At Wit’s End
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At Wit’s End: Plain Talk on Alzheimer’s for Families and Clinicians, now in its Second Edition, is a straightforward summary of leading advice for understanding and caring for someone with Alzheimer’s disease, written without technical jargon and impractical nuance. About one-third of our population will eventually provide care for someone with Alzheimer’s. The strain of caring for a loved one with this disease can be enormous, yet the reward of enhancing a loved one’s quality of life is beyond measure. So, where to begin?
Many books delve into other specific areas of Alzheimer’s care, emphasizing the financial and legal challenges, as well as myriad medical treatment needs of those experiencing the disease. Unique among these offerings, At Wit’s End explains the psychiatric and psychological aspects of Alzheimer’s, and does so in a holistic and practical manner. Dr. Kraus focuses on the whole person across his or her full social, psychological, physical, and spiritual life to provide as complete a picture as possible of the changes that are in play. With this broad, thoughtful, and grounded approach, family members, clinicians, and caregivers are better able to discover and make wise choices from a wealth of effective interventions in all areas of care. It also allows them to care for themselves and their families in the dynamic and supportive care process.



Publié par
Date de parution 15 octobre 2016
Nombre de lectures 0
EAN13 9781612494715
Langue English
Poids de l'ouvrage 1 Mo

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At Wit’s End
At Wit’s End
Plain Talk on Alzheimer’s for Families and Clinicians Second Edition
George Kraus, Ph.D.
Purdue University Press West Lafayette, Indiana
Copyright 2017 by Purdue University. All rights reserved.
Printed in the United States of America.
Library of Congress Cataloging-in-Publication Data
Names: Kraus, George, 1950- author.
Title: At wit’s end : plain talk on Alzheimer’s for families and clinicians / George Kraus, Ph.D.
Description: Second edition. | West Lafayette, Indiana : Purdue University Press, [2017] | Includes bibliographical references and index.
Identifiers: LCCN 2016016854| ISBN 9781557537676 (pbk. : alk. paper) | ISBN 9781612494708 (epdf) | ISBN 9781612494715 (epub)
Subjects: LCSH: Alzheimer’s disease.
Classification: LCC RC523 .K736 2017 | DDC 616.8/31—dc23
LC record available at
Cover image from CelsoDiniz/iStock/Thinkstock
I dedicate this book to my beautiful and inspirational wife, Lori. I love you deeply, my friend .
Second Edition Introduction
Part 1. What Is Alzheimer’s?
1 The Basics
2 Normal Aging
3 Alzheimer’s Is a Type of Dementia
4 Evidence of Alzheimer’s
5 Distinguishing Between Delirium, Alzheimer’s, and Other Dementias
6 Two Case Studies: Applying the Basics
Part 2. How to Evaluate for Alzheimer’s
7 This Person I Used to Know: Measuring the Status of Mental Functioning in Alzheimer’s
8 Measuring Alzheimer’s in Action
9 The Question of Competence
Part 3. Disturbances in Mood and Perception
10 Geriatric Depression and Alzheimer’s
11 I Know She Has Alzheimer’s, But Why Is She Acting Like This? Recognizing Psychotic Symptoms in Alzheimer’s
Part 4. Medical and Psychological Treatment Approaches
12 Treatment of Alzheimer’s with Medicines
13 Changing the Person’s Surroundings
14 Talking to People with Alzheimer’s
15 Preventive Activities for Ourselves and Others: Lowering Our Odds of Getting Alzheimer’s
Appendix A: Additional Resources and Information on Alzheimer’s Dementia
Appendix B: What to Do about Aggressive Behavior
Appendix C: Effective Uses of Psychological Interventions in Long-Term Care Facilities
Appendix D: Additional Tables and Figures
Table 1. Emotional Signs and Symptoms That Accompany Alzheimer’s
Table 2. Distinctions between Alzheimer’s and Delirium
Table 3. Distinctions between Cortical and Subcortical Dementia
Table 4. Features Useful in Differentiating Alzheimer’s Disease from Dementia Syndrome of Depression
Table 5. Medications That Commonly Cause Confusion
Figure 1. How Clinicians Can Differentiate between Alzheimer’s Disease and Vascular Dementia
Figure 2. The Standard Comprehensive Workup for Delirium and Alzheimer’s Dementia
Figure 3. Categories of the Full Mental Status Exam
Figure 4. The Hopkins Competency Assessment Test
Figure 5. The Cornell Scale for Depression in Dementia
Creating a book like this takes support, guidance, and a little inspiration, and I am so grateful for all the help I’ve received. To all of my friends, colleagues, and family, thank you. You have contributed more than you know to this book and to my life.
It’s a rare thing to find the kindness you want to give others reflected in someone else. To John Chang, Ph.D., of Wright State University—for providing me those many hours of consultation on the psychology of the elderly. The time we spent together was essential in developing my practice specialty as a geropsychologist. Your clinical expertise, friendship, and support have helped me set a sound foundation for my clinical work with Alzheimer’s patients.
Over the years that I have provided care and consulted to Livingston Care Center, I have worked with some incredible people—Samuel Berger, Sharon Clay, Hilda Claypool, Brenda Cooper, Kara Crutcher, Jennifer Foley, Patty Free, Cynthia Gifford, Haitham Imam, Romona Pollard, Linda Riebe, Kim Schooler, Rischell Snow, Debbie Steward, Lynn Thurston, Vladimir Trakhter, Dale Valiquette, Barb Vocke, Amy Walters, and Luther Wright III—thank you all for making me feel so welcome and appreciated. The stable center of my work there, though, has been Julie Upchurch, LSW, Director of Social Services, and two of her very finest assistants, Casandra Watson and Bo Hobbs—I am so very grateful for all your efforts in supporting my connection with your residents and making the time I’ve spent at Livingston meaningful and fun. Finally, I want to offer my heartfelt gratitude to Bil Ferrar, Director of Social Services, of Patriot Ridge Community for your dedication and commitment to your residents there, and especially to Ann Wilder, Director of Activities, and Jackie Davis of Patriot Ridge Community—thank you both for the fine activities programming you’ve offered there. I also want to thank Jennifer Jenkins and Sue Holston of Tampico Terrace Care Center; Lydia Swagerty and Trisha Oliver of Rheem Valley Convalescent Hospital; and Sue Fordon and Karen Barnes-Jarvis of Hospice of the East Bay for all their help and support in welcoming and integrating me into my new California community.
To all the clinicians and staff of Layh and Associates of Yellow Springs, Ohio—Joyce Appell, LPC, Bruce Heckman, Ph.D., Casey Kelliher, Psy.D., Jim Kane, LPC, Lorena Kvalheim, Psy.D., Melissa Layman-Guadalupe, Ph.D., Kate LeVesconte, Psy.D., Kathi Lewis, Psy.D., Angela Branch, Katie Malone, and Ruth Willfong—thanks for all the valuable help, feedback, and support you have offered me over the years. And I’d like to give a special thanks to Jack Layh, Ph.D., your experience and indispensable assistance have been invaluable in helping me develop my practice as a psychologist.
To all the wonderful staff at the Greene County Libraries of Yellow Springs, Ohio—Connie Collett, Alan, Staiger, Rick Mickels, Pat Siemer, Peggy Townshend, Tricia Gelmini, Paul Cooper, Lyn Bobo—thanks for all the help and technical guidance in maneuvering through your world of information science, and especially to Amy Margolin of the Greene County Library of Xenia for tracking down the sea of interlibrary loan items I requested.
To all my colleagues at Midwest Behavioral Care of Dayton, Ohio—Steve Pearce, Psy.D., Deb Sowald, Psy.D., Phyllis Kuehnl-Walters, Ph.D., Gary Dixon, LISW, and Lee Wolfe, LPCC—your support and good advice helped me in so many ways to develop my practice and skills as a clinician. I want to thank Tina Bowers, Ruth Waymire, and especially Jennifer Shank and Tabby Masters for all the encouragement and fun you brought into my life working there as I wrote this book.
I want to thank David Goldberg, M.D., of Greene Memorial Hospital—I really appreciated the support and encouragement you gave me when I first presented the seeds for this book at my Grand Rounds talk on dementia.
To Ed Klein, Ph.D., and Walt Stone, M.D., of the University of Cincinnati, thank you for all the sound academic advice, clinical pearls, and kind truths you gave me during my post-doctoral clinical training. You are two of my wise mentors, and it was such a gift to have been able to work with you.
To Gary Gemmill, Ph.D., and Celeste Sinton, M.D., mentors and emotional guides both—thanks for teaching me just how much I can enjoy learning about my vulnerabilities and trusting myself. You each have brought me so much wisdom and faith in the process, and I will forever be grateful to you both.
To my Uncle Chick—although you have long passed, I want to thank you so much for helping me begin to really see and like myself in ways I never had. Your book with Maxwell Maltz and that summer workshop, “How to Live and Be Free Through Psychocybernetics,” inspired me to pursue my passion for psychology. And to Aunt Shirley, thank you so much for all the loving guidance you have given me.
To my sisters, Pat and Betty—your encouragement and love has been a silent undercurrent in all of my efforts here. Thank you, Pat, for your insightful suggestions and Betty, for your simple and beautiful artwork in the book. And to my parents—somewhere you are watching from above, reading this, and smiling with joy.
To my Aunt Peggy, our family historian—your love and encyclopedic knowledge of the genealogy of all the clinicians in our family has contributed to a strong sense of professional identity and connectedness to the traditions of my past. Your love and support have quietly helped me believe in myself.
To Tom Tuttle and Sandy Novak, thank you both for all your incredible insights and optimism. Your experience and wisdom made finding a publisher exciting and fun. And to Vivian Tuttle, my wonderful new mom, thanks for reviewing an early draft of the book and for all the love and silliness you bring into my life. It’s great being in your family.
To my wife, Lori, and to all the special children in my life—Aurianna, Michael, Nancy, Nathan, Miles, Dee, and Axs—you have brightened my life in ways that go beyond words. I love you all very much.
To the late Margaret Hunt of Purdue University Press, thank you for all your editorial wisdom, patience, and faith in making At Wit’s End (2006) the very best it could be. I also want to thank Katherine Purple and Peter Froehlich for shepherding

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