Contributors | p. xiii |
Preface | p. xv |
Foreword | p. xvii |
Introduction | p. xviii |
Frail Older Adults | |
Health Issues of Frail Older Adults | p. 3 |
Defining Frailty | p. 4 |
Comorbidities of Frailty | p. 9 |
Falls | p. 10 |
Adverse Effects of Polypharmacy | p. 11 |
Depression | p. 13 |
Dementia | p. 14 |
Delirium | p. 15 |
Caregiver Issues | p. 17 |
Abuse and Neglect | p. 18 |
Summary | p. 19 |
Health Care Strategies for Frail Older Adults | p. 25 |
Comprehensive Geriatric Assessment | p. 26 |
Description | p. 26 |
Outcomes of Comprehensive Geriatric Assessment | p. 28 |
Components of the Comprehensive Geriatric Assessment | p. 28 |
History | p. 28 |
Physical/Functional Assessment | p. 29 |
Mental Status Assessment | p. 29 |
Depression | p. 30 |
Social and Spiritual Assessment | p. 31 |
Screening and Immunizations | p. 31 |
Frailty Indices | p. 32 |
Problem-Centered Strategies | p. 33 |
Falls | p. 33 |
Polypharmacy | p. 34 |
Depression | p. 35 |
Delirium | p. 36 |
Dementia | p. 38 |
Caregiver Issues, Abuse, and Neglect | p. 38 |
Syndrome-Centered Strategies | p. 39 |
Exercise | p. 39 |
Nutrition | p. 40 |
Pharmacotherapy Interventions | p. 42 |
Systems of Care | p. 42 |
Hospital Care | p. 43 |
Long-Term Care | p. 43 |
Advance Directives | p. 44 |
Summary | p. 46 |
Aging Prisoners | |
Health Issues of Aging Prisoners | p. 57 |
The U.S. Correctional System | p. 58 |
Demographics | p. 58 |
Politics of the Criminal Justice System | p. 60 |
Subcultures Within the Correctional Environment | p. 62 |
Prisoner Subculture | p. 62 |
Administrative Subculture | p. 63 |
Health Care Subculture | p. 64 |
Profile of the Aging Offender | p. 65 |
Health Problems of the Aged Offender | p. 66 |
Summary | p. 70 |
Aging Prisoners: Strategies for Health Care | p. 75 |
Prison Health Care Costs | p. 77 |
Conflict in Goals and Values | p. 77 |
Prison Health Services | p. 79 |
Traditional Approach | p. 79 |
Treatment of Infectious Diseases | p. 81 |
National Standards and Guidelines | p. 82 |
Approaches for Improving Health Care for Older Inmates | p. 83 |
Primary Prevention Programs | p. 83 |
Specialty Units for Older Inmates | p. 84 |
Prison-Based Long-Term Care | p. 86 |
Hospice and End-of-Life Care | p. 87 |
Early Release and Compassionate Release Programs | p. 89 |
Telemedicine | p. 91 |
Joining Correctional Systems and Academic Institutions | p. 91 |
Geriatric Education for Prison Health Providers | p. 92 |
Interdisciplinary Teams | p. 92 |
Summary | p. 93 |
Homeless Older Adults | |
Health Issues of Homeless Older Adults | p. 101 |
Defining Homelessness | p. 102 |
Prevalence of Homelessness Among Older Adults | p. 102 |
Sociodemographic Risk Factors | p. 103 |
Race | p. 105 |
Poverty and Lack of Housing | p. 105 |
Disruptive Childhood and Life Experiences | p. 106 |
Substance Abuse/Addictions | p. 106 |
Mental Illness | p. 107 |
Health Problems of Older Homeless Adults | p. 108 |
Physical Health Problems | p. 109 |
Hypothermia | p. 19 |
Dehydration | p. 110 |
Urinary Incontinence | p. 110 |
Sleep Deprivation | p. 111 |
Infectious Diseases | p. 111 |
Musculoskeletal Ailments | p. 112 |
Foot and Lower Leg Problems | p. 113 |
Accidents and Assaults | p. 114 |
Chronic Diseases Among Homeless Older Adults | p. 114 |
Diabetes Mellitus | p. 114 |
Cardiovascular Diseases: Hypertension, Hyperlipidemia, and Heart Failure | p. 115 |
Mental Health Disorders | p. 116 |
Summary | p. 118 |
Health Care Strategies for Homeless Older Adults | p. 123 |
Interventions and Service Delivery for Older Adults Who Are Homeless | p. 124 |
Downstream Strategies | p. 125 |
Multipurpose Centers | p. 125 |
Shelter Programs | p. 126 |
Food Service Programs | p. 126 |
Health Service Programs | p. 127 |
Social Service Programs | p. 129 |
Emergency Elder Shelters | p. 130 |
Small Day Program for Elders | p. 130 |
Large Day Program for Homeless Elders | p. 130 |
Outreach Programs | p. 131 |
Establishing Homeless/Provider Relationships | p. 131 |
Midstream Strategies | p. 132 |
Empowerment of the Older Adult | p. 132 |
Temporary Housing Programs | p. 134 |
Upstream Strategies | p. 134 |
Policy Implications | p. 135 |
Permanent Supportive Housing | p. 135 |
Identify Early Warning Symptoms for Eviction | p. 136 |
Intervention Program Models for Interdisciplinary Professional Practice | p. 136 |
The Dwelling Place | p. 137 |
Pathways from Street to Resettlement Model | p. 137 |
Ending Elder Homelessness: The Committee to End Elder Homelessness | p. 139 |
CEEH Interdisciplinary Case Management Model | p. 140 |
Summary | p. 141 |
Lesbian, Gay, Bisexual, and Transgender Older Adults | |
Health Issues of Lesbian, Gay, Bisexual, and Transgender Older Adults | p. 149 |
Definitions of Terms | p. 150 |
Stigma and Bias | p. 152 |
Internalized Homophobia | p. 153 |
Demographic Profile | p. 154 |
Physical Health Issues | p. 156 |
Older Lesbian/Bisexual Women | p. 156 |
Older Gay/Bisexual Men | p. 158 |
Older Transgender Adults | p. 158 |
Psychosocial and Spiritual Health Issues | p. 159 |
Adjustment | p. 159 |
Substance Abuse | p. 160 |
Violence and Sexual Assault | p. 162 |
Older Lesbian/Bisexual Women | p. 163 |
Older Gay/Bisexual Men | p. 163 |
Older Transgender Adults | p. 164 |
Spiritual Issues | p. 164 |
Health Care Issues | p. 165 |
Summary | p. 165 |
Health Care Strategies for Lesbian, Gay, Bisexual, and Transgender Older Adults | p. 177 |
Strategies for Caring for LGBT Elders | p. 179 |
Communicating with LGBT Elders | p. 179 |
Assessment Guidelines | p. 180 |
Physical Environment | p. 186 |
Resources for Care of LGBT Elders | p. 186 |
Housing and Long-Term Care | p. 190 |
Multipurpose Community Resources | p. 191 |
Strategies for Health Care Providers | p. 191 |
Cultural Competence | p. 192 |
Education on LGBT Issues | p. 192 |
Consciousness Raising About Attitudes | p. 195 |
Policy and Legal Issues | p. 197 |
Health Policy | p. 197 |
Legal Issues | p. 198 |
Summary | p. 199 |
Older Adults with HIV/AIDS | |
Health Issues of Older Adults with HIV/AIDS | p. 209 |
Gender | p. 211 |
Race/Ethnicity | p. 214 |
Sexual Orientation | p. 216 |
Older Injection-Drug Users | p. 217 |
Health-Related Issues | p. 218 |
Age-Related Changes | p. 218 |
Diagnosis Issues and Testing | p. 221 |
Symptom Management and Comorbidities | p. 221 |
Cognitive Dysfunction | p. 223 |
Medication Issues | p. 223 |
Psychosocial Issues | p. 224 |
Caregiving and Affected Older Adults | p. 226 |
Summary | p. 229 |
Health Care Strategies for Older Adults with HIV/AIDS | p. 235 |
Identifying the Scope of the Problem | p. 236 |
Primary Prevention and Education | p. 237 |
Testing and Diagnosis | p. 239 |
Health Care Interventions | p. 239 |
Systems of Care | p. 241 |
AIDS Service Organizations | p. 242 |
Health/Medical Sector | p. 243 |
Behavioral Health Treatment Sector | p. 244 |
Public Health Sector | p. 245 |
Aging Services Sector | p. 245 |
Components of an Integrated System of Care | p. 247 |
Summary | p. 247 |
Epilogue | p. 251 |
Index | p. 255 |
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