Essentials of Gerontological Nursing: Adaptation to the Aging Process Angela Staab and Linda Hodges; Philadelphia, PA: J. B. Lippincott; 1996; 557 pages; $24.95; softcover
A gerontological nurse practitioner and a nurse educator have teamed up to produce a text that offers clinical guidance for care of the elderly in a succinct and useful format. The authors present this work accurately as a "basic text for undergraduate students" and a "ready reference" for the practicing nurse. The text is divided into four major sections. Part one includes chapters describing aging theory, the role of gerontological nursing, and aging demographics. Part two includes fifteen chapters addressing common physiologic problems in the aging population such as mobility, sight, hearing, nutrition, skin, and continence. Part three addresses psychosocial issues and problems including cognition, sexuality, substance abuse, and problem behavior. Part four concludes with six chapters about general issues affecting the elderly with emphasis on home and community. Topics in this section include abuse and neglect, death and dying, community resources for the elderly, and family and living arrangements. The format is consistent for all chapters and includes sections on normal changes associated with aging, abnormal changes, assessment, nursing diagnoses, interventions, patient/ family teaching, and sample care plans. There are learning objectives at the beginning of each chapter that help to focus the reader. Tables, assessment guides and tools, fact sheets, formulas, and tables of normal lab values are relevant and generously supplied throughout. Patient teaching boxes contain useful information. Unfortunately, the shaded type set in these boxes makes them very difficult to read.
Essentials of Gerontological Nursing deals admirably with a wide range of common gerontologie problems and does provide essentials of assessment and intervention. However, the central concept "adaptation" is not clearly defined for the reader. One presumes that through the recommended nursing interventions, the nurse assists the elderly person to adapt to normal and abnormal changes associated with the aging process. The text is written largely from a wellness and prevention perspective.
Not all chapters are well suited for guiding clinical practice in all settings as suggested by the authors. Frequently, little is mentioned about the nursing home environment. For example, recommended assessments do not refer to methods and processes in the resident assessment instrument, a tool used in nursing homes nationwide. Many chapters are comprehensive in their treatment of the subject, even going beyond "basic." However, a criticism is that the chapter on "skin, hair and nails" fails to cite the AHCPR guidelines on prevention and treatment of pressure ulcers. It also fails to address two common skin problems in the elderly: senile purpura, and skin tears, the most commonly reported injury in nursing homes.