrition and Healthy Aging in the Community
        Geriatric medicine
        June 2012

        Nutrition and Healthy Aging in the Community

        Workshop Summary

        by Sheila Moats and Julia Hoglund, Rapporteurs; Food and Nutrition Board; Institute of Medicine

        The U.S. population of older adults is predicted to grow rapidly as "baby boomers" (those born between 1946 and 1964) begin to reach 65 years of age. Simultaneously, advancements in medical care and improved awareness of healthy lifestyles have led to longer life expectancies. The Census Bureau projects that the population of Americans 65 years of age and older will rise from approximately 40 million in 2010 to 55 million in 2020, a 36 percent increase. Furthermore, older adults are choosing to live independently in the community setting rather than residing in an institutional environment. Furthermore, the types of services needed by this population are shifting due to changes in their health issues. Older adults have historically been viewed as underweight and frail; however, over the past decade there has been an increase in the number of obese older persons. Obesity in older adults is not only associated with medical comorbidities such as diabetes; it is also a major risk factor for functional decline and homebound status. The baby boomers have a greater prevalence of obesity than any of their historic counterparts, and projections forecast an aging population with even greater chronic disease burden and disability. In light of the increasing numbers of older adults choosing to live independently rather than in nursing homes, and the important role nutrition can play in healthy aging, the Institute of Medicine (IOM) convened a public workshop to illuminate issues related to community-based delivery of nutrition services for older adults and to identify nutrition interventions and model programs. Nutrition and Healthy Aging in the Community summarizes the presentations and discussions prepared from the workshop transcript and slides. This report examines nutrition-related issues of concern experienced by older adults in the community including nutrition screening, food insecurity, sarcopenic obesity, dietary patterns for older adults, and economic issues. This report explores transitional care as individuals move from acute, subacute, or chronic care settings to the community, and provides models of transitional care in the community. This report also provides examples of successful intervention models in the community setting, and covers the discussion of research gaps in knowledge about nutrition interventions and services for older adults in the community.

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      • The Older Patient in Clinical Routine
        Geriatric medicine

        The Older Patient in Clinical Routine

        A Practical Textbook of Acute Geriatrics

        by Pinter / Likar / Kada / Janig / Schippinger / Cernic

        Acute geriatrics has become an important specialist discipline. It comprises the preventive, curative, rehabilitative and palliative care for older patients under consideration of the bio-psycho-social model. Multimorbidity, atypical courses of disease, increased risk of complications and many further aspects should be included in the support concept for the often very vulnerable patients. In this book, essential practice-relevant content of the acute geriatric work is presented, based on case studies.

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      • Aging and Disability
        Medicine
        November 2018

        Aging and Disability

        Beyond Stereotypes to Inclusion: Proceedings of a Workshop

        by National Academies of Sciences, Engineering, and Medicine, Division of Behavioral and Social Sciences and Education, Health and Medicine Division, Board on Health Sciences Policy, Forum on Aging, Disability, and Independence, Tracy A. Lustig, Caroline M. Cilio

        Many different groups of people are subject to stereotypes. Positive stereotypes (e.g., “older and wiserâ€) may provide a benefit to the relevant groups. However, negative stereotypes of aging and of disability continue to persist and, in some cases, remain socially acceptable. Research has shown that when exposed to negative images of aging, older persons demonstrate poor physical and cognitive performance and function, while those who are exposed to positive images of aging (or who have positive self-perceptions of aging) demonstrate better performance and function. Furthermore, an individual’s expectations about and perceptions of aging can predict future health outcomes. To better understand how stereotypes affect older adults and individuals with disabilities, the National Academies of Sciences, Engineering, and Medicine, with support from AARP, convened a public workshop on October 10, 2017. This publication summarizes the presentations and discussions from the workshop.

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      • Preventing Cognitive Decline and Dementia
        Medicine
        March 2018

        Preventing Cognitive Decline and Dementia

        A Way Forward

        by National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, Committee on Preventing Dementia and Cognitive Impairment, Autumn Downey, Clare Stroud, Story Landis, Alan I. Leshner

        Societies around the world are concerned about dementia and the other forms of cognitive impairment that affect many older adults. We now know that brain changes typically begin years before people show symptoms, which suggests a window of opportunity to prevent or delay the onset of these conditions. Emerging evidence that the prevalence of dementia is declining in high-income countries offers hope that public health interventions will be effective in preventing or delaying cognitive impairments. Until recently, the research and clinical communities have focused primarily on understanding and treating these conditions after they have developed. Thus, the evidence base on how to prevent or delay these conditions has been limited at best, despite the many claims of success made in popular media and advertising. Today, however, a growing body of prevention research is emerging. Preventing Cognitive Decline and Dementia: A Way Forward assesses the current state of knowledge on interventions to prevent cognitive decline and dementia, and informs future research in this area. This report provides recommendations of appropriate content for inclusion in public health messages from the National Institute on Aging.

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      • Kraftzentrum Beckenboden - Ganzheitsmedizinische Therapie bei Blasenschwäche
        Gynaecology & obstetrics

        Kraftzentrum Beckenboden - Ganzheitsmedizinische Therapie bei Blasenschwäche

        Mit Beckenbodentraining für Frauen ab 50 plus

        by Brigitte Kita

        Blasenschwäche und Harninkontinenz sind kein unvermeidbares altersbedingtes Schicksal, von dem sich Betroffene oft aus Scham in die gesellschaftliche Isolation gezwungen sehen. Als erster Schritt ist der Mut gefordert, offen mit diesen Beschwerden umzugehen. Dr. med. Brigitte Kita, Ärztin für Naturheilverfahren, bietet in ihrem Buch eine kompetente Hilfestellung für Frauen, die durch eigenes Zutun eine dauerhafte Besserung erzielen möchten. Denn ein gezieltes, regelmäßiges Training der Beckenbodenmuskeln kann Inkontinenzbeschwerden wirkungsvoll entgegenwirken und einer Genitalsenkung vorbeugen. Die detailliert angeleiteten und anschaulich bebilderten Beckenbodenübungen sind auch für Ungeübt leicht zu erlernen und fördern ein beckenbodenschonendes Verhalten im Alltag. Da Blasenschwäche nicht gleich Blasenschwäche ist, werden ergänzend zum praktischen Übungsteil die Ursachen und Auswirkungen einer Beckenbodenschwäche, die diagnostischen Verfahren und therapeutischen Methoden wie band- und netzgestützte Operationen, sowie Hilfsmittel und Selbstanwendungen beschrieben, und aufgezeigt, welche Behandlung für welche Harninkontinenzformen und Senkungszustände geeignet ist. Kraftzentrum Beckenboden

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