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Dementia is the loss of cognitive functioning?the ability to think, remember, or reason?to such an extent that it interferes with a person?s daily life and activities. These functions include memory, language skills, visual perception, problem solving, self-management, and the ability to focus and pay attention. Some people with dementia cannot control their emotions, and their personalities may change. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person?s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. Age is the primary risk factor for developing dementia. For that reason, the number of people living with dementia could double in the next 40 years as the number of Americans age 65 and older increases from 48 million today to more than 88 million in 2050. Regardless of the form of dementia, the personal, economic, and societal demands can be devastating.

Lewy body dementia (LBD) is a complex and challenging brain disorder. It is complex because it affects many parts of the brain in ways that scientists are trying to understand more fully. It is challenging because its many possible symptoms make it hard to do everyday tasks that once came easily. Although less known than its ?cousins? Alzheimer?s disease and Parkinson?s disease, LBD is not a rare disorder. More than 1 million Americans, most of them older adults, are affected by its disabling changes in the ability to think and move. As researchers seek better ways to treat LBD?and ultimately to find a cure?people with LBD and their families struggle to get an accurate diagnosis, find the best treatment, and manage at home.

At the end of life, each story is different. Death comes suddenly, or a person lingers, gradually fading. For some older people, the body weakens while the mind stays alert. Others remain physically strong, but cognitive losses take a huge toll. Although everyone dies, each loss is personally felt by those close to the one who has died. End-of-life care is the term used to describe the support and medical care given during the time surrounding death. Such care does not happen only in the moments before breathing ceases and the heart stops beating. Older people often live with one or more chronic illnesses and need a lot of care for days, weeks, and even months before death. The goal of End of Life: Helping with Comfort and Care is to provide guidance and help in understanding the unfamiliar territory of death. This information is based on research, such as that supported by the National Institute on Aging (NIA), along with other parts of the National Institutes of Health.

Few people have heard of frontotemporal disorders, which lead to dementias that affect personality, behavior, language, and movement. These disorders are little known outside the circles of researchers, clinicians, patients, and caregivers who study and live with them. Although frontotemporal disorders remain puzzling in many ways, researchers are finding new clues that will help them solve this medical mystery and better understand other common dementias. The symptoms of frontotemporal disorders gradually rob people of basic abilities?thinking, talking, walking, and socializing?that most of us take for granted. They often strike people in the prime of life, when they are working and raising families. Families suffer, too, as they struggle to cope with the person?s daily needs as well as changes in relationships and responsibilities.

The handouts in this book will help you get the most out of your Matrix treatment. Some handouts ask questions and have spaces for your answers. Other handouts ask you to read and think about a subject or an idea, or they contain advice or reminders about recovery. It is a good idea to keep and review the handouts after you have used them. They will help you stay strong as you continue in your recovery. During each treatment session, your counselor will ask you to follow along on the handout while he or she goes over it with the group. The counselor will give you time to think about what it says and write your answers to questions it may ask. The group will then discuss the handout. You should share your thoughts and ask questions during this time. If you still have questions, there will be more time to ask questions during the last part of each session.

The Matrix IOP method was developed initially in the 1980s in response to the growing numbers of individuals entering the treatment system with cocaine or methamphetamine dependence as their primary substance use disorder. Many traditional treatment models then in use were developed primarily to treat alcohol dependence and were proving to be relatively ineffective in treating cocaine and other stimulant dependence (Obert et al. 2000). To create effective treatment protocols for clients dependent on stimulant drugs, treatment professionals at the Matrix Institute drew from numerous treatment approaches, incorporating into their model methods that were empirically tested and practical. Their treatment model incorporated elements of relapse prevention, cognitive?behavioral, psychoeducation, and family approaches, as well as 12-Step program support (Obert et al. 2000).

American Indians and Alaska Natives haveconsistently experienced disparities in access tohealthcare services, funding, and resources; qualityand quantity of services; treatment outcomes;and health education and prevention services.Availability, accessibility, and acceptability ofbehavioral health services are major barriers torecovery for American Indians and Alaska Natives.Common factors that infuence engagement andparticipation in services include availability oftransportation and child care, treatment infrastructure,level of social support, perceived providereffectiveness, cultural responsiveness of services,treatment settings, geographic locations, and tribalaffliations.

The Crisis Intervention Team (CIT) program has become a globally recognized model for safely and effectively assisting people with mental and substance use disorders who experience crises in the community. The CIT Model promotes strong community partnerships among law enforcement, behavioral health providers, people with mental and substance use disorders, along with their families and others. While law enforcement agencies have a central role in program development and ongoing operations, a continuum of crisis services available to citizens prior to police involvement is part of the model. These other community services (e.g., mobile crisis teams, crisis phone lines) are essential for avoiding criminal justice system involvement for those with behavioral health challenges ? a goal of CIT programs (Steadman & Morrissette, 2016). CIT is just one part of a robust continuum of behavioral health services for the whole community.