Learning Objectives
After completing the course, you’ll be able to:
- Define the older adult population, recognizing stereotypes applied to this population
- Recognize the complexity of factors that influence the lives of older adults–including health maintenance, available care during illness or disability, and current health care financing and services–and the significance of environmental factors that include geographic location and features of the individual’s community and home
- Describe sociologic, economic, and educational trends among older adults
- Recognize current demographic trends among older adults in the United States, identifying present and predictive trends
- Discuss the history of gerontologic nursing
- Describe the current status of gerontologic nursing
- Identify the importance of the nursing process, including nursing diagnosis
- Recognize several conceptual or theoretic frameworks for nursing
- Describe the results of the leadership efforts of the American Nurses’ Association in defining standards for gerontologic nursing, initiating and maintaining nursing certification, and defining the nature and scope of nursing
- Recognize the contributions of the teaching nursing homes
- Identify what is known about the causes of aging
- Recognize that overlap and duplication exist among the aging theories that have been reported to date
- Discuss selected biologic and psychosocial theories about aging
- Understand that application of theories about aging can enhance the nursing care of older adults
- Describe social role changes experienced by older adults in the United States
- Describe changing family roles experienced by older adults in the United States
- Discuss the patterns of late life marriages
- Examine the positive and negative consequences of retirement for older adults
- Discuss physiological age related changes that affect the pharmacologic dynamics of the older person
- Identify signs and symptoms of adverse drug reactions common in older adults
- Recognize high risk drugs and their potential for harm and benefit to older adults
- Identify drug drug interactions in older adults
- Recognize the risks and benefits of the use of over the counter (OTC) drugs in older adults
- Discuss methods to increase older adults’ ability to understand and to follow medication prescriptions.
- Describe sexuality as an integral component of the older adult’s personality
- Identify age related changes and health deviations that affect sexual function of older adults
- Describe demographic, physiologic, and social factors that affect the sexual function of older adults
- Discuss older adults’ needs for closeness, touch, warmth, and sharing
- Identify age related changes in vision, hearing, smell, and taste
- Assess the senses of sight, hearing, smell, taste, and touch of the older adult
- Recognize psychologic and sociocultural factors that interact with sensory functioning
- Understand the causes of sensory impairment in older people
- Develop a plan of nursing care for an older person with sensory impairment
- Provide appropriate nursing interventions for older adults with sensory impairment
- Identify age related changes in the integument and in the oral mucous membranes
- Assess the older adult’s integument and oral mucous membranes
- Recognize risk factors that lead to impaired skin integrity and alterations in oral mucous membranes
- Describe the causes of integumentary impairment, and oral mucous membrane impairment in older adults
- Develop a plan of nursing care for an older adult with integumentary impairment or with alterations in oral mucous membranes
- Implement appropriate nursing interventions for older adults with integumentary impairment and with alterations in oral mucous membranes
- Evaluate the effectiveness of nursing interventions carried out to resolve integumentary and oral mucous membrane problems
- Discuss age related changes in the endocrine system
- Recognize the prevalence of diabetes in the older adult population
- Describe the nursing care of the older diabetic patient
- Discuss the vulnerability of an older adult to disorders of temperature regulation
- Recognize signs and symptoms of hypothermia and hyperthermia in an older adult.
- Identify age related changes and environmental factors that increase susceptibility to infection in the older adult
- Describe the nursing care of the older person with an infection
- Identify age related physiologic changes of the cardiovascular and peripheral vascular system
- Identify and describe the common pathophysiologic changes that affect the cardiovascular system of the older adult
- Assess the cardiovascular functioning of older adults
- Recognize the psychosocial and cultural factors that influence the nursing management of older adults with cardiovascular problems
- Develop a plan of care for an older adult with cardiovascular impairment
- Provide appropriate nursing interventions for older adults with cardiovascular impairment
- Explain the normal structure and function of the respiratory tract
- Identify age related physiologic changes of the respiratory system
- Identify and describe the common pathophysiologic changes that affect the respiratory system of older adults
- Assess the respiratory functioning of older adults
- Recognize the psychosocial and environmental factors that influence the nursing management of older adults with respiratory problems
- Develop nursing diagnoses and a plan of care for an older person with respiratory impairment
- Provide appropriate nursing interventions and evaluations for older adults with respiratory impairment
- Define mobility
- Understand the anatomy and the physiology of the musculoskeletal system
- Know the physical and psychosocial aspects of mobility in the older adult
- Recognize normal age related changes and common health deviations in the musculoskeletal system that affects mobility of the older adult
- Specify common psychosocial problems in relation to health deviations in mobility
- Assess functional mobility of the older adult
- Use the nursing process in determining the care of people with problems in mobility
- Develop methods for promoting healthy mobility throughout the adult life span
- Identify and describe the types and causes of urinary incontinence experienced by older adults
- Describe and/or perform history taking, and physical and functional assessments for patients with urinary incontinence
- Describe urodynamic assessment
- Recognize the psychosocial consequences of urinary incontinence for older adults and their families
- Identify and describe behavioral therapies for urinary incontinence
- Provide appropriate nursing interventions, patient education, and advocacy for older adults with urinary incontinence
- Explain the normal structure and function of the gastrointestinal (GI) system and identify age related changes that influence bowel elimination
- Recognize the significance and prevalence of constipation in older adults
- Identify the contributing factors that cause constipation
- Assess patients for actual or potential constipation
- Develop a plan of care to manage constipation
- Discuss appropriate nursing interventions for patients with constipation
- Promote normal bowel elimination for older adults
- Evaluate the effectiveness of a plan of care for constipation
- Recognize the physiologic, psychosocial, and environmental factors that influence the maintenance of the nutritional status of the older adult
- Discuss drug nutrient interactions and their effect on older adults
- Discuss pathologic conditions that affect the nutritional status of the older adult
- Describe the components of nutritional assessment for the older adult
- Develop a plan of care for the older adult with an alteration in nutrition
- Design appropriate nursing interventions for older adults with alterations in nutrition
- Describe strategies for promoting optimum nutrition in the older adult.
- Identify the stages of normal sleep
- Understand how aging influences sleep patterns.
- Describe sleep disorders that occur as people age
- Recognize what promotes or inhibits sleep in older adults
- Assess sleep patterns of older adults
- Develop a plan of care for an older adult experiencing a sleep pattern disturbance
- Identify appropriate nursing interventions for older adults with sleep pattern disturbance
- Promote healthy adaptation of older adults to changes in the sleep cycle caused by aging.
- Discuss three mental disorders that are frequently experienced by older adults and the relationship between increasing age and the prevalence of these disorders
- Differentiate between two cognitive disorders, dementia and delirium, and specify their distinguishing features
- Differentiate between cognitive disorders and depression, a mood disorder
- Describe the effects of cognitive disorders and depression on the older individual.
- Discuss the role of the caregiver of the cognitively impaired and/or depressed older person
- Discuss the assessment process as it applies to cognitive impairment and the use of instruments to assist in diagnosing the nursing needs of the cognitively impaired or depressed person
- Implement nursing interventions that meet the special needs of cognitively older adults
- Discuss the concept of safety as it applies to the older adult
- Discuss the incidence of injury in the older population
- Recognize the older adult who is at risk for falling
- Discuss interventions to diminish the risk of falling for older adults
- Identify the susceptibility of the older adult to sustaining an injury as a result of a traffic accident and/or burns
- Recognize signs and symptoms of elder abuse
- Discuss the use of restraints with older patients
- Understand the problem of cancer, its myths, and its biases as they related to the older adult
- Discuss biologic aspects of aging as they relate to cancer incidence, morbidity, and mortality
- Recognize major issues (e.g., age, gender, extent of disease, and comorbidity) that may influence decisions concerning eligibility for screening, extent of diagnostic workup, treatment, and treatment aggression for the older adult experiencing cancer
- Address (1) the major therapeutic modalities employed in cancer treatment; (2) the major cancers affecting the older adult; and (3) the nurse’s role in caring for the older adult experiencing cancer
- Identify patterns of care for the older adult, family, and community experiencing cancer
- Project future goals for approaches to cancer prevention, control, treatment, and research in the older adult
- Define the concepts of loss, bereavement, and grief
- Describe the relevance of these concepts (loss, bereavement, and grief) to the older population
- Describe the phases of bereavement, including the physical, psychologic, social, and spiritual manifestations of each
- Describe the emotional responses to dying, using a dynamic model of coping responses
- Describe nursing roles related to care of the dying older person and the person’s family in various care settings
- Describe the care of a person experiencing spiritual distress in relation to death
- Apply the nursing process to the care of the bereaved and the care of the dying person
- Discuss the legal aspects of planning that will help older adult patients manage their affairs, and plan for their potential inability to manage their own affairs
- Identify the public benefit programs that may assist the older adult
- Describe the main regulations governing nursing homes
- Compare and contrast four current approaches to studying and applying bioethics: principle-based ethics, virtue theory, communitarianism, and caring
- Critique age-based rationing as a means to achieve intergenerational justice
- Counsel frail older adults who seek assistance in making end-of-life treatment decisions
- Describe the advocacy responsibilities and related competencies of gerontologic nurses
- Identify strategies to prevent and resolve ethical conflict
- Use a process of ethical decision making to resolve moral distress and dilemmas
- Appreciate the importance of stating ideas and contributing suggestions in public policy discussions to advance professional nursing
- Contribute to the refinement of nursing language, including nursing diagnoses that will improve the understanding of nursing and encourage clear and frequent communication
- Emulate models of care that enable improved practice, research, and education to be understood and applied in patient care
- Prepare for and be prepared to cope with the adjustment that are anticipated to be imposed in the twenty-first century
Table of Contents
Chapter 1: The Older Adult Population
Chapter 2: Gerontologic Nursing
Chapter 3: Theories of Aging
Chapter 4: The Transition Years
Chapter 5: Drug Therapy in Older Adults
Chapter 6: Sexuality
Chapter 7: Sensation
Chapter 8: Integument
Chapter 9: Regulation: Endocrine, Temperature, and Infection
Chapter 10: Cardiovascular Function
Chapter 11: Respiration
Chapter 12: Mobility
Chapter 13: Urinary Incontinence
Chapter 14: Bowel Elimination
Chapter 15: Nutrition and Digestive Function
Chapter 16: Sleep
Chapter 17: Cognition and Mood
Chapter 18: Safety
Chapter 19: Cancer in the Older Adult
Chapter 20: Loss, Bereavement, and Care of the Dying Person
Chapter 21: Legal Perspectives on Planning for Older Adults
Chapter 22: Ethical Perspectives
Chapter 23: The Future