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Foreword by the American Geriatrics Society ... x

Acknowledgments ... xii

A Personal Note from the Author ... xiv

How to Use This Book ... xvii

Part I. How We Age 1

1. Important Considerations 3
Individual Variability
Having Multiple Illnesses
Exposure to Many Medications
Reporting Your Illness
Your Doctor's Response
The Importance of Function

2. How Our Body Ages 9
What is Aging?
How Long Can We Realistically Expect to Live?
The Influence of Genetics on Aging
Environmental Factors That Modify Aging
Aging of Cells
Theories of Aging
Body Changes with Aging
Aging and Body Defens es
Physical Activity and Aging
The Anatomy of Aging
Changes in Body Systems

3. How Our Mind Changes with Aging 34
Changes in Learning and Memory as We Age

4. Preventive Care 41
What Aspects of Aging Can We Influence?
Primary Prevention
Secondary Prevention
Tertiary Prevention

Part II. Making Health Care Decisions 51

5. Choosing a Doctor 53
What to Look for in a Doctor
How to Look for a Doctor
Giving a New Doctor a Checkup
Getting the Most from Your Doctor Visit

6. Going into the Hospital 59

7. Undergoing Surgery 63
Aging and Surgical Risk
Determining Your Risk of Surgery
Complications Following Surgery

8. Principles of Rehabilitation 68
Assistive Devices
Other Rehabilitation Techniques
Who Benefits from Rehabilitation?
Settings for Rehabilitation Programs
Rehabilitation of Walking Problems
Transferring from One Place to Another
Stroke Rehabilitation
H ip Fracture Rehabilitation
Rehabilitation if You Need an Amputation
Common Medical Problems During Rehabilitation

9. Taking Medications 90
Pharmacokinetics
Changes in Pharmacodynamics with Aging
Adverse Drug Effects
Aging Changes That Modify Drug Effects
Drug and Disease Interactions

10. Long-Term Care 100
Institutional and Home Care

Part III. Legal, Ethical, and Financial Considerations 109

11. Ethical Issues and Concerns 111
Respecting Your Choices
Surrogate Decision Making
Acting in Your Best Interests
Preventing Harm
Life-Sustaining Treatments
Do-Not-Resuscitate Orders
Withdrawing Treatment
Tube Feedings
Active Euthanasia
Assisted Suicide

12. Financing Health Care 123
Medicare
Medicaid
Private Insurance Policies

Part IV. Conditions That Affect Older People 133

13. Memory and Thinking: Dementia, Delirium, and Amnesia 135
Overview
Classifying Dementias
Dementia Management
Delirium (Sudden Confusion)
Amnesia

14. Neurologic Disorders 159
Overview
Dizziness
Fainting (Syncope)
Seizures
Tremors
Speaking Difficulty (Aphasia)
Huntington's Disease
Parkinson's Disease
Stroke
Meningitis

15. Psychologic Concerns 187
Overview
Anxiety
Depression
Alcohol Abuse
Drug Dependency

16. Skin Conditions 213
Overview
Skin Dryness
Skin Discoloration in Body Folds (Intertrigo)
Skin Growths
Itching
Allergic Skin Rash (Contact Dermatitis)
Fungal Skin Infections
Infestations
Pressure Ulcers
Psoriasis
Shingles
Skin Cancers
Skin Changes Due to Poor Circulation (Statis Dermatitis)
Skin Infections

17. Joints, Muscles, and Bones 236
Overview
Causes of Joint, Muscle, and Bone Problems
Neck Pain
Shoulder Pain
Back Pain
Hip Problems
Knee Problems
Foot Problems
Gout
Pseudogout
Osteoarthritis
Rheumatoid Arthritis
Osteoporosis and Osteomalacia
Paget's Disease of Bone
Bone Fractures

18. Head, Neck, and Sensory Concerns 282
Overview
Hearing Difficulty
Vision Problems
Dry Mouth
Difficulty Chewing
Oral and Dental Problems
Thyroid Disease

19. Heart and Circulation Conditions 304
Overview
Chest Pain
Swollen Ankles
High Blood Pressure
Coronary Artery Disease
Diseases of the Heart Valves
Congestive Heart Failure
Abdominal Aortic Aneurysm
Poor Circulation
Varicose Veins and Other Venous Disorders

20. Blood Disorders 324
Overview
Anemia
Bleeding and Clotting Disorders
Blood Poisoning
Leukemia
Lymphoma
Multiple Myeloma
Reduced White Blood Cells

21. Lung and Breathing Problems 338
Overview
Cough
Wheezing and Breathing Difficulty
Chronic Lung Disease
Aspiration
Lung Cancer
Pneumonia
Tuberculosis

22. Digestive Disorders 349
Overview
Abdominal Pain
Loss of Appetite
Swallowing Difficulties
Heartburn
Constipation
Diarrhea
Excess Gas
Gastrointestinal Bleeding
Loss of Bowel Control
Peptic Ulcer Disease
Gallbladder Disease
Diverticulitis
Appendicitis
Colon and Rectal Cancers
Hemorrhoids and Other Rectal Problems

23. Nutrition Concerns 376
Nutritional Requirements
Malnutrition
Loss of Weight
Obesity

24. Bladder, Urinary, and Kidney Conditions 387
Overview
Blood in the Urine (Hematuria)
Loss of Bladder Control (Urinary Incontinence)
Urinary Tract Infection
Bladder Cancer
Kidney Problems Caused by Blood Vessel Disease
Problems with Kidneys' Filtering Apparatus (Gl omerulo-nephritis)
Sudden Kidney Failure

25. Sexuality and Sexual Concerns 406
Overview
Sexuality in Relation to Coexisting Illness
Counseling
Gynecologic Disorders
Vaginal Bleeding
Breast Cancer
Cervical Cancer
Uterine or Endometrial Cancer
Ovarian Cancer
Impotence
Prostate Problems

26. Other Important Conditions 432
Cancer (General)
Disorders of Salt and Water
Diabetes Mellitus
Heat Stroke
Hypothermia
Infections (General)
Loss of Vitality
Medication Problems (Polypharmacy)
Pain
Sleep Problems
Walking Problems, Immobility, and Falls

Resources 478

Index 482

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