A Comprehensive Guide to Safety and Aging: Minimizing Risk, Maximizing Security

Cover
Half Title
Title Page
Copyright Page
Table of Contents
Editors’ Note
About the Editors
List of Contributors
1 Introduction
1.1 Why Aging? Why Safety? What Matters
References
2 Hazards of Hospitalization
2.1 Introduction
2.2 Loss of Function
2.3 Falls
2.4 Incontinence
2.5 Delirium
2.6 Malnutrition
2.7 Pressure Injury
2.8 Venous Thromboembolism
2.9 Nosocomial Infection
2.10 The Biology of Normal Aging
2.11 Interventions
2.12 Summary
Bibliography
3 Atypical Presentations of Common Diseases
3.1 Introduction
3.2 Common Atypical Presentations
3.3 Making a Diagnosis
3.4 Assessment
3.5 Atypical Presentations of Common Illnesses
3.5.1 Cardiovascular Disease
3.5.2 Infections
3.5.2.1 Urinary Tract Infections
3.5.2.2 Pneumonia
3.5.2.3 Sepsis
3.5.3 Abdominal Pain
3.6 Summary
Bibliography
4 Hip Fractures in Older Adults
4.1 Risk Factors
4.2 Types of Hip Fracture
4.3 Diagnosis
4.4 Treatment
4.5 Postoperative Complications
Bibliography
5 Functional Fitness for Optimal Aging
5.1 Introduction
5.2 Benefits of Physical Activity for Older Adults
5.3 Psychological Benefits
5.4 Psychosocial Determinants of Exercise
5.5 Physical Inactivity
5.6 Recommendations for Practitioners
5.7 Conclusion
Bibliography
6 Care Transitions
6.1 Overview
6.2 Significance of Care Transitions and Impact On Patient Outcomes
6.3 Successful Care Transitions
6.4 Care Transition Models
6.5 Care Transition Tools
6.6 Impact On Patient Safety
6.7 Care Transitions Team Members
6.8 Patient Education and Teach-Back Role in Patient Safety and Care Transitions
6.9 Improvements in Care Transitions and Future Directions
6.10 Summary
Bibliography
7 Medication Management Issues in the Older Adult Patient
7.1 Terminology Pearls
7.2 Clinical Pearls
7.3 When to Seek Help From Your Prescriber Or Pharmacist
7.4 Medication Management Tools
7.5 Medicare Part D (Drug) Plan Information
7.6 Important Medicare Part D Tidbits
7.7 Conclusion
Bibliography
8 Oral Health and Older Adults
8.1 Oral Health and Systemic Health
8.2 Oral Health and Long-Term Care
8.3 Oral Health and Palliative Care
8.4 Strategies to Consider Before Entering Care
8.5 Care Strategies for Improving Oral Health of Palliative Care Patients
8.6 Diet and Sugar
8.7 Chronic Health and Medication Effects On Oral Health
8.8 Effects of Smoking and Alcohol On the Oral Tissues
8.8.1 Smoking
8.8.2 Alcohol
8.9 Managing the Risks Associated With Nausea and Vomiting
8.10 Radiation and Chemotherapy and Oral Health
8.11 Oral Integrity in Communication and Social Interactions
8.12 Educating Caregivers and Staff
8.13 The Intersection of Oral Health and Social Determinants of Health
8.14 Mental Health and Oral Disease
8.15 Oral Health Is the Responsibility of the Interdisciplinary Team
8.16 Summary
References
9 Preventing Falls and Fall-Related Injuries Among Older Adults
9.1 Introduction
9.2 National Statistics On Falls Among Older Adults
9.3 Risk Factors for Falls
9.4 Falls Risk Screening and Assessment
9.5 A Team Approach to Falls Prevention
9.6 Falls Prevention Coalitions
9.7 Community-Based Falls Prevention Programs
9.8 Program Benefits to Older Adults
9.9 Program Benefits to Community-Based and Health Care Organizations
9.10 Funding for Falls Prevention Interventions
9.11 National Efforts to Reduce Falls Among Older Adults
9.12 International Efforts to Reduce Falls
9.13 Novel Technologies for Falls Prevention
Notes
Bibliography
10 Home Modifications
10.1 Planning to Age in Place
10.2 Individual and Home Usage
10.3 Home Environment
10.4 Funding Home Modifications
10.5 Home Features By Room
10.6 General House Features
10.7 Layout, Approaches, Entryways, and Stairwells
10.8 Bathrooms
10.9 Kitchen
10.10 Specific Recommendations for Functional Limitations
10.10.1 Decreased Vision (Presbyopia)
10.10.2 Decreased Balance, Frequent Falls, Or Difficulty Bending Over
10.10.3 Decreased Memory
10.10.4 Decreased Grip Strength Or Limited Shoulder Range of Motion
10.11 Conclusion
References
11 Advancements in Technology to Promote Safety and Support Aging in Place
11.1 Introduction
11.2 Aging in Place
11.3 The Home Environment
11.4 Implications for Aging in Place
11.5 Needs of Older Adults
11.6 Understanding Safety Issues in the Home
11.6.1 Potential for Technology
11.6.2 Crafting a Smart Home Environment
11.7 Home Security
11.8 Fall Detection
11.9 Health Technologies
11.10 Comfort Technologies
11.11 Smart Appliances
11.12 Personal Devices
11.13 Robots
11.13.1 Technology Considerations
11.13.1.1 Accessibility
11.13.1.2 Accommodations
11.13.1.3 Compatibility
11.13.1.4 Features and Functionalities
11.13.1.5 Hazards
11.13.1.6 Interface
11.13.1.7 Unintended Consequences
11.13.2 Enabling Older Adults to Take Advantage of These Technology Innovations
11.13.2.1 Customizability
11.13.2.2 Adaptability
11.13.2.3 Maintenance
11.13.2.4 Privacy and Security
11.13.2.5 Trust
11.13.2.6 Technology Acceptance Models
11.13.3 Recommendations for Professionals
11.14 Summary
Acknowledgments
References
12 Supporting Community Engagement With Assistive Technology as a Means of Health Promotion for Older Adults
12.1 Introduction
12.2 Barriers to Community Engagement for Aging Adults
12.2.1 Self-Care Challenges
12.2.2 Cognitive Challenges
12.2.3 Vision Challenges
12.2.4 Communication Challenges With Hearing and Speaking
12.2.5 Mobility Challenges
12.3 Supports for Community Engagement
12.3.1 The Role of Assistive Technology
12.3.2 Types of AT Devices
12.3.3 AT Self-Care Supports
12.3.4 AT Cognitive Supports
12.3.5 AT Vision and Hearing Supports
12.3.6 AT Communication Supports – Speaking
12.3.7 AT Mobility Supports
12.4 Additional Resources for Older Adults
12.5 Conclusion
References
13 Older Adult Driver Safety
13.1 Introduction
13.2 Risk Factors for Unsafe Driving
13.3 Risk Assessment
13.4 Interventions
13.5 Advising Older Adults About Driving Retirement
13.6 Legal and Ethical Issues
13.7 Conclusion
Bibliography
14 Travel and Seasonal Safety for Older Adults
14.1 Travel
14.2 Essential Elements for Travel Preparation
14.3 International and Air Travel
14.3.1 Health Care Provider Visit
14.3.2 Vaccinations
14.3.3 Medications
14.3.4 Current Health Conditions
14.3.5 Travelling With Functional Impairments
14.3.6 Traveling With Oxygen
14.3.7 Preventing Deep Venous Thrombosis
14.3.8 Medical Insurance
14.3.9 Travel-Acquired Infections and Dehydration
14.3.10 Travelling With Dementia
14.3.11 Emergency Travel Kit
14.4 Seasonal Safety for Older Adults
14.4.1 Hot Weather Or Heat Extreme
14.5 Expert Recommendations to Prevent Heat-Related Illness in Older Adults
14.6 Cold Weather
14.7 Emergency Car Kit
14.8 Snow and Ice Conditions
14.9 Flood Conditions
14.10 Windy Conditions
Bibliography
15 Emergency Preparedness and Fire Safety
15.1 Basic Elements of Emergency Planning for Older Adults
15.2 Risk Assessment and Planning
15.3 Risk Factors for Older Adults in an Emergency
15.4 Communication
15.4.1 Contact Information
15.4.2 Meeting Place
15.4.3 Medical and Insurance Information
15.5 Education and Drills
15.6 Fire Safety
15.7 The Disaster Supply Kit
15.7.1 What to Include in a Disaster Supply Kit (“Go-Bag”)
15.8 Deciding Whether to Evacuate Or Shelter in Place
15.9 Post-Disaster Risk Awareness
15.10 Disaster Planning for CBOs
15.11 Conclusion
Bibliography
16 Safety Considerations for Older Workers
16.1 Introduction
16.2 Characteristics of Older Workers: Myths and Realities
16.3 Enhancing the Health and Safety of Older Workers
References
17 Mental Health: Depression, Anxiety, and Social Isolation
17.1 Depression
17.2 Symptoms of Depression
17.2.1 Key Symptoms
17.2.2 Other Symptoms
17.3 Risk Factors
17.4 Treatments for Depression
17.5 Anxiety
17.5.1 Symptoms of Anxiety
17.5.2 Risk Factors
17.5.3 Treatments for Anxiety
17.6 Social Isolation
17.6.1 Mental Health and Increased Safety Risks
17.7 Conclusion
References
18 Suicide Prevention
18.1 Suicide Incidence and Risk Factors
18.2 Prevention Strategies
18.3 Assessing and Addressing Risk for Suicide
18.4 Role of Providers
18.5 Public Policy and Societal Recommendations
Bibliography
19 Social Isolation and Loneliness
19.1 Social Isolation and Loneliness
19.2 Risk Factors for Social Isolation
19.3 Health Consequences of Social Isolation and Loneliness
19.4 Chronic Health Conditions
19.5 Assessments
19.6 Strategies to Prevent Social Isolation and Loneliness
19.6.1 Lifestyle Changes
19.7 Meaningful and Fulfilling Roles and Activities
19.7.1 Work and Volunteering
19.8 Routine Planning
19.8.1 Role and Leisure Exploration
19.8.2 Expanding Community and Social Networks
19.9 Following Up With a Physician
19.10 Conclusion
References
20 Caregiver Safety and Self-Care
20.1 Caregiving Roles
20.1.1 Responsibilities
20.1.2 Challenges
20.2 Safety With Caregiving
20.2.1 Mental
20.2.2 Biomechanical
20.3 Self-Care
20.3.1 Self-Awareness/Support
20.4 Caregiver Burnout
References
21 Opioid Use and Abuse in Older Adults
21.1 Some Basics About Pain
21.2 Appropriate Treatment of Pain
21.3 Treatment of Opioid Use Disorder (OUD)
21.4 Conclusion
Bibliography
22 Reducing Harm Related to Substance Use By Older Adults
22.1 Overview
22.2 Aging Increases Vulnerability
22.3 Links to Chronic Conditions
22.4 Health Implications for Older Adults of Commonly Used Drugs
22.5 Health and Safety Risks By Drug Class
22.5.1 Alcohol
22.5.2 Cannabis
22.5.3 Opioids
22.5.4 Sedative/Hypnotics
22.5.5 Stimulants
22.5.6 Tobacco
22.6 Interventions and Best Practices to Reduce Harm
22.6.1 Approaches to Care
22.6.2 Screening, Brief Intervention, Referral to Treatment (SBIRT)
22.6.3 Harm Reduction Approaches to Improve Safety
22.7 Financial Costs to Society
22.8 Policy Implications
Resources
23 Hearing and Aging
23.1 Introduction
23.2 Cerumen Impaction
23.3 Middle Ear
23.4 Inner Ear and Neural Pathways
23.4.1 Age-Related Changes Beyond the Cochlea
23.5 Other Comorbid Conditions Related to Aging
23.6 Consequences of Age-Related Hearing Loss
23.7 Impact of Hearing Loss On the Aging
23.8 Cognitive Factors
23.9 Potential Consequences of Hearing Loss Experiences By Older Adults
23.10 Referral to Hearing Evaluation
23.10.1 Rehabilitation Goal and Options
23.11 Hearing Aid Fitting
23.12 OTC Devices
23.12.1 Adaptive Or Assistive Listening Devices
23.13 Communication Considerations
Note
References
24 Common Eye Diseases, Their Visual Outcomes, and Strategies for Enhancing Use of Remaining Vision
24.1 Introduction
24.2 Cataracts
24.2.1 Treatment Options
24.2.2 Associated Visual Changes
24.3 Diabetic Retinopathy
24.3.1 Treatment Options
24.3.2 Associated Visual Changes
24.4 Stroke
24.4.1 Treatment
24.4.2 Associated Visual Changes
24.5 Chronic Open Angle Glaucoma
24.5.1 Treatment Options
24.5.2 Associated Visual Changes
24.6 Age-Related Macular Degeneration (AMD)
24.6.1 Treatment Options
24.6.2 Associated Visual Changes
24.7 Management OF VISUAL DEFICITS With Low Vision Rehabilitation
24.7.1 History
24.7.2 Exam Elements
24.7.3 Refraction and Lens Selection
24.7.4 Magnification
24.7.5 Near and Intermediate Devices
24.7.6 Distance Devices
24.7.7 Nonoptical Options and Assistive Technology
24.7.8 Peripheral Field Loss
24.7.9 Referral to Rehabilitation
24.8 Conclusion
References
25 Blindness and Low Vision Rehabilitation Services
25.1 Vision Rehabilitation Therapists
25.2 Orientation and Mobility Specialists
25.3 Low Vision Therapists
25.4 Assistive Technology Instructional Specialists
25.5 BLV Rehabilitation Assessment
25.6 Understanding Eye Conditions
25.7 Functional Vision Assessment
25.8 Wearable Filter Evaluations
25.9 Environmental Assessment
25.10 BLV Rehabilitation Instruction and Interventions
25.10.1 Visual Efficiency Skills
25.10.2 Orientation and Mobility Skills
25.10.3 Independent Living Skills
25.10.4 Low Vision Assistive Technology
Note
References
26 Safety Considerations in Older Adults With Cognitive Impairment Including Dementia
26.1 Introduction
26.2 Background On Dementia
26.2.1 What Is Dementia?
26.2.2 What Are the Symptoms of Dementia?
26.2.3 How Is Dementia Diagnosed?
26.2.4 What Are the Stages of Dementia?
26.2.5 What Treatments Are Available for People Living With Dementia?
26.2.6 Dementia as a Fatal Disease; Advance Care Planning; and the Role of Palliative and Hospice Care
26.3 Safety Issues in People Living With Dementia
26.3.1 Safety Issues in Early Dementia
26.3.1.1 Transportation
26.3.1.2 Financial Management
26.3.1.3 Nutrition
26.3.1.4 Healthcare Management
26.3.2 Safety Issues in Middle Stages of Dementia
26.3.2.1 Wandering
26.3.2.2 Falls
26.3.2.3 Other Accidents/Injuries
26.3.2.4 Worsening Behavioral and Psychological Disturbances
26.3.3 Safety Risks in Late Stage/Advanced Dementia
26.3.3.1 Caregiver Burnout
26.3.3.2 Elder Abuse/Neglect
26.3.3.3 Burdensome Or Unwanted Medical Interventions
26.4 Health Disparities as a Safety Issue in Dementia
26.5 Interventions to Address Safety Issues in Dementia
26.6 Summary
Bibliography
27 Legal Safety Tools
27.1 Introduction
27.2 Supported Decision-Making
27.3 Financial Decision-Making
27.3.1 Putting Money On Automatic Pilot
27.3.2 Use Joint Ownership Carefully
27.3.3 Add a Trusted Contact to Accounts
27.3.4 Appoint an Agent in a Power of Attorney
27.3.5 Establish a Representative Payee
27.3.6 Consider Establishing a Trust If Needed
27.4 Health Care Decision-Making
27.4.1 Engage in Advance Care Planning
27.4.2 Be Aware of POLST
27.5 Conclusion
References
28 Older Adults and Scams
28.1 How Much Do We Lose From Being Scammed?
28.2 Older Adults Are Targeted
28.3 How Do They Scam Us?
28.4 Some “Popular” Scams
28.5 How to Avoid Getting Scammed
28.6 What to Do If You Have Been Scammed?
Other Important Resources
Bibliography
Lifespan of Greater Rochester’s Scam Prevention Program
29 Elder Abuse and Financial Exploitation
29.1 Elder Abuse
29.1.1 Prevalence and Impact
29.1.2 Unique Considerations in Cases of Elder Abuse
29.1.3 Trauma-Informed Approach
29.1.4 Identification, Intervention, and Prevention
29.1.4.1 Identification
29.1.4.2 Interventions
29.1.4.3 Prevention
29.2 Financial Exploitation: Spotlight On Scams
29.2.1 Prevalence and Impact
29.2.2 Prevention and Reporting
Notes
Bibliography
30 Financing Care: How Clinicians Can Support and Prepare Their Patients
30.1 Financial Health Landscape of Older Americans
30.2 The Basics of Health Insurance for Older Adults
30.3 Medicare’s Covered Benefits
30.4 Financing Long-Term Care
30.5 Looking Beyond Direct Health Care Costs
30.6 Conclusion: Include Costs Conversations Early and Often
Notes
31 Health Inequities: Closing the Disparities Gap in the Aging Population
31.1 Introduction and Background
31.1.1 Aging
31.1.2 Ageism
31.1.3 Health Disparities
31.2 Fundamentals and Frameworks
31.2.1 Behavioral Influences On Health
31.2.2 Social Influences On Health
31.2.3 Cultural Influences On Health
31.2.4 Environmental Influences On Health
31.2.5 Biological Influences On Health
31.3 Strategies for Reducing Health Inequities in the Aging Population
31.3.1 Action Plans On Aging and Health
31.3.2 Allocation of Resources
31.3.3 Research and Data Collection: Promoting Equity and Life-Course Perspectives
31.3.4 Understand Racial/Ethnic and Socioeconomic Health Disparities
31.3.5 Unveil the Biological and Health Effects of Discrimination
31.3.6 Reduce the Impact of Stress Related to Sociocultural Influences
31.3.7 Cultivate Inclusiveness and a Sense of Belonging
31.4 Conclusion
References
32 The Value of Age-Friendly Public Health Systems to Older Adult Health and Well-Being
32.1 The Aging Population in the United States
32.2 The Need for Public Health Engagement in Healthy Aging
32.3 Creating an Age-Friendly Public Health System
32.4 State Momentum and Expansion
32.5 Age-Friendly Public Health Systems Recognition Program
32.6 COVID-19 and Older Adults
32.7 COVID-19 Vaccine Access for Older Adults Who Are Homebound
32.8 The Age-Friendly Ecosystem: A Systems Approach to Healthy Aging
References
33 The Impact of Aging On Healthy Eyes
33.1 Introduction and Background
33.2 Anatomical and Physiological Changes in Our Eyes With Age
33.3 Visual Skills Changes With Age
33.4 Additional Helpful Recommendations
33.5 Conclusion
References
Index