Lewis et al: Medical-Surgical Nursing: Assessment and Management of

Clinical Problems, 7th edition

Key Points

Chapter 6: Older Adults

• Ageism (negative attitude based on another’s age) can lead to discrimination and
disparities in health care provided to older adults.

• Aging affects every body system. Biologic aging is a balance of positive (e.g., healthy
diet, exercise, coping, resources) and negative factors (e.g., smoking, obesity).

• Biologic theories can be divided into stochastic and non-stochastic theories.

• Older women are especially at risk for chronic health problems, including arthritis,
hypertension, strokes, and diabetes.

• The frail elderly are individuals who are more vulnerable because of declining physical
health and limited resources.

• Activities of daily living (ADL), including bathing, dressing, eating, toileting, and
transferring, are important for the nurse to assess in the older patient living with chronic
illness.

• For the hospitalized older adult, there are special concerns related to high surgical risk,
acute confusional state, nosocomial infection, and premature discharge with an unstable
condition.

• The intensity and complexity of caregiving place the caregiver at risk for high levels of
stress. This may lead to emotional problems, including depression, anger, and resentment.

• Family members are perpetrators in approximately 9 out of 10 cases of domestic elder

abuse and neglect.

• Continuing care retirement communities, congregate housing, and assisted living

facilities are housing options for the older adult.

• Home health care services require physician recommendation and skilled nursing care for
Medicare reimbursement.

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Key Points 6-2

• Ethical issues surrounding care of the older adult include using restraints, evaluating the
patient’s ability to make decisions, initiating resuscitation, treating infections, providing
nutrition and hydration, and advocating for an institutional ethics committee.

• Reducing disability through geriatric rehabilitation is important to the quality of life of

the older adult.

• Age-related changes in pharmacodynamics and pharmacokinetics of drugs, as well as

polypharmacy, put the older adult at risk for adverse drug reactions.

• Depression is the most common mood disorder in older adults.

• The comprehensive nursing geriatric assessment includes a thorough history using a

functional health pattern format, physical assessment, mood assessment, mental status
evaluation, ADL and instrumental ADL (IADL) evaluation, and social-environmental
assessment.

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.