A Comprehensive Guide to Safety and Aging: Minimizing Risk, Maximizing Security

Cover
Half Title
Title Page
Copyright Page
Table of Contents
Editors’ Note
About the Editors
List of Contributors
1 Introduction
	1.1 Why Aging? Why Safety? What Matters
	References
2 Hazards of Hospitalization
	2.1 Introduction
	2.2 Loss of Function
	2.3 Falls
	2.4 Incontinence
	2.5 Delirium
	2.6 Malnutrition
	2.7 Pressure Injury
	2.8 Venous Thromboembolism
	2.9 Nosocomial Infection
	2.10 The Biology of Normal Aging
	2.11 Interventions
	2.12 Summary
	Bibliography
3 Atypical Presentations of Common Diseases
	3.1 Introduction
	3.2 Common Atypical Presentations
	3.3 Making a Diagnosis
	3.4 Assessment
	3.5 Atypical Presentations of Common Illnesses
		3.5.1 Cardiovascular Disease
		3.5.2 Infections
			3.5.2.1 Urinary Tract Infections
			3.5.2.2 Pneumonia
			3.5.2.3 Sepsis
		3.5.3 Abdominal Pain
	3.6 Summary
	Bibliography
4 Hip Fractures in Older Adults
	4.1 Risk Factors
	4.2 Types of Hip Fracture
	4.3 Diagnosis
	4.4 Treatment
	4.5 Postoperative Complications
	Bibliography
5 Functional Fitness for Optimal Aging
	5.1 Introduction
	5.2 Benefits of Physical Activity for Older Adults
	5.3 Psychological Benefits
	5.4 Psychosocial Determinants of Exercise
	5.5 Physical Inactivity
	5.6 Recommendations for Practitioners
	5.7 Conclusion
	Bibliography
6 Care Transitions
	6.1 Overview
	6.2 Significance of Care Transitions and Impact On Patient Outcomes
	6.3 Successful Care Transitions
	6.4 Care Transition Models
	6.5 Care Transition Tools
	6.6 Impact On Patient Safety
	6.7 Care Transitions Team Members
	6.8 Patient Education and Teach-Back Role in Patient Safety and Care Transitions
	6.9 Improvements in Care Transitions and Future Directions
	6.10 Summary
	Bibliography
7 Medication Management Issues in the Older Adult Patient
	7.1 Terminology Pearls
	7.2 Clinical Pearls
	7.3 When to Seek Help From Your Prescriber Or Pharmacist
	7.4 Medication Management Tools
	7.5 Medicare Part D (Drug) Plan Information
	7.6 Important Medicare Part D Tidbits
	7.7 Conclusion
	Bibliography
8 Oral Health and Older Adults
	8.1 Oral Health and Systemic Health
	8.2 Oral Health and Long-Term Care
	8.3 Oral Health and Palliative Care
	8.4 Strategies to Consider Before Entering Care
	8.5 Care Strategies for Improving Oral Health of Palliative Care Patients
	8.6 Diet and Sugar
	8.7 Chronic Health and Medication Effects On Oral Health
	8.8 Effects of Smoking and Alcohol On the Oral Tissues
		8.8.1 Smoking
		8.8.2 Alcohol
	8.9 Managing the Risks Associated With Nausea and Vomiting
	8.10 Radiation and Chemotherapy and Oral Health
	8.11 Oral Integrity in Communication and Social Interactions
	8.12 Educating Caregivers and Staff
	8.13 The Intersection of Oral Health and Social Determinants of Health
	8.14 Mental Health and Oral Disease
	8.15 Oral Health Is the Responsibility of the Interdisciplinary Team
	8.16 Summary
	References
9 Preventing Falls and Fall-Related Injuries Among Older Adults
	9.1 Introduction
	9.2 National Statistics On Falls Among Older Adults
	9.3 Risk Factors for Falls
	9.4 Falls Risk Screening and Assessment
	9.5 A Team Approach to Falls Prevention
	9.6 Falls Prevention Coalitions
	9.7 Community-Based Falls Prevention Programs
	9.8 Program Benefits to Older Adults
	9.9 Program Benefits to Community-Based and Health Care Organizations
	9.10 Funding for Falls Prevention Interventions
	9.11 National Efforts to Reduce Falls Among Older Adults
	9.12 International Efforts to Reduce Falls
	9.13 Novel Technologies for Falls Prevention
	Notes
	Bibliography
10 Home Modifications
	10.1 Planning to Age in Place
	10.2 Individual and Home Usage
	10.3 Home Environment
	10.4 Funding Home Modifications
	10.5 Home Features By Room
	10.6 General House Features
	10.7 Layout, Approaches, Entryways, and Stairwells
	10.8 Bathrooms
	10.9 Kitchen
	10.10 Specific Recommendations for Functional Limitations
		10.10.1 Decreased Vision (Presbyopia)
		10.10.2 Decreased Balance, Frequent Falls, Or Difficulty Bending Over
		10.10.3 Decreased Memory
		10.10.4 Decreased Grip Strength Or Limited Shoulder Range of Motion
	10.11 Conclusion
	References
11 Advancements in Technology to Promote Safety and Support Aging in Place
	11.1 Introduction
	11.2 Aging in Place
	11.3 The Home Environment
	11.4 Implications for Aging in Place
	11.5 Needs of Older Adults
	11.6 Understanding Safety Issues in the Home
		11.6.1 Potential for Technology
		11.6.2 Crafting a Smart Home Environment
	11.7 Home Security
	11.8 Fall Detection
	11.9 Health Technologies
	11.10 Comfort Technologies
	11.11 Smart Appliances
	11.12 Personal Devices
	11.13 Robots
		11.13.1 Technology Considerations
			11.13.1.1 Accessibility
			11.13.1.2 Accommodations
			11.13.1.3 Compatibility
			11.13.1.4 Features and Functionalities
			11.13.1.5 Hazards
			11.13.1.6 Interface
			11.13.1.7 Unintended Consequences
		11.13.2 Enabling Older Adults to Take Advantage of These Technology Innovations
			11.13.2.1 Customizability
			11.13.2.2 Adaptability
			11.13.2.3 Maintenance
			11.13.2.4 Privacy and Security
			11.13.2.5 Trust
			11.13.2.6 Technology Acceptance Models
		11.13.3 Recommendations for Professionals
	11.14 Summary
	Acknowledgments
	References
12 Supporting Community Engagement With Assistive Technology as a Means of Health Promotion for Older Adults
	12.1 Introduction
	12.2 Barriers to Community Engagement for Aging Adults
		12.2.1 Self-Care Challenges
		12.2.2 Cognitive Challenges
		12.2.3 Vision Challenges
		12.2.4 Communication Challenges With Hearing and Speaking
		12.2.5 Mobility Challenges
	12.3 Supports for Community Engagement
		12.3.1 The Role of Assistive Technology
		12.3.2 Types of AT Devices
		12.3.3 AT Self-Care Supports
		12.3.4 AT Cognitive Supports
		12.3.5 AT Vision and Hearing Supports
		12.3.6 AT Communication Supports – Speaking
		12.3.7 AT Mobility Supports
	12.4 Additional Resources for Older Adults
	12.5 Conclusion
	References
13 Older Adult Driver Safety
	13.1 Introduction
	13.2 Risk Factors for Unsafe Driving
	13.3 Risk Assessment
	13.4 Interventions
	13.5 Advising Older Adults About Driving Retirement
	13.6 Legal and Ethical Issues
	13.7 Conclusion
	Bibliography
14 Travel and Seasonal Safety for Older Adults
	14.1 Travel
	14.2 Essential Elements for Travel Preparation
	14.3 International and Air Travel
		14.3.1 Health Care Provider Visit
		14.3.2 Vaccinations
		14.3.3 Medications
		14.3.4 Current Health Conditions
		14.3.5 Travelling With Functional Impairments
		14.3.6 Traveling With Oxygen
		14.3.7 Preventing Deep Venous Thrombosis
		14.3.8 Medical Insurance
		14.3.9 Travel-Acquired Infections and Dehydration
		14.3.10 Travelling With Dementia
		14.3.11 Emergency Travel Kit
	14.4 Seasonal Safety for Older Adults
		14.4.1 Hot Weather Or Heat Extreme
	14.5 Expert Recommendations to Prevent Heat-Related Illness in Older Adults
	14.6 Cold Weather
	14.7 Emergency Car Kit
	14.8 Snow and Ice Conditions
	14.9 Flood Conditions
	14.10 Windy Conditions
	Bibliography
15 Emergency Preparedness and Fire Safety
	15.1 Basic Elements of Emergency Planning for Older Adults
	15.2 Risk Assessment and Planning
	15.3 Risk Factors for Older Adults in an Emergency
	15.4 Communication
		15.4.1 Contact Information
		15.4.2 Meeting Place
		15.4.3 Medical and Insurance Information
			15.5 Education and Drills
		15.6 Fire Safety
			15.7 The Disaster Supply Kit
		15.7.1 What to Include in a Disaster Supply Kit (“Go-Bag”)
		15.8 Deciding Whether to Evacuate Or Shelter in Place
			15.9 Post-Disaster Risk Awareness
	15.10 Disaster Planning for CBOs
	15.11 Conclusion
	Bibliography
16 Safety Considerations for Older Workers
	16.1 Introduction
	16.2 Characteristics of Older Workers: Myths and Realities
	16.3 Enhancing the Health and Safety of Older Workers
	References
17 Mental Health: Depression, Anxiety, and Social Isolation
	17.1 Depression
	17.2 Symptoms of Depression
		17.2.1 Key Symptoms
		17.2.2 Other Symptoms
	17.3 Risk Factors
	17.4 Treatments for Depression
	17.5 Anxiety
		17.5.1 Symptoms of Anxiety
		17.5.2 Risk Factors
		17.5.3 Treatments for Anxiety
	17.6 Social Isolation
		17.6.1 Mental Health and Increased Safety Risks
	17.7 Conclusion
	References
18 Suicide Prevention
	18.1 Suicide Incidence and Risk Factors
	18.2 Prevention Strategies
	18.3 Assessing and Addressing Risk for Suicide
	18.4 Role of Providers
	18.5 Public Policy and Societal Recommendations
	Bibliography
19 Social Isolation and Loneliness
	19.1 Social Isolation and Loneliness
	19.2 Risk Factors for Social Isolation
	19.3 Health Consequences of Social Isolation and Loneliness
	19.4 Chronic Health Conditions
	19.5 Assessments
	19.6 Strategies to Prevent Social Isolation and Loneliness
		19.6.1 Lifestyle Changes
	19.7 Meaningful and Fulfilling Roles and Activities
		19.7.1 Work and Volunteering
	19.8 Routine Planning
		19.8.1 Role and Leisure Exploration
		19.8.2 Expanding Community and Social Networks
	19.9 Following Up With a Physician
	19.10 Conclusion
	References
20 Caregiver Safety and Self-Care
	20.1 Caregiving Roles
		20.1.1 Responsibilities
		20.1.2 Challenges
	20.2 Safety With Caregiving
		20.2.1 Mental
		20.2.2 Biomechanical
	20.3 Self-Care
		20.3.1 Self-Awareness/Support
	20.4 Caregiver Burnout
	References
21 Opioid Use and Abuse in Older Adults
	21.1 Some Basics About Pain
	21.2 Appropriate Treatment of Pain
	21.3 Treatment of Opioid Use Disorder (OUD)
	21.4 Conclusion
	Bibliography
22 Reducing Harm Related to Substance Use By Older Adults
	22.1 Overview
	22.2 Aging Increases Vulnerability
	22.3 Links to Chronic Conditions
	22.4 Health Implications for Older Adults of Commonly Used Drugs
	22.5 Health and Safety Risks By Drug Class
		22.5.1 Alcohol
		22.5.2 Cannabis
		22.5.3 Opioids
		22.5.4 Sedative/Hypnotics
		22.5.5 Stimulants
		22.5.6 Tobacco
	22.6 Interventions and Best Practices to Reduce Harm
		22.6.1 Approaches to Care
		22.6.2 Screening, Brief Intervention, Referral to Treatment (SBIRT)
		22.6.3 Harm Reduction Approaches to Improve Safety
	22.7 Financial Costs to Society
	22.8 Policy Implications
	Resources
23 Hearing and Aging
	23.1 Introduction
	23.2 Cerumen Impaction
	23.3 Middle Ear
	23.4 Inner Ear and Neural Pathways
		23.4.1 Age-Related Changes Beyond the Cochlea
	23.5 Other Comorbid Conditions Related to Aging
	23.6 Consequences of Age-Related Hearing Loss
	23.7 Impact of Hearing Loss On the Aging
	23.8 Cognitive Factors
	23.9 Potential Consequences of Hearing Loss Experiences By Older Adults
	23.10 Referral to Hearing Evaluation
		23.10.1 Rehabilitation Goal and Options
	23.11 Hearing Aid Fitting
	23.12 OTC Devices
		23.12.1 Adaptive Or Assistive Listening Devices
	23.13 Communication Considerations
	Note
	References
24 Common Eye Diseases, Their Visual Outcomes, and Strategies for Enhancing Use of Remaining Vision
	24.1 Introduction
	24.2 Cataracts
		24.2.1 Treatment Options
		24.2.2 Associated Visual Changes
	24.3 Diabetic Retinopathy
		24.3.1 Treatment Options
		24.3.2 Associated Visual Changes
	24.4 Stroke
		24.4.1 Treatment
		24.4.2 Associated Visual Changes
	24.5 Chronic Open Angle Glaucoma
		24.5.1 Treatment Options
		24.5.2 Associated Visual Changes
	24.6 Age-Related Macular Degeneration (AMD)
		24.6.1 Treatment Options
		24.6.2 Associated Visual Changes
	24.7 Management OF VISUAL DEFICITS With Low Vision Rehabilitation
		24.7.1 History
		24.7.2 Exam Elements
		24.7.3 Refraction and Lens Selection
		24.7.4 Magnification
		24.7.5 Near and Intermediate Devices
		24.7.6 Distance Devices
		24.7.7 Nonoptical Options and Assistive Technology
		24.7.8 Peripheral Field Loss
		24.7.9 Referral to Rehabilitation
	24.8 Conclusion
	References
25 Blindness and Low Vision Rehabilitation Services
	25.1 Vision Rehabilitation Therapists
	25.2 Orientation and Mobility Specialists
	25.3 Low Vision Therapists
	25.4 Assistive Technology Instructional Specialists
	25.5 BLV Rehabilitation Assessment
	25.6 Understanding Eye Conditions
	25.7 Functional Vision Assessment
	25.8 Wearable Filter Evaluations
	25.9 Environmental Assessment
	25.10 BLV Rehabilitation Instruction and Interventions
		25.10.1 Visual Efficiency Skills
		25.10.2 Orientation and Mobility Skills
		25.10.3 Independent Living Skills
		25.10.4 Low Vision Assistive Technology
	Note
	References
26 Safety Considerations in Older Adults With Cognitive Impairment Including Dementia
	26.1 Introduction
	26.2 Background On Dementia
		26.2.1 What Is Dementia?
		26.2.2 What Are the Symptoms of Dementia?
		26.2.3 How Is Dementia Diagnosed?
		26.2.4 What Are the Stages of Dementia?
		26.2.5 What Treatments Are Available for People Living With Dementia?
		26.2.6 Dementia as a Fatal Disease; Advance Care Planning; and the Role of Palliative and Hospice Care
	26.3 Safety Issues in People Living With Dementia
		26.3.1 Safety Issues in Early Dementia
			26.3.1.1 Transportation
			26.3.1.2 Financial Management
			26.3.1.3 Nutrition
			26.3.1.4 Healthcare Management
		26.3.2 Safety Issues in Middle Stages of Dementia
			26.3.2.1 Wandering
			26.3.2.2 Falls
			26.3.2.3 Other Accidents/Injuries
			26.3.2.4 Worsening Behavioral and Psychological Disturbances
		26.3.3 Safety Risks in Late Stage/Advanced Dementia
			26.3.3.1 Caregiver Burnout
			26.3.3.2 Elder Abuse/Neglect
			26.3.3.3 Burdensome Or Unwanted Medical Interventions
	26.4 Health Disparities as a Safety Issue in Dementia
	26.5 Interventions to Address Safety Issues in Dementia
	26.6 Summary
	Bibliography
27 Legal Safety Tools
	27.1 Introduction
	27.2 Supported Decision-Making
	27.3 Financial Decision-Making
		27.3.1 Putting Money On Automatic Pilot
		27.3.2 Use Joint Ownership Carefully
		27.3.3 Add a Trusted Contact to Accounts
		27.3.4 Appoint an Agent in a Power of Attorney
		27.3.5 Establish a Representative Payee
		27.3.6 Consider Establishing a Trust If Needed
	27.4 Health Care Decision-Making
		27.4.1 Engage in Advance Care Planning
		27.4.2 Be Aware of POLST
	27.5 Conclusion
	References
28 Older Adults and Scams
	28.1 How Much Do We Lose From Being Scammed?
	28.2 Older Adults Are Targeted
	28.3 How Do They Scam Us?
	28.4 Some “Popular” Scams
	28.5 How to Avoid Getting Scammed
	28.6 What to Do If You Have Been Scammed?
	Other Important Resources
	Bibliography
	Lifespan of Greater Rochester’s Scam Prevention Program
29 Elder Abuse and Financial Exploitation
	29.1 Elder Abuse
		29.1.1 Prevalence and Impact
		29.1.2 Unique Considerations in Cases of Elder Abuse
		29.1.3 Trauma-Informed Approach
		29.1.4 Identification, Intervention, and Prevention
			29.1.4.1 Identification
			29.1.4.2 Interventions
			29.1.4.3 Prevention
	29.2 Financial Exploitation: Spotlight On Scams
		29.2.1 Prevalence and Impact
		29.2.2 Prevention and Reporting
	Notes
	Bibliography
30 Financing Care: How Clinicians Can Support and Prepare Their Patients
	30.1 Financial Health Landscape of Older Americans
	30.2 The Basics of Health Insurance for Older Adults
	30.3 Medicare’s Covered Benefits
	30.4 Financing Long-Term Care
	30.5 Looking Beyond Direct Health Care Costs
	30.6 Conclusion: Include Costs Conversations Early and Often
	Notes
31 Health Inequities: Closing the Disparities Gap in the Aging Population
	31.1 Introduction and Background
		31.1.1 Aging
		31.1.2 Ageism
		31.1.3 Health Disparities
	31.2 Fundamentals and Frameworks
		31.2.1 Behavioral Influences On Health
		31.2.2 Social Influences On Health
		31.2.3 Cultural Influences On Health
		31.2.4 Environmental Influences On Health
		31.2.5 Biological Influences On Health
	31.3 Strategies for Reducing Health Inequities in the Aging Population
		31.3.1 Action Plans On Aging and Health
		31.3.2 Allocation of Resources
		31.3.3 Research and Data Collection: Promoting Equity and Life-Course Perspectives
		31.3.4 Understand Racial/Ethnic and Socioeconomic Health Disparities
		31.3.5 Unveil the Biological and Health Effects of Discrimination
		31.3.6 Reduce the Impact of Stress Related to Sociocultural Influences
		31.3.7 Cultivate Inclusiveness and a Sense of Belonging
	31.4 Conclusion
	References
32 The Value of Age-Friendly Public Health Systems to Older Adult Health and Well-Being
	32.1 The Aging Population in the United States
	32.2 The Need for Public Health Engagement in Healthy Aging
	32.3 Creating an Age-Friendly Public Health System
	32.4 State Momentum and Expansion
	32.5 Age-Friendly Public Health Systems Recognition Program
	32.6 COVID-19 and Older Adults
	32.7 COVID-19 Vaccine Access for Older Adults Who Are Homebound
	32.8 The Age-Friendly Ecosystem: A Systems Approach to Healthy Aging
	References
33 The Impact of Aging On Healthy Eyes
	33.1 Introduction and Background
	33.2 Anatomical and Physiological Changes in Our Eyes With Age
	33.3 Visual Skills Changes With Age
	33.4 Additional Helpful Recommendations
	33.5 Conclusion
	References
Index