BOOK
Ebersole and Hess' Gerontological Nursing & Healthy Aging - E-Book
Theris A. Touhy | Kathleen F Jett
(2016)
Additional Information
Book Details
Abstract
Discover a wellness-based, holistic approach to older adult care. Ebersole & Hess’ Gerontological Nursing and Healthy Aging, 5th Edition is the only gerontological nursing text on the market that focuses on this thoughtful, organic method of care. Designed to facilitate healthy aging regardless of the situation or disease process, this text goes beyond simply tracking recommended treatments to addressing complications, alleviating discomfort, and helping older adults lead healthy lives. Featuring an updated four-color design, additional information on long-term care, evidence-based practice boxes, safety alerts, expanded tables, and careful attention to age, gender, and cultural differences, Ebersole & Hess’ Gerontological Nursing and Healthy Aging is the most complete text on the market.
- Focus on health and wellness helps you gain an understanding of the patient’s experience.
- Safety Alerts highlight safe practices and quality of care QSEN competencies.
- Careful attention to age, cultural, and gender differences helps you to understand these important considerations in caring for older adults.
- AACN and the Hartford Institute for Geriatric Nursing core competencies integrated throughout.
- Evidence-Based Practice boxes summarize research findings that confirm effective practices or identify practices with unknown, ineffective, or harmful effects.
- Activities and discussion questions at the end of every chapter equip you with the information that you need to assess the patient.
- Healthy People 2020 boxes integrate information about healthy aging.
- Expanded tables, boxes, and forms, including the latest scales and guidelines for proper health assessment make information easy to find and use.
- NEW! New four-color design provides a higher-level of detail and readability to caregiving procedures.
- NEW! New chapter on Caregiving includes expanded coverage of abuse and neglect.
- NEW! Expanded content about Long-Term and Transitional Care added to chapter six.
- NEW! Expanded Safety coverage spans two separate chapters.
- NEW! Expanded Nutrition and Hydration content divided into two separate chapters.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Evolve ad | IFC1 | ||
| Ebersole and Hess' Gerontological Nursing & Healthy Aging | i | ||
| Copyright Page | ii | ||
| Dedication | iii | ||
| Reviewers and Evolve Writers | iv | ||
| Preface | v | ||
| Ancillaries | v | ||
| For Instructors | v | ||
| For Students | vi | ||
| Acknowledgments | vi | ||
| Table Of Contents | vii | ||
| 1 Foundations of Healthy Aging | 1 | ||
| 1 Introduction to Healthy Aging | 1 | ||
| Learning Objectives | 1 | ||
| The Lived Experience | 1 | ||
| The Years Ahead | 2 | ||
| How Old Is Old? | 3 | ||
| Chronological Aging | 3 | ||
| The Super-Centenarians | 4 | ||
| The Centenarians | 5 | ||
| Those In-Between | 5 | ||
| The “Baby Boomers” | 6 | ||
| Moving Toward Healthy Aging | 6 | ||
| Implications for Gerontological Nursing and Healthy Aging | 8 | ||
| Key Concepts | 9 | ||
| Activities and Discussion Questions | 9 | ||
| References | 9 | ||
| 2 Cross-Cultural Caring and Aging | 11 | ||
| Learning Objectives | 11 | ||
| The Lived Experience | 11 | ||
| Culture | 12 | ||
| Diversity | 12 | ||
| Health Disparities and Inequities | 13 | ||
| Implications for Gerontological Nursing and Healthy Aging | 13 | ||
| Moving Toward Cultural Proficiency to Improve Health Outcomes | 13 | ||
| Cultural Destructiveness | 13 | ||
| Cultural Blindness | 14 | ||
| Cultural Precompetence | 14 | ||
| Cultural Competence | 15 | ||
| Cultural Proficiency | 15 | ||
| Cultural Knowledge | 15 | ||
| Orientation to Family and Self | 16 | ||
| Orientation to Time | 16 | ||
| Health Beliefs | 16 | ||
| Implications for Gerontological Nursing and Healthy Aging | 17 | ||
| L—Listen | 18 | ||
| Physical Contact | 18 | ||
| Eye Contact | 18 | ||
| Verbal Communication | 18 | ||
| Working With Interpreters | 18 | ||
| E—Explain | 19 | ||
| A—Acknowledge | 19 | ||
| R—Recommend | 19 | ||
| N—Negotiate | 19 | ||
| Integrating Concepts | 20 | ||
| Key Concepts | 20 | ||
| Activities and Discussion Questions | 21 | ||
| References | 21 | ||
| 3 Biological Theories of Aging and Age-Related Physical Changes | 22 | ||
| Learning Objectives | 22 | ||
| The Lived Experience | 22 | ||
| Biological Theories of Aging | 22 | ||
| Cellular Functioning and Aging | 23 | ||
| Oxidative Stress Theories | 23 | ||
| Free Radical Theory | 24 | ||
| Immunological Theory of Aging | 25 | ||
| Aging and DNA | 25 | ||
| Telomeres | 25 | ||
| Physical Changes That Accompany Aging | 26 | ||
| Skin | 26 | ||
| Epidermis | 26 | ||
| Dermis | 27 | ||
| Hypodermis: Subcutaneous Layer | 27 | ||
| Hair and Nails | 27 | ||
| Musculoskeletal | 28 | ||
| Stature, Posture, and Body Composition | 28 | ||
| Cardiovascular | 29 | ||
| Cardiac | 29 | ||
| Blood Vessels | 30 | ||
| Respiratory | 30 | ||
| Renal | 31 | ||
| Endocrine | 31 | ||
| Pancreas | 31 | ||
| Thyroid | 31 | ||
| Reproductive | 32 | ||
| Female Reproductive System | 32 | ||
| Male Reproductive System | 32 | ||
| Gastrointestinal | 32 | ||
| Mouth | 32 | ||
| Esophagus | 33 | ||
| Stomach | 33 | ||
| Intestines | 33 | ||
| Accessory Organs | 33 | ||
| Neurological | 34 | ||
| Central Nervous System | 34 | ||
| Peripheral Nervous System | 34 | ||
| Sensory Changes | 35 | ||
| Eyes and Vision | 35 | ||
| Extraocular. | 35 | ||
| Ocular. | 35 | ||
| Intraocular. | 36 | ||
| Ears and Hearing | 36 | ||
| Immune | 37 | ||
| Key Concepts | 38 | ||
| Activities and Discussion Questions | 38 | ||
| References | 38 | ||
| 4 Psychosocial, Spiritual, and Cognitive Aspects of Aging | 40 | ||
| Learning Objectives | 40 | ||
| The Lived Experience | 40 | ||
| Psychosocial Theories of Aging | 41 | ||
| First Generation | 41 | ||
| Role Theory | 41 | ||
| Activity Theory | 41 | ||
| Second Generation | 41 | ||
| Disengagement Theory | 41 | ||
| Continuity Theory | 42 | ||
| Age-Stratification Theory | 42 | ||
| Social Exchange Theory | 42 | ||
| Modernization Theory | 42 | ||
| Developmental Theories | 42 | ||
| Gerotranscendence Theory | 43 | ||
| Third Generation | 43 | ||
| The Life Story | 43 | ||
| Reminiscing | 43 | ||
| Life Review | 45 | ||
| Implications for Gerontological Nursing and Healthy Aging | 45 | ||
| Spirituality and Aging | 46 | ||
| Implications for Gerontological Nursing and Healthy Aging | 47 | ||
| Assessment | 47 | ||
| Interventions | 48 | ||
| Nurturing the Spirit of the Nurse | 48 | ||
| Adult Cognition | 48 | ||
| Neuroplasticity | 49 | ||
| Fluid and Crystallized Intelligence | 50 | ||
| Memory | 50 | ||
| Implications for Gerontological Nursing and Healthy Aging | 50 | ||
| Learning in Later Life | 51 | ||
| Learning Opportunities | 51 | ||
| Information Technology and Older Adults | 52 | ||
| Implications for Gerontological Nursing and Healthy Aging | 52 | ||
| Key Concepts | 52 | ||
| Activities and Discussion Questions | 52 | ||
| References | 52 | ||
| 2 Foundations of Gerontological Nursing | 55 | ||
| 5 Gerontological Nursing and Promotion of Healthy Aging | 55 | ||
| Learning Objectives | 55 | ||
| The Lived Experience | 55 | ||
| Care of Older Adults: a Nursing Imperative | 55 | ||
| Who Will Care for an Aging Society? | 56 | ||
| History of Gerontological Nursing | 56 | ||
| Current Initiatives | 57 | ||
| Gerontological Nursing Education | 58 | ||
| Organizations Devoted to Gerontology Research and Practice | 58 | ||
| Research on Aging | 59 | ||
| Nursing Research | 59 | ||
| Gerontological Nursing Roles | 60 | ||
| Specialist Roles | 60 | ||
| Generalist Roles | 61 | ||
| Acute Care | 61 | ||
| NICHE. | 61 | ||
| Community- and Home-Based Care | 62 | ||
| Case and Care Management Roles | 62 | ||
| Certified Nursing Facilities (Nursing Homes) | 62 | ||
| Implications for Gerontological Nursing and Healthy Aging | 63 | ||
| Key Concepts | 63 | ||
| Activities and Discussion Questions | 64 | ||
| References | 64 | ||
| 6 Gerontological Nursing Across the Continuum of Care | 66 | ||
| Learning Objectives | 66 | ||
| The Lived Experience | 66 | ||
| Community Care | 67 | ||
| Program for All-Inclusive Care for the Elderly | 67 | ||
| Adult Day Services | 67 | ||
| Continuing Care Retirement Communities | 67 | ||
| Residential Care/Assisted Living | 68 | ||
| Assisted Living | 68 | ||
| Skilled Nursing Facilities (Nursing Homes) | 69 | ||
| Sub–Acute Care (Short-Term) | 69 | ||
| Chronic Care (Long-Term) | 70 | ||
| Long-Term Care and the U.S. Health Care System | 70 | ||
| Costs of LTC | 71 | ||
| Quality of Care in Skilled Nursing Facilities | 71 | ||
| Implications for Gerontological Nursing and Healthy Aging | 73 | ||
| Resident Bill of Rights | 73 | ||
| Advancing Excellence in America’s Nursing Homes | 73 | ||
| The Culture Change Movement | 74 | ||
| Transitions Across the Continuum | 74 | ||
| Readmissions: The Revolving Door | 75 | ||
| Factors Contributing to Poor Transitional Care Outcomes | 75 | ||
| Improving Transitional Care | 75 | ||
| Implications for Gerontological Nursing and Healthy Aging | 76 | ||
| Key Concepts | 77 | ||
| Activities and Discussion Questions | 77 | ||
| References | 77 | ||
| 7 Economic and Legal Issues | 79 | ||
| Learning Objectives | 79 | ||
| The Lived Experience | 79 | ||
| Late Life Income | 79 | ||
| Social Security | 80 | ||
| Supplemental Security Income (SSI) | 81 | ||
| Other Late Life Income | 81 | ||
| Health Care Insurance Plans in Later Life | 81 | ||
| Medicare | 82 | ||
| Medicare Part A | 83 | ||
| Medicare Part B | 84 | ||
| Medicare Part C | 85 | ||
| Alternatives to Medicare Part C. | 85 | ||
| Medicare Part D | 85 | ||
| Supplemental Insurance/Medigap Policies | 86 | ||
| Medicaid | 86 | ||
| Other Means to Finance Health Care | 87 | ||
| Indian Health Services | 87 | ||
| Care for Veterans | 87 | ||
| TRICARE for life. | 87 | ||
| Veteran aid and dependence. | 87 | ||
| Long-Term Care Insurance | 87 | ||
| Legal Issues in Gerontological Nursing | 88 | ||
| Decision-Making | 88 | ||
| Capacity | 88 | ||
| Advance Care Planning | 88 | ||
| Power of Attorney | 89 | ||
| Health Care Proxy | 89 | ||
| Guardians and Conservators | 89 | ||
| Implications for Gerontological Nursing and Healthy Aging | 90 | ||
| Key Concepts | 90 | ||
| Activities and Discussion Questions | 91 | ||
| References | 91 | ||
| 3 Fundamentals of Caring | 92 | ||
| 8 Assessment and Documentation for Optimal Care | 92 | ||
| Learning Objectives | 92 | ||
| The Lived Experience | 92 | ||
| The Assessment Process | 93 | ||
| The Health History | 94 | ||
| Physical Assessment | 96 | ||
| Comprehensive Physical Assessment of the Frail and Medically Complex Elder | 96 | ||
| F—Fluids | 96 | ||
| A—Aeration | 98 | ||
| N—Nutrition | 98 | ||
| C—Communication | 98 | ||
| A—Activity | 98 | ||
| P—Pain | 99 | ||
| E—Elimination | 99 | ||
| S—Socialization and Social Skills | 99 | ||
| Assessment of Mental Status | 99 | ||
| Cognitive Measures | 99 | ||
| Mini-Mental State Examination | 99 | ||
| Clock Drawing Test | 99 | ||
| The Mini-Cog | 100 | ||
| The Global Deterioration Scale | 100 | ||
| Mood Measures | 100 | ||
| Geriatric Depression Scale | 102 | ||
| Functional Assessment | 102 | ||
| Activities of Daily Living | 103 | ||
| Barthel Index | 103 | ||
| Functional Independence Measure | 103 | ||
| Instrumental Activities of Daily Living | 103 | ||
| Comprehensive Geriatric Assessments | 103 | ||
| The OARS Multidimensional Functional Assessment Questionnaire (OMFAQ) | 104 | ||
| Fulmer SPICES | 104 | ||
| Resident Assessment Instrument (RAI)/Minimum Data Set (MDS 3.0) | 104 | ||
| Outcome and Assessment Information Set (OASIS-C1) | 105 | ||
| Documentation for Quality Care | 105 | ||
| Documentation in Acute Care and Acute Rehabilitation Care Settings | 106 | ||
| Documentation in Long-Term Care Facilities | 106 | ||
| Documentation in Home Care | 106 | ||
| Documentation and Reimbursement | 106 | ||
| Implications for Gerontological Nursing and Healthy Aging | 107 | ||
| Key Concepts | 107 | ||
| Activities and Discussion Questions | 107 | ||
| References | 108 | ||
| 9 Safe Medication Use | 110 | ||
| Learning Objectives | 110 | ||
| The Lived Experience | 110 | ||
| Pharmacokinetics | 111 | ||
| Absorption | 112 | ||
| Distribution | 112 | ||
| Metabolism | 112 | ||
| Excretion | 113 | ||
| Pharmacodynamics | 114 | ||
| Chronopharmacology | 114 | ||
| Medication-Related Problems and Older Adults | 115 | ||
| Polypharmacy | 115 | ||
| Drug Interactions | 115 | ||
| Medication–Herb/Supplement Interactions | 116 | ||
| Medication-Food Interactions | 116 | ||
| Drug-Drug Interactions | 118 | ||
| Adverse Drug Reactions | 118 | ||
| Misuse of Drugs | 119 | ||
| Potentially Inappropriate Medications: The “Beers Criteria” | 120 | ||
| Psychoactive Medications | 120 | ||
| Antidepressants | 121 | ||
| Antianxiety Agents | 121 | ||
| Mood Stabilizers | 122 | ||
| Antipsychotics (Neuroleptics) | 122 | ||
| Neuroleptic Malignant Syndrome | 123 | ||
| Extrapyramidal Reactions | 123 | ||
| Acute dystonia. | 123 | ||
| Akathisia. | 123 | ||
| Parkinsonian symptoms. | 123 | ||
| Tardive dyskinesia. | 123 | ||
| Implications for Gerontological Nursing and Healthy Aging | 124 | ||
| Assessment | 124 | ||
| Education | 124 | ||
| Administration | 125 | ||
| Monitoring | 126 | ||
| Key Concepts | 128 | ||
| Activities and Discussion Questions | 128 | ||
| References | 128 | ||
| 10 Nutrition | 130 | ||
| Learning Objectives | 130 | ||
| The Lived Experience | 130 | ||
| Nutrition | 130 | ||
| United States Dietary Guidelines | 131 | ||
| MyPlate for Older Adults | 131 | ||
| Other Dietary Recommendations | 131 | ||
| Fats | 131 | ||
| Protein | 132 | ||
| Fiber | 132 | ||
| Vitamins and Minerals | 132 | ||
| Obesity (Overnutrition) | 133 | ||
| Malnutrition (Undernutrition) | 133 | ||
| Consequences | 133 | ||
| Characteristics | 134 | ||
| Factors Affecting Fulfillment of Nutritional Needs | 134 | ||
| Lifelong Eating Habits | 135 | ||
| Socialization | 135 | ||
| Chronic Diseases and Conditions | 135 | ||
| Dysphagia | 135 | ||
| Implications for Gerontological Nursing and Healthy Aging | 135 | ||
| Assessment | 135 | ||
| Interventions | 136 | ||
| Feeding tubes. | 136 | ||
| Tube feeding in end-stage dementia. | 136 | ||
| Socioeconomic Deprivation | 138 | ||
| Transportation | 138 | ||
| Implications for Gerontological Nursing and Healthy Aging | 138 | ||
| Nutritional Screening | 139 | ||
| Nutritional Assessment | 139 | ||
| Interview | 139 | ||
| Food/Nutrient Intake | 139 | ||
| Anthropomorphic Measurements | 140 | ||
| Weight/Height Considerations | 140 | ||
| Biochemical Analysis/Measures of Visceral Protein | 140 | ||
| Interventions | 141 | ||
| Feeding Assistance | 141 | ||
| Approaches to Enhancing Intake in Long-Term Care | 141 | ||
| Restrictive Diets and Caloric Supplements | 141 | ||
| Pharmacological Therapy | 142 | ||
| Patient Education | 142 | ||
| Implications for Gerontological Nursing and Healthy Aging | 142 | ||
| Key Concepts | 142 | ||
| Activities and Discussion Questions | 142 | ||
| References | 142 | ||
| 11 Hydration and Oral Care | 145 | ||
| Learning Objectives | 145 | ||
| The Lived Experience | 145 | ||
| Hydration Management | 145 | ||
| Dehydration | 145 | ||
| Risk Factors for Dehydration | 146 | ||
| Implications for Gerontological Nursing and Healthy Aging | 146 | ||
| Assessment | 146 | ||
| Signs/Symptoms of Dehydration | 146 | ||
| Laboratory Tests | 147 | ||
| Urine Color | 147 | ||
| Interventions | 147 | ||
| Rehydration Methods | 147 | ||
| Hypodermoclysis | 147 | ||
| Oral Health | 148 | ||
| Common Oral Problems | 149 | ||
| Xerostomia (Mouth Dryness) | 149 | ||
| Treatment of xerostomia. | 149 | ||
| Oral Cancer | 149 | ||
| Oral Care | 149 | ||
| Implications for Gerontological Nursing and Healthy Aging | 150 | ||
| Assessment | 150 | ||
| Interventions | 150 | ||
| Dentures | 150 | ||
| Oral Hygiene in Hospitals and Long-Term Care | 152 | ||
| Tube Feeding and Oral Hygiene | 152 | ||
| Key Concepts | 152 | ||
| Activities and Discussion Questions | 153 | ||
| References | 153 | ||
| 12 Elimination | 154 | ||
| Learning Objectives | 154 | ||
| The Lived Experience | 154 | ||
| Urinary Incontinence | 155 | ||
| UI Facts and Figures | 155 | ||
| Risk Factors for UI | 156 | ||
| Consequences of UI | 156 | ||
| Types of UI | 156 | ||
| Implications for Gerontological Nursing and Healthy Aging | 156 | ||
| Assessment | 156 | ||
| Interventions | 157 | ||
| Behavioral | 157 | ||
| Scheduled (timed) voiding. | 158 | ||
| Bladder training. | 159 | ||
| Pelvic floor muscle exercises. | 159 | ||
| Prompted voiding. | 160 | ||
| Lifestyle modifications. | 160 | ||
| Promotion of Continence Friendly Environment | 161 | ||
| Absorbent products. | 161 | ||
| Pharmacological Treatment | 161 | ||
| Surgical Treatment | 162 | ||
| Nonsurgical Devices | 162 | ||
| Urinary catheters. | 162 | ||
| Urinary Tract Infections | 163 | ||
| Catheter-Associated Urinary Tract Infections | 163 | ||
| Bowel Elimination | 163 | ||
| Constipation | 164 | ||
| Fecal Impaction | 164 | ||
| Implications for Gerontological Nursing and Healthy Aging | 165 | ||
| Assessment | 165 | ||
| Interventions | 165 | ||
| Nonpharmacological Treatment | 165 | ||
| Physical activity. | 165 | ||
| Positioning. | 166 | ||
| Toileting regimen. | 166 | ||
| Pharmacological Treatment | 166 | ||
| Enemas. | 167 | ||
| Alternative Treatments | 167 | ||
| Accidental Bowel Leakage/Fecal Incontinence | 167 | ||
| Implications for Gerontological Nursing and Healthy Aging | 168 | ||
| Assessment | 168 | ||
| Interventions | 168 | ||
| Key Concepts | 168 | ||
| Activities and Discussion Questions | 168 | ||
| References | 168 | ||
| 13 Rest, Sleep, and Activity | 170 | ||
| Learning Objectives | 170 | ||
| The Lived Experience | 170 | ||
| Rest and Sleep | 170 | ||
| Biorhythm and Sleep | 171 | ||
| Sleep and Aging | 171 | ||
| Sleep Disorders | 172 | ||
| Insomnia | 172 | ||
| Insomnia and Alzheimer’s disease. | 172 | ||
| Implications for Gerontological Nursing and Healthy Aging | 173 | ||
| Assessment | 173 | ||
| Interventions | 173 | ||
| Nonpharmacological Treatment | 173 | ||
| Sleep in hospitals and nursing homes. | 174 | ||
| Pharmacological Treatment | 175 | ||
| Sleep Disordered Breathing and Sleep Apnea | 176 | ||
| Implications for Gerontological Nursing and Healthy Aging | 176 | ||
| Assessment | 176 | ||
| Interventions | 176 | ||
| Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) | 177 | ||
| Rapid Eye Movement Sleep Behavior Disorder | 177 | ||
| Circadian Rhythm Sleep Disorders | 178 | ||
| Activity | 178 | ||
| Physical Activity and Aging | 178 | ||
| Implications for Gerontological Nursing and Healthy Aging | 179 | ||
| Assessment | 179 | ||
| Screening | 179 | ||
| Interventions | 179 | ||
| Physical Activity Guidelines | 180 | ||
| Incorporating Physical Activity Into Lifestyle | 180 | ||
| Special Considerations | 180 | ||
| Key Concepts | 182 | ||
| Activities and Discussion Questions | 182 | ||
| References | 182 | ||
| 14 Promoting Healthy Skin | 185 | ||
| Learning Objectives | 185 | ||
| The Lived Experience | 185 | ||
| Skin | 186 | ||
| Common Skin Problems | 186 | ||
| Xerosis | 186 | ||
| Pruritus | 186 | ||
| Scabies | 186 | ||
| Purpura | 187 | ||
| Skin Tears | 187 | ||
| Keratoses | 187 | ||
| Herpes Zoster | 188 | ||
| Candidiasis (Candida albicans) | 189 | ||
| Photo Damage of the Skin | 190 | ||
| Skin Cancers | 190 | ||
| Facts and Figures | 190 | ||
| Basal Cell Carcinoma | 190 | ||
| Squamous Cell Carcinoma | 190 | ||
| Melanoma | 191 | ||
| Incidence and Prevalence | 191 | ||
| Risk Factors | 191 | ||
| Indoor tanning. | 191 | ||
| Implications for Gerontological Nursing and Healthy Aging | 191 | ||
| Pressure Injuries | 192 | ||
| Definition | 192 | ||
| Scope of the Problem | 192 | ||
| Cost and Regulatory Requirements | 193 | ||
| Characteristics | 193 | ||
| Classification | 193 | ||
| Skin Changes at Life’s End (SCALE) | 195 | ||
| Risk Factors | 195 | ||
| Prevention of Pressure Injuries | 196 | ||
| Consequences of Pressure Injuries | 196 | ||
| Implications for Gerontological Nursing and Healthy Aging | 196 | ||
| Assessment of Pressure Injury Risk | 196 | ||
| Interventions | 197 | ||
| Pressure Injury Assessment | 198 | ||
| Pressure Injury Dressings | 198 | ||
| Key Concepts | 198 | ||
| Activities and Discussion Questions | 199 | ||
| References | 199 | ||
| 15 Falls and Fall Risk Reduction | 201 | ||
| Learning Objectives | 201 | ||
| The Lived Experience | 201 | ||
| Falls | 201 | ||
| Consequences of Falls | 202 | ||
| Hip Fractures | 202 | ||
| Traumatic Brain Injury | 202 | ||
| Fallophobia | 203 | ||
| Fall Risk Factors | 204 | ||
| Gait Disturbances | 204 | ||
| Foot Deformities | 205 | ||
| Implications for Gerontological Nursing and Healthy Aging | 206 | ||
| Orthostatic and Postprandial Hypotension | 206 | ||
| Cognitive Impairment | 207 | ||
| Vision and Hearing | 207 | ||
| Medications | 207 | ||
| Implications for Gerontological Nursing and Healthy Aging | 207 | ||
| Screening and Assessment | 207 | ||
| Screening and Assessment in Hospital/ Long-Term Care | 207 | ||
| Fall Risk Assessment Instruments | 207 | ||
| Postfall Assessment | 208 | ||
| Components of the PFA | 208 | ||
| Interventions | 209 | ||
| Fall Risk–Reduction Programs | 209 | ||
| Environmental Modifications | 210 | ||
| Assistive Devices | 210 | ||
| Safe Patient Handling | 211 | ||
| Wheelchairs | 211 | ||
| Osteoporosis Treatment/Vitamin D Supplementation | 211 | ||
| Hip Protectors | 211 | ||
| Alarms/Motion Sensors | 211 | ||
| Restraints and Side Rails | 212 | ||
| Definition and History | 212 | ||
| Consequences of Restraints | 212 | ||
| Side Rails | 212 | ||
| Restraint-Free Care | 212 | ||
| Implications for Gerontological Nursing and Healthy Aging | 214 | ||
| Key Concepts | 214 | ||
| Activities and Discussion Questions | 214 | ||
| References | 214 | ||
| 16 Promoting Safety | 217 | ||
| Learning Objectives | 217 | ||
| The Lived Experience | 217 | ||
| Home Safety | 217 | ||
| Vulnerability to Environmental Temperatures | 217 | ||
| Thermoregulation | 218 | ||
| Temperature Monitoring in Older Adults | 218 | ||
| Hyperthermia | 218 | ||
| Hypothermia | 219 | ||
| Implications for Gerontological Nursing and Healthy Aging | 220 | ||
| Vulnerability to Natural Disasters | 221 | ||
| Transportation Safety | 221 | ||
| Driving | 221 | ||
| Driving Safety | 221 | ||
| Driving and Dementia | 222 | ||
| Silver Alert systems. | 222 | ||
| Driving Cessation | 222 | ||
| Implications for Gerontological Nursing and Healthy Aging | 223 | ||
| Emerging Technologies to Enhance Safety of Older Adults | 223 | ||
| Telehealth | 224 | ||
| Smart Homes | 224 | ||
| Robots | 225 | ||
| Elder-Friendly Communities | 225 | ||
| Key Concepts | 225 | ||
| Activities and Discussion Questions | 226 | ||
| References | 226 | ||
| 4 Promoting Health in Chronic Illness | 228 | ||
| 17 Living With Chronic Illness | 228 | ||
| Learning Objectives | 228 | ||
| The Lived Experience | 228 | ||
| Acute Illness | 229 | ||
| Chronic Illness | 229 | ||
| Prevention | 231 | ||
| Theoretical Frameworks for Chronic Illness | 231 | ||
| Chronic Illness Trajectory | 231 | ||
| The Shifting Perspectives Model of Chronic Illness | 232 | ||
| Implications for Gerontological Nursing and Healthy Aging | 233 | ||
| Assessment | 233 | ||
| Interventions | 233 | ||
| Key Concepts | 234 | ||
| Activities and Discussion Questions | 235 | ||
| References | 235 | ||
| 18 Pain and Comfort | 236 | ||
| Learning Objectives | 236 | ||
| The Lived Experience | 236 | ||
| Acute and Chronic Pain | 237 | ||
| Acute Pain | 237 | ||
| Chronic Pain | 238 | ||
| Barriers to Providing Comfort for Those in Pain | 238 | ||
| Special Circumstances: Pain in Elders With Cognitive and Communication Limitations | 238 | ||
| Implications for Gerontological Nursing and Healthy Aging | 239 | ||
| Assessment | 239 | ||
| Assessment of Pain in Those With Cognitive or Communication Limitations | 240 | ||
| Interventions | 241 | ||
| Pharmacological Interventions | 243 | ||
| Nonopioid analgesics. | 243 | ||
| Opioid analgesics. | 244 | ||
| Adjuvant drugs. | 244 | ||
| Other agents. | 245 | ||
| Nonpharmacological Measures of Pain Relief | 245 | ||
| Cutaneous stimulation. | 245 | ||
| Acupuncture and acupressure. | 245 | ||
| Touch. | 245 | ||
| Biofeedback. | 245 | ||
| Distraction. | 245 | ||
| Relaxation, meditation, and imagery. | 245 | ||
| Pain Clinics | 246 | ||
| Evaluation | 246 | ||
| Key Concepts | 247 | ||
| Activities and Discussion Questions | 247 | ||
| References | 247 | ||
| 19 Diseases Affecting Vision and Hearing | 249 | ||
| Learning Objectives | 249 | ||
| The Lived Experience | 249 | ||
| Visual Impairment | 249 | ||
| Consequences of Visual Impairment | 250 | ||
| Prevention of Visual Impairment | 250 | ||
| Diseases and Disorders of the Eye | 250 | ||
| Cataracts | 250 | ||
| Treatment of Cataracts | 251 | ||
| Presurgical and Postsurgical Interventions | 251 | ||
| Glaucoma | 251 | ||
| Screening and Treatment of Glaucoma | 253 | ||
| Diabetic Retinopathy | 253 | ||
| Screening and Treatment of Diabetic Retinopathy | 253 | ||
| Diabetic Macular Edema (DME) | 254 | ||
| Age-Related Macular Degeneration | 254 | ||
| Screening and Treatment of AMD | 255 | ||
| Detached Retina | 255 | ||
| Dry Eye | 256 | ||
| Implications for Gerontological Nursing and Healthy Aging | 256 | ||
| Assessment | 256 | ||
| Interventions | 256 | ||
| Special Considerations in Long-Term Care Settings | 256 | ||
| Low-Vision Optical Devices | 257 | ||
| Hearing Impairment | 258 | ||
| Consequences of Hearing Impairment | 258 | ||
| Types of Hearing Loss | 258 | ||
| Interventions to Enhance Hearing | 259 | ||
| Hearing Aids | 259 | ||
| Adjustment to Hearing Aids | 259 | ||
| Cochlear Implants | 260 | ||
| Assistive Listening and Adaptive Devices | 260 | ||
| Implications for Gerontological Nursing and Healthy Aging | 261 | ||
| Assessment | 261 | ||
| Interventions | 262 | ||
| Tinnitus | 262 | ||
| Interventions | 263 | ||
| Key Concepts | 263 | ||
| Activities and Discussion Questions | 263 | ||
| References | 263 | ||
| 20 Metabolic Disorders | 265 | ||
| Learning Objectives | 265 | ||
| The Lived Experience | 265 | ||
| Thyroid Disease | 265 | ||
| Hypothyroidism | 266 | ||
| Hyperthyroidism | 266 | ||
| Complications | 266 | ||
| Implications for Gerontological Nursing and Healthy Aging | 267 | ||
| Diabetes | 267 | ||
| Signs and Symptoms | 268 | ||
| Complications | 269 | ||
| Implications for Gerontological Nursing and Healthy Aging | 270 | ||
| Assessment | 270 | ||
| Management | 271 | ||
| Diabetes Self-Management (DSM) | 272 | ||
| Nutrition | 273 | ||
| Exercise | 273 | ||
| Medications | 273 | ||
| Long-Term Care and the Elder With Diabetes | 274 | ||
| Key Concepts | 274 | ||
| Activities and Discussion Questions | 274 | ||
| References | 274 | ||
| 21 Bone and Joint Problems | 276 | ||
| Learning Objectives | 276 | ||
| The Lived Experience | 276 | ||
| Musculoskeletal System | 276 | ||
| Osteoporosis | 277 | ||
| Implications for Gerontological Nursing and Healthy Aging | 278 | ||
| Reducing Osteoporosis-Related Risk and Injury | 278 | ||
| Pharmacological Interventions | 278 | ||
| The Arthritides | 279 | ||
| Osteoarthritis | 279 | ||
| Polymyalgia Rheumatica and Giant Cell Arteritis | 280 | ||
| Rheumatoid Arthritis | 281 | ||
| Gout | 281 | ||
| Implications for Gerontological Nursing and Healthy Aging | 282 | ||
| Assessment | 282 | ||
| Interventions | 282 | ||
| Complementary and Alternative Interventions | 284 | ||
| Key Concepts | 284 | ||
| Activities and Discussion Questions | 284 | ||
| References | 284 | ||
| 22 Cardiovascular and Respiratory Disorders | 286 | ||
| Learning Objectives | 286 | ||
| The Lived Experience | 286 | ||
| Cardiovascular Disease | 286 | ||
| Hypertension | 287 | ||
| Heart Disease | 288 | ||
| Atrial Fibrillation | 288 | ||
| Heart Failure | 289 | ||
| Implications for Gerontological Nursing and Healthy Aging | 290 | ||
| Assessment | 290 | ||
| Interventions | 290 | ||
| Respiratory Disorders | 291 | ||
| Chronic Obstructive Pulmonary Disease | 291 | ||
| Pneumonia | 292 | ||
| Implications for Gerontological Nursing and Healthy Aging | 292 | ||
| Assessment | 292 | ||
| Interventions | 293 | ||
| Multidisciplinary Care | 294 | ||
| Key Concepts | 295 | ||
| Activities and Discussion Questions | 295 | ||
| References | 296 | ||
| 23 Neurological Disorders | 297 | ||
| Learning Objectives | 297 | ||
| The Lived Experience | 297 | ||
| Cerebrovascular Disease | 298 | ||
| Ischemic Events | 298 | ||
| Hemorrhagic Events | 299 | ||
| Signs and Symptoms of Cerebrovascular Events | 299 | ||
| Complications | 299 | ||
| Management | 299 | ||
| Implications for Gerontological Nursing and Healthy Aging | 300 | ||
| Neurodegenerative Disorders | 301 | ||
| Parkinson’s Disease | 301 | ||
| Signs and Symptoms | 302 | ||
| Management | 302 | ||
| Alzheimer’s Disease | 303 | ||
| Management | 303 | ||
| Implications for Gerontological Nursing and Healthy Aging | 304 | ||
| Communication and Persons With Neurological Disorders | 305 | ||
| The Aphasias | 305 | ||
| Fluent (Wernicke’s) Aphasia | 305 | ||
| Nonfluent (Broca’s) Aphasia | 305 | ||
| Global Aphasia | 305 | ||
| Anomic Aphasia | 306 | ||
| Dysarthria | 306 | ||
| Enhancing Communication | 306 | ||
| Key Concepts | 307 | ||
| Activities and Discussion Questions | 307 | ||
| References | 307 | ||
| 24 Mental Health | 309 | ||
| Learning Objectives | 309 | ||
| The Lived Experience | 309 | ||
| Mental Health | 309 | ||
| Factors Influencing Mental Health Care | 310 | ||
| Attitudes and Beliefs | 310 | ||
| Culture and Mental Health | 311 | ||
| Availability of Mental Health Care | 312 | ||
| Settings of Care | 312 | ||
| Mental Health Disorders | 313 | ||
| Anxiety Disorders | 313 | ||
| Prevalence and Characteristics | 313 | ||
| Implications for Gerontological Nursing and Healthy Aging | 313 | ||
| Assessment | 313 | ||
| Interventions | 314 | ||
| Pharmacological Approaches | 314 | ||
| Nonpharmacological Approaches | 315 | ||
| Posttraumatic Stress Disorder | 315 | ||
| Prevalence | 315 | ||
| Symptoms | 316 | ||
| Implications for Gerontological Nursing and Healthy Aging | 316 | ||
| Assessment | 316 | ||
| Interventions | 317 | ||
| Schizophrenia | 317 | ||
| Prevalence | 317 | ||
| Types | 318 | ||
| Consequences | 318 | ||
| Implications for Gerontological Nursing and Healthy Aging | 318 | ||
| Interventions | 318 | ||
| Psychotic Symptoms in Older Adults | 318 | ||
| Delusions | 319 | ||
| Hallucinations | 319 | ||
| Implications for Gerontological Nursing and Healthy Aging | 319 | ||
| Assessment | 319 | ||
| Interventions | 320 | ||
| Bipolar Disorder | 320 | ||
| Implications for Gerontological Nursing and Healthy Aging | 320 | ||
| Assessment | 320 | ||
| Interventions | 321 | ||
| Pharmacotherapy | 321 | ||
| Psychosocial Approaches | 321 | ||
| Depression | 321 | ||
| Prevalence | 321 | ||
| Racial, Ethnic, and Cultural Considerations | 322 | ||
| Consequences | 322 | ||
| Etiology | 322 | ||
| Implications for Gerontological Nursing and Healthy Aging | 323 | ||
| Assessment | 323 | ||
| Interventions | 325 | ||
| Nonpharmacological Approaches | 325 | ||
| Collaborative care. | 325 | ||
| Pharmacological Approaches | 325 | ||
| Other Treatments | 326 | ||
| Suicide | 326 | ||
| Implications for Gerontological Nursing and Healthy Aging | 327 | ||
| Assessment | 327 | ||
| Interventions | 328 | ||
| Substance Use Disorders | 328 | ||
| Alcohol Use Disorder | 328 | ||
| Prevalence and Characteristics | 328 | ||
| Gender Issues | 328 | ||
| Physiology | 329 | ||
| Consequences | 329 | ||
| Alcohol Guidelines for Older Adults | 329 | ||
| Implications for Gerontological Nursing and Healthy Aging | 329 | ||
| Assessment | 329 | ||
| Interventions | 330 | ||
| Acute Alcohol Withdrawal | 331 | ||
| Other Substance Abuse Concerns | 332 | ||
| Implications for Gerontological Nursing and Healthy Aging | 332 | ||
| Key Concepts | 332 | ||
| Activities and Discussion Questions | 333 | ||
| References | 333 | ||
| 5 Caring for Elders and Their Caregivers | 336 | ||
| 25 Care of Individuals With Neurocognitive Disorders | 336 | ||
| Learning Objectives | 336 | ||
| The Lived Experience | 336 | ||
| Neurocognitive Disorder: Delirium | 336 | ||
| Differences Among Delirium, Dementia (Mild and Major Neurocognitive Disorder), and Depression | 337 | ||
| Etiology | 337 | ||
| Incidence and Prevalence | 337 | ||
| Delirium Superimposed on Mild and Major Neurocognitive Disorders (Dementia) | 337 | ||
| Recognition of Delirium | 338 | ||
| Risk Factors for Delirium | 338 | ||
| Clinical Subtypes of Delirium | 339 | ||
| Consequences of Delirium | 339 | ||
| Implications for Gerontological Nursing and Healthy Aging | 340 | ||
| Assessment | 340 | ||
| Cognitive Assessment | 340 | ||
| Assessment of Delirium | 340 | ||
| Interventions | 341 | ||
| Nonpharmacological Approaches | 341 | ||
| Pharmacological Approaches | 342 | ||
| Care of Individuals With Mild and Major Neurocognitive Disorders | 342 | ||
| Person-Centered Care | 343 | ||
| Communication | 344 | ||
| Evidence-Based Communication Strategies | 345 | ||
| Reality Orientation | 345 | ||
| Implications for Gerontological Nursing and Healthy Aging | 346 | ||
| Behavior Concerns and Nursing Models of Care | 346 | ||
| The Progressively Lowered Stress Threshold Model | 347 | ||
| Need-Driven Dementia-Compromised Behavior Model | 347 | ||
| Implications for Gerontological Nursing and Healthy Aging | 348 | ||
| Assessment | 348 | ||
| Interventions | 349 | ||
| Pharmacological Approaches | 349 | ||
| Nonpharmacological Approaches | 350 | ||
| Providing Care for Activities of Daily Living | 351 | ||
| Bathing | 351 | ||
| Implications for Gerontological Nursing and Healthy Aging | 352 | ||
| Assessment and Interventions | 352 | ||
| Wandering | 353 | ||
| Implications for Gerontological Nursing and Healthy Aging | 353 | ||
| Assessment and Interventions | 353 | ||
| Nutrition | 353 | ||
| Implications for Gerontological Nursing and Healthy Aging | 354 | ||
| Assessment and Interventions | 354 | ||
| Nursing Roles in the Care of Persons With Dementia | 354 | ||
| Key Concepts | 355 | ||
| Activities and Discussion Questions | 357 | ||
| References | 357 | ||
| 26 Relationships, Roles, and Transitions | 360 | ||
| Learning Objectives | 360 | ||
| The Lived Experience | 360 | ||
| Later Life Transitions | 360 | ||
| Retirement | 360 | ||
| Special Considerations in Retirement | 361 | ||
| Retirement Planning | 361 | ||
| Implications for Gerontological Nursing and Healthy Aging | 361 | ||
| Death of a Spouse or Life Partner | 362 | ||
| Implications for Gerontological Nursing and Healthy Aging | 362 | ||
| Assessment | 362 | ||
| Interventions | 363 | ||
| Relationships in Later Life | 363 | ||
| Friendships | 363 | ||
| Families | 364 | ||
| Multigenerational Families | 364 | ||
| Family Relationships | 365 | ||
| Types of Families | 366 | ||
| Traditional Couples | 366 | ||
| Divorce. | 366 | ||
| Nontraditional Couples | 367 | ||
| Elders and Their Adult Children | 367 | ||
| Never-Married Older Adults | 368 | ||
| Grandparents | 368 | ||
| Siblings | 369 | ||
| Fictive Kin | 369 | ||
| Intimacy | 369 | ||
| Sexuality | 370 | ||
| Sexual Health | 371 | ||
| Factors Influencing Sexual Health | 372 | ||
| Expectations | 372 | ||
| Activity Levels | 372 | ||
| Cohort and Cultural Influences | 372 | ||
| Biological Changes With Age | 373 | ||
| Sexual Dysfunction | 373 | ||
| Male Dysfunction | 373 | ||
| Female Dysfunction | 374 | ||
| Alternative Sexual Lifestyles: Lesbian, Gay, Bisexual, and Transgender | 375 | ||
| Implications for Gerontological Nursing and Healthy Aging | 375 | ||
| Assessment | 375 | ||
| Interventions | 375 | ||
| Intimacy and Chronic Illness | 376 | ||
| Intimacy and Sexuality in Long-Term Care Facilities | 376 | ||
| Interventions | 379 | ||
| Intimacy, Sexuality, and Dementia | 379 | ||
| HIV/AIDS and Older Adults | 379 | ||
| Assessment | 380 | ||
| Interventions | 381 | ||
| Implications for Gerontological Nursing and Healthy Aging | 381 | ||
| Assessment | 381 | ||
| Interventions | 382 | ||
| Key Concepts | 382 | ||
| Activities and Discussion Questions | 383 | ||
| References | 383 | ||
| 27 Caregiving | 386 | ||
| Learning Objectives | 386 | ||
| The Lived Experience | 386 | ||
| Caregiving | 386 | ||
| Impact of Caregiving | 387 | ||
| Spousal Caregiving | 388 | ||
| Caring for Individuals With Dementia | 388 | ||
| Aging Parents Caring for Developmentally Disabled Children | 389 | ||
| Grandparents Raising Grandchildren | 389 | ||
| Interventions | 390 | ||
| Long-Distance Caregiving | 390 | ||
| Implications for Gerontological Nursing and Healthy Aging | 390 | ||
| Caregiver Assessment | 390 | ||
| Interventions | 391 | ||
| Special Considerations for Caregivers of Individuals With Dementia | 391 | ||
| Elder Mistreatment | 392 | ||
| Abuse | 393 | ||
| Impact of Elder Abuse | 393 | ||
| Neglect | 393 | ||
| Neglect by a Caregiver | 393 | ||
| Self-Neglect | 393 | ||
| Implications for Gerontological Nursing and Healthy Aging | 394 | ||
| Elder Mistreatment | 394 | ||
| Mandatory Reporting | 394 | ||
| Key Concepts | 395 | ||
| Activities and Discussion Questions | 395 | ||
| References | 395 | ||
| 28 Loss, Death, and Palliative Care | 397 | ||
| Learning Objectives | 397 | ||
| The Lived Experience | 397 | ||
| Grief Work | 398 | ||
| A Loss Response Model | 398 | ||
| Types of Grief | 399 | ||
| Anticipatory Grief | 400 | ||
| Acute Grief | 400 | ||
| Shadow Grief | 400 | ||
| Complicated Grief | 400 | ||
| Disenfranchised Grief | 401 | ||
| Factors Affecting Coping With Loss | 401 | ||
| Implications for Gerontological Nursing and Healthy Aging | 402 | ||
| Assessment | 402 | ||
| Interventions | 402 | ||
| Countercoping | 403 | ||
| Clarification and control. | 403 | ||
| Collaboration. | 404 | ||
| Directed relief. | 404 | ||
| Cooling off. | 404 | ||
| Dying, Death, and Palliative Care | 404 | ||
| The Family | 404 | ||
| Implications for Gerontological Nursing and Healthy Aging | 405 | ||
| The Six C’s Approach | 405 | ||
| Care | 406 | ||
| Control | 406 | ||
| Composure | 406 | ||
| Communication | 406 | ||
| Continuity | 407 | ||
| Closure | 407 | ||
| Dying and the Nurse | 407 | ||
| Palliative Care | 409 | ||
| Hospice | 409 | ||
| Decision-Making at the End of Life | 410 | ||
| Advance Directives | 410 | ||
| Euthanasia, Assisted Suicide, and Aid-in-Dying | 411 | ||
| Key Concepts | 412 | ||
| Activities and Discussion Questions | 412 | ||
| References | 413 | ||
| Index | 415 | ||
| A | 415 | ||
| B | 417 | ||
| C | 417 | ||
| D | 419 | ||
| E | 420 | ||
| F | 420 | ||
| G | 421 | ||
| H | 422 | ||
| I | 422 | ||
| J | 423 | ||
| K | 423 | ||
| L | 423 | ||
| M | 423 | ||
| N | 424 | ||
| O | 426 | ||
| P | 426 | ||
| Q | 427 | ||
| R | 428 | ||
| S | 428 | ||
| T | 429 | ||
| U | 430 | ||
| V | 430 | ||
| W | 430 | ||
| X | 430 | ||
| Y | 430 | ||
| Z | 430 |