The Aged Person and the Nursing Process, 3rd ed. Yurick AG, Spier BE, Robb SS, Ebert NJ, Norwalk, Conn, Appleton and Lange, 1989, 730 pages, hardbound.
This third edition of The Aged Person and the Nursing Process will be a useful text and resource for gerontological nursing, as past editions have. Its content is not specific to care settings, thus it is applicable to community as well as longterm and acute settings.
The focus of this book is on normal age-related changes and nursing care needs. Specific disease processes are not addressed. The first part covers the nursing process as it is understood today. Examples of the focus on the individuality of the older adult are the sections about assessment of minority and ethnic groups, special needs of elderly women, and the rural elderly. Nursing diagnoses (using primarily NANDA categories) are used throughout and NANDA's 1 988 approved list is included in an appendix. Goal statements, although described as clientcentered, are, at times, not written from the client's perspective when examples are given.
Planning, intervention, and evaluation stress client or family participation. Little mention is made of interdisciplinary care planning, which is essential for provision of quality care for older adults.
A chapter on aging theories and implications for nursing, although interesting, is probably too academic for the interests of practicing nurses. A chapter on behaviors takes the reader by surprise, since it is a discussion of nurses' attitudes and behaviors. It is a thought-provoking description of the need to look beyond attitudes toward actual behaviors of nurses, their causes, and ways to change these behaviors. The importance of rewarding nurses for positive approaches to the care of older clients is stressed.
A chapter on resources in health care contains important but poorly organized material on types of community-based care, long-term care, payment sources, quality of care measurements, research, management, advocacy, and medical versus holistic service delivery models. Although it is worthwhile in content, the variety of information makes it difficult to use this chapter as a reference. However, the chapter on life changes is well-written and comprehensive.
Practicing nurses may find the second part of the book more useful. It applies the nursing process life changes, cognitive aspects, sensory experiences, nutrition, eliminations, activity, body protection (immunity), and medications, with a chapter devoted to each. These chapters include common nursing diagnoses, goals, and intervention for the many age-related physical, psychological, and social changes. The information presented is common to textbooks of this type, but it is presented well.
The book closes with appendices, including an outline for gerontological education for nurses, a health assessment guide, nursing diagnosis categories, and print resources and organizations. It has a glossary and an index.
The major flaw of this book is the organization of its content, which makes it difficult to be used as a reference.
The major strength are the wide scope of content, typeface (including bold-faced emphasis of major points throughout), the bibliographies at the end of each chapter, and the health promotion approach to gerontological nursing. Another advantage is the availability of a teaching manual.