INTRODUCTION

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INTRODUCTION Powered By Docstoc
					INTRODUCTION


     A. How Old is Old?
     B. The Study of Aging
           1. Research Tools Used To Study Elders
                   a) Observational and Interventional Studies
                   b) Cross-Sectional and Longitudinal Approaches
     C. Why Study Health and Aging?


CHAPTER ONE: OUR NATION’S ELDERS: MYTHS AND FACTS

     A. Ageism: The Myths
     B. Our Nation’s Elders: The Facts
           1. Number and Growth of the Older Population
           2. Life Expectancy
           3. Housing And Geographic Distribution
           4. Marital Status and Living Arrangements
           5. Education
           6. Income and Employment
           7. Health Status and Health Care
     C. Racial and Ethnic Diversity Among Elders
           1. Black Americans
           2. Hispanic Americans
           3. Native Americans
           4. Asian and Pacific Islander Americans
     D. Working With Minority Elders: Obstacles and Opportunities




                                                                                            Ferrini/Ferrini
                                                                         Health in the Later Years 3rd Ed.
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CHAPTER TWO: BIOLOGIC AGING THEORIES AND LONGEVITY

    A. Factors Influencing Longevity
           1. Heredity and Parental Influences
           2. Gender
           3. Ethnicity
           4. Cigarette Smoking
           5. Genetic and Acquired Disease
           6. Obesity
           7. Physical Activity
           8. Alcohol Use
           9. Marital Status
           10. Psychological Factors
           11. Social Class, Education, Income and Occupation
           12. Cultural Factors
           13. The Physical Environment
    B. Biologic Theories of Aging
    C. Attempts to Extend Length of Life
           1. Caloric Restriction
           2. Melatonin
           3. DHEA
           4. Antioxidant Therapy
           5. Prescription Drugs




                                                                                               Ferrini/Ferrini
                                                                            Health in the Later Years 3rd Ed.
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CHAPTER THREE: THE BODY AND ITS AGE CHANGES

     A. Studying the Physiological Process of Aging
     B. Defining Age Changes
     C. The Integumentary System
     D. The Musculoskeletal System
     E. The Cardiovascular System
     F. The Lymphatic System
     G. The Respiratory System
     H. The Digestive System
     I. The Urinary System
     J. The Nervous System
     D. The Sensory System
            1. Vision
            1. Hearing
            2. Taste and Smell
            3. Balance and Equilibrium
            4. Somatic Receptors
     K. The Endocrine System
     L. The Reproductive System
            1. The Male
            2. The Female




                                                                                     Ferrini/Ferrini
                                                                  Health in the Later Years 3rd Ed.
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CHAPTER FOUR: PHYSICAL ACTIVITY

     A. Components of Physical Fitness
     B. Benefits of Physical Activity
            1. Decreased Death Rate
            2. Increased Metabolic Rate and Decreased Body Fat
            3. Changes in Blood Fats and Insulin Resistance
            4. Increased Cardiovascular Endurance
            5. Increased Bone Mass
            6. Improved Muscle Strength
            7. Positive Psychological Effects
     C. Hazards of Inactivity
     D. Physical Activity to Reduce Chronic Illness
            1. Heart Disease
            2. Hypertension
            3. Peripheral Vascular Disease
            4. Adult-Onset Diabetes
            5. Obesity
            6. Respiratory Diseases
            7. Osteoporosis
            8. Arthritis
            9. Lower Back Pain
            10. Cancer
            11. Falls
     E. Elders’ Activity Level and Attitudes Towards Exercise
     F. Exercise Promotion
            1. Medical Assessment
            2. The Exercise Prescription
            3. Risks and Complications of Exercise
            4. Implementing Effective Fitness Programs




                                                                                           Ferrini/Ferrini
                                                                        Health in the Later Years 3rd Ed.
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CHAPTER FIVE: NUTRITION

     A.   The Study of Diet and Nutrition
     B.   The Science of Nutrition
     C.   Dietary Guidelines for Americans
     D.   Recommended Dietary Allowances
     E.   Nutritional Diseases
              1. Malnutrition
              2. Weight Loss and Artificial Feeding
              3. Obesity
     F.   Essential Dietary Components
              1. Water
              2. Protein
              3. Carbohydrates
              4. Fats
              5. Fiber
              6. Vitamins
              7. Minerals
     G.   Vitamin and Mineral Supplements
     H.   Relation of Nutrition to Chronic Illness
              1. Cancer
              2. Diabetes
              3. Heart Disease
     I.   Effect Of Drug Use on Nutritional Status
     J.   Nutritional Status of Elders
              1. Factors Influencing Nutritional Status
              2. Assessment of Inadequate Nutrition
     K.   Nutritional Education and Counseling
     L.   Nutrition Programs




                                                                                         Ferrini/Ferrini
                                                                      Health in the Later Years 3rd Ed.
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CHAPTER SIX: SEXUALITY

     A. Stereotypes of Elder Sexuality
     B. Sexual Activity in Later Life
            1. Sexual Interest
            2. Intercourse
            3. Masturbation
            4. Other Sexual Behaviors
     C. Changes in Sexual Response with Age
     D. Sexuality in Special Elder Populations
            1. Older Unmarried Women
            2. Elder Homosexuals
            3. Institutionalized Elders
     E. The Effect of Chronic Illness on Sexuality
            1. Heart Disease
            2. Hypertension
                    a) Cancer
            3. Diabetes
            4. Arthritis
     F. Other Factors Influencing Sexual Function
            1. Medications
            2. Alcohol and Tobacco
            3. Surgery
            4. Widower’s Syndrome
            5. Psychosocial Considerations
     G. Sexual Dysfunction
            1. Diagnosis
            2. Treatment
                    a) Medications and Hormones
                    b) Mechanical Aids
                    c) Sex Therapy
     H. Sex Education




                                                                                    Ferrini/Ferrini
                                                                 Health in the Later Years 3rd Ed.
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CHAPTER SEVEN: MENTAL HEALTH AND ILLNESS

    A. Mental Health
          1. Changes with Age
                    a) Cognition
                    b) Memory
          2. Personality
    B. Transitions in Later Life
          1. Retirement
          2. New Relationships with Adult Children/Grandchildren
          3. Marital Transitions
                    a) Changes in Relationship Satisfaction
                    b) Spousal Illness
                    c) Widowhood
                    d) Elderly Lovers and Newly Weds
          4. Factors Affecting Adjustment
                    a) Personality
                    b) Health
                    c) Finances
                    d) Ability to Cope with Stress
    C. Mental Illness
          1. Anxiety Disorders
                    a) Generalized Anxiety Disorders
                    b) Panic Disorders
                    c) Phobic Disorders
                    d) Adjustment Disorders with Anxiety
                    e) Post-Traumatic Stress Disorder
                    f) Obsessive-Compulsive Disorders
          2. Mood or Affective Disorders
                    a) Depression
                    b) Bipolar Disorder
          3. Somatform Disorders
                    a) Somatization Disorder
                    b) Hypochondriasis
                    c) Schizophrenia
                    d) Sleep Disorders
                    e) Substance Use Disorders
                    f) Dementia
                    g) Delirium
    D. Assessment of Psychological Vulnerability
    E. Psychological Treatments
    F. Mental Health Services
          1. History of Mental Health Reforms
          2. Providers of Mental Health Services
          3. Types Of Mental Health Services
                    a) Nursing Homes
                    b) Public Mental Institutions
                    c) Psychiatric Units of Acute-Care Hospitals
                    d) Community Mental Health Centers
                    e) Private Therapists and Psychiatric Outpatient Clinics
                                                                                               Ferrini/Ferrini
                                                                            Health in the Later Years 3rd Ed.
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       f) Halfway Houses
4. Financial Reimbursement
       a) Medicare
       b) Medicaid
5. Elder Utilization of Mental Health Services
6. Future Directions




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                                                             Health in the Later Years 3rd Ed.
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CHAPTER EIGHT: CHRONIC ILLNESSES

     A. The Nature of Chronic Illness
     B. Psychosocial Aspects of Chronic Illness
     C. Common Chronic Conditions Among Elders
           1. Cardiovascular Diseases
                   a) Atherosclerosis
                   b) Hypertension
                   c) Coronary Artery Disease
                   d) Congestive Heart Failure
                   e) Cardiac Arrhythmia
                   f) Stroke
                   g) Aortic Aneurysm
                   h) Venous Diseases
                           (1) Varicose Veins
                           (2) Deep Venous Thrombosis
           2. Cancer
           3. Respiratory Diseases
                   a) COPD
                   b) Lung Cancer
           4. Sensory Disorders
                   a) Glaucoma
                   b) Macular Degeneration
                   c) Tinnitis
           5. Neurological Disorders
                   a) Parkinson’s Disease
                   b) Tardive Dyskinesia
                   c) Essential Tremor
                   d) Meneire’s Disease
           6. Digestive Disorders
                   a) Periodontal Disease
                   b) Heartburn and Gastroesophageal Reflux
                   c) Hiatal Hernia
                   d) Diverticulosis
                   e) Colorectal Cancer
                   f) Hemorrhoids
                   g) Constipation
                   h) Fecal Incontinence
           7. Skeletal Disorders
                   a) Osteoarthritis
                   b) Rheumatoid Arthritis
                   c) Gout
                   d) Osteoporosis
                   e) Back Pain
           8. Endocrine Disorders
                   a) Diabetes
                   b) Thyroid Problems
           9. Breast Cancer and Genitourinary Disorders
                   a) Breast Cancer
                   b) Benign Prostatic Hyperplasia
                                                                                             Ferrini/Ferrini
                                                                          Health in the Later Years 3rd Ed.
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        c) Prostate Cancer
        d) Urinary Incontinence
10. Skin Disorders
        a) Psoriasis
        b) Senile Pruritis
        c) Skin Cancer




                                                                 Ferrini/Ferrini
                                              Health in the Later Years 3rd Ed.
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CHAPTER NINE: ACUTE ILLNESSES AND ACCIDENTS

     A. Common Acute Illnesses among Elders
           1. Respiratory Infections
                  a) The Common Cold
                  b) Influenza
                  c) Acute Bronchitis
                  d) Pneumonia
                  e) Aspiration Pneumonia
                  f) Tuberculosis
           2. Gastrointestinal Illnesses
                  a) Cavities
                          (1) Ulcer Disease
                  b) Gallbladder Disease
                  c) Diverticulitis
                  d) Appendicitis
                  e) Fecal Impaction
                  f) Diarrhea
           3. Urinary Tract Infections
                  a) Cystitis and Pyelonephritis
                  b) Prostatitis
                  c) Kidney Stones
           4. Vaginal Infections
           5. Pressure Ulcers
           6. Shingles
           7. AIDS
           8. Dehydration
           9. Dizziness
           10. Environmentally Induced Acute Illnesses
                  a) Hyperthermia
                  b) Hypothermia
     B. Accidents
           1. Factors Increasing Accident Susceptibility
           2. Common Types of Accidents
                  a) Falls
                  b) Motor Vehicle Accidents
                  c) Pedestrian Accidents
                  d) Fires and Burns
                  e) Choking
           3. Medical Assessment after an Accident
           4. Accident Prevention




                                                                                          Ferrini/Ferrini
                                                                       Health in the Later Years 3rd Ed.
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CHAPTER TEN: MEDICATION USE

    A. Elder Medication Consumption and Expenditures
    B. Factors Affecting Medication Use
    C. Pharmacokinetics
           1. Changes In Drug Absorption
           2. Changes In Drug Distribution
           3. Changes In Drug Metabolism
           4. Changes In Drug Excretion
    D. Polypharmacy
           1. Drug Interactions
           2. Adverse Drug Effects
           3. Medication Errors
    E. Compliance
           1. Non Compliant Behaviors
                   a) Education To Increase Compliance
                   b) Memory Aids
           2. The Issue of Non-Compliance
    F. Promoting Rational Drug Use
           1. The Physician’s Responsibility
           2. The Pharmacist’s Responsibility
           3. The Responsibilities Of The Nurse And Social Worker
           4. The Elder’s Responsibility
    G. Over-The-Counter Drugs Commonly Used By Elders
           1. Pain Relievers
           2. Antacids
           3. Diarrhea Medications
           4. Antihistimines
           5. Laxatives
           6. Cold and Flu Medications
           7. Topical Medications
    H. Prescription Drugs Commonly Used by Elders
           1. Analgesics
           2. Antibiotics and Antivirals
           3. Antihistimines
           4. Antiinflammatory Drugs
           5. Osteoporosis Drugs
           6. Bronchodilators and Anti-Asthmatics
           7. Corticosteroids
           8. Drugs for Skin Problems
           9. Hormone Replacement
           10. Drugs To Reduce Cholesterol
           11. Gout Drugs
           12. Diabetic Drugs
           13. Gastric Acid Blockers
           14. Psychoactive Drugs
                   a) Drugs for Siezures
                   b) Drugs for Parkinson’s Disease
                   c) Sedatives
                   d) Anti-Psychotic Drugs
                                                                                          Ferrini/Ferrini
                                                                       Health in the Later Years 3rd Ed.
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               e) Anti-Anxiety Drugs
               f) Anti-Depressants
               g) Drugs for Alzheimer’s Disease
       15. Cardiovascular Drugs
               a) Drugs for High Blood Pressure
               b) Drugs for Congestive Heart Failure
               c) Drugs for Angina
               d) Anticoagulants
       16. Drugs To Shrink the Prostate
I. Generic vs. Brand Name Drugs
J. Alternatives to Drugs




                                                                                      Ferrini/Ferrini
                                                                   Health in the Later Years 3rd Ed.
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CHAPTER ELEVEN: PREVENTION AND HEALTH PROMOTION

    A. Prevention: An Overview
    B. What Is A Risk Factor?
    C. Prevention and Health Promotion Efforts towards Elders
           1. Primary Prevention
                   a) Influenza Vaccines
                   b) Pneumococcal Vaccines
                   c) Tetanus Immunizations
                   d) Post-Menopausal Hormone Replacement Therapy
                   e) Aspirin to Prevent Heart Attack and Stroke
           2. Secondary Prevention: Screening
                   a) Breast Cancer
                   b) Prostate Cancer
                   c) Colorectal Cancer
                   d) Cervical Cancer
                   e) Cardiovascular Disease
                   f) Hypertension
                   g) Elevated Cholesterol
                   h) Tuberculosis
                   i) Vision
                   j) Hearing Loss
                   k) Osteoporosis
                   l) Problem Drinking
           3. Health Promotion and Counseling
                   a) Changing Health Behaviors
                   b) Stages of Behavior Change
                   c) Specific Health Promotion Interventions
                   d) Health Promotion in Community Settings
    D. Prevention and Health Promotion on A National Scale
    E. Prevention: Problems and Prospects




                                                                                       Ferrini/Ferrini
                                                                    Health in the Later Years 3rd Ed.
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CHAPTER TWELVE: MEDICAL CARE

    A. Elder Use of Medical Services
    B. Financing Medical Services
           1. Medicare
                    a) Reimbursement to Hospitals And Physicians
                            (1) Diagnostic Related Groups
                            (2) Resource-Based Relative Value Scales
                    b) Medicare Managed Care
           2. Benefits and Limitations of Medicare
           3. Medicaid
           4. Private Insurance (Medigap)
           5. Veteran’s Health Care Benefits
           6. Private Funds
    C. Our Health Care System: Problems and Prospects
           1. High Cost Of Care
           2. Medical Malpractice
           3. For-Profit Medical Care
           4. Patient-Physician Relationship
           5. Lack Of Training in Geriatrics
           6. Inequities in Medical Treatment
           7. Overspecialization and Fragmentation
           8. Inaccessible Services
           9. Unnecessary Diagnostic Tests
           10. Surgery: Too Much or Too Little
           11. Iatrogenic Illnesses
           12. The Educated Health Consumer
           13. Alternative Healing Approaches
                    a) Osteopathy
                    b) Chiropracty
                    c) Chinese Medicine
                    d) Ayurveda
                    e) Homeopathy
                    f) Native Healing Practices
                    g) Natural Healing
                    h) Mind-Body Approaches




                                                                                             Ferrini/Ferrini
                                                                          Health in the Later Years 3rd Ed.
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CHAPTER THIRTEEN: LONG TERM CARE

    A. The Need for Long Term Care
    B. Long Term Care Financing
    C. In-Home Services
           1. Benefits and Limitations of Home Care
           2. Types of In-Home Services
                  a) Homemaker and Home Health Services
                  b) Skilled Nursing Services
                  c) Physician Services
                  d) Physical, Speech and Occupational Therapists
                  e) Emergency Response System Services
                  f) Telephone and Visiting Programs
                  g) Home-Delivered Meals
                  h) Hospice Care
    D. Community-Based Services
           1. Congregate Meal Services
           2. Adult Daycare Centers and Adult Day Health Centers
           3. Multipurpose Senior Centers
           4. Transportation Services
           5. Case Management Services
           6. Comprehensive Community-Based Care
           7. Community-Based Sheltered Living
    E. Family Providers of Home Care
           1. Formal Support for Caregivers
           2. Elder Abuse
    F. Long Term Care Institutions
    G. Nursing Homes
           1. Nursing Home Population
           2. Nursing Home Reform Act
           3. Nursing Home Costs
           4. Benefits and Limitations Of Nursing Home Care
           5. Nursing Home Advocacy
           6. Families of Nursing Home Residents
    H. Planning Long-Term Care




                                                                                           Ferrini/Ferrini
                                                                        Health in the Later Years 3rd Ed.
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CHAPTER FOURTEEN: DYING, DEATH, AND GRIEF

     A. Death Defined
     B. Who Should Decide?
            1. Euthanasia
            2. Advance Directives
            3. Assisted Suicide
            4. Suicide
     C. Attitudes towards Dying and Death
     D. Options On Where to Die
     E. The Dying Trajectory
            1. Rights of the Dying
            2. Tasks of the Dying
            3. Caring for the Dying
                    a) The Family
                    b) The Health Professional
     F. Bereavement
            1. The Grieving Process
            2. Assisting the Bereaved




                                                                                Ferrini/Ferrini
                                                             Health in the Later Years 3rd Ed.
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