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Society today, writes Stephen Post, is "hypercognitive": it places inordinate emphasis on people's powers of rational thinking and memory. Thus, Alzheimer disease and other dementias, which over an extended period incrementally rob patients of exactly those functions, raise many dilemmas. How are we to view—and value—persons deprived of what some consider the most important human capacities? In the second edition of The Moral Challenge of Alzheimer Disease, Post updates his highly praised account of the major ethical issues relating to dementia care. With chapters organized to follow the progression from mild to severe and then terminal stages of dementia, Post discusses topics including the experience of dementia, family caregiving, genetic testing for Alzheimer disease, quality of life, and assisted suicide and euthanasia. New to this edition are sections dealing with end-of-life issues (especially artificial nutrition and hydration), the emerging cognitive-enhancing drugs, distributive justice, spirituality, and hospice, as well as a critique of rationalistic definitions of personhood. The last chapter is a new summary of practical solutions useful to family members and professionals. -- Peter M. Jucovey
Written by an eminent authority from the American Academy of Neurology's Committee on Ethics, Law, and Humanities, this book is an excellent text for all clinicians interested in ethical decision-making. The book features outstanding presentations on dying and palliative care, physician-assisted suicide and voluntary active euthanasia, medical futility, and the relationship between ethics and the law. New chapters in this edition discuss how clinicians resolve ethical dilemmas in practice and explore ethical issues in neuroscience research. Other highlights include updated material on palliative sedation, advance directives, ICU withdrawal of life-sustaining therapy, gene therapy, the very-low-birth-weight premature infant, the developmentally disabled patient, informed consent, organizational ethics, brain death controversies, and fMRI and PET studies relating to persistent vegetative state.
The genetics of Alzheimer disease has been a point of intense concern and immense informational confusion for families in which a loved one is diagnosed with dementia. In recent years, however, scientists have begun to uncover the genetic bases for some forms of Alzheimer disease. Once a chromosomal defect is identified, it becomes possible to devise a test for its presence. The far-reaching implications of such tests are the focus of the present volume. In Genetic Testing for Alzheimer Disease, Stephen G. Post and Peter J. Whitehouse bring together experts from the fields of ethics, genetics, policy, neurology, philosophy, and anthropology to examine the ethical and social aspects of genetic testing for Alzheimer disease. The authors begin by focusing on current genetic findings and their clinical applicability. They then address ethical issues in genetic testing and genetic counseling for Alzheimer disease. They examine social issues such as confidentiality, discrimination, and fairness in health care. Finally, they discuss ways to educate professionals and laypeople regarding these issues. Contributors: Robert H. Binstock, Ph.D.?Thomas D. Bird, M.D. ? Robert Mullan Cook-Deegan, M.D.? Leonard Fleck, Ph.D. ? Atwood D. Gaines, Ph.D, M.P.H. ? Eric T. Juengst, Ph.D. ? Harry Karlinsky, M.D. ? Steven Miles, M.D. ? Thomas H. Murray, Ph.D. ? Stephen G. Post, Ph.D. ? Kimberly A. Quaid, Ph.D. ? Allen D. Roses, M.D. ? Greg A. Sachs, M.D. ? Peter H. St. George-Hyslop, M.D. ? Bonnie Steinbock, Ph.D. ? Arthur B. Zinn, M.D., Ph.D.
Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities. The most common form of dementia among older people is Alzheimer's disease (AD), which involves the parts of the brain that control thought, memory, and language. Age is the most important known risk factor for AD. The number of people with the disease doubles every 5 years beyond age 65. AD is a slow disease, starting with mild memory problems and ending with severe brain damage. The course the disease takes and how fast changes occur vary from person to person. On average, AD patients live from 8 to 10 years after they are diagnosed, though the disease can last for as many as 20 years. Current research is aimed at understanding why AD occurs and who is at greatest risk of developing it, improving the accuracy of diagnosis and the ability to identify those at risk, discovering, developing, and testing new treatments, and discovering treatments for behavioural problems in patients with AD. This new book gathers state-of-the-art research from leading scientists throughout the world which offers important information on understanding the underlying causes and discovering the most effective treatments for Alzheimer's Disease.
Positive conceptions of ‘healthy aging’ are rightly displacing negative ageist perceptions of older members of our society. Nevertheless, at some stage, most elderly citizens will require some form of assistance from other members of society. When the body or mind begins to fail, a legitimate need for intervention and care will arise. This second volume on Aging discusses this theme.
More than 5 million Americans are currently living with Alzheimer's disease or a related form of dementia. By the year 2030, experts estimate that as many as 66 million people around the world will be faced with this life-altering disease. Unfortunately, these staggering statistics impact millions of caregivers, too. Compared with all types of caregivers, those who assist someone with dementia experience the highest levels of burnout, depression, poor health, and premature death. A Dignified Life, Revised and Expanded offers hope and help with a proven approach. Ten years ago, the first edition of A Dignified Life changed the way the caregiving community approached Alzheimer's disease by showing caregivers how to act as a Best Friend to the person, finding positive ways to interact even as mental abilities declined. Firmly grounded in the latest knowledge about the progression and treatment of dementia, this expanded edition offers a wealth of immediately usable tips and new problem-solving advice. It incorporates practical ideas for therapeutic activities—including the latest brain-fitness exercises—stimulate the brain while adding structure, meaning, and context to daily routines. With new stories and examples as well as an updated resources section, A Dignified Life, Revised and Expanded gives caregivers the support and advice they need to be successful and inspired in their demanding roles. While medical treatment of the disease hasn't changed in the past ten years, our understanding and awareness of treating people in a more caring way has changed substantially. With no cure on the immediate horizon, respectful care by effective and compassionate care partners is the only real "treatment" available to people with dementia. The Best Friends™ Approach is successful because it sustains people's connection to their world, their loved ones, and themselves. It's a universal program which has been embraced by professional and family caregivers throughout the United States, Europe, Asia, the Middle East, and South America. In its revised form, A Dignified Life offers caregivers an antidote to the burnout and frustration that often accompanies the role of caring for a person with Alzheimer's and dementia. Rather than struggling through a series of frustrations and failures, A Dignified Life shows the new generation care partners how to bring dignity, meaning, and peace of mind to the lives of both those who have Alzheimer's and dementia and those who care for them.
Health care and human service professionals often experience anxiety about potential adverse legal repercussions for actions taken or not taken in the course of caring for patients or clients. In this volume, professionally distinguished and diverse authors discuss both the real and perceived legal liability context within which health and human service delivery to older persons takes place. The benefits and costs of litigious, legislative, and regulatory interventions on the quality of care and the quality of life for recipients of geriatric services is evaluated. Most important, chapters present suggestions for ways to effectively reduce or manage legal risks and anxieties while improving patient care. This volume fills a gap in the literature by providing careful and accurate analysis of legal issues rarely translated into practical and useful advice for health care and human service professionals.

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