BOOK
Ebersole and Hess' Gerontological Nursing and Healthy Aging in Canada - E-Book
Theris A. Touhy | Kathleen F Jett | Veronique Boscart | Lynn McCleary
(2018)
Additional Information
Book Details
Abstract
Equip yourself with the skills to meet the needs of an aging Canadian population. Ebersole and Hess’ Gerontological Nursing and Healthy Aging in Canada, Second Edition is a concise, gerontological nursing text that follows a wellness-based, holistic approach to older adult care. Featuring the most up-to-date CGNA guidelines, this new edition identifies potential problems and gives you the means to address complications, alleviate discomfort, and assist older adults to help them lead healthy lives. Plus, it contains a variety of learning features that focus your attention on statistics, legislation, practice guidelines, standards of care, and examples relevant to Canadian practice.
- Focus on health and wellness throughout the book highlights all aspects of the aging process.
- Core competencies identified by the CGNA integrated throughout book.
- Careful attention to age, cultural, and gender differences are integrated throughout book to help you care for different population groups.
- Expanded assessment guidelines and tools incorporated throughout as tables, boxes, and forms, including the latest scales and guidelines for proper health assessment.
- Activities and discussion questions at the end of every chapter ensure you understand the material and know how to use it in clinical situations.
- NEW! Enhanced coverage regarding the safety of nurses and clients emphasizes important information for you to consider while working in a clinical setting.
- NEW! UNIQUE! Latest CGNA guidelines/standards included to ensure you have access to the most up-to-date knowledge and understanding of gerontological nursing.
- NEW! Additional coverage on disease process and treatment for the older adult covers current findings on timely issues.
- NEW! Evidence-informed Practice boxes summarize research findings that confirm effective practices and identify practices with unknown, ineffective or harmful effects.
- NEW! UNIQUE! Gerontology coverage adequately addresses questions on the NCLEX®-RN.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Ebersole and Hess' Gerontological Nursing and Healthy Aging in Canada | i | ||
| Copyright Page | ii | ||
| Dedication | iii | ||
| Table Of Contents | v | ||
| Reviewers | ix | ||
| Preface | xi | ||
| Organization | xi | ||
| New to This Edition | xi | ||
| Ancillaries | xii | ||
| For Instructors | xii | ||
| For Students | xii | ||
| Acknowledgements | xiii | ||
| I Foundations of Healthy Aging | 1 | ||
| 1 Introduction to Healthy Aging | 1 | ||
| Learning Objectives | 1 | ||
| Glossary | 1 | ||
| The Lived Experience | 1 | ||
| Aging in Canada | 2 | ||
| Global Aging | 3 | ||
| Health, Wellness, and Aging | 4 | ||
| Promoting Healthy Aging | 6 | ||
| Primary Health Care Principles | 6 | ||
| Implications for Gerontological Nursing and Healthy Aging | 7 | ||
| Key Concepts | 8 | ||
| Activities and Discussion Questions | 8 | ||
| Resources | 8 | ||
| References | 8 | ||
| 2 Gerontological Nursing History, Education, and Roles | 10 | ||
| Learning Objectives | 10 | ||
| Glossary | 10 | ||
| The Lived Experience | 11 | ||
| Care of Older Persons: a Nursing Imperative | 11 | ||
| History of Gerontological Nursing | 11 | ||
| Standards of Gerontological Nursing Practice | 15 | ||
| Certification | 16 | ||
| Gerontological Nursing Education | 16 | ||
| Roles in Gerontological Nursing | 17 | ||
| Specialist Roles | 18 | ||
| Generalist Roles | 18 | ||
| Hospital-Based Care | 18 | ||
| Community- and Home-Based Care | 19 | ||
| Long-Term Care | 19 | ||
| Health Care Aides | 20 | ||
| Gerontological Nursing and Gerontology Organizations | 21 | ||
| Implications for Gerontological Nursing and Healthy Aging | 21 | ||
| Key Concepts | 22 | ||
| Activities and Discussion Questions | 22 | ||
| Resources | 22 | ||
| References | 23 | ||
| 3 Communicating With Older Persons | 25 | ||
| Learning Objectives | 25 | ||
| Glossary | 25 | ||
| the Lived Experience | 25 | ||
| Ageism and Communication | 26 | ||
| Implications for Gerontological Nursing and Healthy Aging | 27 | ||
| Communication With Older Persons With Sensory Impairments | 27 | ||
| Hearing Impairment | 28 | ||
| Cerumen Impaction | 29 | ||
| Hearing Aids | 29 | ||
| Cochlear Implants | 30 | ||
| Assistive Listening and Adaptive Devices | 30 | ||
| Implications for Gerontological Nursing and Healthy Aging | 30 | ||
| Vision Impairment | 31 | ||
| Low-Vision Assistive Devices | 32 | ||
| Implications for Gerontological Nursing and Healthy Aging | 33 | ||
| Communication With Older Persons With Neurological Disorders | 33 | ||
| Aphasia | 33 | ||
| Alternative and Augmentative Speech Aids | 34 | ||
| Dysarthria | 35 | ||
| Implications for Gerontological Nursing and Healthy Aging | 35 | ||
| Communication With Older Persons With Cognitive Impairment | 36 | ||
| Implications for Gerontological Nursing and Healthy Aging | 38 | ||
| the Life Story | 39 | ||
| Reminiscing | 39 | ||
| Life Review | 40 | ||
| Implications for Gerontological Nursing and Healthy Aging | 41 | ||
| Communication With Groups of Older Persons | 41 | ||
| Group Structure and Special Considerations for Groups of Older Persons | 42 | ||
| Reminiscing and Storytelling With Individuals Experiencing Cognitive Impairment | 42 | ||
| Summary | 43 | ||
| Key Concepts | 43 | ||
| Activities and Discussion Questions | 44 | ||
| Resources | 44 | ||
| References | 44 | ||
| 4 Culture, Ethnicity, and Aging | 47 | ||
| Learning Objectives | 47 | ||
| Glossary | 47 | ||
| The Lived Experience | 48 | ||
| The Gerontological Explosion | 48 | ||
| Health Disparities | 49 | ||
| Reducing Health Disparities | 51 | ||
| Increasing Cultural Competence | 52 | ||
| Cultural Awareness | 52 | ||
| Cultural Knowledge | 53 | ||
| Western or Biomedical System | 54 | ||
| Personalistic or Magico-Religious System | 54 | ||
| Naturalistic or Holistic Health System | 54 | ||
| Cultural Skills | 55 | ||
| Working With Interpreters | 55 | ||
| Implications for Gerontological Nursing and Healthy Aging | 56 | ||
| Cross-Cultural Caring and Long-Term Care | 58 | ||
| Key Concepts | 59 | ||
| Activities and Discussion Questions | 59 | ||
| Resources | 59 | ||
| General | 59 | ||
| Residential Schools | 60 | ||
| References | 60 | ||
| 5 Nursing Documentation | 63 | ||
| Learning Objectives | 63 | ||
| Glossary | 63 | ||
| The Lived Experience | 63 | ||
| Documentation | 64 | ||
| Documentation Across Care Settings | 64 | ||
| Acute Care Setting | 64 | ||
| Residential Care Settings | 65 | ||
| Resident Assessment Instrument | 66 | ||
| Home Care | 66 | ||
| Implications for Gerontological Nursing and Healthy Aging | 66 | ||
| Key Concepts | 67 | ||
| Activities and Discussion Questions | 67 | ||
| Resources | 67 | ||
| References | 68 | ||
| II Changes of Aging | 69 | ||
| 6 Biological Theories and Physical Changes of Aging | 69 | ||
| Learning Objectives | 69 | ||
| Glossary | 69 | ||
| The Lived Experience | 69 | ||
| Biological Theories of Aging | 70 | ||
| Error (Stochastic) Theories | 70 | ||
| Wear-and-Tear Theory | 70 | ||
| Cross-Link Theory | 70 | ||
| Oxidative Stress (Free-Radical) Theory) | 71 | ||
| Programmed Aging (Nonstochastic) Theories | 71 | ||
| Neuroendocrine-Immunological Theory | 71 | ||
| Physical Changes of Aging | 71 | ||
| Integument | 71 | ||
| Epidermis | 72 | ||
| Dermis | 72 | ||
| Hypodermis | 72 | ||
| Hair and Nails | 73 | ||
| Musculo-Skeletal System | 73 | ||
| Structure, Posture, and Body Composition | 74 | ||
| Cardiovascular System | 75 | ||
| Cardiac Changes | 75 | ||
| Blood Vessels | 76 | ||
| Respiratory System | 76 | ||
| Renal System | 77 | ||
| Endocrine System | 78 | ||
| Pancreas Function | 78 | ||
| Thyroid Function | 78 | ||
| Reproductive System | 78 | ||
| Female Reproductive System | 78 | ||
| Male Reproductive System | 79 | ||
| Gastrointestinal System | 79 | ||
| Mouth | 79 | ||
| Esophagus | 79 | ||
| Stomach | 80 | ||
| Intestines | 80 | ||
| Accessory Organs | 80 | ||
| Neurological System | 80 | ||
| Central Nervous System | 81 | ||
| Peripheral Nervous System | 82 | ||
| Sensory Changes | 82 | ||
| Eyes and Vision. | 82 | ||
| Extraocular Changes. | 82 | ||
| Ocular Changes. | 83 | ||
| Intraocular Changes. | 83 | ||
| Ears and Hearing. | 83 | ||
| Immune System | 84 | ||
| Evidence-Informed Practice: Smoking Cessation | 85 | ||
| Summary | 85 | ||
| Key Concepts | 86 | ||
| Activities and Discussion Questions | 86 | ||
| Resources | 86 | ||
| References | 86 | ||
| 7 Social, Psychological, Spiritual, and Cognitive Aspects of Aging | 89 | ||
| Learning Objectives | 89 | ||
| Glossary | 89 | ||
| The Lived Experience | 89 | ||
| Social, Psychological, Spiritual, and Cognitive Aspects Of Aging | 90 | ||
| Lifespan Development and Life-Course Approaches | 90 | ||
| Types of Aging | 90 | ||
| Sociological Theories of Aging | 91 | ||
| Disengagement Theory | 91 | ||
| Activity Theory | 91 | ||
| Continuity Theory | 92 | ||
| Age-Stratification Theory | 92 | ||
| Social Exchange Theory | 92 | ||
| Modernization Theory | 93 | ||
| Symbolic Interaction Theories | 93 | ||
| Implications for Gerontological Nursing and Healthy Aging | 93 | ||
| Psychological Theories of Aging | 93 | ||
| Jung’s Theories of Personality | 94 | ||
| Developmental Theories | 94 | ||
| Theory of Gerotranscendence | 95 | ||
| Implications for Gerontological Nursing and Healthy Aging | 95 | ||
| Spirituality and Aging | 96 | ||
| Implications for Gerontological Nursing and Healthy Aging | 97 | ||
| Assessment | 97 | ||
| Interventions | 98 | ||
| Cognition and Aging | 98 | ||
| Fluid and Crystallized Intelligence | 99 | ||
| Memory | 99 | ||
| Implications for Gerontological Nursing and Healthy Aging | 100 | ||
| Learning in Late Life | 100 | ||
| Health Literacy | 100 | ||
| Implications for Gerontological Nursing and Healthy Aging | 102 | ||
| Key Concepts | 103 | ||
| Activities and Discussion Questions | 103 | ||
| Resources | 103 | ||
| References | 103 | ||
| 8 Nutritional Needs | 106 | ||
| Learning Objectives | 106 | ||
| Glossary | 106 | ||
| The Lived Experience | 106 | ||
| Nutrition | 106 | ||
| Nutrition-Related Concerns for Older Persons | 107 | ||
| Age-Related Concerns | 108 | ||
| Taste. | 108 | ||
| Smell. | 108 | ||
| Digestive System. | 108 | ||
| Regulation of Appetite. | 108 | ||
| Nutritional Needs | 108 | ||
| Lifelong Eating Habits | 109 | ||
| Socialization | 110 | ||
| Income | 110 | ||
| Transportation | 111 | ||
| Housing | 111 | ||
| Malnutrition | 111 | ||
| Oral Health | 112 | ||
| Age-Related Changes of the Buccal Cavity | 113 | ||
| Xerostomia | 113 | ||
| Oral Cancer | 113 | ||
| Implications for Gerontological Nursing and Healthy Aging | 114 | ||
| Assessment | 114 | ||
| Interventions | 114 | ||
| Dentures | 116 | ||
| Health Conditions Affecting Nutrition | 117 | ||
| Chronic Diseases | 117 | ||
| Dementia | 117 | ||
| Dysphagia | 117 | ||
| Implications for Gerontological Nursing and Healthy Aging | 118 | ||
| Assessment | 118 | ||
| Interventions | 118 | ||
| Constipation | 119 | ||
| Fecal Impaction. | 119 | ||
| Implications for Gerontological Nursing and Healthy Aging | 121 | ||
| Assessment | 121 | ||
| Interventions | 121 | ||
| Exercise | 122 | ||
| Positioning | 122 | ||
| Regularity | 122 | ||
| Laxatives | 122 | ||
| Enemas | 122 | ||
| Older Persons in Hospitals and Institutions | 123 | ||
| Implications for Gerontological Nursing and Healthy Aging | 125 | ||
| Assessment | 125 | ||
| Interview | 125 | ||
| Diet Histories. | 125 | ||
| Physical Examination | 126 | ||
| Anthropometrical Measurements | 126 | ||
| Biochemical Examination | 126 | ||
| Interventions | 126 | ||
| Pharmacological Therapy | 126 | ||
| Patient and Family Education | 127 | ||
| Enteral Feeding | 127 | ||
| Summary | 128 | ||
| Key Concepts | 128 | ||
| Activities and Discussion Questions | 129 | ||
| Resources | 129 | ||
| Nutrition | 129 | ||
| Oral Health | 129 | ||
| Constipation | 129 | ||
| References | 129 | ||
| 9 Hydration and Continence | 133 | ||
| Learning Objectives | 133 | ||
| Glossary | 133 | ||
| The Lived Experience | 133 | ||
| Hydration | 133 | ||
| Hydration Management | 133 | ||
| Dehydration | 134 | ||
| Risk Factors for Dehydration | 134 | ||
| Implications for Gerontological Nursing and Healthy Aging | 135 | ||
| Assessment | 135 | ||
| Interventions | 135 | ||
| Urinary Continence | 136 | ||
| Bladder Function | 136 | ||
| Age-Related Changes in Bladder Function | 136 | ||
| Urinary Incontinence | 136 | ||
| Epidemiology of Urinary Incontinence | 137 | ||
| Consequences of Urinary Incontinence | 137 | ||
| Risk Factors for Urinary Incontinence | 138 | ||
| Types of Urinary Incontinence | 138 | ||
| Implications for Gerontological Nursing and Healthy Aging | 139 | ||
| Assessment | 139 | ||
| Interventions | 140 | ||
| Behavioural | 140 | ||
| Lifestyle Modifications | 143 | ||
| Absorbent Products | 143 | ||
| Urinary Catheters | 143 | ||
| Pharmacological | 144 | ||
| Nonsurgical Devices | 144 | ||
| Surgical | 145 | ||
| Fecal and Bowel Incontinence | 145 | ||
| Implications for Gerontological Nursing and Healthy Aging | 145 | ||
| Assessment | 145 | ||
| Interventions | 146 | ||
| Summary | 147 | ||
| Key Concepts | 147 | ||
| Activities and Discussion Questions | 147 | ||
| Resources | 147 | ||
| References | 148 | ||
| 10 Rest, Sleep, and Activity | 150 | ||
| Learning Objectives | 150 | ||
| Glossary | 150 | ||
| The Lived Experience | 150 | ||
| Rest and Sleep | 151 | ||
| Sleep Disorders | 152 | ||
| Insomnia | 152 | ||
| Sleep Apnea | 153 | ||
| Restless Legs Syndrome | 154 | ||
| Rapid Eye Movement Sleep Behaviour Disorder | 155 | ||
| Implications for Gerontological Nursing and Healthy Aging | 155 | ||
| Sleep Assessment | 155 | ||
| Interventions | 155 | ||
| Nonpharmacological Interventions | 155 | ||
| Pharmacological Interventions | 157 | ||
| Activity | 157 | ||
| Implications for Gerontological Nursing and Healthy Aging | 158 | ||
| Assessment | 158 | ||
| Interventions | 158 | ||
| Exercise Prescription | 159 | ||
| Summary | 159 | ||
| Key Concepts | 160 | ||
| Activities and Discussion Questions | 160 | ||
| Resources | 161 | ||
| References | 161 | ||
| 11 Promoting Healthy Skin and Feet | 163 | ||
| Learning Objectives | 163 | ||
| Glossary | 163 | ||
| The Lived Experience | 163 | ||
| Integument | 163 | ||
| Common Skin Problems | 164 | ||
| Xerosis | 164 | ||
| Pruritus | 164 | ||
| Herpes Zoster | 164 | ||
| Implications for Gerontological Nursing and Healthy Aging | 165 | ||
| Xerosis | 165 | ||
| Pruritus | 165 | ||
| Herpes Zoster | 166 | ||
| Premalignant Conditions of the Skin | 166 | ||
| Keratoses | 166 | ||
| Photodamage to the Skin | 167 | ||
| Skin Cancers | 167 | ||
| Basal Cell Carcinoma | 167 | ||
| Squamous Cell Carcinoma | 167 | ||
| Melanoma | 168 | ||
| Implications for Gerontological Nursing and Healthy Aging | 168 | ||
| Skin Problems Associated With Cardiovascular Problems | 169 | ||
| Arterial Insufficiency | 169 | ||
| Venous Insufficiency | 169 | ||
| Implications for Gerontological Nursing and Healthy Aging | 169 | ||
| Skin Problems of Particular Concern for Persons With Limited Mobility | 170 | ||
| Candidiasis | 170 | ||
| Pressure Injuries | 171 | ||
| Risk Factors | 172 | ||
| Implications for Gerontological Nursing and Healthy Aging | 172 | ||
| Assessment | 172 | ||
| Pressure Injury Classification | 175 | ||
| Interventions | 175 | ||
| Healthy Feet | 177 | ||
| Common Foot Problems | 177 | ||
| Corns and Calluses | 177 | ||
| Bunions | 177 | ||
| Hammer Toes | 178 | ||
| Fungal Infections | 178 | ||
| Implications for Gerontological Nursing and Healthy Aging | 178 | ||
| Care of Toenails | 179 | ||
| Summary | 180 | ||
| Key Concepts | 180 | ||
| Activities and Discussion Questions | 180 | ||
| Resources | 180 | ||
| References | 181 | ||
| 12 Maintaining Mobility and Environmental Safety | 182 | ||
| Learning Objectives | 182 | ||
| Glossary | 182 | ||
| The Lived Experience | 182 | ||
| Mobility | 182 | ||
| Age-Related Changes in Mobility and Agility | 183 | ||
| Disorders Affecting Mobility | 183 | ||
| Falls | 183 | ||
| Falls: a Significant Geriatric Syndrome | 184 | ||
| Factors Contributing to Falls | 184 | ||
| Implications for Gerontological Nursing and Healthy Aging | 185 | ||
| Assessment | 185 | ||
| Assessment of Fall Risk | 185 | ||
| Environmental Assessment | 187 | ||
| Assessment After a Fall Has Occurred | 187 | ||
| Restraints | 187 | ||
| Side Rails | 192 | ||
| Fall Prevention and Reduction | 192 | ||
| Fall Reduction Interventions | 192 | ||
| Exercise | 194 | ||
| Environmental Modifications | 194 | ||
| Medication Review | 194 | ||
| Behaviour and Education Programs | 194 | ||
| Assistive Devices | 194 | ||
| Other Interventions | 195 | ||
| Environmental Safety | 195 | ||
| Vulnerability to Environmental Temperatures | 195 | ||
| Hyperthermia | 196 | ||
| Hypothermia | 196 | ||
| Implications for Gerontological Nursing and Healthy Aging | 198 | ||
| Transportation | 198 | ||
| Driving | 199 | ||
| Implications for Gerontological Nursing and Healthy Aging | 200 | ||
| Key Concepts | 200 | ||
| Activities and Discussion Questions | 201 | ||
| Resources | 201 | ||
| References | 201 | ||
| 13 Assessment Tools in Gerontological Nursing | 204 | ||
| Learning Objectives | 204 | ||
| Glossary | 204 | ||
| The Lived Experience | 204 | ||
| Assessing Older Persons | 204 | ||
| Gerontological Assessment | 205 | ||
| Data Collection | 205 | ||
| Health Assessment | 206 | ||
| Health History | 206 | ||
| Physical Assessment | 206 | ||
| Comprehensive Assessment for the Frail and Medically Complex Older Person | 206 | ||
| Functional Assessment | 206 | ||
| Performance Tests | 210 | ||
| Mental Status Assessment | 210 | ||
| Cognitive Measures | 210 | ||
| Mini-Mental State Examination. | 210 | ||
| Clock Drawing Test. | 210 | ||
| Mini-Cog. | 210 | ||
| Montreal Cognitive Assessment. | 210 | ||
| Cognitive Performance Scale | 212 | ||
| Delirium Index | 212 | ||
| Mood Measures | 212 | ||
| Geriatric Depression Scale. | 212 | ||
| Cornell Scale for Depression in Dementia. | 213 | ||
| Assessment of Social Supports | 213 | ||
| Caregiver Burden | 214 | ||
| Environmental and Safety Assessment | 215 | ||
| Integrated Assessments | 215 | ||
| Older American’s Resources and Service | 215 | ||
| Social Resources. | 215 | ||
| Economic Resources. | 215 | ||
| Mental Health. | 215 | ||
| Physical Health. | 215 | ||
| Activities of Daily Living. | 215 | ||
| Fulmer SPICES | 216 | ||
| Summary | 216 | ||
| Key Concepts | 216 | ||
| Activities and Discussion Questions | 216 | ||
| Resources | 216 | ||
| References | 217 | ||
| 14 Safe Medication Use for Older Persons | 219 | ||
| Learning Objectives | 219 | ||
| Glossary | 219 | ||
| The Lived Experience | 220 | ||
| Medication Use for Older Persons | 220 | ||
| Pharmacokinetics | 220 | ||
| Absorption | 220 | ||
| Distribution | 222 | ||
| Metabolism | 222 | ||
| Excretion | 224 | ||
| Pharmacodynamics | 224 | ||
| Chronopharmacology | 224 | ||
| Medication Issues for Older Persons | 225 | ||
| Polypharmacy | 225 | ||
| Medication Interactions | 226 | ||
| Adverse Drug Reactions | 226 | ||
| Misuse of Medications | 228 | ||
| Implications for Gerontological Nursing and Healthy Aging | 229 | ||
| Assessment | 229 | ||
| Monitoring and Evaluation | 229 | ||
| Patient Education | 230 | ||
| Medication Administration | 231 | ||
| Psychotropic Medications | 232 | ||
| Psychotropic Medication for Older Persons | 232 | ||
| Antidepressants | 233 | ||
| Anti-Anxiety Agents | 234 | ||
| Antipsychotics | 234 | ||
| Movement Disorders | 235 | ||
| Acute Dystonia. | 235 | ||
| Akathisia. | 236 | ||
| Parkinsonian Symptoms. | 236 | ||
| Tardive Dyskinesia. | 236 | ||
| Mood Stabilizers | 236 | ||
| Summary | 237 | ||
| Key Concepts | 237 | ||
| Activities and Discussion Questions | 237 | ||
| Resources | 238 | ||
| References | 238 | ||
| III Coping With Chronic Illness in Later Life | 240 | ||
| 15 Living With Chronic Illness | 240 | ||
| Learning Objectives | 240 | ||
| Glossary | 240 | ||
| The Lived Experience | 240 | ||
| Chronic Illness | 241 | ||
| Chronic Illness and Aging | 241 | ||
| Acute Versus Chronic Illness | 242 | ||
| Frailty Syndrome | 243 | ||
| Prevention of Chronic Illness | 243 | ||
| Care Delivery System | 244 | ||
| Theoretical Frameworks for Chronic Illness | 244 | ||
| Wellness in Chronic Illness | 244 | ||
| Chronic Illness Trajectory | 245 | ||
| The Shifting Perspectives Model of Chronic Illness | 245 | ||
| Implications for Gerontological Nursing and Healthy Aging | 247 | ||
| Assessment | 247 | ||
| Interventions | 248 | ||
| Caring | 248 | ||
| Special Considerations in Chronic Illness | 248 | ||
| Fatigue | 249 | ||
| Grieving | 249 | ||
| Fostering Self-Care | 250 | ||
| Rehabilitation and Restorative Care | 250 | ||
| Prevention of Iatrogenic Disturbances | 250 | ||
| Assistive Technology | 251 | ||
| Models of Chronic Illness Care | 252 | ||
| Small-Group Approaches to Chronic Illness | 252 | ||
| Summary | 253 | ||
| Key Concepts | 253 | ||
| Activities and Discussion Questions | 253 | ||
| Resources | 253 | ||
| References | 254 | ||
| 16 Pain and Comfort | 256 | ||
| Learning Objectives | 256 | ||
| Glossary | 256 | ||
| The Lived Experience | 256 | ||
| Communication of Pain and Discomfort | 257 | ||
| Acute and Persistent Pain | 257 | ||
| Acute Pain | 257 | ||
| Persistent Pain | 257 | ||
| Osteoarthritis | 258 | ||
| Herpes Zoster | 259 | ||
| Implications for Gerontological Nursing and Healthy Aging | 259 | ||
| Assessment | 259 | ||
| Interventions | 260 | ||
| Nonpharmacological Measures for Pain Relief | 264 | ||
| Physical Approaches | 264 | ||
| Touch. | 264 | ||
| Cutaneous Nerve Stimulation. | 264 | ||
| Transcutaneous Electrical Nerve Stimulation. | 264 | ||
| Cognitive-Behavioural Approaches | 265 | ||
| Biofeedback. | 265 | ||
| Distraction. | 265 | ||
| Relaxation, Meditation, and Imagery. | 265 | ||
| Pharmacological Interventions for Pain Relief | 266 | ||
| Non-narcotic Analgesics. | 266 | ||
| Narcotic Analgesics. | 266 | ||
| Evaluation | 267 | ||
| Summary | 267 | ||
| Key Concepts | 267 | ||
| Activities and Discussion Questions | 268 | ||
| Resources | 268 | ||
| References | 268 | ||
| 17 Diabetes Mellitus | 270 | ||
| Learning Objectives | 270 | ||
| Glossary | 270 | ||
| The Lived Experience | 270 | ||
| Diabetes | 271 | ||
| Complications | 272 | ||
| Treatment and Goals | 272 | ||
| Implications for Gerontological Nursing and Healthy Aging | 273 | ||
| Assessment | 273 | ||
| Management | 273 | ||
| Standards of Care | 274 | ||
| Nutrition | 275 | ||
| Exercise | 275 | ||
| Medications | 276 | ||
| Long-Term Care and the Older Person With Diabetes | 277 | ||
| Summary | 277 | ||
| Key Concepts | 278 | ||
| Activities and Discussion Questions | 278 | ||
| Resources | 278 | ||
| References | 279 | ||
| 18 Bone and Joint Health | 280 | ||
| Learning Objectives | 280 | ||
| Glossary | 280 | ||
| The Lived Experience | 280 | ||
| Musculo-Skeletal System | 280 | ||
| Osteoporosis | 281 | ||
| Reducing Osteoporosis-Related Risks and Injury | 281 | ||
| Pharmacological Interventions. | 282 | ||
| Arthritis | 283 | ||
| Osteoarthritis | 284 | ||
| Polymyalgia Rheumatica | 284 | ||
| Rheumatoid Arthritis | 285 | ||
| Gout | 286 | ||
| Implications for Gerontological Nursing and Healthy Aging | 287 | ||
| Assessment | 287 | ||
| Interventions | 287 | ||
| Complementary and Alternative Interventions for Osteoarthritis | 288 | ||
| Summary | 288 | ||
| Key Concepts | 288 | ||
| Activities and Discussion Questions | 289 | ||
| Resources | 289 | ||
| References | 289 | ||
| 19 Visual and Auditory Changes | 291 | ||
| Learning Objectives | 291 | ||
| Glossary | 291 | ||
| The Lived Experience | 291 | ||
| Age-Related Changes in Vision | 292 | ||
| Diseases Affecting Vision | 292 | ||
| Glaucoma | 292 | ||
| Assessment | 293 | ||
| Interventions | 294 | ||
| Cataracts | 294 | ||
| Assessment | 295 | ||
| Interventions | 295 | ||
| Macular Degeneration | 295 | ||
| Assessment | 296 | ||
| Interventions | 296 | ||
| Diabetic Retinopathy | 297 | ||
| Assessment | 297 | ||
| Interventions | 297 | ||
| Auditory Impairment and Loss | 298 | ||
| Tinnitus | 298 | ||
| Assessment | 298 | ||
| Interventions | 298 | ||
| Prelingual Deafness | 298 | ||
| Implications for Gerontological Nursing and Healthy Aging | 299 | ||
| Summary | 299 | ||
| Key Concepts | 299 | ||
| Activities and Discussion Questions | 300 | ||
| Resources | 300 | ||
| References | 301 | ||
| 20 Cardio-Vascular and Respiratory Disorders | 302 | ||
| Learning Objectives | 302 | ||
| Glossary | 302 | ||
| The Lived Experience | 302 | ||
| Cardio-Vascular Disorders | 303 | ||
| Hypertension | 303 | ||
| Coronary Heart Disease | 305 | ||
| Heart Failure | 305 | ||
| Implications for Gerontological Nursing and Healthy Aging | 306 | ||
| Assessment | 306 | ||
| Interventions | 306 | ||
| Respiratory Disorders | 307 | ||
| Chronic Obstructive Pulmonary Disease | 308 | ||
| Pneumonia | 308 | ||
| Influenza | 309 | ||
| Implications for Gerontological Nursing and Healthy Aging | 310 | ||
| Assessment | 310 | ||
| Interventions | 310 | ||
| Interdisciplinary Care | 311 | ||
| Tuberculosis | 312 | ||
| Implications for Gerontological Nursing and Healthy Aging | 313 | ||
| Key Concepts | 314 | ||
| Activities and Discussion Questions | 314 | ||
| Resources | 314 | ||
| References | 315 | ||
| 21 Cognitive Impairment and Neurological Disorders | 317 | ||
| Learning Objectives | 317 | ||
| Glossary | 317 | ||
| The Lived Experience | 318 | ||
| Cognitive Impairment | 318 | ||
| The Three D’s | 318 | ||
| Cognitive Assessment | 319 | ||
| Screening for Cognitive Impairment | 320 | ||
| Considerations in Cognitive Assessment | 321 | ||
| Delirium | 321 | ||
| Etiology | 321 | ||
| Incidence and Prevalence | 321 | ||
| Recognition of Delirium | 322 | ||
| Risk Factors for Delirium | 322 | ||
| Clinical Subtypes of Delirium | 323 | ||
| Consequences of Delirium | 324 | ||
| Implications for Gerontological Nursing and Healthy Aging | 324 | ||
| Assessment | 324 | ||
| Interventions | 324 | ||
| Nonpharmacological | 325 | ||
| Pharmacological | 326 | ||
| Overview of Dementia | 326 | ||
| Types of Dementia | 327 | ||
| Incidence and Prevalence | 328 | ||
| Alzheimer’s Disease | 328 | ||
| Diagnosis of Alzheimer’s Disease | 330 | ||
| Preclinical Stage. | 330 | ||
| Mild Cognitive Impairment. | 330 | ||
| Alzheimer’s Disease. | 330 | ||
| Cultural Differences | 331 | ||
| Pharmacological Treatment | 332 | ||
| Vascular Dementia | 332 | ||
| Lewy Body Dementia | 333 | ||
| Frontotemporal Dementia | 333 | ||
| Implications for Gerontological Nursing and Healthy Aging | 333 | ||
| Person-Centred Care | 333 | ||
| Behaviour Concerns and Nursing Models of Care for Persons With Dementia | 334 | ||
| Progressively Lowered Stress Threshold Model | 335 | ||
| Need-Driven Dementia-Compromised Behaviour Model | 335 | ||
| Recognition of Retained Abilities Approach | 336 | ||
| Relating Well | 336 | ||
| Implications for Gerontological Nursing and Healthy Aging | 336 | ||
| Assessment | 336 | ||
| Interventions | 337 | ||
| Nonpharmacological Approaches | 338 | ||
| Activities of Daily Living | 338 | ||
| Bathing. | 338 | ||
| Wandering. | 339 | ||
| Family Caregiving for Persons With Dementia | 340 | ||
| Cerebro-Vascular Disease | 342 | ||
| Etiology | 342 | ||
| Ischemic Events | 342 | ||
| Hemorrhagic Events | 342 | ||
| Signs and Symptoms of Cerebro-Vascular Disease | 343 | ||
| Complications | 343 | ||
| Management | 343 | ||
| Implications for Gerontological Nursing and Healthy Aging | 344 | ||
| Parkinson’s Disease | 345 | ||
| Etiology | 345 | ||
| Signs and Symptoms of Parkinson’s Disease | 345 | ||
| Management | 347 | ||
| Implications for Gerontological Nursing and Healthy Aging | 347 | ||
| Summary | 348 | ||
| Key Concepts | 350 | ||
| Activities and Discussion Questions | 350 | ||
| Resources | 351 | ||
| References | 351 | ||
| IV Caring for Older Persons and Their Caregivers | 356 | ||
| 22 Economic and Legal Issues | 356 | ||
| Learning Objectives | 356 | ||
| Glossary | 356 | ||
| The Lived Experience | 356 | ||
| The Canadian Health Care System | 357 | ||
| The Canada Health Act | 357 | ||
| Health Care Financing | 357 | ||
| Social Security Retirement Income Programs | 359 | ||
| Old Age Security Program | 359 | ||
| Old Age Security Pension | 359 | ||
| Guaranteed Income Supplement | 359 | ||
| Allowance and Allowance for the Survivor | 359 | ||
| Canada Pension Plan and Quebec Pension Plan | 360 | ||
| Financing OAS, CPP, and QPP | 360 | ||
| Implications for Gerontological Nursing and Healthy Aging | 361 | ||
| Health Care and Services for Veterans | 362 | ||
| War Veterans Allowance and Disability Pension | 362 | ||
| Veterans Health Care Program | 363 | ||
| Veterans Independence Program. | 363 | ||
| Health Care Benefits. | 363 | ||
| Long-Term Care. | 363 | ||
| Implications for Gerontological Nursing and Healthy Aging | 363 | ||
| Legal Issues in Gerontological Nursing | 364 | ||
| Mental Capacity | 364 | ||
| Power of Attorney | 364 | ||
| Guardians | 365 | ||
| Implications for Gerontological Nursing and Healthy Aging | 365 | ||
| Abuse, Mistreatment, and Neglect of Older Persons | 365 | ||
| Institutional Abuse | 368 | ||
| Implications for Gerontological Nursing and Healthy Aging | 369 | ||
| Assessment | 369 | ||
| Intervention | 369 | ||
| Prevention | 370 | ||
| Addressing Abuse and Preventing Recurrence | 371 | ||
| Criminal Code and Reporting | 371 | ||
| Preventing Institutional Abuse | 371 | ||
| Summary | 372 | ||
| Key Concepts | 372 | ||
| Activities and Discussion Questions | 372 | ||
| Resources | 373 | ||
| References | 373 | ||
| 23 Relationships, Roles, and Transitions | 376 | ||
| Learning Objectives | 376 | ||
| Glossary | 376 | ||
| The Lived Experience | 376 | ||
| Relationships, Roles, and Transitions | 377 | ||
| Families | 377 | ||
| Traditional Couples | 378 | ||
| Divorce | 378 | ||
| Nontraditional Couples | 378 | ||
| Older People and Their Adult Children | 379 | ||
| Older Persons Who Have Never Married | 380 | ||
| Grandparenting | 380 | ||
| Siblings | 380 | ||
| Other Kin | 381 | ||
| Fictive Kin | 381 | ||
| Late-life Transitions | 381 | ||
| Retirement | 382 | ||
| Retirement Planning | 382 | ||
| Special Considerations in Retirement | 383 | ||
| Implications for Gerontological Nursing and Healthy Aging | 384 | ||
| Widows and Widowers | 384 | ||
| Implications for Gerontological Nursing and Healthy Aging | 385 | ||
| Assessment | 385 | ||
| Interventions | 386 | ||
| Caregiving | 386 | ||
| Impact of Caregiving | 387 | ||
| Spousal Caregiving | 389 | ||
| Aging Parents Caring for Developmentally Disabled Children | 390 | ||
| Grandparents Raising Grandchildren | 390 | ||
| Long-Distance Caregiving | 391 | ||
| Implications for Gerontological Nursing and Healthy Aging | 391 | ||
| Assessment | 391 | ||
| Family Assessment | 391 | ||
| Caregiver Assessment | 392 | ||
| Interventions | 392 | ||
| Intimacy and Sexuality | 394 | ||
| Intimacy | 394 | ||
| Sexuality | 394 | ||
| Sexual Health | 395 | ||
| Factors Influencing Sexual Health | 395 | ||
| Expectations. | 395 | ||
| Activity Levels. | 396 | ||
| Cohort and Cultural Influences. | 396 | ||
| Lesbian, Gay, Bisexual, Transgender, and Queer Older Persons. | 396 | ||
| Biological Changes With Age. | 397 | ||
| Sexual Dysfunction | 397 | ||
| Male Sexual Dysfunction. | 397 | ||
| Female Dysfunction. | 398 | ||
| Intimacy and Persistent Illness | 398 | ||
| Intimacy and Sexuality in Long-Term Care Homes | 399 | ||
| Intimacy, Sexuality, and Dementia | 401 | ||
| Sexually Transmitted Infections | 402 | ||
| Implications for Gerontological Nursing and Healthy Aging | 402 | ||
| Assessment | 403 | ||
| Interventions | 404 | ||
| Key Concepts | 404 | ||
| Activities and Discussion Questions | 405 | ||
| Resources | 405 | ||
| References | 405 | ||
| 24 Mental Health and Wellness in Later Life | 409 | ||
| Learning Objectives | 409 | ||
| Glossary | 409 | ||
| The Lived Experience | 409 | ||
| Mental Health and Mental Disorder in Later Life | 410 | ||
| Mental Health Care | 411 | ||
| Cultural and Ethnic Disparities | 411 | ||
| Assessment and Mental Illness | 412 | ||
| Anxiety Disorders | 412 | ||
| Prevalence | 413 | ||
| Implications for Gerontological Nursing and Healthy Aging | 413 | ||
| Assessment | 413 | ||
| Interventions | 414 | ||
| Nonpharmacological Interventions | 414 | ||
| Pharmacological Interventions | 415 | ||
| Obsessive-Compulsive Disorders | 415 | ||
| Post-Traumatic Stress Disorder | 415 | ||
| Implications for Gerontological Nursing and Healthy Aging | 416 | ||
| Assessment | 416 | ||
| Interventions | 417 | ||
| Psychosis and Psychotic Symptoms in Late Life | 417 | ||
| Paranoia | 417 | ||
| Delusions | 417 | ||
| Hallucinations | 417 | ||
| Implications for Gerontological Nursing and Healthy Aging | 418 | ||
| Assessment | 418 | ||
| Interventions | 418 | ||
| Schizophrenia | 419 | ||
| Implications for Gerontological Nursing and Healthy Aging | 419 | ||
| Assessment | 419 | ||
| Treatment | 419 | ||
| Bipolar Disorder and Mania | 420 | ||
| Implications for Gerontological Nursing and Healthy Aging | 420 | ||
| Depression | 420 | ||
| Prevalence and Consequences | 420 | ||
| Etiology and Risk Factors | 421 | ||
| Differing Presentation of Depression in Older Persons | 421 | ||
| Implications for Gerontological Nursing and Healthy Aging | 422 | ||
| Assessment | 422 | ||
| Interventions | 423 | ||
| Somatic Therapies and Medications | 423 | ||
| Suicide | 424 | ||
| Implications for Gerontological Nursing and Healthy Aging | 425 | ||
| Assessment | 425 | ||
| Interventions | 426 | ||
| Substance Use Disorders | 426 | ||
| Alcohol | 426 | ||
| Gender Issues | 428 | ||
| Medication Effects | 428 | ||
| Physiology | 428 | ||
| Other Substances | 428 | ||
| Illicit Drugs | 428 | ||
| Prescription and Over-the-Counter Medications | 429 | ||
| Implications for Gerontological Nursing and Healthy Aging | 429 | ||
| Assessment | 429 | ||
| Alcohol | 430 | ||
| Other Substances | 431 | ||
| Interventions | 431 | ||
| Acute Alcohol Withdrawal | 432 | ||
| Problem Gambling | 433 | ||
| Implications for Gerontological Nursing and Healthy Aging | 433 | ||
| Assessment | 433 | ||
| Interventions | 434 | ||
| Implications for Gerontological Nursing and Healthy Aging | 434 | ||
| Key Concepts | 434 | ||
| Activities and Discussion Questions | 435 | ||
| Resources | 435 | ||
| References | 436 | ||
| 25 Loss, Death, and Palliative Care | 439 | ||
| Learning Objectives | 439 | ||
| Glossary | 439 | ||
| The Lived Experience | 439 | ||
| The Grieving Process | 440 | ||
| Worden’s Model of Bereavement | 440 | ||
| Loss Response Model | 441 | ||
| Types of Grief | 441 | ||
| Anticipatory Grief | 441 | ||
| Acute Grief | 442 | ||
| Persistent or Complicated Grief | 442 | ||
| Disenfranchised Grief | 442 | ||
| Factors Affecting Coping With Loss | 443 | ||
| Implications for Gerontological Nursing and Healthy Aging | 444 | ||
| Assessment | 444 | ||
| Interventions | 444 | ||
| Countercoping | 445 | ||
| Clarification and Control | 445 | ||
| Collaboration | 445 | ||
| Directed Relief | 445 | ||
| Cooling Off | 446 | ||
| Dying, Death, and Palliative Care | 446 | ||
| Conceptual Models | 446 | ||
| The Living–Dying Interval | 446 | ||
| Implications for Gerontological Nursing and Healthy Aging | 447 | ||
| The Six C’s Approach | 448 | ||
| Care | 448 | ||
| Control | 449 | ||
| Composure | 449 | ||
| Communication | 449 | ||
| Continuity | 449 | ||
| Closure | 450 | ||
| Family | 450 | ||
| End-Of-Life Care Models in Canada | 450 | ||
| Hospice Palliative Care | 451 | ||
| The Nurse’s Role in Hospice Palliative Care | 453 | ||
| Dying and The Nurse | 453 | ||
| Decision Making at The End of Life | 454 | ||
| Advance Care Planning | 454 | ||
| Medical Assistance in Dying | 455 | ||
| Key Concepts | 456 | ||
| Activities and Discussion Questions | 456 | ||
| Resources | 456 | ||
| References | 457 | ||
| 26 Care Across the Continuum | 459 | ||
| Learning Objectives | 459 | ||
| Glossary | 459 | ||
| The Lived Experience | 459 | ||
| Age-Friendly Communities | 460 | ||
| Residential Options in Later Life | 460 | ||
| Independent Living Options | 462 | ||
| Social Housing | 462 | ||
| Life Lease | 462 | ||
| Adult Lifestyle Communities | 463 | ||
| Shared Housing | 463 | ||
| Cohabitation or Cohousing | 463 | ||
| Community Services for Aging in Place | 463 | ||
| Adult Day Services | 463 | ||
| Home and Community Care | 464 | ||
| Supported Living Options | 465 | ||
| Supportive Housing | 465 | ||
| Assisted-Living Facilities and Retirement Homes | 466 | ||
| Health Care Facility–Based Living Options | 467 | ||
| Long-Term Care Homes | 467 | ||
| Costs of Care | 467 | ||
| Regulations and Quality of Care | 467 | ||
| The Culture Change Movement in Long-Term Care Homes | 468 | ||
| Making LTC Home Decisions | 468 | ||
| Improving Transitions Across the Continuum of Care | 471 | ||
| Relocation | 472 | ||
| Implications for Gerontological Nursing and Healthy Aging | 473 | ||
| Key Concepts | 473 | ||
| Activities and Discussion Questions | 473 | ||
| Resources | 474 | ||
| World Health Organization (WHO) | 474 | ||
| References | 474 | ||
| Glossary | e1 | ||
| Index | 477 | ||
| A | 477 | ||
| B | 479 | ||
| C | 479 | ||
| D | 482 | ||
| E | 483 | ||
| F | 484 | ||
| G | 484 | ||
| H | 485 | ||
| I | 486 | ||
| J | 487 | ||
| K | 487 | ||
| L | 487 | ||
| M | 488 | ||
| N | 489 | ||
| O | 490 | ||
| P | 490 | ||
| Q | 491 | ||
| R | 491 | ||
| S | 492 | ||
| T | 493 | ||
| U | 494 | ||
| V | 494 | ||
| W | 494 | ||
| X | 495 | ||
| Z | 495 |