Comprehensive Care of Orthopaedic Injuries in the Elderly. Zucke rman JD (Ed), Baltimore, Urban & Schwarzen berg, 1990, 699 pages, $1 25, hardback.
If ever a book truly achieved the intent of its name, it would be this volume. It is, indeed, a comprehensive and complete examination of caring for orthopedic injuries specifically as they are manifested in elderly cl ients. Concepts of geriatric health care are so thoroughly interwoven into the fabric of the text that it is obvious that the knowledge imparted by the contributors is born of extensive practical experience with these clients.
Many of the 35 contributors are affiliated with the Hospital for Joint Diseases Orthopaedic Institute, New York. The contributors are primarily physicians; however, there is representation from the fields of psychology, social work, nutrition, and nursing. This multidisciplinary mix of perspectives allows the book to achieve its purpose of promoting coordination among disciplines toward meeting the complex and multifaceted needs of an elderly clientele with orthopedic injuries.
The book opens with a thorough discussion of the aging neuromusculoskeletal system, and principles of individualized fracture treatment are then highlighted. The entire range of fractures and soft tissue injuries is discussed using an anatomical approach, and difficult and challenging management problems are addressed as well. For each injury, the frequency of occurrence, aspects of patient evaluation, and recommendations for treatment options are given.
The second part of the text examines the multiple related components necessary (or comprehensive geriatric care. Frequently underemphasized areas, such as the behavioral management of depression, dementia, and chronic pain, are examined thoroughly here because of their importance in the elderly. Perioperative care and anesthesia receive in-depth coverage as well. In addition, individual chapters are included on the topics of nutrition, nursing care, and social work to round out the comprehensive care theme.
The third section addresses two related issues. The contributors share the data collection system in place in their facility so that it might serve as a prototype for research and analysis in other facilities. The text concludes with a discussion of the impact of the current health-care financing system on the care of the elderly.
From a nursing perspective, the coverage of nursing care is of a general nature. The addition of a case study exemplifying application of the nursing process does, however, make it adequate for the purpose of this work. Although not intended as a nursing text, it is an excellent reference source.
This book's greatest strength is that it is truly comprehensive. The impact is enhanced by the extensive use of illustrations and case studies. Although primarily physician directed, it would be a practical addition to the library of any health-care worker serving the elderly with orthopedic injuries.