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People with chronic disease often make a sharp distinction between being ill and having a serious underlying problem. This distinction is more than semantic. There is substantial danger in using, as a basis for making plans, people's ideas about their feelings about contracting diseases or entering into states of disability. The discrepancies between how people with serious health problems feel about these problems and the conceptions of those who do not have serious health problems raise warning flags about how far to proceed on the basis of theoretical preconceptions. Several studies suggest that patients' actual behavior is quite different from what we might expect. They may be less willing to eschew technology than we have thought.

Family Caregiving in the New Normal discusses how the drastic economic changes that have occurred over the past few years have precipitated a new conversation on how family care for older adults will evolve in the future. This text summarizes the challenges and potential solutions scientists, policy makers, and clinical providers must address as they grapple with these changes, with a primary focus given to the elements that may impact how family caregiving is organized and addressed in subsequent decades, including sociodemographic trends like divorce, increased participation of women in

Complicated requirements regarding eligibility and coverage as well as variations in the availability of programs confuse even the most diligent physicians trying to advise elderly patients about health care services. Nevertheless, awareness of such government and community resources is critical because physicians play an essential role in assisting the elderly to receive maximum health care benefits, particularly during long-term illness.

The fourth volume in the prestigious Advances in Long-Term Care Series continues to address the challenges of long-term care with innovation and practical insight. Highlighting the dynamic nature of long-term care, the authors share their practical insight and explore issues linked to the cost and process of delivering care to an increasing number of clients. Topics include transitions between acute and long-term care, geriatric day hospitals, subacute care, and more. Contributors from a range of gerontologic disciplines use new research as bases to develop care solutions under the mandates of

From 1987–99, influenza and pneumococcal vaccination rates among elderly Medicare beneficiaries increased by 300 percent and 500 percent, respectively. Despite these gains, annual rates of hospitalizations for pneumonia and influenza (P&I) have not decreased; rather, they have increased steadily. The authors investigate whether this paradoxical increase in hospitalization rates reflects an increasing burden of P&I or the effects of a changing healthcare environment. They find that from 1987–99, P&I hospitalizations per one thousand beneficiaries increased from 15.1 to 23.4. Of this increase, 23 percent was due to an aging Medicare population, 2.4 percent was due to increased rates of rehospitalization, and at most 5 percent was due to upcoding. There was no evidence that physicians were increasingly admitting patients with less complicated cases of P&I. The changing healthcare environment only partially explained the paradoxical increase in P&I hospitalizations. P&I appears to be an increasing burden to the elderly, despite increased vaccination rates.