Critical Care Nursing of the Elderly - Book Review

AORN Journal,  Nov, 2002  by Cynthia D. Turner

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second ed Terry T. Fulmer et al, eds 2001, 430pp $53.95 hardback

As the US population ages, medical care will be affected. Medical care providers need to be aware of a wide variety of health care issues not seen routinely among the younger population. This book examines critical care nursing practices for older adults, but it can be used in several health care arenas. It covers a wide spectrum of older adult health care issues seen in hospitals, nursing homes, and community health nursing. The book is well written and an excellent resource for all nurses who provide care for this population, no matter what the health care setting.

The book is divided into four parts. The first part provides information about basic clinical issues that often arise when dealing with the older adult population, such as nutritional problems, assessment for pain, sleep disturbances, urinary tract problems, comorbidities with acute illnesses, and prevention of injuries in the home and elsewhere. Several tables and charts are presented that nurses can use to evaluate patients and their specific problems. The second part of the book examines the interaction of disease and aging, as well as older adults' perceptions on aging. It presents information on how disease and aging affect the use, effects, and metabolism of medications; methods of educating older adult patients about their health care problems; assessing patient outcomes and deciding what outcomes to measure; discharge planning for each level of health care; and helping family members through short- and long-term care of their loved one.

The third part of the book focuses exclusively on the care of older adult patients in the intensive care, coronary care, and trauma care units. Not only are specific injuries and diseases examined, but quality of life, discharge planning, use of invasive therapies, and how aging affects the course of disease and injury also are examined. The last part of the book covers the social and political implications of providing care for this patient population. Ethical decision making is discussed using the moral principles of autonomy, respect for others, justice, beneficence, and non-malfeasance. The author examines end-of-life care through several different perspectives, such as palliative care, hospice care, and curing to caring. The importance of spiritual and religious concerns also is discussed in-depth, including how nurses may help with the patient's and patient's family members' spiritual well-being. The meanings and implications of advanced directives, do-not-resuscitate orders, and withholding or withdrawing care are reviewed, ethically and legally.

This book is easy to read and understand, and it provides nurses with a wealth of useful information. It is an excellent resource book, and I highly recommend it for anyone providing care to the older adult population.

This book is available from Springer Publishing Co, 536 Broadway, New York, NY 10010; http://www.springerpub.com.

CYNTHIA D. TURNER
RN, BSN, MSN, CNOR,
LCDR, NURSE CORPS, US NAVY
TEAM LEADER
NAVAL HOSPITAL CAMP PENDLETON

CALIF

COPYRIGHT 2002 Association of Operating Room Nurses, Inc.
COPYRIGHT 2002 Gale Group