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A personal narrative and guide to the safe, responsible use of MDMA for personal healing and social transformation • Details the author's 50 years of responsible experimentation with mind-altering substances and how Ecstasy has helped him become a better therapist • Explains how he and his wife found Ecstasy to be the key to renewing and enriching their lives and marriage as they entered their senior years • Describes what the experience actually feels like and provides protocols for the safe, responsible, recreational, and celebrational use of MDMA for individuals and groups In a world that keeps us separate from each other, MDMA is the chemical of connection. Aptly known in popular culture as “Ecstasy,” MDMA helps us rediscover our own true loving nature, often obscured by the traumas of life. On its way to becoming a prescription medication due to groundbreaking research on its use to treat PTSD, Ecstasy can offer benefits for all adult life stages, from 20-somethings to seniors. In this memoir and guide to safe use, Charles Wininger, a licensed psychoanalyst and mental health counselor, details the countless ways that Ecstasy has helped him become a better therapist and husband. He recounts his coming of age in the 1960s counterculture, his 50 years of responsible experimentation with mind-altering substances, and his immersion in the new psychedelic renaissance. He explains how he and his wife found Ecstasy to be the key to renewing and enriching their lives as they entered their senior years. It also strengthened the bonds of their marriage. Countering the fearful propaganda that surrounds this drug, Wininger describes what the experience actually feels like and explores the value of Ecstasy and similar substances for helping psychologically healthy individuals live a more “optimal” life. He provides protocols for the responsible, recreational, and celebrational use of MDMA, including how to perfect the experience, maximize the benefits and minimize the risks, and how it may not be for everyone. He reveals how MDMA has revitalized his marriage, both erotically and emotionally, and describes how pleasure, fun, and joy can be profound bonding and transformative experiences. Revealing MDMA's versatility when it comes to bringing lasting renewal, pleasure, and inspiration to one's life, Wininger shows that recognizing the transformative power of happiness-inducing experiences can be the first step on the path to healing.

Der Einsatz von Psychopharmaka in Senioreneinrichtungen in Deutschland steht seit Jahren in der Kritik – oftmals würden sie nur zur Ruhigstellung, nicht aber aus medizinischen Gründen verordnet. Renate Wittig hat für ihre hier vorgelegte Studie anhand von Daten der AOK-Versicherten die Verordnung von Psychopharmaka in den Jahren 2010 bis einschließlich 2014 mit Blick auf alters- und geschlechtsspezifische Besonderheiten analysiert. Ein besonderes Interesse galt dabei der Frage, in welcher Pflegestufe sich diese Patienten während des Einnahmezeitraumes befanden und ob es sich um Bewohner einer Pflegeeinrichtung handelte. Entgegen den Erwartungen erfolgten die meisten Psychopharmaka-Verordnungen für Patienten der Pflegestufe 0. Gerade für diese wäre ein Ausweichen auf andere Therapiemöglichkeiten und -optionen und Interventionen durchaus möglich, hilfreich und sinnvoll. In der Altersklasse von 70 bis 75 Jahre sind für die männlichen und in der Altersklasse von 75 bis 80 Jahre für die weiblichen Versicherten die höchsten Verordnungszahlen gefunden worden. Gesondert betrachtet wurden die Psycholeptika-Verordnungen der AOK-Versicherten im Zeitraum von 2010 bis 2015. Im Fokus standen dabei insbesondere Benzodiazepin- und Antidepressiva-Verordnungen. Obwohl durch Studien belegt ist, dass deren Einnahme über einen Zeitraum von mehr als 3 Monaten das Risiko, an einer Alzheimer-Demenz zu erkranken, um rund fünfzig Prozent steigert, werden Benzodiazepine besonders in der Altersklasse der 70- bis 80-Jährigen noch immer in hohem Ausmaße verordnet. Über die Analyse hinaus gibt Wittig einen Abriss über den Einfluss von Psychopharmaka auf kognitive Fähigkeiten und belegt unter Bezugnahme auf bereits vorhandene Studien, dass verschiedene alternative Wege möglich sind, den Alltag von an Demenz oder Depression erkrankten Senioren durch nichtmedikamentöse Interventionen wesentlich zu erleichtern. Dabei geht es vor allem darum, die Lebensqualität zu steigern und die Alltagskompetenz zu erhöhen. Wittig stellt geeignete Trainingsprogramme für Senioren zur Steigerung der physischen und kognitiven Leistungsfähigkeit vor und bewertet sie. Das Buch richtet sich insbesondere an die Leitungen von Senioreneinrichtungen, an Pflegedienstleitungen und heimversorgende Apotheken, aber auch an Ärzte, die Pflegeheime betreuen, sowie an Betroffene und Interessierte im Bereich der Pflege. Sowohl die Bewohner dieser Einrichtungen als auch das Pflegepersonal würden unmittelbar von einer Berücksichtigung und Umsetzung der hier präsentierten Ergebnisse profitieren.

Sleeping patterns change with age, whether we are growing up, or growing old. While most people are prepared for the rapidly altering sleep patterns of growing children, the evidence suggests that many are unprepared for additional sleep changes in later life, either in themselves or in others. In this book, originally published in 1987, two research disciplines – social gerontology and sleep research – are brought together with the aim of providing a straightforward account of how sleep is changed and disrupted by the biological and social impact of ageing. Attention then focuses on the personal and clinical response to these changes. The use of sleeping drugs among elderly people is critically examined, and effective alternatives, including self-help practices and psychological therapies, are described. The influence of ageing on the recall and content of dreams is also considered. In the final chapter, the author comments on current styles of responding to sleep problems in old age and discusses the need and the scope for change. This book deals with topics of universal interest and provides valuable information for those professionally as well as personally concerned with sleep quality in later life, including health professionals (nurses, doctors, psychologists etc.) working with elderly people, gerontologists, and sleep researchers.

Praxiserprobte Maßnahmen für die Pflege älterer Suchtkranker.Schädlicher Substanzmittelkonsum oder eine Abhängigkeit werden bei älteren Menschen häufig nicht oder erst sehr spät bemerkt. Unerkannt können sie zu einem frühzeitigen Verlust der Selbständigkeit führen. Das Praxisbuch vereint die neusten wissenschaftlichen Erkenntnisse und Handlungsempfehlungen für eine qualifizierte Versorgung bei substanzbezogenen Störungen im Alter. Mitarbeiter der ambulanten und stationären Altenpflege werden unterstützt, Suchtprobleme zu erkennen und gezielt Maßnahmen einzuleiten. Die vorgestellten Praxiskonzepte fördern das sichere Handeln im Umgang mit Suchtproblemen im Pflegealltag und haben das Ziel die Lebensqualität der ihnen anvertrauten älteren Menschen zu verbessern.Aus dem InhaltPraxiserprobte Handlungsempfehlungen und -strategien für die Pflege bei Alkohol-, Medikamenten- und Drogenabhängigkeit im AlterPflegekonzepte imUmgang mit Suchterkrankungen im Alter

Help stop the widespread problem of medication errors among the elderly The problem of medication errors among the elderly is widespread. Improving Medication Management in Home Care: Issues and Solutions tackles this tough issue by closely examining the challenges faced in preventing medication errors in home and community care program settings and putting forth effective solutions to better manage medication use. Respected experts discuss the unique role of the pharmacist in improving patient safety, presenting a comprehensive collection of evidence-based studies featuring national and international viewpoints, cutting-edge interventions, and cost-effective procedures that address medication problems in older adults.Polypharmacy is the term used for patients receiving too many medications for a specific treatment. The implications for drug-drug interactions can be dangerous for the unaware patient. Improving Medication Management in Home Care: Issues and Solutions focuses on several different effective management programs and examines each in detail, completely explaining the positiveand negativeresults. This hands-on practical information is useful for all professionals and field providers working with older adults and their medication concerns. The book also provides valuable lessons through the experiences of national home health leaders in various settingshospital-based, rural, large or small, etc., as well as community-based programs for dually eligable older adults. The book is extensively referenced and includes an abundance of clear, helpful tables, figures, and Web resources.Improving Medication Management in Home Care: Issues and Solutions explores: developing computerized risk assessment screenings implementing pharmacist-centered interventions improving transitional care from hospital to home the Prescription Intervention and Lifelong Learning (PILL) program Medication Therapy Management Services a quality-improvement project to reduce falls and improve medication management outcome-based quality improvement for patient safety intern programs that can provide cost-effective consultant services Improving Medication Management in Home Care: Issues and Solutions is essential reading for home health care administrators, clinicians, managers, pharmacists, physicians, educators, students, those professionals involved in the field of aging, and health practitioners world-wide.

This book aims to address the major aspects of future drug product development and therapy for older adults, giving practical guidance for the rational product and clinical development and prescribing of drug products to this ever growing segment of the population. With authors coming from key “aging” markets such as Europe, the USA, China and Japan, the book will provide valuable information for students, scientists, regulators, practitioners, and other healthcare professionals from academia, industry and regulatory bodies.

Substance use and addiction is an increasing problem amongst older people. The identification of this problem is often more difficult in older patients and is frequently missed, particularly in the primary care context and in emergency departments, but also in a range of medical and psychiatric specialties.Substance Use and Older People shows how to recognise and treat substance problems in older patients. However, it goes well beyond assessment and diagnosis by incorporating up-to-date evidence on the management of those older people who are presenting with chronic complex disorders, which result from the problematic use of alcohol, inappropriate prescribed or over the counter medications, tobacco, or other drugs. It also examines a variety of biological and psychosocial approaches to the understanding of these issues in the older population and offers recommendations for policy.Substance Use and Older People is a valuable resource for geriatricians, old age psychiatrists, addiction psychiatrists, primary care physicians, and gerontologists as well as policy makers, researchers, and educators. It is also relevant for residents and fellows training in geriatrics or geri-psychiatry, general practitioners and nursing home physicians.

Here is a detailed description of an innovative approach for treating elderly persons who have alcohol or drug problems. During the past few years there has been growing recognition of the special needs of these individuals. Addictions Treatment for Older Adults describes the evaluation of the Community Older Persons Alcohol (COPA) Program. This book helps readers understand the nature of substance abuse among the elderly, as well as how to identify and intervene with older persons who have alcohol and drug problems, including persons who are reluctant to seek treatment. Addictions Treatment for Older Adults explains the development of the COPA program and how it works. Many case studies and tables provide illuminating details for readers who work with this elderly population. Chapters examine characteristics of elderly persons with alcohol or drug problems the typology of COPA clients and their problem areas treatment interventions variables associated with improvement analysis of progress made by clients during and after treatment the factors that seem to predict recoveryThe in-depth descriptions in this book provide much needed information and guidance for professionals striving to meet the treatment and care needs of elderly substance abusers. Addictions Treatment for Older Adults should be read by researchers in the substance abuse field and by persons who work with the elderly, such as community nurses, social workers, and physicians. In this book they will find the best description to date of the nature of alcohol and drug problems among elderly who live in their communities.

Arzneimittel – richtig verabreichen und die Wirkung pflegerisch beobachten Altenpflegende müssen Medikamente sicher verabreichen. Deshalb stehen hier Krankenbeobachtung und Beratung im Vordergrund, für die Anwendnung in der täglichen Praxis helfen Fallbeispiele. Die Altenpflegeschüler lernen die Beobachtung von Wirkungen und Nebenwirkungen - mit Rückschlüssen auf die jeweilige vom Arzt angeordnete Therapie - Konsequenzen für die Pflege aus der Einnahme von Medikamenten - Krankenbeobachtung, Pflegeintervention in Bezug auf unerwünschte Wirkungen

With the use of multiple medications in the elderly patient comes the risk of drug-related problems. This issue covers polypharmacy in the elderly patient with topics that include: The Interplay between Polypharmacy, Geriatric Conditions, and Adverse Drug Reactions, Factors Leading to Excessive Polypharmacy, Clinical Practice Guidelines for Chronic Diseases and How They Contribute to Polypharmacy, Polypharmacy in Nursing Home Residents, Psychotropic Polypharmacy, Deprescribing Trials: Methods to Reduce Polypharmacy and the Impact on Prescribing and Clinical Outcomes, Ethical Framework for Medication Discontinuation in Nursing Home Residents with Limited Life Expectancy, Pharmacokinetics in the Elderly and the Interaction with Polypharmacy, Medication Adherence to Multi-drug Regimens, Improvements in Electronic Prescribing to Reduce Inappropriate Medication Use and Polypharmacy, and Tools to Decrease Polypharmacy.

At least 5.6 million to 8 million—nearly one in five—older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

For baby boomers and beyond—an honest, often humorous look at how staying clean and sober takes on a new dimension as the challenges of aging are thrown into the mix.'Funny, courageous, and empowering. In exploring the richness of his own life, Alexander celebrates and invites us to discover the uniqueness and wisdom within ourselves. This book is a gift to those of us who are old, and even more, perhaps, to those who are young.'Zen Master Dennis Genpo Merzel, author of Big Mind, Big Heart: Finding Your Way,'Moving between the intimacy of self-revelation and the universality of spiritual wisdom, Alexander takes us on an absorbing and illuminating journey to the outer edges of life.'Kevin Griffin, author of One Breath at a Time: Buddhism and the Twelve StepsOut of author William Alexander's personal reflections and hard-won insights emerges an unconventional approach to the challenges of achieving and maintaining real sobriety--'a radical way of living on this earth, endlessly honest, open, and willing'--that come with aging. Beginning with the admission that we are as powerless over growing old as we are over our addictions, Bill takes readers on a journey of discovery and, in doing so, overturns the clich鳠of age, revealing how he was able to let go of old ideas about'self,'experience meditation in a new light, and discover the virtues of simplicity. With one foot planted in the principles of AA, and the other in his ever-evolving personal spiritual journey blending Eastern and Western traditions, Hi, I'm Bill and I'm Old helps people in recovery embrace the unique challenges that come with age as lessons for reinventing their own sobriety.William Alexander is a writer, storyteller, and teacher who leads sobriety workshops at such venues as Union Theological Seminary, the Esalen Institute, and Hazelden Foundation. He is the author of Cool Water and Still Waters.

Medication use is the predominant form of health intervention in our society. And as we age, the likelihood of medication use increases dramatically, with more than 80 percent of those over age 65 using one or more medications. Along with that, the potential for medication errors also increases. Indeed adverse drug reactions (ADRs) and adverse drug events (ADEs) are a significant problem in older adults. Written in a practical format by contributors from Australia and the United States, Medication Management in Older Adults: A Concise Guide for Clinicians presents the available evidence on research interventions designed to reduce the incidence of medication errors in older adults, with a focus on acute, subacute, and residential (long-term) care settings. Because medication errors can occur at all stages in the medication process, from prescription by physicians to delivery of medication to the patient by nurses, and in any site in the health system, it is essential that interventions be targeted at all aspects of medication delivery. Chapters cover the principles of medical ethics in relation to medication management; common medication errors in the acute care sector; medication management in long-term care settings; nutrition and medications; the outcomes of a systematic review; dose form alterations; Electronic Health Records (EHR), Computerized Order Entry (COE), Beers criteria; and pharmacokinetics and pharmacodynamics. For those clinicians especially concerned with providing the best possible outcomes for their older adult patients, Medication Management in Older Adults: A Concise Guide for Clinicians is an invaluable resource and a significant contribution to the burgeoning literature on medication errors.

Part of the CAMH Healthy Aging Project, Improving Our Response provides the information, tools and guidance that service providers need to work more effectively with older adults who may have substance use, mental health or gambling problems. With a foreword by geriatric psychiatrist Benoit Mulsant. This comprehensive resource includes: • an overview of alcohol use, anxiety, bipolar disorder, depression, schizophrenia, tobacco use and other problems as they appear in older adults • a selection of screening tools that can be used to help identify problems • practical guidance on building a relationship, adopting a holistic approach and advocacy for older adults • an introduction to the recovery, harm reduction and stages of change models as guiding principles of care • ways to guide and support staff, families and others who care for older adults with these problems • information on referring to specialized addiction and mental health treatment services • case studies and practical strategies for complex situations • information sheets for older adults and their families on substance use, mental health and gambling. This guide is for professionals who work with older adults, including nurses, social workers, occupational therapists, physiotherapists, educators and management staff in community support services, retirement and long-term care homes. The guide is also a useful resource for mental health and addiction treatment providers.

Understanding how substance use, mental health and gambling problems affect older adults can help people who work with them to respond more sensitively and effectively when difficult situations arise. This easy-to-read booklet is designed to help workers and volunteers understand and recognize signs of problems. The booklet describes each of the following problem areas, as they relate to older adults: • alcohol problems • anxiety • dementia • depression • gambling problems • medication issues. Tips on communicating with older adults with each of these problems are included, as are guidelines on when to seek help. The booklet also includes: • facts about the aging process • a discussion of cultural issues • lists of organizations offering information about services for older adults with substance use, mental health and gambling challenges • further resources on the web, and in print. Administrators and managers of services and facilities for older adults are encouraged to order this booklet for their staff.

Projet de CAMH sur le vieillissement en santé En comprenant les effets des problèmes de toxicomanie, de santé mentale et de jeu sur les personnes âgées, les intervenants pourront réagir avec plus de délicatesse et d'efficacité lorsque des situations difficiles se présenteront. Ce livret facile à lire a pour but d'aider les intervenants et les bénévoles à comprendre et à reconnaître les signes de problèmes. Il décrit les divers problèmes avec lesquels les personnes âgées peuvent être aux prises : • problèmes d'alcool • angoisse • démence • dépression • problèmes de jeu • médicaments. Le livret contient des conseils sur la façon de communiquer avec les personnes âgées aux prises avec ces problèmes ainsi que des lignes directrices sur le moment où demander de l'aide. On y retrouve également : • des faits sur le processus de vieillissement • une analyse des questions culturelles • des listes d'organismes qui offrent des renseignements sur les services destinés aux personnes âgées ayant des problèmes de toxicomanie, de santé mentale et de jeu • de l'information sur d'autres ressources disponibles sur Internet ou sur papier. Nous encourageons les gestionnaires et les chefs de services et d'établissements pour personnes âgées à le commander pour leur personnel.

As we age, our physiology changes. Also, we tend to place less emphasis on proper nutrition. The more elderly we grow, the less resistant we become to major diseases such as cancer and heart disease. This state of affairs renders the elderly more vulnerable to alcohol and other drugs of abuse. Alcohol and tobacco are routinely used together. Chroni

Choosing to Change is a practical handbook for staff of health and social service agencies, people working in addiction treatment programs, and anyone who comes into contact with older adults who have problems with their use of alcohol and/or psychoactive medications. The book uses brief case histories to illustrate the distinct nature of alcohol and medication use among people in this age group. It includes a monitoring form that can help people keep track of their drinking, and answers questions such as: • Why are different treatment options needed for older adults? • How can the signs of problems with alcohol or medication use be distinguished from the signs of aging or age-related illnesses? • How does alcohol interact with commonly prescribed medications? • Which strategies work best to overcome an older person's resistance to change?

Ce manuel pratique s'adresse au personnel des organismes de services sociaux et de santé ou des programmes de traitement de la toxicomanie, et à quiconque est en contact avec des personnes âgées ayant des problèmes liés à l'alcool ou à des médicaments psychotropes. Le manuel répond entre autres aux questions suivantes : • Pourquoi faut-il recourir à des options de traitement différentes pour les personnes âgées • Comment peut-on distinguer les signes d'un problème lié à l'alcool ou aux médicaments de ceux des maladies associées au vieillissement? • Quelles sont les interactions entre l'alcool et les médicaments couramment prescrits? • Quelles sont les stratégies les plus efficaces pour surmonter la résistance au changement chez une personne âgée?