Additional Information
Book Details
Abstract
Grounded in the core competencies recommended by the AACN in collaboration with the Hartford Institute for Geriatric Nursing, Ebersole & Hess’ Toward Healthy Aging, 8th Edition is the most comprehensive resource on health promotion and maintenance for older adults and their caregivers. With coverage of communication, safety and ethical considerations, new genetic research, key aging issues, and common and uncommon conditions, you will have the knowledge you need to promote healthy lifestyle choices, properly address end-of-life issues, and provide effective, holistic care for older adults.
- Consistent chapter organization with objectives, case studies with critical thinking questions, and research questions make information easy to access and use.
- A strong focus on health and wellness emphasizes a positive approach to aging.
- Disease processes are discussed in the context of healthy adaptation, nursing support, and responsibilities.
- Research highlights help incorporate the latest research findings into practice.
- Nutrition chapter includes the most current guidelines for older adults and addresses patients’ dietary needs.
- Scales and guidelines for proper health assessment provide the essential information for assessing the older adult patient.
- Case studies with critical thinking questions offer realistic situations to expand your knowledge and understanding.
- Careful attention to age, cultural, and gender differences are integrated throughout and highlight important considerations when caring for older adults.
- Content grounded in the core competencies offers the knowledge needed to achieve the National League for Nursing ACES program’s Essential Nursing Actions and meets the Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older Adults, the Geriatric Nursing Education State of the Science Papers, and the Hartford Institute for Geriatric Nursing Best Practices in Nursing Care to Older Adults.
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NEW! QSEN content highlights quality and safety issues students need to know when treating older patients.
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NEW! Chapter covering the role of communication emphasizes the importance of communication in improving care.
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NEW! Focus on genetics highlights the vast amount of new genetic research and its effects on all aspects of health and aging.
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NEW! Information on ethical considerations explores and illustrates potential issues when dealing with older adults.
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NEW! Healthy People 2020 information assists your students in integrating their knowledge about healthy aging considerations into care.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Inside front cover | ifc1 | ||
| Ebersole & Hess' Toward Healthy Aging, 8/e | i | ||
| Evolve page | ii | ||
| Copyright page | iv | ||
| Dedication | v | ||
| About the Authors | vi | ||
| Contributors | vii | ||
| Reviewers | viii | ||
| Preface | ix | ||
| Acknowledgments | x | ||
| TOC | xi | ||
| 1 Foundations of Healthy Aging | 1 | ||
| 1 Gerontological Nursing and an Aging Society | 1 | ||
| Learning Objectives | 1 | ||
| The Study of Aging | 1 | ||
| Gerontology | 2 | ||
| How Old Is Old? | 2 | ||
| Today’s Older People | 3 | ||
| Nonagenarians and Centenarians | 3 | ||
| The Future Old | 4 | ||
| Aging Today | 4 | ||
| Demographics of Aging | 4 | ||
| Aging in the United States | 4 | ||
| Life Expectancy | 4 | ||
| Marital Status | 5 | ||
| Living Arrangements | 5 | ||
| Education | 6 | ||
| Income and Employment | 6 | ||
| Diversity of Aging in the United States | 6 | ||
| Global Aging | 7 | ||
| Who Will Care for an Aging Society? | 7 | ||
| Development of Gerontological Nursing | 8 | ||
| Early History | 10 | ||
| Current Initiatives | 10 | ||
| Gerontological Nursing Education | 12 | ||
| Gerontological Nursing Roles | 12 | ||
| Organizations Devoted to Gerontology Research and Practice | 14 | ||
| Research on Aging | 14 | ||
| Nursing Research | 15 | ||
| The Politics of Aging | 15 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 16 | ||
| Key Concepts | 17 | ||
| Research Questions | 17 | ||
| References | 18 | ||
| APPENDIX 1-A Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older Adults | 19 | ||
| Gerontological Nursing Competency Statements | 19 | ||
| 2 Health and Wellness | 21 | ||
| Learning Objectives | 21 | ||
| Wellness | 22 | ||
| Dimensions of Wellness | 23 | ||
| Healthy Aging | 23 | ||
| Health Status of Older People | 24 | ||
| Self-reported Health | 24 | ||
| Disability and Chronic Illness | 25 | ||
| Causes of Death | 25 | ||
| Disease Prevention and Health Promotion for Older Adults | 26 | ||
| Goals | 26 | ||
| Primary and Secondary Disease Prevention | 26 | ||
| Guidelines | 27 | ||
| Cognitive Health | 28 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 30 | ||
| Key Concepts | 30 | ||
| Research Questions | 31 | ||
| References | 31 | ||
| 3 Theories of Aging | 33 | ||
| Learning Objectives | 33 | ||
| What is Aging? | 33 | ||
| Biological Theories of Aging | 34 | ||
| Cellular Functioning | 34 | ||
| Programmed Aging Theories | 35 | ||
| Neuroendocrine Control or Pacemaker Theory | 35 | ||
| Immunity Theory | 35 | ||
| Error Theories | 35 | ||
| Wear-and-Tear Theory | 36 | ||
| Cross-linkage Theory | 36 | ||
| Oxidative Stress Theory (Free Radical Theory) | 36 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 37 | ||
| Psychosocial and Developmental Theories of Aging | 37 | ||
| Role Theory | 37 | ||
| Age Norms | 37 | ||
| Activity Theory | 38 | ||
| Disengagement Theory | 38 | ||
| Continuity Theory | 38 | ||
| Age-stratification Theory | 38 | ||
| Modernization Theory | 38 | ||
| Developmental Theories of Aging | 38 | ||
| Jung’s Theory of Personality | 39 | ||
| Erikson | 39 | ||
| Peck | 39 | ||
| Maslow | 39 | ||
| Tornstam | 39 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 40 | ||
| Key Concepts | 41 | ||
| Research Questions | 42 | ||
| References | 42 | ||
| 4 Physiological Changes | 44 | ||
| Learning Objectives | 44 | ||
| The Integument | 45 | ||
| Skin | 45 | ||
| Epidermis | 45 | ||
| Dermis | 46 | ||
| Hypodermis | 46 | ||
| Thermoregulation. | 46 | ||
| Hair | 47 | ||
| Nails | 47 | ||
| The Musculoskeletal System | 48 | ||
| Structure and Posture | 48 | ||
| Bones | 48 | ||
| Joints, Tendons, and Ligaments | 49 | ||
| Muscles | 49 | ||
| The Cardiovascular System | 49 | ||
| Heart | 49 | ||
| Valves | 49 | ||
| Conductivity | 50 | ||
| Blood Vessels | 50 | ||
| The Respiratory System | 50 | ||
| Airways | 51 | ||
| Nose | 51 | ||
| Trachea and Larynx | 51 | ||
| Chest Wall and Lung | 51 | ||
| Oxygen Exchange | 52 | ||
| The Renal and Urological Systems | 52 | ||
| Kidneys | 52 | ||
| Glomerular Filtration Rate | 52 | ||
| Ureters, Bladder, and Urethra | 52 | ||
| The Endocrine System | 52 | ||
| Thyroid Gland | 53 | ||
| Adrenal Glands | 53 | ||
| Endocrine Pancreas | 53 | ||
| The Digestive System | 53 | ||
| Mouth and Teeth | 53 | ||
| Esophagus | 53 | ||
| Stomach | 53 | ||
| Small Intestine | 54 | ||
| Large Intestine | 54 | ||
| Accessory Organs of Digestion | 54 | ||
| Liver and Gallbladder | 54 | ||
| Exocrine Pancreas | 54 | ||
| The Nervous System | 54 | ||
| The Central Nervous System | 54 | ||
| The Peripheral Nervous System | 56 | ||
| Proprioception | 56 | ||
| Sensory Changes | 56 | ||
| Smell | 56 | ||
| Taste | 56 | ||
| Touch | 56 | ||
| Sight | 56 | ||
| Extraocular Changes | 56 | ||
| Ocular Changes | 57 | ||
| Intraocular Changes | 57 | ||
| Hearing | 58 | ||
| Outer Ear | 58 | ||
| Middle Ear | 58 | ||
| Inner Ear | 58 | ||
| The Reproductive System | 58 | ||
| The Female Reproductive System | 59 | ||
| The Male Reproductive System | 59 | ||
| The Immune System | 59 | ||
| Key Concepts | 60 | ||
| Research Questions | 61 | ||
| References | 61 | ||
| 5 Culture, Gender, and Aging | 62 | ||
| Learning Objectives | 62 | ||
| The Gerontological Explosion | 63 | ||
| Health Disparities and Older Adults | 65 | ||
| Health Disparities | 65 | ||
| Cultural Proficiency | 66 | ||
| Cultural Awareness | 66 | ||
| Cultural Knowledge | 68 | ||
| Definitions of Terms. | 68 | ||
| Orientation to Time. | 68 | ||
| Orientation to Family and Self. | 69 | ||
| Intensity of Relationships. | 69 | ||
| Cohort Effect. | 70 | ||
| Beliefs about Health, Illness, and Treatment. | 70 | ||
| Biomedical. | 70 | ||
| Magico-religious. | 70 | ||
| Naturalistic or holistic. | 70 | ||
| Obstacles to Cultural Knowledge | 71 | ||
| Ethnocentrism | 71 | ||
| Stereotyping | 71 | ||
| Cultural Skills | 71 | ||
| Unspoken Communication. | 71 | ||
| The handshake. | 71 | ||
| Eye contact. | 71 | ||
| The use of silence. | 72 | ||
| Spoken Communication. | 72 | ||
| Gender | 72 | ||
| Older Women | 73 | ||
| Social Status | 73 | ||
| Economic Status | 73 | ||
| Health Status | 73 | ||
| Older Men | 75 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 76 | ||
| Assessment | 76 | ||
| Designing Interventions | 77 | ||
| The LEARN Model | 77 | ||
| Models of Cross-cultural Care | 77 | ||
| Integrating Concepts | 77 | ||
| Key Concepts | 78 | ||
| Research Questions | 79 | ||
| References | 79 | ||
| 6 Communicating with Older Adults | 81 | ||
| Learning Objectives | 81 | ||
| Ageism and Communication | 82 | ||
| Elderspeak | 82 | ||
| Therapeutic Communication with Older Adults | 82 | ||
| Communicating with Older Adults with Sensory Impairments | 83 | ||
| Hearing Impairment | 83 | ||
| Types of Hearing Loss | 84 | ||
| Tinnitus | 85 | ||
| Assessment | 85 | ||
| Interventions | 85 | ||
| Interventions to Enhance Hearing | 85 | ||
| Hearing Aids | 85 | ||
| Cochlear Implants | 86 | ||
| Assistive Listening and Adaptive Devices | 87 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 87 | ||
| Vision Impairment | 87 | ||
| Diseases of the Eye | 89 | ||
| Glaucoma | 89 | ||
| Screening and Treatment | 89 | ||
| Cataracts | 89 | ||
| Diabetic Retinopathy | 91 | ||
| Macular Degeneration | 91 | ||
| Detached Retina | 92 | ||
| Dry Eye | 92 | ||
| Interventions to Enhance Vision | 93 | ||
| Use of Contrasting Colors | 93 | ||
| Low-vision Assistive Devices | 93 | ||
| Communicating through Touch | 93 | ||
| Promoting Healthy Aging: Implications for Gerontological Nurses | 93 | ||
| Communicating with Older Adults with Neurological Disorders | 94 | ||
| Aphasia | 94 | ||
| Alternative and Augmentative Speech Aids | 95 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 95 | ||
| Dysarthria | 95 | ||
| Communicating with Older Adults with Cognitive Impairment | 96 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 98 | ||
| The Life Story | 99 | ||
| Reminiscing | 99 | ||
| Life Review | 99 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 100 | ||
| Communicating with Groups of Older Adults | 100 | ||
| Group Structure and Special Considerations | 101 | ||
| Reminiscing and Storytelling with Individuals Experiencing Cognitive Impairment | 101 | ||
| Health Literacy and Communication | 102 | ||
| Learning in Late Life | 103 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 103 | ||
| Key Concepts | 104 | ||
| Research Questions | 105 | ||
| References | 105 | ||
| 2 Foundations of Caring | 107 | ||
| 7 Health Assessment | 107 | ||
| Learning Objectives | 107 | ||
| The Health History | 108 | ||
| Physical Assessment | 108 | ||
| Fancapes | 109 | ||
| Fluids | 109 | ||
| Aeration | 109 | ||
| Nutrition | 109 | ||
| Communication | 109 | ||
| Activity | 109 | ||
| Pain | 109 | ||
| Elimination | 109 | ||
| Social Skills | 109 | ||
| Spices | 109 | ||
| Functional Assessment | 109 | ||
| Activities of Daily Living | 110 | ||
| Katz Index | 110 | ||
| Barthel Index and Functional Independence Measure | 111 | ||
| Instrumental Activities of Daily Living | 111 | ||
| Function and Cognition | 111 | ||
| Screening Assessment of Cognition and Mood | 111 | ||
| Mental Status Examination | 111 | ||
| Mini-Mental State Examination | 111 | ||
| Clock Drawing Test | 112 | ||
| Mini-Cog | 113 | ||
| Assessment of Mood | 113 | ||
| Geriatric Depression Scale | 113 | ||
| Center for Epidemiologic Studies Depression Scale | 114 | ||
| Cornell Scale for Depression in Dementia | 114 | ||
| Comprehensive Geriatric Assessment | 114 | ||
| The Minimum Data Set | 114 | ||
| Older Americans Resources and Services | 115 | ||
| Social Resources | 115 | ||
| Economic Resources | 115 | ||
| Mental Health | 115 | ||
| Physical Health | 115 | ||
| Activities of Daily Living | 115 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 115 | ||
| Key Concepts | 116 | ||
| Research Questions | 116 | ||
| References | 116 | ||
| 8 Laboratory Values and Diagnostics | 118 | ||
| Learning Objectives | 118 | ||
| Hematological Testing | 118 | ||
| Red Blood Cell Count | 119 | ||
| Hemoglobin and Hematocrit | 119 | ||
| White Blood Cells | 119 | ||
| Platelets | 120 | ||
| Common Diagnostic Testing | 120 | ||
| Measures of Inflammation | 120 | ||
| Erythrocyte Sedimentation Rate | 120 | ||
| C-reactive Protein | 120 | ||
| Iron Studies | 121 | ||
| Iron | 121 | ||
| Vitamins | 121 | ||
| B Vitamins | 121 | ||
| Vitamin D | 122 | ||
| Blood Chemistry Studies | 122 | ||
| Hormones: Thyroxin | 122 | ||
| Electrolytes | 123 | ||
| Sodium and Chloride | 123 | ||
| Potassium | 124 | ||
| Calcium and Phosphorus | 124 | ||
| Glucose | 125 | ||
| Uric Acid | 125 | ||
| Prostate-specific Antigen | 125 | ||
| Laboratory Testing for Cardiac Health | 126 | ||
| Acute Cardiac Events | 126 | ||
| Creatinine Kinase | 126 | ||
| Troponin | 126 | ||
| Monitoring Cardiovascular Risk and Health | 126 | ||
| Homocysteine | 126 | ||
| Brain Natriuretic Peptide | 126 | ||
| Lipids | 126 | ||
| Cholesterol. | 126 | ||
| Testing for Body Proteins | 127 | ||
| Total Protein | 127 | ||
| Serum Albumin | 127 | ||
| Laboratory Tests of Renal Health | 127 | ||
| Blood Urea Nitrogen | 127 | ||
| Creatinine | 128 | ||
| Monitoring for Therapeutic Blood Levels | 128 | ||
| Anticoagulants | 128 | ||
| Antiarrhythmics: Digoxin | 129 | ||
| Thyroid Hormones | 129 | ||
| Urine Studies | 129 | ||
| Implications for The Nurse in the Long-Term Care Setting | 129 | ||
| Key Concepts | 130 | ||
| Research Questions | 130 | ||
| References | 131 | ||
| 9 Geropharmacology | 132 | ||
| Learning Objectives | 132 | ||
| Pharmacokinetics | 133 | ||
| Absorption | 133 | ||
| Distribution | 134 | ||
| Metabolism | 135 | ||
| Excretion | 135 | ||
| Pharmacodynamics | 135 | ||
| Issues in Medication Use | 136 | ||
| Polypharmacy | 136 | ||
| Drug Interactions | 136 | ||
| Drug–Supplement Interactions | 136 | ||
| Drug–Food Interactions | 136 | ||
| Drug–Drug Interactions | 137 | ||
| Adverse Drug Reactions | 139 | ||
| The “Do Not Use” List | 139 | ||
| Psychoactive Drugs | 139 | ||
| Antidepressants | 139 | ||
| Anxiolytic Agents | 140 | ||
| Mood Stabilizers | 140 | ||
| Antipsychotics | 141 | ||
| Neuroleptic Malignant Syndrome (NMS) | 141 | ||
| Movement Disorders | 141 | ||
| Acute Dystonia. | 141 | ||
| Akathisia. | 141 | ||
| Parkinsonian Symptoms. | 141 | ||
| Tardive Dyskinesia. | 141 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 141 | ||
| Assessment | 142 | ||
| Education | 143 | ||
| Safe Medication Use | 143 | ||
| Key Concepts | 145 | ||
| Research Questions | 146 | ||
| References | 146 | ||
| 10 The Use of Herbs and Supplements | 148 | ||
| Learning Objectives | 148 | ||
| Use of Herbs and Supplements in the United States | 148 | ||
| Standards in Manufacturing | 149 | ||
| Herb Forms | 150 | ||
| Teas | 150 | ||
| Select Commonly Used Teas, Herbs, and Supplements | 151 | ||
| Chamomile | 151 | ||
| Echinacea | 151 | ||
| Garlic | 151 | ||
| Ginkgo biloba | 151 | ||
| Ginseng | 152 | ||
| Glucosamine Sulfate | 154 | ||
| Hawthorn | 154 | ||
| Red Yeast Rice | 154 | ||
| St. John’s Wort | 154 | ||
| Saw Palmetto | 155 | ||
| Use of Herbs and Supplements for Select Conditions | 155 | ||
| Hypertension | 155 | ||
| Human Immunodeficiency Virus–related Symptoms | 156 | ||
| Gastrointestinal Disorders | 156 | ||
| Cancer | 156 | ||
| Alzheimer’s Disease | 156 | ||
| Diabetes | 157 | ||
| Herb and Supplement Interactions with Standardized Drugs | 157 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 158 | ||
| Perioperative Assessment | 158 | ||
| Interventions | 158 | ||
| Education | 159 | ||
| Key Concepts | 159 | ||
| Research Questions | 160 | ||
| References | 160 | ||
| National Center for Complementary and Alternative Medicine (NCCAM): | 162 | ||
| Natural Standard: The Authority on Integrative Medicine | 162 | ||
| Natural Standard: News | 162 | ||
| 3 Wellness and Function | 164 | ||
| 11 Elimination, Sleep, Skin, and Foot Care | 164 | ||
| Learning Objectives | 164 | ||
| Bladder Elimination | 164 | ||
| Bladder Function | 165 | ||
| Age-Related Changes | 165 | ||
| Urinary Incontinence | 165 | ||
| Prevalence of UI | 165 | ||
| Risk Factors for UI | 165 | ||
| Consequences of UI | 166 | ||
| Types of UI | 166 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 167 | ||
| Assessment | 167 | ||
| Interventions | 170 | ||
| Behavioral | 170 | ||
| Lifestyle Modifications | 172 | ||
| Urinary Catheters | 172 | ||
| Urinary Tract Infections | 173 | ||
| Absorbent Products | 173 | ||
| Pharmacological | 173 | ||
| Surgical | 173 | ||
| Nonsurgical Devices | 173 | ||
| Bowel Elimination | 175 | ||
| Fecal Impaction | 175 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 176 | ||
| Assessment | 176 | ||
| Interventions | 177 | ||
| Exercise | 177 | ||
| Positioning | 177 | ||
| Regularity | 177 | ||
| Laxatives | 177 | ||
| Enemas | 177 | ||
| Fecal Incontinence | 177 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 178 | ||
| Assessment | 178 | ||
| Interventions | 179 | ||
| Sleep | 179 | ||
| Biorhythm and Sleep | 179 | ||
| Sleep and Aging | 179 | ||
| Sleep Disorders | 180 | ||
| Insomnia | 180 | ||
| Sleep Apnea | 180 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 181 | ||
| Assessment | 181 | ||
| Interventions | 181 | ||
| Restless Legs Syndrome | 181 | ||
| Rapid Eye Movement Sleep Behavior Disorder | 181 | ||
| Circadian Rhythm Sleep Disorders | 182 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 182 | ||
| Assessment | 182 | ||
| Interventions | 183 | ||
| Nonpharmacological Treatment | 183 | ||
| Pharmacological Treatment | 183 | ||
| Skin | 184 | ||
| Common Skin Problems | 184 | ||
| Xerosis | 184 | ||
| Pruritus | 184 | ||
| Scabies | 185 | ||
| Purpura | 185 | ||
| Keratoses | 185 | ||
| Herpes Zoster | 185 | ||
| Photo Damage of the Skin | 185 | ||
| Skin Cancers | 186 | ||
| Actinic Keratosis | 186 | ||
| Basal Cell Carcinoma | 186 | ||
| Squamous Cell Carcinoma | 186 | ||
| Melanoma | 187 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 187 | ||
| Xerosis | 187 | ||
| Pruritus | 188 | ||
| Cancer | 188 | ||
| Other Skin Conditions | 188 | ||
| Candidiasis (Candida albicans) | 188 | ||
| Pressure Ulcers | 189 | ||
| Definition | 189 | ||
| Prevalence | 189 | ||
| Cost and Regulatory Requirements | 189 | ||
| Characteristics | 189 | ||
| Classification | 189 | ||
| Risk Factors | 191 | ||
| Prevention | 191 | ||
| Consequences | 191 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 192 | ||
| Assessment | 192 | ||
| Interventions | 192 | ||
| Healthy Feet | 193 | ||
| Common Foot Problems | 193 | ||
| Corns, Calluses, and Bunions | 193 | ||
| Hammer Toes | 194 | ||
| Fungal Infections | 194 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 194 | ||
| Assessment | 194 | ||
| Interventions | 194 | ||
| Care of the Toenails | 194 | ||
| Key Concepts | 196 | ||
| Research Questions | 197 | ||
| Elimination | 197 | ||
| Rest and Sleep | 197 | ||
| Skin and Foot Care/Pressure Ulcers | 197 | ||
| References | 197 | ||
| 12 Mobility | 200 | ||
| Learning Objectives | 200 | ||
| Mobility and Aging | 200 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 201 | ||
| Assessment | 201 | ||
| Interventions | 201 | ||
| Physical Fitness | 201 | ||
| Guidelines for Physical Activity | 202 | ||
| Special Considerations | 203 | ||
| Exercise Prescription | 204 | ||
| Falls | 207 | ||
| Consequences of Falls | 208 | ||
| Hip Fractures | 208 | ||
| Traumatic Brain Injury | 208 | ||
| Fallophobia | 208 | ||
| Factors Contributing to Falls | 208 | ||
| Gait Disturbances | 209 | ||
| Foot Deformities | 210 | ||
| Postural and Postprandial Hypotension | 210 | ||
| Cognitive Impairment | 210 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 210 | ||
| Screening and Assessment | 210 | ||
| Fall Risk Assessment Instruments | 210 | ||
| Postfall Assessment | 212 | ||
| Interventions | 212 | ||
| Exercise | 213 | ||
| Medication Review | 214 | ||
| Environmental Modifications | 214 | ||
| Behavior and Education Programs | 214 | ||
| Assistive Devices | 214 | ||
| Other Interventions | 216 | ||
| Restraints and Side Rails | 216 | ||
| Definition and History | 216 | ||
| Consequences of Restraints | 216 | ||
| Side Rails | 216 | ||
| Restraint-Free Care | 217 | ||
| Promotion of Healthy Aging: Implications for Gerontological Nursing | 218 | ||
| Key Concepts | 219 | ||
| Research Questions | 220 | ||
| References | 220 | ||
| APPENDIX 12-A Tinetti Balance and Gait Evaluation | 223 | ||
| Balance | 223 | ||
| Gait | 223 | ||
| 13 Environmental Safety and Security | 225 | ||
| Learning Objectives | 225 | ||
| Influences of Changing Health and Disability on Safety and Security | 225 | ||
| Physical Vulnerability | 225 | ||
| Home Safety | 226 | ||
| Vulnerability to Environmental Temperatures | 226 | ||
| Thermoregulation | 226 | ||
| Temperature Monitoring in Older Adults. | 226 | ||
| Hyperthermia | 228 | ||
| Hypothermia | 228 | ||
| Vulnerability to Natural Disasters | 230 | ||
| Crimes Against Older Adults | 230 | ||
| Risks and Vulnerability | 230 | ||
| Fraudulent Schemes Against Elders | 231 | ||
| Fire Safety for Elders | 231 | ||
| Risk Factors for Elders | 231 | ||
| Reducing Fire Risks in Group Residential Settings | 232 | ||
| Transportation Safety | 232 | ||
| Driving | 233 | ||
| Driving Safety | 233 | ||
| Driving and Dementia | 233 | ||
| Driving Cessation | 234 | ||
| Emerging Technologies to Enhance Safety of Older Adults | 235 | ||
| Elder-Friendly Communities | 236 | ||
| Key Concepts | 237 | ||
| Research Questions | 237 | ||
| References | 238 | ||
| 14 Nutrition and Hydration | 240 | ||
| Learning Objectives | 240 | ||
| Age-Related Requirements | 241 | ||
| Modified MyPyramid | 241 | ||
| Other Dietary Recommendations | 241 | ||
| Fats | 241 | ||
| Protein | 241 | ||
| Fiber | 241 | ||
| Vitamins and Minerals | 242 | ||
| Obesity (Overnutrition) | 243 | ||
| Malnutrition | 243 | ||
| Factors Affecting Fulfillment of Nutritional Needs | 244 | ||
| Age-Associated Changes | 245 | ||
| Taste | 245 | ||
| Smell | 245 | ||
| Digestive System | 245 | ||
| Buccal Cavity | 245 | ||
| Regulation of Appetite | 246 | ||
| Lifelong Eating Habits | 246 | ||
| Socialization | 246 | ||
| Chronic Diseases and Conditions | 247 | ||
| Socioeconomic Deprivation | 247 | ||
| Transportation | 247 | ||
| Hospitalization and Long-Term Care Residence | 248 | ||
| Dementia | 249 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 250 | ||
| Nutritional Screening and Assessment | 250 | ||
| Interview | 252 | ||
| Diet Histories | 252 | ||
| Physical Examination | 252 | ||
| Anthropometrical Measurements | 252 | ||
| Biochemical Examination | 252 | ||
| Interventions | 253 | ||
| Pharmacological Therapy | 253 | ||
| Patient Education | 253 | ||
| Special Considerations in Nutrition for Older People: Hydration, Dysphagia, Oral Care | 253 | ||
| Hydration Management | 253 | ||
| Dehydration | 253 | ||
| Risk Factors for Dehydration | 254 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 254 | ||
| Assessment | 254 | ||
| Interventions | 255 | ||
| Dysphagia | 256 | ||
| Promotion of Healthy Aging: Implications for Gerontological Nursing | 256 | ||
| Assessment | 256 | ||
| Interventions | 256 | ||
| Feeding Tubes | 257 | ||
| Oral Care | 258 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 259 | ||
| Assessment | 259 | ||
| Interventions | 260 | ||
| Key Concepts | 262 | ||
| Research Questions | 263 | ||
| References | 263 | ||
| 4 Wellness and Chronic Illness | 265 | ||
| 15 Chronic Conditions | 265 | ||
| Learning Objectives | 265 | ||
| Theoretical Frameworks for Chronic Disease | 267 | ||
| Chronic Illness Trajectory | 267 | ||
| Cardiovascular Disease | 268 | ||
| Hypertension | 268 | ||
| Etiology | 269 | ||
| Signs and Symptoms | 269 | ||
| Complications | 269 | ||
| Promoting Healthy Aging; Implications for Gerontological Nursing: Hypertension | 269 | ||
| Coronary Heart Disease | 270 | ||
| Etiology | 270 | ||
| Signs and Symptoms | 270 | ||
| Complications | 271 | ||
| Promoting Healthy Aging; Implications for Gerontological Nursing: Coronary Artery Disease | 271 | ||
| Heart Failure | 272 | ||
| Etiology | 272 | ||
| Signs and Symptoms | 272 | ||
| Complications | 273 | ||
| Promoting Healthy Aging; Implications for Gerontological Nursing: Heart Failure | 273 | ||
| Peripheral Vascular Disease | 274 | ||
| Etiology | 274 | ||
| Signs and Symptoms | 274 | ||
| Complications | 275 | ||
| Promoting Healthy Aging; Implications for Gerontological Nursing: Peripheral Vascular Disease | 275 | ||
| Polymyalgia Rheumatica and Giant Cell (Temporal) Arteritis | 276 | ||
| Polymyalgia Rheumatica | 276 | ||
| Giant Cell Arteritis | 276 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 277 | ||
| Neurological Disorders | 277 | ||
| Cerebrovascular Disorders | 277 | ||
| Etiology: Ischemic Events | 277 | ||
| Etiology: Hemorrhagic Events | 277 | ||
| Signs and Symptoms | 278 | ||
| Complications | 278 | ||
| Promoting Healthy Aging; Implications for Gerontological Nursing: Transient Ischemic Attack | 278 | ||
| Parkinson’s Disease | 279 | ||
| Etiology | 279 | ||
| Signs and Symptoms | 279 | ||
| Complications | 280 | ||
| Promoting Healthy Aging; Implications for Gerontological Nursing: Parkinson’s Disease | 280 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 280 | ||
| Endocrine Disorders | 281 | ||
| Diabetes Mellitus | 281 | ||
| Etiology | 281 | ||
| Signs and Symptoms | 282 | ||
| Complications | 282 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 283 | ||
| Assessment | 284 | ||
| Medications | 284 | ||
| Nutrition | 285 | ||
| Exercise | 285 | ||
| Self-Care | 285 | ||
| Implications for the Long-Term Care Setting | 285 | ||
| Thyroid Disease | 286 | ||
| Etiology | 286 | ||
| Signs and Symptoms | 286 | ||
| Complications | 286 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 286 | ||
| Gastrointestinal Disorders | 286 | ||
| Gastroesophageal Reflux Disease | 287 | ||
| 5 Healthy Aging for Elders and Their Families | 391 | ||
| 20 Economic, Legal, and Ethical Issues | 391 | ||
| Learning Objectives | 391 | ||
| Finance in Late Life | 391 | ||
| Social Security | 392 | ||
| Supplemental Security Income | 392 | ||
| Other Late Life Income | 393 | ||
| Paying for Health Care | 393 | ||
| Medicare | 393 | ||
| History | 393 | ||
| Overview | 394 | ||
| Medicare Part A | 395 | ||
| Medicare Part B | 395 | ||
| Medicare Part C | 396 | ||
| Medicare Part D | 396 | ||
| Supplemental Insurance/Medigap Policies | 397 | ||
| Care for Veterans | 397 | ||
| TRICARE for Life | 397 | ||
| Medicaid | 397 | ||
| Long-Term Care Insurance | 398 | ||
| Legal and Ethical Issues in Gerontological Nursing | 398 | ||
| Decision Making | 399 | ||
| Powers of Attorney | 400 | ||
| Guardians and Conservators | 400 | ||
| Elder Mistreatment | 400 | ||
| Abuse | 401 | ||
| Physical Abuse | 401 | ||
| Psychological/Emotional Abuse | 402 | ||
| Sexual Abuse | 402 | ||
| Financial or Material Exploitation | 402 | ||
| Undue Influence | 402 | ||
| Neglect | 402 | ||
| Caregiver Neglect | 403 | ||
| Self-Neglect | 403 | ||
| Risk Factors | 403 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 404 | ||
| Mandatory Reporting | 405 | ||
| Prevention of Abuse | 405 | ||
| Advocacy | 407 | ||
| Key Concepts | 407 | ||
| Research Questions | 408 | ||
| References | 408 | ||
| 21 Intimacy and Sexuality | 409 | ||
| Learning Objectives | 409 | ||
| Touch | 409 | ||
| Response to Touch | 410 | ||
| Fear of Touching | 410 | ||
| Touch Zones | 410 | ||
| Touch Deprivation | 410 | ||
| Adaptation to Touch Deprivation | 411 | ||
| Therapeutic Touch | 411 | ||
| Intimacy | 411 | ||
| Sexuality | 412 | ||
| Acceptance and Companionship | 412 | ||
| Femininity and Masculinity | 412 | ||
| Sexual Health | 413 | ||
| Factors Influencing Sexual Health | 413 | ||
| Expectations | 413 | ||
| Redefinitions | 413 | ||
| Activity Levels | 413 | ||
| Cohort and Cultural Influences | 414 | ||
| Biological Changes with Age | 414 | ||
| Sexual Dysfunction | 415 | ||
| Male Dysfunction | 415 | ||
| Female Dysfunction | 416 | ||
| Alternative Sexual Lifestyles: Lesbian, Gay, Bisexual, and Transgender | 416 | ||
| Intimacy and Chronic Illness | 417 | ||
| Intimacy and Sexuality in Long-Term Care Facilities | 419 | ||
| Intimacy, Sexuality, and Dementia | 419 | ||
| HIV/AIDS and Older Adults | 420 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 421 | ||
| Assessment | 421 | ||
| Interventions | 421 | ||
| Key Concepts | 422 | ||
| Research Questions | 423 | ||
| References | 423 | ||
| 22 Relationships, Roles, and Transitions | 425 | ||
| Learning Objectives | 425 | ||
| Later Life Transitions | 425 | ||
| Retirement | 426 | ||
| Retirement Planning | 426 | ||
| Special Considerations in Retirement | 427 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 427 | ||
| Death of a Spouse | 427 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 428 | ||
| Assessment | 428 | ||
| Interventions | 428 | ||
| Relationships in Later Life | 429 | ||
| Friendships | 429 | ||
| Mentoring Relationships | 429 | ||
| Families | 430 | ||
| Types of Families | 430 | ||
| Traditional Couples | 430 | ||
| Divorce. | 431 | ||
| Nontraditional Couples | 431 | ||
| Elders and Their Adult Children | 431 | ||
| Never Married Older Adults | 432 | ||
| Grandparents | 432 | ||
| Siblings | 432 | ||
| Other Kin | 433 | ||
| Fictive Kin | 433 | ||
| Family Caregiving | 433 | ||
| Impact of Caregiving | 434 | ||
| Spousal Caregiving | 435 | ||
| Aging Parents Caring for Developmentally Disabled Children | 435 | ||
| Grandparents Raising Grandchildren | 436 | ||
| Long-Distance Caregiving | 437 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 438 | ||
| Assessment | 438 | ||
| Family Assessment | 438 | ||
| Caregiver Assessment | 438 | ||
| Interventions | 439 | ||
| Key Concepts | 441 | ||
| Research Questions | 442 | ||
| References | 442 | ||
| 23 Loss, Death, and Palliative Care | 444 | ||
| Learning Objectives | 444 | ||
| Loss, Grief, and Bereavement | 444 | ||
| Grief Work | 445 | ||
| A Loss Response Model | 445 | ||
| Types of Grief | 445 | ||
| Anticipatory Grief | 445 | ||
| Acute Grief | 446 | ||
| Chronic Grief | 446 | ||
| Complicated Grief | 446 | ||
| Disenfranchised Grief | 446 | ||
| Factors Affecting Coping with Loss | 447 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 447 | ||
| Assessment | 448 | ||
| Interventions | 448 | ||
| Loss Response Model | 448 | ||
| Countercoping | 449 | ||
| Clarification and Control. | 449 | ||
| Collaboration. | 449 | ||
| Directed Relief. | 449 | ||
| Cooling Off. | 450 | ||
| Dying and Death | 450 | ||
| Conceptual Model for Understanding the Dying Process | 450 | ||
| The Living-Dying Interval | 450 | ||
| The Family | 452 | ||
| Promoting a Good Death: Implications for Gerontological Nursing | 452 | ||
| Interventions | 452 | ||
| Care | 453 | ||
| Control | 453 | ||
| Composure | 454 | ||
| Communication | 454 | ||
| Continuity | 454 | ||
| Closure | 454 | ||
| Spirituality | 455 | ||
| Hope | 455 | ||
| The Family | 455 | ||
| Palliative Care | 455 | ||
| Providing Palliative Care through Hospice | 456 | ||
| Palliative Care in the Long-Term Care Setting | 457 | ||
| Decision Making at the End of Life | 457 | ||
| Advance Directives | 458 | ||
| Barriers to Completing Advance Directives | 458 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 459 | ||
| Approaching Death | 459 | ||
| Physician-Assisted Suicide | 459 | ||
| Terminal Sedation or Sedation to Relief | 460 | ||
| Promoting Healthy Dying While Aging: Implications for Gerontological Nursing | 460 | ||
| Key Concepts | 461 | ||
| Research Questions | 462 | ||
| References | 462 | ||
| 24 Self-Actualization, Spirituality, and Transcendence | 463 | ||
| Learning Objectives | 463 | ||
| Self-Actualization | 464 | ||
| Characteristics of the Self-Actualized | 464 | ||
| Courage | 464 | ||
| Altruism | 465 | ||
| Humor | 465 | ||
| Continuous Moral Development | 465 | ||
| Self-Renewal | 465 | ||
| Collective Self-Actualization | 465 | ||
| Wisdom | 465 | ||
| Creativity | 466 | ||
| Creative Arts for Older Adults | 467 | ||
| Creative Expression Through Theater, Dance, Music, and Poetry | 467 | ||
| Theater | 467 | ||
| Dance | 467 | ||
| Music | 468 | ||
| Poetry | 468 | ||
| Reading for Self-Development | 469 | ||
| Creative Arts and People with Dementia | 469 | ||
| Recreation | 469 | ||
| Bringing Young and Old Together | 470 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 470 | ||
| Spirituality | 470 | ||
| Spirituality and Religion | 471 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 471 | ||
| Assessment | 471 | ||
| Spiritual Responses | 473 | ||
| Nurturing the Spirit of the Nurse | 473 | ||
| Faith Community Nursing | 474 | ||
| Transcendence | 474 | ||
| Gerotranscendence | 475 | ||
| Achieving Transcendence | 475 | ||
| Time Transcendence | 475 | ||
| Peak Experiences | 475 | ||
| Meditation | 475 | ||
| Hope as a Transcendent Mechanism | 476 | ||
| Transcendence in Illness | 476 | ||
| Legacies | 477 | ||
| Types of Legacies | 477 | ||
| Autobiographies and Life Histories | 477 | ||
| Creation of Self Through Journaling | 478 | ||
| Collective Legacies | 478 | ||
| Legacies Expressed Through Other People | 478 | ||
| Living Legacies | 478 | ||
| Property and Assets | 479 | ||
| Personal Possessions | 479 | ||
| Promoting Healthy Aging: Implications for Gerontological Nursing | 479 | ||
| Key Concepts | 480 | ||
| Research Questions | 481 | ||
| References | 481 | ||
| Index | 483 | ||
| A | 483 | ||
| B | 484 | ||
| C | 485 | ||
| D | 487 | ||
| E | 488 | ||
| F | 489 | ||
| G | 489 | ||
| H | 490 | ||
| I | 491 | ||
| J | 492 | ||
| K | 492 | ||
| L | 492 | ||
| M | 493 | ||
| N | 494 | ||
| O | 495 | ||
| P | 495 | ||
| Q | 496 | ||
| R | 497 | ||
| S | 497 | ||
| T | 498 | ||
| U | 499 | ||
| V | 499 | ||
| W | 500 | ||
| X | 500 | ||
| Y | 500 | ||
| Z | 500 |