Handbook of Geriatric Psychiatry, edited by Edwald W. Busse, MD and Dan G. Blazer, MD. New York, Van Nostrand Reinhold, 1980. 542 pps. $34.50.
A publication whose time has arrived, the Handbook of Geriatric Psychiatry, deals with the aging personality, taking into consideration the behavioral sciences, current practices and treatment modalities, as well as the psychodynamic concepts. A handbook in the truest sense, this text is a compact reference book, with well-known contributors across the country, including Harold Brody, Carl Eisdorfer, Eric Pfeiffer, Adrian Verwoerdt, and Alan Wanger. This text can be used by geriatric psychiatrists, geriatricians, nurses, social workers, psychologists, and health care providers in general.
The 24 chapters presented divide the book into three basic parts. Part I is The Biological and Psychosocial Basis for Geriatric Psychiatry; Part II, The Diagnosis and Treatment of Psychiatric Disorders in Late Life; and Part III, Future Directions.
Part I begins with a discussion defining aging and its process. Significantly the term "gerontophobia" is introduced and addressed as an issue with which all health professionals must deal. Special emphasis is placed on physicians and their contacts with this population. The remaining chapters in this section discuss at length neuroanatomy, neurophysiology, and social factors in aging. Although this first part is written from a medical model perspective there is a wealth of valuable information for the nurse practitioner andclinical nurse specialist. Included in Part I is an excellent chapter by J. Walker and H. Keith Brodie on Neuropharmacology of Aging. This chapter can be of particular interest to nurses in health care settings in which they can assess and evaluate the effects of psychotropic drugs on the elderly. It is with particular concern that this chapter cites the paucity of psychopharmacologic studies involving the older adult, since approximately one third of the 20 million U.S. citizens over 60 years of age receive psychotropic medication during a ong-year period. The thorough discussion that ensues includes the us specific psychotropic agents, their indications and contraindications with the elderly population.
Part II emphasizes the diagnosis and treatment of psychiatric disorders of late life. It opens with the psychosocial evaluation of the aging adult and presents some very basic principles and techniques of effective communications with this population, which nurses have already identified and incorporated into their practice over the years. The classification of all disorders in Part II conforms with the new DSM III (Diagnostic and Statistical Manual of Mental Disorders). Chapter 13 in this section discusses the organic mental disorders, with careful attention to the diagnosis and management of these disorders. Chapter 18, another informative chapter, deals with disorders related to biologic functioning; this includes sleep disorders, psychosexual disorders, and somatoform disorders. The last three chapters in Part II explore, in brief, treatment in an ambulatory setting, institutionalization and nutrition of the aging adult. It has been cited that there are diagnosable psychiatric problems in 80% of the aging adult population placed in nursing care facilities. This statistic has far-reaching implications for appropriate placement and types of services available. We are entering a time during which it is crucial to examine alternatives to institutionalization. Another pressing issue briefly discussed in this text is the family's reaction to its aging parent. Nurses, social workers and physicians will need to engage themselves actively with this issue through support and teaching of the family.
Part III moves into the arena of future directions, and presents the case for community-based care and the cost effectiveness of alternatives for the aging adult in a thoughtprovoking manner.
The book is written clearly and well illustrated with clinical situations, charts, tables, and graphs. Any lack in a particular chapter is covered by good sources of references. The material is timely and up-to-date, but inevitably will change as new studies are brought forth.
Written from a physician's point of view primarily for physicians, this text retains the quality of a good reference book. The gérontologie and psychiatric nurse in an inpatient as well as outpatient setting can translate some of this material into the nursing process, especially in the form of teaching adaptive and effective coping patterns of the emotionally disturbed elderly.