Elder maltreatment is an increasing issue worldwide, mostly due to the rise in the older adult population. Abuse of the elderly can happen to anyone and varies with culture. Nurses are mandatory reporters, so it is crucial to know your organization’s policy and your state laws. The chapter helps the nurse to: define elderly abuse; differentiate between the different types of elderly abuse; recognize the “red flags” of elderly abuse; explain elderly abuse reporting; and identify various resources for elderly abuse. Forensic nurses and nurses who work with elders are in a key position to screen, identify, and provide linkage and resources to those most vulnerable and at risk. It is imperative that nurses have a foundational knowledge in elder maltreatment so that they can help patients who may be experiencing any types of abuse and address this serious public health problem.
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This book encompasses the wide range of injury and assault cases requiring the collection of forensic evidence in preparation for a legal case. This includes different types of sexual assault and violence, child maltreatment, elder maltreatment, bullying, interpersonal violence, gunshot wounds, community violence, human trafficking, terrorist acts, and mass disasters. With supporting case scenarios, the book describes step-by-step how to collect evidence and the proper procedure for handing over evidence once it is collected. The book is organized into four parts comprising eighteen chapters and begins with a brief description of history of forensic nursing. It also describes providing testimony in forensic cases and trauma-informed care. The book provides insight into some common and not-so common aspects of forensic nursing and how nurses in any setting can implement forensic nursing skills in delivering optimal care to patients. Forensic nursing is a growing nursing field blending nursing science with forensic science, law, and criminology. Forensic nurses trained in this field gather findings such as documenting injuries, collecting biological fluids, and preserving evidence such as clothing from the assault.
Use of medications and/or use of herbal supplements and/or over the counter medications is common place among the older adult population to manage diseases and maintain current level of function. As with any population who receive medications, there are always issues which effect appropriate medication use and monitoring for therapeutic effectiveness. In general the older adult population is at risk for medication related issues, owing to: higher incidence of adverse drug reactions and use of contraindicated medications; presence of physiological age related factors that may alter the pharmacokinetics and dynamics of drug prescribing; and high incidence of polypharmacy. The nursing assessment of the older adult taking medications includes a review of medications prescribed and ingested, inclusive of all over the counter medications. Older adults taking medications and over the counter supplements should know the name, dosage, frequency, and what the medication looks like (color, size, shape).
The nursing assessment of the older adult is based on a comprehensive history of health and absence of health (illness) issues, including a review of systems, a physical examination, and a functional assessment. The nursing assessment involves a combination of both listening to the older adult and observing the older adult. Health appraisals are an important component of the overall management of the older adult and their illness(es), as elucidating in the Self-Regulation Theory and Illness Perception Model. A critical component following the history and physical examination is to make time to complete a functional assessment. The nursing assessment is the gateway to identifying issues and setting goals in the plan of care, implementing appropriate interventions and then evaluating the patient response to those interventions. The chapter outlines the health history, physical examination, functional assessment, and standardized patient assessments as obtained by use of measurement tools.
This chapter describes the environment, including safety and security, relocation, transportation, the importance of space, community-based resources, and residential facilities. It discusses the safety and security issues such as falls, climate and temperature changes in the environment, and home safety issues. Fall prevention is critical to avoiding the negative consequences of falling among older adults. Natural disasters and unforeseen weather events jeopardize the health, safety, and wellbeing of older adults, particularly older adults residing in nursing homes. Areas of focus in home safety include interior home safety inspection, fires/burns/poisoning, medication safety, inspection of the contents of the refrigerator, exterior home inspection, use of restraints, relocation, transportation, and maintaining autonomy and independence. The chapter finally describes community-based services and resources, residential facilities, and homeless elders. Several types of residential facilities perform care for older adults such as skilled nursing facilities, assisted living facilities, and continuing care retirement communities.
As the older adult population continues to grow and life spans continue to increase, the number of chronic illnesses among older adults also increases. These chronic conditions are not the result of normal age-related changes, but are impacted by physiological age-related changes. Chronic conditions require effective disease management according to the latest and strongest degree of evidence based research or accepted standard of practice approaches. Care of older adults with chronic illness requires an effective healthcare team of interdisciplinary clinicians as well as family, friends, and hired caregivers. Patient centered care must include the coordination of care across specialists and clinical services to provide the most effective care management. This chapter discusses cardiac and peripheral vascular problems, respiratory problems, gastrointestinal problems, hematological problems, genitourinary problems, and sexually transmitted diseases. It also discusses cancer, musculoskeletal problems, metabolic and endocrine problems, immunologic problems, neurologic problems, pressure ulcers, and sensory problems.
This chapter covers descriptions of health policy issues and organizations that advocate for older adults. Older adults as a group have taken action to prevent the effects of ageism on healthcare policy. Older adults have formed two large and influential national organizations that provide them with representation concerning legislative issues and resources for successful aging -
AARPand National Council on Aging. As a result of the vast improvements in healthcare technology, healthcare costs increased 12% to 14% per year in the 1970s and began to decrease slightly in the 1980s. However, overtime, healthcare costs have risen substantially. Reimbursement for healthcare has changed as a result of increasing costs. Allowable expenses under Medicare and Medicaid plans as well as private insurances have diminished in many cases and have been removed altogether in some cases. The chapter discusses the Older Americans Act, Medicare, Medigap, Medicaid, long-term care insurance, and veterans benefits.
This chapter discusses special topics such as pain, sexuality, and elder neglect and abuse. Pain is a common occurrence among older adults. Pain is often described in terms of its origin, duration, location, and other associated factors. These other associated factors have great implications on lifestyle and function for older adults who are affected by pain interrupting their sleep or pain associated with weigh bearing and walking. To assess the older adult in pain, make sure they are in the most comfortable position and then proceed to gather through a focused review of systems if pain is occurring. One of the most prevalent myths of aging is that older adults are no longer interested in sex. The fulfillment of sexual needs may be just as satisfying for older adults as it is for younger people. If elder abuse or neglect is suspected, the healthcare provider must report it immediately.
This third edition, has been written as a reference and certification test review guide for registered nurse (RNs) preparing for gerontological certification. It is also a useful text for students who are studying gerontology, teachers preparing gerontology classes, and RNs working with older adults. The book presents information about preparing for the certification exam, a comprehensive compilation of content specific to gerontology, and a test bank of questions specifically developed for the RN preparing for certification in gerontology. It focuses on topics specific to the aging population, such as demographics, myths about aging, theories of aging and nursing, communication skills geared for the older adult, teaching–learning principles that work well with older adults, and the history of gerontological nursing. The book identifies the health promotion needs of elders, such as nutrition, exercise, primary and secondary prevention strategies, and alternative and complementary healthcare practices used with older adults. It describes the environment, including safety and security, relocation, transportation, the importance of space, community-based resources, and residential facilities. It discusses spirituality and dying with special attention to advance directives, hospice and palliative care, and the grieving process. The book describes the acute and chronic physical illnesses most frequently experienced by older adults and discusses the cognitive and psychological disorders experienced by elders, including dementia, delirium, and depression. It covers common medications used by older adults, as well as discussions about polypharmacy, issues related to pharmacokinetics and pharmacodynamics, noncompliance, and adverse drug effects. It also discusses special topics such as pain, sexuality, and elder neglect and abuse, and covers descriptions of health policy issues and organizations that advocate for older adults. The book finally discusses the scope and standards of geriatric nursing practice relating to leadership and management, research, ethical and legal issues, and professional competency.
Preparing for a standardized exam can cause some anxiety and fear. This chapter discusses the strategies for preparing the gerontologic nurse certification exam. It outlines the similarity of the thought processes that occur when taking the exam and being in practice. Some of the most significant content information necessary to competently care for older adults reflects assessing, analyzing, planning, implementing, and evaluating patient outcomes of conditions that older adults most frequently experience. These conditions are denoted as red flag problems. Timing oneself with practice questions is good preparation for a successful outcome on a standardized test such as this certification exam. The chapter provides examples of challenging questions that may require some extra attention to answer correctly. It also provides strategies for analyzing the questions and the clues to memorizing information. When reviewing content before taking an exam, it is helpful to use certain methods of remembering information.