Diane E. Meier – författare

Geriatric Palliative Care covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and cultural context of old age and frailty, this volume details specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes, dementia, etc.) as well as individual symptoms (e.g., pain, fatigue, anxiety, etc.). Communication between care-givers and patients, in a variety of settings, is also discussed. The theme of this book is that palliative care is the best approach to the care of chronically ill and frail elderly because of its focus on: quality of life; support for functional independence; and the centrality of the patient''s values and experiences in determining the goals of medical care. Indeed, Geriatric Palliative Care provides a comprehensive medical reference for all clinicians who care for older adults.

Geriatric Palliative Care covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and cultural context of old age and frailty, this volume details with specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes, dementia) as well as individual symptoms (e.g. pain, fatigue, anxiety.). Communication between care-givers and patients, in a variety of settings, is also discussed.The theme of this book is that palliative care is the best approach to the care of chronically ill and frail elderly because of its focus on quality of life, support for functional independence, and the centrality of the patient's values and experiences in determining the goals of medical care. Geriatric Palliative Care provides a comprehensive medical reference for all clinicians who care for older adults.

Geriatric Palliative Care covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and cultural context of old age and frailty, this volume details specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes, dementia, etc.) as well as individual symptoms (e.g., pain, fatigue, anxiety, etc.). Communication between care-givers and patients, in a variety of settings, is also discussed. The theme of this book is that palliative care is the best approach to the care of chronically ill and frail elderly because of its focus on: quality of life; support for functional independence; and the centrality of the patient''s values and experiences in determining the goals of medical care. Indeed, Geriatric Palliative Care provides a comprehensive medical reference for all clinicians who care for older adults.

Since the publication of the third edition of Geriatric Medicine,extraordinary advances have occurred in the science of aging and the potential for biomedical research to give us answers to many, if not most, of the age-related disorders that threaten the quality of life in older years. At the most basic level, the successful mapping of the human genome was declared complete in the fall of 2000. Understanding the map of the human genome is as important as understanding the map of genomes of important laboratory species, ranging from the microscopic worms and fruit?ies used in most classic genetic studies to rodents such as laboratory mice, and eventually to primates, on which much of the research on the aging human brain is done. The genetic maps of all of these species,including our own,does not answer clinical questions,but it does open the door to dramatic, rapid, and ef?cient answers to questions about the genetic polymorphisms related to diseases in humans. The telomerase story also unfolded since the third edition. Telomerase is an enzyme responsible for maintaining the telomeres—the redundant DNA portions at the end of chromosomes—whose shortening seems to be linked directly to cell senescence,ap- tosis,and the control over cell death,which,at the level of the individual cell,seems to be linked to the decline of organ function and eventually aging and death within the org- ism.

Palliative Care is the first book to provide a comprehensive understanding of the new field that is transforming the way Americans deal with serious illness.Diane E. Meier, M.D., one of the field's leaders and a recipient of a MacArthur Foundation "genius award" in 2009, opens the volume with a sweeping overview of the field. In her essay, Dr. Meier examines the roots of palliative care, explores the key legal and ethical issues, discusses the development of palliative care, and presents ideas on policies that can improve access to palliative care.Dr. Meier's essay is followed by reprints of twenty-five of the most important articles in the field. They range from classic pieces by some of the field's pioneers, such as Eric Cassel, Balfour Mount, and Elizabeth Kübler-Ross, to influential newer articles on topics such as caregiving and cost savings of palliative care. The reprints cover a wide range of topics including: Why the care of the seriously ill is so important Efforts to cope with advanced illness Legal and ethical issues Pain management Cross-cultural issues Philosophical perspective The demand for palliative care has been nothing short of stunning—largely because of palliative care's positive impact on both the quality and the cost of care provided to seriously ill individuals. By providing a wide-ranging perspective on this growing field, this book will serve as a guide for developing meaningful approaches that will lead to better health care for all Americans.

Palliative Care is the first book to provide a comprehensive understanding of the new field that is transforming the way Americans deal with serious illness.

Diane E. Meier, M.D., one of the field''s leaders and a recipient of a MacArthur Foundation "genius award" in 2009, opens the volume with a sweeping overview of the field. In her essay, Dr. Meier examines the roots of palliative care, explores the key legal and ethical issues, discusses the development of palliative care, and presents ideas on policies that can improve access to palliative care.

Dr. Meier''s essay is followed by reprints of twenty-five of the most important articles in the field. They range from classic pieces by some of the field''s pioneers, such as Eric Cassel, Balfour Mount, and Elizabeth Kübler-Ross, to influential newer articles on topics such as caregiving and cost savings of palliative care. The reprints cover a wide range of topics including:

Why the care of the seriously ill is so important

Efforts to cope with advanced illness

Legal and ethical issues

Pain management

Cross-cultural issues

Philosophical perspective

The demand for palliative care has been nothing short of stunning—largely because of palliative care''s positive impact on both the quality and the cost of care provided to seriously ill individuals. By providing a wide-ranging perspective on this growing field, this book will serve as a guide for developing meaningful approaches that will lead to better health care for all Americans.

Palliative Care is the first book to provide a comprehensive understanding of the new field that is transforming the way Americans deal with serious illness.

Diane E. Meier, M.D., one of the field''s leaders and a recipient of a MacArthur Foundation "genius award" in 2009, opens the volume with a sweeping overview of the field. In her essay, Dr. Meier examines the roots of palliative care, explores the key legal and ethical issues, discusses the development of palliative care, and presents ideas on policies that can improve access to palliative care.

Dr. Meier''s essay is followed by reprints of twenty-five of the most important articles in the field. They range from classic pieces by some of the field''s pioneers, such as Eric Cassel, Balfour Mount, and Elizabeth Kübler-Ross, to influential newer articles on topics such as caregiving and cost savings of palliative care. The reprints cover a wide range of topics including:

Why the care of the seriously ill is so important

Efforts to cope with advanced illness

Legal and ethical issues

Pain management

Cross-cultural issues

Philosophical perspective

The demand for palliative care has been nothing short of stunning—largely because of palliative care''s positive impact on both the quality and the cost of care provided to seriously ill individuals. By providing a wide-ranging perspective on this growing field, this book will serve as a guide for developing meaningful approaches that will lead to better health care for all Americans.

Reorganized into a single, tightly focused volume, the new edition of Geriatric Medicine offers practical, authoritative, and comprehensive coverage of the diseases, common problems, and medical care of older persons. The thorough revision includes new chapters on "Urinary Incontinence" and "Falls" as well as expanded discussions of rheumatic/orthopedic disorders and neuropsychological testing. Particularly noteworthy is the superb chapter on "Dementia"; written by a neurologist and a psychiatrist, it provides a remarkably complete account of the dementing disorders. The book also reviews central issues in health care systems and policies, including the unique legal aspects of caring for older persons and the rising importance of home care.

The third edition of Geriatric Medicine appears at a crucial time for health profession­ als, a time when the values and goals of our overall American health care system are being reoriented to those values and goals that have long been at the core of geriatrics. It is likely that the readership of this highly respected textbook will be even substan­ tially greater than that for the two previous editions or, for that matter, for any other textbook on geriatric medicine published in the United States. This third edition continues what its predecessors began-the goal of closing the gap between our knowl­ edge of the proper care of older persons and our capacity to deliver that care. Numerous journal articles and forewords and prefaces to geriatrics textbooks claim that the field of geriatrics has matured. Geriatrics may have "matured" since the publication of the first edition of Geriatric Medicine in 1984, but the maturation process has been slow and is still incomplete. It is true that the field has advanced in many areas. It has been recognized as an area of added qualification by the American Board of Internal Medicine and the American Board of Family Practice, and they have certified thousands of fully qualified physicians in geriatrics over the past decade.

Since the publication of the third edition of Geriatric Medicine,extraordinary advances have occurred in the science of aging and the potential for biomedical research to give us answers to many, if not most, of the age-related disorders that threaten the quality of life in older years. At the most basic level, the successful mapping of the human genome was declared complete in the fall of 2000. Understanding the map of the human genome is as important as understanding the map of genomes of important laboratory species, ranging from the microscopic worms and fruit?ies used in most classic genetic studies to rodents such as laboratory mice, and eventually to primates, on which much of the research on the aging human brain is done. The genetic maps of all of these species,including our own,does not answer clinical questions,but it does open the door to dramatic, rapid, and ef?cient answers to questions about the genetic polymorphisms related to diseases in humans. The telomerase story also unfolded since the third edition. Telomerase is an enzyme responsible for maintaining the telomeres—the redundant DNA portions at the end of chromosomes—whose shortening seems to be linked directly to cell senescence,ap- tosis,and the control over cell death,which,at the level of the individual cell,seems to be linked to the decline of organ function and eventually aging and death within the org- ism.

Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expertclinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.