Mildred O. Hogstel, PhD, RN, CMary S. Harper, PhD, RN, FAAN and Mildred O. Hogstel, PhD, RN, CMildred O. Hogstel, PhD, RN, CLinda Cox Curry, PhD, RNLaura Talbot, RN, CS, EdD, PhD and Mildred O. Hogstel, PhD, RN, CBert Hayslip, Jr., PhDSusan Brown Eve, PhD and Sharon Prentice, RN, MS and Charlie D. Pruitt, Jr., MS and Diana Torrez, PhDJanis M. Felming, PhD, RNDianne M. Chiu, RD, LDMildred O. Hogstel, PhD, RN, CMargaret C. Basiliadis, DO and Mildred O. Hogstel, PhD, RN, CJan W. Weaver, PhD, RNKaty Scherger, RN, MSN, CS and Barbara Harty, RN, MSN, CSCarol A. Stephenson, EdD, RN, C, CRNHCarol A. Stephenson, EdD, RN, C, CRNHGail C. Davis, EdD, RN and Barbara M. Raudonis, PhD, RN, CSJanice A. Knebl, DO, CMD, FACPSusan Ellen Margolis, PhD, RN, CNS--P/MHMildred O. Hogstel, PhD, RN, CDeborah K. Fultner, MS, RN, CSBarbara M. Raudonis, PhD, RN, CSMarsha Cox, PhD, RN, CS, GNP, ANP and Libby High, NP, PhD(C), MS, BSN, RNM. Nelia Davis, RN, MSN and Debbie Schutkowski, LMSW, CCM, MSJacqueline M. Stolley, PhD, RN, CS and Beth Cameron, MS, RN, FNP and JoAnn Wedig, RN, MACarolyn Spence Cagle, PhD, RNCKay Weiler, BSN, RN, MA, JDKay Weiler, BSN, RN, MA, JD and Perle Slavik Cowen, PhD, RNMildred O. Hogstel, PhD, RN, C

Preface	p. xi
About the Author	p. xiii
Acknowledgments	p. xv
Contributors	p. xvii
Reviewers	p. xix
How to Use This Book	p. xxi
Unit 1 An Overview of Aging Issues	p. 1
Chapter 1 Aging Yesterday, Today, and Tomorrow	p. 3
Demographics	p. 4
Definitions	p. 4
Morbidity and Mortality	p. 5
Issues and Problems	p. 6
Ageism: Myths and Facts	p. 6
Major Needs of Older Adults	p. 8
The Aging Network	p. 12
National Organizations	p. 14
Chapter 2 Gerontological Nursing	p. 17
Historical Development	p. 18
Educational Programs	p. 18
Specialty Roles	p. 18
Organizations	p. 20
Standards	p. 20
Case Management and Teaching	p. 21
Special Issues	p. 22
Future Projections and Visions	p. 23
Chapter 3 Changes in the Health Care Delivery System Affecting Older Adults	p. 27
Problems Related to Geriatric Health Care	p. 28
Financing Health Care	p. 29
Effects of Health Care Delivery System Changes on Older Adults	p. 37
Interdisciplinary Approach to Geriatric Health Care	p. 42
Legislation Affecting Health Care Delivery	p. 44
Unit 2 The Process of Aging	p. 49
Chapter 4 Developmental Aspects of Aging	p. 51
Developmental Tasks	p. 52
Theories	p. 55
Chapter 5 Biological and Physiological Aging	p. 65
Theories of Biological Aging	p. 66
Changes in Organ Systems	p. 66
Nursing Implications	p. 80
Chapter 6 Psychological Aspects of Aging	p. 83
The Life Span Developmental Approach to Aging	p. 84
Perception	p. 87
Learning and Memory	p. 88
Intelligence	p. 92
Personality	p. 95
Psychological Interventions with Older Persons	p. 98
Chapter 7 Social Aging	p. 109
Aging and Structural Lag	p. 110
Cultural, Race, and Ethnic Issues	p. 111
Social Roles	p. 114
Spirituality	p. 122
Chapter 8 Successful Aging	p. 131
Essential Components of Successful Aging	p. 132
Activities Important to Successful Aging	p. 148
Unit 3 Holistic Health Care	p. 153
Chapter 9 Geriatric Nutrition	p. 155
Nutritional Considerations	p. 156
Nutrient Standards and Food Guides for Health Promotion	p. 163
Factors Influencing Nutritional Status of Older Adults	p. 166
Suggestions for Feeding Clients	p. 172
Nutrition Programs for Older Adults	p. 174
Chapter 10 Informal Support Systems	p. 183
Informal Caregiving	p. 184
Other Voluntary Community Resources	p. 191
Nursing Roles and Responsibilities	p. 195
Chapter 11 Wellness and Health Promotion	p. 199
Overview	p. 200
Health Screening	p. 202
Barriers to Health Promotion	p. 206
Attitudes and Assertiveness	p. 208
Role of the Nurse	p. 211
Chapter 12 Health Education	p. 217
Shifts in the U.S. Population	p. 218
Shifts in Policy and Practice	p. 220
Health Education	p. 220
Educational Settings	p. 221
Age-Integrated Versus Age-Segregated Educational Programs	p. 223
Educational Theories and Methods	p. 223
From Pedagogy to Geragogy	p. 227
Barriers to Learning for Older Adults	p. 228
Educational Strategies	p. 229
Technology in Older Adult Education	p. 230
Evaluating Education for Older Adults	p. 231
Unit 4 Health Needs and Care	p. 235
Chapter 13 Assessment, Diagnosis, and Planning	p. 237
Techniques for Geriatric Assessment	p. 238
Physiological Changes Associated with Aging	p. 239
Age-Related Laboratory Values	p. 242
Atypical Presentation of Disease in the Older Adult	p. 243
Functional Assessment	p. 244
Psychosociospiritual Assessment	p. 246
Chapter 14 Major Diseases: An Overview	p. 257
General Indicators of Disease in Older Adults	p. 258
Cardiovascular Diseases in Older Adults	p. 258
Obstructive Airway Diseases	p. 267
Parkinson's Disease	p. 270
Cancer	p. 274
Infectious Diseases	p. 276
Chapter 15 Acute Care Issues	p. 289
Older Adults as Health Care Consumers	p. 290
The Admission Process	p. 291
Teaching and Discharge Planning	p. 295
Care During Hospitalization	p. 297
Chapter 16 Chronic Illness	p. 317
Demographics of Chronic Illness	p. 318
Financial Issues	p. 318
Major Chronic Illnesses	p. 319
Effects of Chronic Illness on Health Status and Quality of Life	p. 320
Approaches to Assessment	p. 323
Approaches and Services Addressing Chronic Illnesses and Their Effects	p. 325
Planning for the Future	p. 329
Chapter 17 Management of Medications	p. 345
Polypharmacy	p. 346
Pharmacodynamics	p. 347
Pharmacokinetics	p. 347
Drug Interactions	p. 350
Generic Medications	p. 351
Medication Administration	p. 351
Effects of Medications Commonly Used by Older Adults	p. 353
Geriatric Psychopharmacology	p. 356
Chapter 18 Mental Health Issues	p. 367
Assessment and Diagnosis	p. 368
Depression	p. 369
Suicide	p. 372
Organic Mental Disorders	p. 373
Schizophrenia	p. 375
Substance Abuse	p. 377
Unit 5 The Dilemma of Long-Term Care	p. 385
Chapter 19 Nursing Facilities	p. 387
Classification and Types of Services	p. 388
Characteristics of Residents	p. 389
Administration and Staffing	p. 391
Payment Mechanisms	p. 395
Regulations and Oversight	p. 396
Nursing Issues and Concerns	p. 398
Emerging Needs and Trends	p. 406
Chapter 20 Home Health Care	p. 409
History of Home Health Care	p. 410
Demographics	p. 411
Living Arrangements	p. 413
Home Health Personnel	p. 413
Eligibility and Funding	p. 416
The Nursing Process	p. 417
Case Management	p. 423
Community Resources	p. 423
Discharging the Client	p. 428
Ethical and Legal Issues	p. 428
Future of Home Health Care	p. 438
Chapter 21 Hospice and Palliative Care	p. 441
History of Hospice	p. 442
Philosophy and Goals of Care	p. 443
Services Provided	p. 444
Interdisciplinary Team	p. 445
Insurance Coverage	p. 447
Nursing Interventions	p. 448
End of Life Care in the Twenty-First Century	p. 451
Unit 6 Community Health Care Resources	p. 471
Chapter 22 Primary Care Centers	p. 473
Types of Primary Health Care Centers	p. 474
Medicare Reimbursement for Nurse Practitioners	p. 475
Developing a Primary Health Care Clinic/Center for Older Adults	p. 475
Business Plan for Opening a Primary Health Care Clinic for Older Adults	p. 476
Primary Health Care Clinic Services	p. 479
Organizational Development	p. 481
Professional Development	p. 483
Chapter 23 Hospital Outpatient Care and Services	p. 487
The Need for Outpatient Services	p. 488
Categories of Services	p. 488
Ambulatory Care Centers	p. 496
Implications for Nursing	p. 499
Chapter 24 Community Organizations and Services	p. 501
The Need for Community Organizations and Services	p. 502
National Aging Network	p. 502
Eldercare Resources	p. 507
Unit 7 Ethical, Legal, and Financial Issues	p. 523
Chapter 25 Ethical Theories and Principles	p. 525
Ethical Dilemmas	p. 526
Ethical Theories	p. 527
Ethical Principles	p. 529
Chapter 26 End-of-Life Decisions and Choices	p. 545
Autonomy	p. 546
Constitutional Rights	p. 547
State Legislative Actions	p. 550
Societal Interests	p. 550
The Patient Self Determination Act	p. 552
Implications for Nurses	p. 554
Chapter 27 Legal and Financial Issues	p. 564
Options Regarding Financial Issues Available for Adults with Decision-Making Capacity	p. 564
Options Available for Financial Decisions after Loss of Decision-Making Capacity	p. 568
Protective Statutes	p. 569
Implications for Nurses	p. 571
Unit 8 The Future	p. 575
Chapter 28 Trends and Future Needs	p. 577
Evolving Demographics	p. 578
Continuum of Care	p. 578
Geriatric Health Care	p. 580
Legislation and Public Policy	p. 583
Research Needs	p. 583
Trends	p. 585
Predictions for the Future	p. 586
Gerontological Nursing: Where to Go from Here	p. 588
Glossary	p. 591
Index	p. 609