Part of the Wiley Series in Clinical Geropsychology, Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention helps to familiarize you with the legal and social contexts for decision making in potentially impaired individuals. Editors Sara Qualls and Michael Smyer have brought together a notable team of international contributors to provide you with a unique framework of the legal, social, and psychological approaches to assessing the ability of older adults to make decisions.

Possible new breakthroughs in understanding the aging mind that can be used to benefit older people are now emerging from research. This volume identifies the key scientific advances and the opportunities they bring. For example, science has learned that among older adults who do not suffer from Alzheimer's disease or other dementias, cognitive decline may depend less on loss of brain cells than on changes in the health of neurons and neural networks. Research on the processes that maintain neural health shows promise of revealing new ways to promote cognitive functioning in older people. Research is also showing how cognitive functioning depends on the conjunction of biology and culture. The ways older people adapt to changes in their nervous systems, and perhaps the changes themselves, are shaped by past life experiences, present living situations, changing motives, cultural expectations, and emerging technology, as well as by their physical health status and sensory-motor capabilities. Improved understanding of how physical and contextual factors interact can help explain why some cognitive functions are impaired in aging while others are spared and why cognitive capability is impaired in some older adults and spared in others. On the basis of these exciting findings, the report makes specific recommends that the U.S. government support three major new initiatives as the next steps for research.

This book demonstrates how to address practical and ethical challenges when assessing older adults with neurocognitive disorders, like dementia. Expanding on the ABA/APA's Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists, it explores the tension between ensuring a client's autonomy while protecting them from harm, particularly when decision-making capacity or daily living skills are impaired. Chapters cover a range of complex issues in careful detail, including financial exploitation, undue influence, sexual consent, and medical aid in dying.

By 2030 there will be about 70 million people in the United States who are older than 64. Approximately 26 percent of these will be racial and ethnic minorities. Overall, the older population will be more diverse and better educated than their earlier cohorts. The range of late-life outcomes is very dramatic with old age being a significantly different experience for financially secure and well-educated people than for poor and uneducated people. The early mission of behavioral science research focused on identifying problems of older adults, such as isolation, caregiving, and dementia. Today, the field of gerontology is more interdisciplinary. When I'm 64 examines how individual and social behavior play a role in understanding diverse outcomes in old age. It also explores the implications of an aging workforce on the economy. The book recommends that the National Institute on Aging focus its research support in social, personality, and life-span psychology in four areas: motivation and behavioral change; socioemotional influences on decision-making; the influence of social engagement on cognition; and the effects of stereotypes on self and others. When I'm 64 is a useful resource for policymakers, researchers and medical professionals.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.