9780801865213

The 36-Hour Day

by ;
  • ISBN13:

    9780801865213

  • ISBN10:

    0801865212

  • Format: Paperback
  • Copyright: 2000-12-01
  • Publisher: Johns Hopkins Univ Pr

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Summary

"I welcome with enthusiasm the third edition of this book for families and friends of patients with dementing illnesses. It has served well in its prior appearances and should accomplish even more with this edition." -- Paul R. McHugh, M.D., in the foreword Through two editions, this best-selling book has remained the "bible" for families who are giving care to people with Alzheimer disease. The 36-Hour Day has offered comfort and support to millions of people in North America and, in translations and adapted editions, throughout the rest of the world. For this third edition, the authors have retained the structure, scope, and purpose of the original book, while thoroughly updating chapters to reflect the latest medical research and the current delivery of care. Topics that have been added or extensively revised include: Updated terminology and statistics ? New material on the evaluation of persons with dementia ? Updated changes in laws on driving ? A new section on hospice care ? New information on assisted living facilities and financing care ? Information on other types of dementia ? The latest findings on eating and nutrition ? New medical research in areas such as drugs, genetics, and diagnostic tests. The revised appendices include: New bibliographic references ? websites ? Updated addresses of associations and state offices. Praise for previous editions: "The best guide of its kind." -- Chicago Sun Times "An excellent book for families who are caring for persons with dementia... A book that physicians can confidently recommend to the families of their patients." -- Journal of the American Medical Association "Excellent guidance and clear information of a kind that the family needs... The authors offer the realistic advice that sometimes it is better to concede the patient's frailties than to try to do something about them, and that a compassionate sense of humor often helps." -- New York Times "An excellent, practical manual for families and professionals involved in the care of persons with progressive illnesses... The book is specific and thought-provoking, and it will be helpful to anyone even remotely involved with an 'impaired' person... Highly recommended, especially for public and nursing libraries." -- Library Journal " The 36-Hour Day has served its readers well. The revised edition should be even more useful both to family caregivers and professional health care providers." -- HMO Practice "The reader who is familiar with the first edition will recognize the strengths that continue in the revised edition -- numerous case examples, practical advice, thoroughness of coverage, and communication of caring and humane attitudes while presenting information that may be sensitive and upsetting to families." -- Clinical Gerontologist

Table of Contents

Foreword xix
Preface xxiii
Acknowledgments xxvii
Preface to the First Edition xxxi
Dementia
1(21)
What is Dementia?
9(4)
The Person with a Dementing Illness
13(4)
Where Do You Go from Here?
17(5)
Getting Medical Help for the Impaired Person
22(14)
The Evaluation of the Person with a Suspected Dementia
23(7)
Finding Someone to Do an Evaluation
30(1)
The Medical Treatment and Management of Dementia
31(5)
The Physician
32(1)
The Nurse
33(1)
The Social Worker
34(2)
Characteristic Problems of Dementia
36(42)
The Brain, Behavior, and Personality: Why People with Dementia Do the Things They Do
37(6)
Caregiving: Some General Suggestions
43(4)
Memory Problems
47(2)
Overreacting, or Catastrophic Reactions
49(8)
Combativeness
57(1)
Problems with Speech and Communication
58(10)
Problems the Impaired Person Has in Making Himself Understood
59(5)
Problems the Impaired Person Has in Understanding Others
64(4)
Loss of Coordination
68(6)
Loss of Sense of Time
74(2)
Symptoms that Are Better Sometimes and Worse at Other Times
76(2)
Problems in Independent Living
78(91)
When a Person Must Give Up a Job
80(2)
When a Person Can No Longer Manage Money
82(2)
When a Person Can No Longer Drive Safely
84(6)
When a Person Can No Longer Live Alone
90(12)
When You Suspect that Someone Living Alone Is Getting Confused
91(4)
What You Can Do
95(1)
Moving to a New Residence
96(6)
Problems Arising in Daily Care
102(1)
Hazards to Watch For
102(9)
In the House
104(4)
Outdoors
108(1)
In the Car
109(1)
Smoking
109(1)
Hunting
110(1)
Highways and Parking Lots
110(1)
Nutrition and Mealtimes
111(15)
Meal Preparation
112(1)
Problem Eating Behaviors
113(1)
Mealtimes
114(5)
Malnutrition
119(1)
Weight Loss
120(2)
Choking
122(1)
When to Consider Tube Feeding
123(3)
Exercise
126(3)
Recreation
129(5)
Meaningful Activity
133(1)
Personal Hygiene
134(12)
Bathing
136(4)
Dressing
140(1)
Grooming
141(1)
Oral Hygiene
142(2)
Bathroom Supplies
144(2)
Incontinence (Wetting or Soiling)
146(9)
Urinary Incontinence
146(6)
Bowel Incontinence
152(1)
Cleaning Up
152(3)
Problems with Walking and Balance; Falling
155(6)
Becoming Chairbound or Bedbound
158(2)
Wheelchairs
160(1)
Changes You Can Make at Home
161(8)
Should Environments Be Cluttered or Bare?
166(3)
Medical Problems
169(85)
Pain
172(1)
Falls and Injuries
172(1)
Pressure Sores
173(1)
Dehydration
174(1)
Pneumonia
175(1)
Constipation
175(3)
Medications
178(4)
Dental Problems
182(1)
Vision Problems
183(3)
Hearing Problems
186(1)
Visiting the Doctor
187(2)
If the Ill Person Must Enter the Hospital
189(2)
Seizures, Fits, or Convulsions
191(3)
Jerking Movements (Myoclonus)
194(1)
The Death of the Impaired Person
194(10)
The Cause of Death
195(1)
Dying at Home
195(2)
Hospice
197(1)
Dying in the Hospital or Nursing Home
197(1)
When Should Treatment End?
198(1)
What Kind of Care Can Be Given at the End of Life?
199(5)
Problems of Behavior
204(1)
The Six R's of Behavior Management
205(2)
Concealing Memory Loss
207(2)
Wandering
209(13)
Reasons Why People Wander
210(2)
The Management of Wandering
212(10)
Sleep Disturbances and Night Wandering
222(4)
Worsening in the Evening
226(2)
Losing, Hoarding, or Hiding Things
228(2)
Rummaging in Drawers and Closets
230(1)
Inappropriate Sexual Behavior
230(4)
Repeating the Question
234(1)
Repetitious Actions
235(2)
Distractibility
237(1)
Clinging or Persistently Following You Around
237(2)
Complaints and Insults
239(5)
Taking Things
244(1)
Forgetting Telephone Calls
245(1)
Demands
246(3)
Stubbornness and Uncooperativeness
249(2)
When the Sick Person Insults the Sitter
251(1)
Using Medication to Manage Behavior
252(2)
Problems of Mood
254(27)
Depression
254(3)
Complaints about Health
257(1)
Suicide
257(1)
Alcohol or Drug Abuse
258(1)
Apathy and Listlessness
259(1)
Remembering Feelings
260(1)
Anger and Irritability
261(2)
Anxiety, Nervousness, and Restlessness
263(3)
False Ideas, Suspiciousness, Paranoia, and Hallucinations
266(13)
Misinterpretation
267(2)
Failure to Recognize People or Things (Agnosia)
269(1)
``My Mother Is Coming for Me''
270(1)
Suspiciousness
271(5)
Hiding Things
276(1)
Delusions and Hallucinations
276(3)
Having Nothing to Do
279(2)
Special Arrangements If You Become Ill
281(6)
In the Event of Your Death
284(3)
Getting Outside Help
287(31)
Help from Friends and Neighbors
288(4)
Finding Information and Services
292(1)
Kinds of Services
292(7)
Having Someone Come into Your Home
294(1)
Adult Day Care
295(2)
Day Hospitals
297(1)
Short-Stay Residential Care
298(1)
Planning in Advance for Home Care or Day Care
299(1)
When the Confused Person Rejects the Care
300(4)
Your Own Feelings about Getting Respite for Yourself
304(2)
Locating Resources
306(4)
Paying for Care
310(3)
Should Respite Programs Mix People Who Have Different Problems?
313(1)
Determining the Quality of Services
314(3)
Research and Demonstration Programs
317(1)
You and the Impaired Person as Parts of a Family
318(33)
Changes in Roles
321(7)
Understanding Family Conflicts
328(4)
Division of Responsibility
329(3)
Your Marriage
332(1)
Coping with Role Changes and Family Conflict
333(6)
A Family Conference
335(4)
When You Live out of Town
339(2)
When You Are Not the Primary Caregiver, What Can You Do to Help?
341(2)
Caregiving and Your Job
343(1)
Your Children
344(7)
Teenagers
348(3)
How Caring for an Impaired Person Affects You
351(36)
Emotional Reactions
351(22)
Anger
353(5)
Embarrassment
358(2)
Helplessness
360(1)
Guilt
361(4)
Laughter, Love, and Joy
365(1)
Grief
366(2)
Depression
368(2)
Isolation and Feeling Alone
370(1)
Worry
370(1)
Being Hopeful and Being Realistic
371(2)
Mistreating the Confused Person
373(1)
Physical Reactions
374(2)
Fatigue
374(1)
Illness
375(1)
Sexuality
376(5)
If Your Spouse Is Impaired
377(3)
If Your Impaired Parent Lives with You
380(1)
The Future
381(5)
You as a Spouse Alone
383(3)
When the Person You Have Cared for Dies
386(1)
Caring for Yourself
387(23)
Take Time Out
389(4)
Give Yourself a Present
391(1)
Friends
391(1)
Avoid Isolation
392(1)
Find Additional Help If You Need It
393(8)
Recognize the Warning Signs
394(3)
Couseling
397(4)
Joining with Other Families: The Alzheimer's Association
401(5)
Support Groups
403(1)
Excuses
404(2)
Advocacy
406(4)
For Children and Teenagers
410(6)
Financial and Legal Issues
416(16)
Your Financial Assessment
416(7)
Potential Expenses
417(2)
Potential Resources
419(4)
Where to Look for the Forgetful Person's Resources
423(4)
Legal Matters
427(5)
Nursing Homes and Other Living Arrangements
432(61)
General Rules for Evaluating a Care Facility
433(1)
Moving with a Confused Person
434(1)
Types of Living Arrangements
435(6)
Nursing Homes and Assisted Living Facilities
441(49)
Paying for Care
445(2)
Payment Sources
447(10)
Establishing the Need for Medical Care
457(1)
The Mental Health Screening Requirement
458(1)
Finding a Home or Other Facility
459(14)
Nursing Home and Assisted Living Programs that Specialize in Dementia Care
473(2)
Moving to a Nursing Home
475(3)
Adjusting to a New Life
478(1)
Visiting
478(5)
Your Own Adjustment
483(2)
When Problems Occur in the Nursing Home
485(3)
Sexual Issues in Nursing Homes
488(2)
The Department of Veterans Affairs (VA)
490(1)
State Mental Hospitals
490(3)
Brain Disorders and the Causes of Dementia
493(17)
Dementia
493(12)
Dementia Associated with Alcohol Abuse
496(1)
Alzheimer Disease
497(3)
Multi-Infarct or Vascular Dementia
500(1)
Lewy Body Dementia
501(1)
The Frontotemporal Dementias, Including Pick Disease
501(1)
Depression
502(1)
Binswanger Disease
503(1)
AIDS
503(2)
Other Brain Disorders
505(5)
Delirium
505(1)
Senility, Chronic Organic Brain Syndrome, Acute or Reversible Organic Brain Syndromes
506(3)
Anoxia or Hypoxia
509(1)
Research in Dementia
510(23)
Understanding Research
511(4)
Bogus Cures
514(1)
Research in Multi-Infarct Dementia and Stroke
515(1)
Research in Alzheimer Disease
516(7)
Structural Changes in the Brain
516(1)
Brain Cell Structure
516(1)
Neurotransmitters
516(1)
Abnormal Proteins
517(2)
Transplants of Brain Tissue
519(1)
Drug Studies
520(1)
Metals
520(1)
Viruses
521(1)
Immunological Defects
522(1)
Head Trauma
522(1)
Epidemiology
523(1)
Down Syndrome
523(1)
Old Age
524(1)
Heredity
524(3)
Gender
527(1)
Promising Clinical and Research Tools
528(1)
Keeping Active
529(1)
The Effect of Acute Illness on Dementia
530(1)
Research into the Delivery of Services
530(2)
Protective Factors
532(1)
Appendix 1. Further Reading 533(6)
Appendix 2. Organizations 539(7)
Appendix 3. Locating Your State Office on Aging and State Nursing Home Ombudsperson 546(9)
Appendix 4. Nursing Home Residents' Rights 555(6)
Index 561

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