Meera Balasubramaniam – författare

The process of aging is frequently associated with changes in the physical and mental functioning of older adults, challenging their autonomy and rendering them vulnerable to exploitation. Certain illnesses that are more common in older adults can affect their capacity to function independently. These include the capacity to make medical decisions, live independently, manage finances, to name a few. Healthcare professionals, especially psychiatrists are often entrusted with the responsibility of assessing an older adult’s capacity to perform one or more functions. This makes it imperative for them to be cognizant of these issues, understand the need for these evaluations, and be able to conduct them in a comprehensive manner. Another way of protecting an older person’s rights and facilitating a life based on their own decisions even after they lose decision making capacity is Advanced Health Care Planning (AHCP). Health care professionals are required to initiate a discussion about AHCP with their patients and their families and review it periodically. Lastly, the older adults incarcerated in prisons is a group that is growing in numbers. They have unique needs at the intersection of the geriatric and forensic services, but are often marginalized by both services. The combination of poor quality of life and increasing costs makes the care of older adults in the criminal justice system makes this topic an important public health concern. There is a pressing need for better training of prison staff in issues of geriatric psychiatry. Assessment of criminal responsibility and competence to stand trial in aging offenders are other complex but under-studied issues.This proposed book will provide a comprehensive view of ethical, medicolegal, and forensic issues that will be useful in clinical practice. There will be three sub-sections, each focusing on ethical, medicolegal and forensic issues respectively. The first section will focus on ethical issues. Its first chapters will provide an overview of the how age and the process of aging influence decision-making and introduce unique ethical dimensions to clinical care. This will be followed by a discussion of the concepts of informed consent and capacity evaluation. The next chapters will focus on common scenarios that arise in the care of elderly patients and offer a practical approach to understanding and managing them. These will include assessments of the capacity to make medical decisions, the capacity to live independently, manage finances, drive a vehicle, have sexual relations etc. A chapter on ethical issues specific to dementia will outline issues related to diagnostic disclosure and genetic testing. Research ethics issues in geriatric psychiatry will also be outlined.The next section of the book will focus on surrogate decision making in an older adult who has been deemed to lack the capacity to serve one or more functions independently. The first chapters in this sub-section will focus on patient directed advance health care planning tools, namely, living will and power of attorney. This will be followed by an overview of default surrogate making. Guardianship will subsequently be covered. A separate chapter will cover the issue of elder abuse and discuss an approach to assessing it.The last section of the book will cover forensic issues in geriatric psychiatry. The first chapter will discuss aging older adults in the criminal justice system from an epidemiological perspective. The growing numbers of incarcerated older adults, their illness burden, the challenges in the diagnosis and management of neurocognitive disorders in the prison setting will be elucidated. The following chapter will discuss competence to stand trial with reference to elderly offenders. This will be followed by a discussion of the concepts of medical reprieve, compassionate release as well as model programs and policies currently in the works for older incarcerated adults.

The process of aging is frequently associated with changes in the physical and mental functioning of older adults, challenging their autonomy and rendering them vulnerable to exploitation. Certain illnesses that are more common in older adults can affect their capacity to function independently. These include the capacity to make medical decisions, live independently, manage finances, to name a few. Healthcare professionals, especially psychiatrists are often entrusted with the responsibility of assessing an older adult’s capacity to perform one or more functions. This makes it imperative for them to be cognizant of these issues, understand the need for these evaluations, and be able to conduct them in a comprehensive manner. Another way of protecting an older person’s rights and facilitating a life based on their own decisions even after they lose decision making capacity is Advanced Health Care Planning (AHCP). Health care professionals are required to initiate a discussion about AHCP with their patients and their families and review it periodically.

 Lastly, the older adults incarcerated in prisons is a group that is growing in numbers. They have unique needs at the intersection of the geriatric and forensic services, but are often marginalized by both services. The combination of poor quality of life and increasing costs makes the care of older adults in the criminal justice system makes this topic an important public health concern. There is a pressing need for better training of prison staff in issues of geriatric psychiatry. Assessment of criminal responsibility and competence to stand trial in aging offenders are other complex but under-studied issues.

 This proposed book will provide a comprehensive view of ethical, medicolegal, and forensic issues that will be useful in clinical practice. There will be three sub-sections, each focusing on ethical, medicolegal and forensic issues respectively. The first section will focus on ethical issues. Its first chapters will provide an overview of the how age and the process of aging influence decision-making and introduce unique ethical dimensions to clinical care. This will be followed by a discussion of the concepts of informed consent and capacity evaluation. The next chapters will focus on common scenarios that arise in the care of elderly patients and offer a practical approach to understanding and managing them. These will include assessments of the capacity to make medical decisions, the capacity to live independently, manage finances, drive a vehicle, have sexual relations etc. A chapter on ethical issues specific to dementia will outline issues related to diagnostic disclosure and genetic testing. Research ethics issues in geriatric psychiatry will also be outlined.

 The next section of the book will focus on surrogate decision making in an older adult who has been deemed to lack the capacity to serve one or more functions independently. The first chapters in this sub-section will focus on patient directed advance health care planning tools, namely, living will and power of attorney. This will be followed by an overview of default surrogate making. Guardianship will subsequently be covered. A separate chapter will cover the issue of elder abuse and discuss an approach to assessing it.

 The last section of the book will cover forensic issues in geriatric psychiatry. The first chapter will discuss aging older adults in the criminal justice system from an epidemiological perspective. The growing numbers of incarcerated older adults, their illness burden, the challenges in the diagnosis and management of neurocognitive disorders in the prison setting will be elucidated. The following chapter will discuss competence to stand trial with reference to elderly offenders. This will be followed by a discussion of the concepts of medical reprieve, compassionate release as well as model programs and policies currently in the works for older incarcerated adults.

This book critically reviews 75 important published papers that influence the practice of geriatric psychiatry. This book will assist anyone who is interested in the care of older adults with psychiatric disorders. It was written by thought leaders who shape the way geriatric psychiatry is currently practiced in the United States. All the major psychiatric disorders in later life are covered including anxiety disorders, bipolar disorders, depressive disorders, neurocognitive disorders, psychotic disorders, sleep disorders, and substance use disorders. It also reviews important studies on suicides in late life and interventional procedures in geriatric psychiatry like the ECT, and also evaluates the adverse effects of psychotropic medications on older adults with psychiatric disorders.    The editors of the book along with input from members of the teaching and training committee of the American Association for Geriatric Psychiatry (AAGP) have chosen 75 published papers from the field of geriatric psychiatry that they believe provides the highest knowledge-yield/impact for practicing clinicians and educators in the field of geriatric mental health. The AAGP is a national association that represents and serves its members and the field of geriatric psychiatry. These 75 papers are critically appraised by the members of AAGP using a standardized format and a summary of these papers and their practical application is provided by these experts. This information can be used by anyone who wants to learn about the field of geriatric psychiatry.

This book critically reviews 75 important published papers that influence the practice of geriatric psychiatry. This book will assist anyone who is interested in the care of older adults with psychiatric disorders. It was written by thought leaders who shape the way geriatric psychiatry is currently practiced in the United States. All the major psychiatric disorders in later life are covered including anxiety disorders, bipolar disorders, depressive disorders, neurocognitive disorders, psychotic disorders, sleep disorders, and substance use disorders. It also reviews important studies on suicides in late life and interventional procedures in geriatric psychiatry like the ECT, and also evaluates the adverse effects of psychotropic medications on older adults with psychiatric disorders.    

The editors of the book along with input from members of the teaching and training committee of the American Association for Geriatric Psychiatry (AAGP) have chosen 75 published papers from the field of geriatric psychiatry that they believe provides the highest knowledge-yield/impact for practicing clinicians and educators in the field of geriatric mental health. The AAGP is a national association that represents and serves its members and the field of geriatric psychiatry. These 75 papers are critically appraised by the members of AAGP using a standardized format and a summary of these papers and their practical application is provided by these experts. This information can be used by anyone who wants to learn about the field of geriatric psychiatry.

This book critically reviews 75 important published papers that influence the practice of geriatric psychiatry. This book will assist anyone who is interested in the care of older adults with psychiatric disorders. It was written by thought leaders who shape the way geriatric psychiatry is currently practiced in the United States. All the major psychiatric disorders in later life are covered including anxiety disorders, bipolar disorders, depressive disorders, neurocognitive disorders, psychotic disorders, sleep disorders, and substance use disorders. It also reviews important studies on suicides in late life and interventional procedures in geriatric psychiatry like the ECT, and also evaluates the adverse effects of psychotropic medications on older adults with psychiatric disorders.    The editors of the book along with input from members of the teaching and training committee of the American Association for Geriatric Psychiatry (AAGP) have chosen 75 published papers from the field of geriatric psychiatry that they believe provides the highest knowledge-yield/impact for practicing clinicians and educators in the field of geriatric mental health. The AAGP is a national association that represents and serves its members and the field of geriatric psychiatry. These 75 papers are critically appraised by the members of AAGP using a standardized format and a summary of these papers and their practical application is provided by these experts. This information can be used by anyone who wants to learn about the field of geriatric psychiatry.

This book provides a comprehensive view of rational suicide in the elderly, a group that has nearly twice the rate of suicide when chronically ill than any other demographic. Its frame of reference does not endorse a single point-of-view about the legitimacy of rational suicide, which is evolving across societies with little guidance for geriatric mental health professionals. Instead, it serves as a resource for both those clinicians who agree that older people may rationally commit suicide and those who believe that this wish may require further assessment and treatment. The first chapters of the book provides an overview of rational suicide in the elderly, examining it through history and across cultures also addressing the special case of baby boomers. This book takes an ethical and philosophical look at whether suicide can truly be rational and whether the nearness of death in late-life adults means that suicide should be considered differently than in younger adults. Clinical criteria for rational suicide in the elderly are proposed in this book for the first time, as well as a guidelines for the psychosocial profile of an older adult who wants to commit rational suicide. Unlike any other book, this text examines the existential, psychological, and psychodynamic perspectives. A chapter on terminal mental illness and a consideration of suicide in that context and proposed interventions even without a diagnosable mental illness also plays a vital role in this book as these are key issues in within the question of suicide among the elderly. This book is the first to consider all preventative measures, including the spiritual as well as the psychotherapeutic, and pharmacologic. A commentary on modern society, aging, and rational suicide that ties all of these elements together, making this the ultimate guide for addressing suicide among the elderly.Rational Suicide in the Elderly is an excellent resource for all medical professionals with potentially suicidal patients, including geriatricians, geriatric and general psychiatrists, geriatric nurses, social workers, and public health officials.

This book provides a comprehensive view of rational suicide in the elderly, a group that has nearly twice the rate of suicide when chronically ill than any other demographic. Its frame of reference does not endorse a single point-of-view about the legitimacy of rational suicide, which is evolving across societies with little guidance for geriatric mental health professionals. Instead, it serves as a resource for both those clinicians who agree that older people may rationally commit suicide and those who believe that this wish may require further assessment and treatment. The first chapters of the book provides an overview of rational suicide in the elderly, examining it through history and across cultures also addressing the special case of baby boomers. This book takes an ethical and philosophical look at whether suicide can truly be rational and whether the nearness of death in late-life adults means that suicide should be considered differently than in younger adults. Clinical criteria for rational suicide in the elderly are proposed in this book for the first time, as well as a guidelines for the psychosocial profile of an older adult who wants to commit rational suicide. Unlike any other book, this text examines the existential, psychological, and psychodynamic perspectives. A chapter on terminal mental illness and a consideration of suicide in that context and proposed interventions even without a diagnosable mental illness also plays a vital role in this book as these are key issues in within the question of suicide among the elderly. This book is the first to consider all preventative measures, including the spiritual as well as the psychotherapeutic, and pharmacologic. A commentary on modern society, aging, and rational suicide that ties all of these elements together, making this the ultimate guide for addressing suicide among the elderly.Rational Suicide in the Elderly is an excellent resource for all medical professionals with potentially suicidal patients, including geriatricians, geriatric and general psychiatrists, geriatric nurses, social workers, and public health officials.