Case Studies in Gerontological Nursing for the Advanced Practice Nurse

Meredith Wallace Kazer, PhD, APRN, A/GNP- BC, FAAN is Associate Professor at Fairfield University School of Nursing. Dr. Kazer has authored or edited numerous books, two of which received the American Journal of Nursing Book of the Year Award. She has authored over 50 peer-reviewed journal publications, and 22 book chapters. Dr. Kazer maintains a clinical practice with a focus on chronic illness in older persons. Leslie Neal-Boylan, PhD, CRRN, APRN-BC, FNP is Professor and Graduate Coordinator at Southern Connecticut State University. Dr. Neal-Boylan has extensive experience in academia as well as family practice, chronic care, and internal medicine. She has edited or co-edited four books including one which won the American Journal of Nursing Award in the medical-surgical division in 2005. Additionally Dr. Neal-Boylan has published over 90 articles in peer-reviewed journals.

Contributors ix Introduction xvii

Abbreviations and Acronyms xxi

Section 1 The Aging Population 1

Case 1.1 Recipe for Successful Aging 3
By Christine Tocchi, PhD(C), MSN, APRN, GNP-BC

Case 1.2 Cultural Competence Is a Journey 15
By Jina Ko, MSN, RN, ANP-C and Julie M. L. Lautner, MSW, MSN, RN

Case 1.3 The Ugly Face of Ageism 23
By Shelley Yerger Hawkins, DSN, APRN, FNP, GNP, FAANP

Case 1.4 If Only We Had National Health Insurance 31
By Philip A. Greiner, DNSc, RN

Section 2 Common Health Challenges of Aging 37

Case 2.1 The Heart of It All 39
By Jaclyn R. Jones, MSN, APRN, NP-C

Case 2.2 I Have This Thing on My Skin 47
By Everol M. Ennis, Jr., MSN, APRN, A/GNP-BC

Case 2.3 Why Is My Mother Wearing a Diaper? 57
By Annemarie Dowling-Castronovo, PhD(c), RN

Case 2.4 My Aching Back 65
By Anne Moore, DNP, RN

Case 2.5 More Than Just Constipation 75
By Frieda R. Butler, PhD, MPH, FAAN, FGSA

Case 2.6 Are You in the Hospital Again? 85
By Kimberly O. Lacey, DNSc, MSN, CNS

Case 2.7 It Hurts When I Pee 93
By Rebecca Herter, MSN, RN

Case 2.8 The History Reveals All 101
By Devon Kwassman, MSN, RN

Case 2.9 Kneedless Pain 111
By Maureen E. O’Rourke, RN, PhD, and Kenneth S. O’Rourke, MD

Case 2.10 Life after a Right CVA 125
By Cynthia S. Jacelon, PhD, RN, CRRN, FAAN

Case 2.11 It Takes My Breath Away 135
By Kathy Murphy, RN, BA, DipN, RNT, MSc, PhD, Dympna Casey, RGN, BA, MA, PhD, and Bernard McCarthy, MSc

Case 2.12 What’s Shaking? 145
By Donna Packo Diaz, MS, RN, and Cathi A. Thomas, MS, RN, CNRN

Case 2.13 Too Much to Manage 153
By Melanie J. Holland, BSN, MS

Case 2.14 Them Bones, Them Bones 167
By Ivy M. Alexander, PhD, APRN, ANP-BC, FAAN

Section 3 Health Promotion 181

Case 3.1 Never Too Old to Quit 183
By Geraldine Marrocco, EdD, APRN, CNS, ANP-BC and Amanda LaManna, MSN, RN, NP-C

Case 3.2 Protection by Prevention 189
By Kimberlee-Ann Bridges, MSN, RN-BC, CNL

Case 3.3 Is Being Careful Enough? 195
By Bonnie Cashin Farmer, PhD, RN

Case 3.4 Sick and Tired of Being Sick and Tired 203
By Kathleen Lovanio, MSN, APRN, F/ANP-BC, Patricia C. Gantert, MSN, RN-BC, and Susan A. Goncalves, DNP(c), MS, RN-BC

Case 3.5 To Screen or Not to Screen 213
By Meredith Wallace Kazer, PhD, APRN, A/GNP-BC, FAAN

Section 4 Environments of Care 221

Case 4.1 Who Says I Can’t Go Home 223
By Antoinette Larkin, RGN, H. Dip. Gerontology, and Claire Welford, RGN, DipNS, BNS–Hons., MSc, PGC–TLHE

Case 4.2 Regressing in Rehab 231
By Kendra M. Grimes, MSN, APRN, GNP-BC

Case 4.3 There’s No Place Like Home 239
By Nicholas R. Nicholson, Jr., PhD, MPH, RN, PHCNS-BC

Case 4.4 Caring for the Caregiver 245
By Evanne Juratovac, PhD, RN (GCNS-BC)

Case 4.5 Transitions 253
By Elizabeth McGann, DNSc, RN, and Lynn Price, JD, MSN, MPH, FNP-BC

Case 4.6 Shifting the Focus of Care 261
By Alison Kris, PhD, RN

Case 4.7 Without a Home 267
By Mary Shelkey, PhD, ARNP

Case 4.8 A Place Called Home 277
By Kelly Smith Papa, MSN, RN, and Eileen O’Connor Smith BSN, RN-C

Case 4.9 Aging in Place 285
By Karen Dick, PhD, GNP-BC, FAANP

Section 5 Cognitive and Psychological Issues in Aging 293

Case 5.1 The Diabolical Ds 295
By Kathleen Lovanio, MSN, APRN, F/ANP-BC, Patricia C. Gantert, MSN, RN-BC, and Susan A. Goncalves, DNP(c), MS, RN-BC

Case 5.2 What a Difference a Day Makes 305
By Cora D. Zembrzuski, PhD, APRN

Case 5.3 I Don’t Feel Good 313
By Evanne Juratovac, PhD, RN (GCNS-BC)

Case 5.4 Understanding Distress 323
By Eileen O’Connor Smith, BSN, RN-C, and Kelly Smith Papa, MSN, RN

Section 6 Issues of Aging and Independence 333

Case 6.1 Too Much of a Good Thing 335
By Susan C. Frazier, MS, NP-C, GNP-BC

Case 6.2 Driving in My Car 343
By Valerie C. Sauda, RN-BC, MS

Case 6.3 Sex Does Not Stop with Seniority 351
By Ashley Domingue, MSN, RN, ANP-BC, GNP-C

Case 6.4 Hidden Pathology 359
By Marie Boltz, PhD, APRN, BC

Case 6.5 Taking Control of the Pain 367
By Alison Kris, PhD, RN

Case 6.6 The Road toward End-of-Life Decision Making: Who Has the Right of Way? 373
By Barbara L. Kramer, MSN, RN, CHPN, and Christine M. Goldstein, LCSW-R, OCW-C

Index 381