Table of Contents
Section 1 Foundations of Healthy Aging
1 Introduction to Healthy Aging 1
Aging in the United States 1
Healthy, Wellness, and Aging 2
Maslow's Hierarchy of Human Needs 4
2 Gerontological Nursing History, Education, and Roles 9
Gerontological Nursing: Growth of a Specialty 10
Gerontological Nursing Education 15
Roles in Gerontological Nursing 16
Gerontological Nursing and Gerontology Organizations 21
3 Communicating with Elders 25
Communicating with Elders: General Principles 25
Communication with Elders with Neurological Disorders 33
Communication with Elders with Cognitive Impairment 36
The Life Story 38
4 Culture and Aging 48
The Gerontological Explosion 49
Health Disparities 49
Increasing Cultural Competence 49
5 Documentation for Optimal Care 61
Documentation 61
Documentation Across Health Care Settings 62
Section 2 Changes of Aging
6 Theories and Physical Changes of Aging 66
Biological Theories of Aging 67
Physical Changes that Accompany Aging 68
7 Social, Psychological, Spiritual, and Cognitive Aspects of Aging 84
Social, Psychological, Spiritual, and Cognitive Aspects of Aging 85
Life Span Development Approach 85
Types of Aging 85
Sociological Theories of Aging 86
Psychological Theories of Aging 88
Spirituality and Aging 90
Cognition and Aging 91
Learning in Late Life 95
8 Nutritional Needs 101
Nutrition and Aging 101
Factors Affecting Fulfillment of Nutritional Needs in Aging 104
Health Conditions Affecting Nutrition 114
Malnutrition 121
9 Fluids and Continence 130
Fluids 131
Continence 133
10 Rest, Sleep, and Activity 148
Rest and Sleep 148
Activity 156
11 Promoting Healthy Skin andFeet 163
Integument 163
Healthy Feet 174
12 Maintaining Mobility and Environmental Safety 179
Mobility, Safety, and Satisfaction 179
Falls and Risk Reduction 181
Environmental Safety 196
13 Assessment Tools in Gerontological Nursing 205
Assessment Tools in Gerontological Nursing 205
14 Safe Medication Use for Older Adults 219
Pharmacokinetics 220
Pharmacodynamics 223
Chronopharmacology 225
Medication Issues and Older Adults 226
Psychotropic Medications 232
Section 3 Coping With Chronic Disorders In Late Life
15 Living with Chronic Illness 239
Chronic Illness 239
Theoretical Frameworks for Chronic Illness 244
16 Pain and Comfort 259
Acute and Persistent Pain 261
17 Diabetes Mellitus 272
Diabetes 272
18 Bone and Joint Problems 281
Musculoskeletal System 281
Osteoporosis 282
Arthritis 285
19 Diseases Affecting Vision and Hearing 291
Diseases Affecting Vision 292
Diseases of the Ear 299
20 Cardiac and Respiratory Disorders 303
Cardiovascular Disorders 304
Respiratory Disorders 309
21 Cognitive Impairment 317
Overview of Cognitive Impairment 318
Overview of Dementia 328
Caregiving for Persons with Dementia 348
Section 4 Caring For Elders And Their Caregivers
22 Economic and Legal Issues 355
Social Security 356
Medicare and Medicaid 357
Care for Veterans 360
Long-Term Care Insurance 361
Legal Issues in Gerontological Nursing 362
Elder Mistreatment and Neglect 364
Appendix 22-A The National Elder Abuse Incidence Study 371
Appendix 22-B Abuse and Neglect Assessment 373
23 Relationships, Roles, and Transitions 374
Relationships, Roles, and Transitions 375
Families 375
Late Life Transitions 378
Caregiving 383
Intimacy and Sexuality 391
AIDS and the Elderly 400
24 Mental Health and Wellness in Late Life 406
Mental Health and Wellness in Late Life 407
Suicide 423
Substance Misuse and Alcohol Use Disorders 424
Appendix 24-A Depression Rating Scales 433
25 Loss, Grief, Dying, and Death in Late Life 434
Death and Dying 441
The Needs of the Dying and Their Families and Implications for Gerontological Nursing 442
Dying and the Nurse 444
Decision Making at End of Life 446
26 Care Across the Continum 450
Residential Options in Late Life 450
Improving Transitions Across the Continuum of Care 460