This chapter includes information related to the clinical evaluation of a concussion that a child might receive in a medical setting. It discusses guidelines for appropriate use of smartphone concussion evaluation apps. This chapter examines a brief section on the future of concussion assessment. The Acute Concussion Evaluation (ACE) can help the school concussion team obtain information regarding the injury, including the cause, severity, any amnesia, loss of consciousness (LOC), and any early signs. The computerized neurocognitive assessment typically measures player symptoms, verbal/visual memory, attention span, working memory, processing speed, response variability, nonverbal problem solving, and reaction time. Neurocognitive tests, sideline assessments, and smartphone apps can help district staff and parents determine the severity of a student’s symptoms. A neuropsychological assessment to assess cognitive functioning, memory, speed, and processing time may also be administered.
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The medical model in psychiatry assumes medical intervention is the treatment of choice for the constellations of diagnosed symptoms that comprise various mental disorders. These treatments may include pharmacotherapy, electroconvulsive treatment, brain stimulation, and psychosurgery. Therefore, psychopharmacology for older adults can be considered palliative rather than a cure for a brain disease causing psychopathology. Older adults experience many psychopathological problems, including anorexia tardive, anxiety disorders, delusional disorders, mood disorders, personality disorders, schizophrenia, and co-occurring disorders with substance abuse/dependence disorders. Therefore, it is critical for the social worker to understand the various manifestations of psychological problems in older adults from the perspective of an older adult, rather than extrapolating information commonly taught in social work programs that neglect to focus on older adults and restrict teaching to psycho-pathological problems in younger and middle-aged adults.
For older adults, the phenomenon of death is accepted and does not induce the fear experienced by younger adults. Older adults who do not engage in end-of-life planning may receive unwanted, unnecessary, costly, and painful medical interventions or withdrawal of desired treatment. Many older people feel that the goal of palliative care is to make the best possible dying experience for the older adult and his/her family. In addition to palliative care, an older adult will most likely find himself or herself in an intensive care unit as part of his or her terminal care. Euthanasia, or hastened death, is seen by some as an alternative to palliative care. A psychological aspect of death that an older adult is concerned with, in addition to place of death, is whether he or she will die in his or her sleep or die suddenly, making the death experience an individual phenomenon.
Depression is sometimes referred to as the common cold of psy-chopathology. Consistent with this aphorism, epidemiological studies demonstrate that depressive disorders are indeed rather common across the life span. Given the importance of the social relationships and context to understanding depression, it seems likely that culturally informed and diverse research will yield important findings about those critical components of human cognition, emotion, and social relationships that underlie risk for depression, as well as those that serve to aid in recovery from these disorders. Most researchers believe it is unlikely there is a direct effect of hormones on depression, but rather that they indirectly increase risk via any one of several mechanisms, including: the effects of hormones on brain development, the development of secondary gender characteristics that are generated by these hormones, or the hormonal changes that occur during the pubertal transition may interact with life events and the social context.Source:
This concluding chapter summarizes the major points regarding elder abuse (EA) presented in the preceding chapters. It concludes the chapter by taking one last opportunity to encourage exploration and initiation of system-level efforts to solve a major public health problem. The socioecological framework for violence prevention utilized within domestic and global public health work is applicable and extendable to EA. Throughout this book, the authors have argued that EA is a public health problem and that EA may well be among the most under-recognized and under-resourced population health problems of the early 21st century. Public health has frameworks, tools, approaches, relationships, structures, systems, and a variety of agents and organizations poised to address the problem of EA. The imprimatur of the growing population of older adults and the character of demographic transitions occurring globally provide the perfect rationale for action—now.
- Go to chapter: Theories of Environmental Gerontology: Old and New Avenues for Person–Environmental Views of Aging
This chapter provides some integrative perspectives to some of the enduring conceptual challenges in the area, such as place dimension while we age; what available theories in the ecology of aging are telling us; and what kind of new impulses refinement in this area are needed. It argues that the current trend toward intensive measurement designs in the daily ecology and the related increasing use of ambulatory assessment, taking into account short-term, interindividual variability in areas such as cognitive and emotional functioning, and daily stress experiences, may benefit from environmental gerontology perspectives. As we see it, environmental gerontology rests on three main principles two more related to the concept level and one more related to research strategy: importance of person-environmental (P-E) transaction and developmental co-construction; importance of explicitly considering the environment, with a focus on the physical-spatial dimension; and importance of optimizing ecological validity in research.Source:
Delirium, also known as acute confusional state, organic brain syndrome, brain failure, and encephalopathy, is a common occurrence among medical and surgical patients and causes extensive morbidity and mortality. This chapter provides an updated review of delirium, including pathophysiological correlates, clinical features, diagnostic considerations, and contemporary treatment options. The defining features of delirium include an acute change in mental status characterized by altered consciousness, cognition, and fluctuations. The chapter explores the risk factors for delirium. These can be divided into two categories: predisposing factors and precipitating factors. Imbalances in the synthesis, release, and degradation in gamma-aminobutyric acid (GABA), glutamate, acetylcholine, and the monoamines have also been hypothesized to have roles in delirium. GABA is the primary inhibitory neurotransmitter in the central nervous system (CNS) and medications such as benzodiazepines and propofol have known actions at GABA receptors and have been associated with delirium.
This chapter focuses on informal caregiving among minority groups. It also focuses on context of caregiving and discuss the various specific challenges caregivers of minority older adults face. The chapter examines some of the specific caregiving interventions tailored for families of color and discuss the implications for practice, policy, and research. Medical advances and greater longevity point to healthier and longer lives for many, but both formal and informal caregiving remain a concern as individuals age and develop conditions that require care. Caregivers are often able to realize the positive aspects of caregiving when they are not struggling with financial or social support challenges. Despite the vast literature on caregiving in general, research pertaining to the needs and experiences of racial/ethnic minority older adults and their caregivers is limited, particularly for American Indians, Pacific Islanders, specific Asian American and Latino subgroups, and religious minorities groups such as Muslim Americans.Source:
This chapter discusses current thinking in the field of social support and social relationships, and physical and mental health among older racial and ethnic minorities. Social relationships are an important predictor of health and psychological well-being across the life course. Many minority older adults will face the continued challenges of declining functional status due to physical and mental health conditions over the course of their lives. Most empirical studies on social support among older racial and ethnic minority adults explore the association between social support and both physical and mental health. The wealth of studies on social support among minority older adults has much to offer with respect to understanding the correlates of emotional support and patterns of assistance. The biological mechanisms explaining the link between social support and physical health outcomes have been largely unexplored among older racial and ethnic minority groups.Source:
This chapter presents a case study on performance dysfunction in the case of a 21-year-old African American female basketball player entering her senior year at a major Division I-level university. She described regret about not working out harder during the off-season, which she blamed for a poor start to her current season. In addition, she also reported feeling a great deal of worry over the possibility that she may have a poor season and ruin her chance to be drafted in the first round of the WNBA entry draft. According to the case formulation model, there are 10 elements that are necessary to consider prior to making an intervention decision contextual performance demands; skill level; situational demands; transitional and developmental issues; psychological characteristics/performance and nonperformance schemas; attentional focus; cognitive responses; affective responses; behavioral responses; and readiness for change and level of reactance.