H o The Gerontology Nurse’s Guide w e The Gerontology to the T h Community-Based Health Network e G e Nurse’s Guide r o n t o Brenda L. Bonham Howe, MSN, RN, BSLS l o g y to the This is a timely and vital resource for new and seasoned gerontology nurses responsible for N coordinating care and advocacy for their patients as health care shifts from hospital-based u to community-based care. Comprehensive and organized for quick access to information, this r clinical guide encompasses the broad network of community health resources available and se Community-Based describes how to access them on behalf of geriatric patients and clients. It provides an overview ’s of growing old in the United States and discusses cultural and socioeconomic considerations, G common conditions and morbidities affecting older adults, and the wide variety of community u i resources available to address these concerns. d e Health Network The book provides the critical information gerontology nurses need to synthesize the health to conditions affecting older adults with education about and access to vital community-based th e services. It discusses health delivery in regard to cultural diversity, the physical and psychologi- C o cal changes of aging and how to adapt to them, and different types of community-based health m options including home health services, independent and assisted living, long-term care, and m hospice and palliative care. Woven throughout are the themes of empowerment and advocacy u for the nurse, patient, and family. Included in each chapter are abundant tools and resources n that can be quickly referenced, and there is an emphasis on patient advocacy and teaching it y throughout. The book is also a supportive resource for nursing education programs and for - B nurses in mentorship roles in hospital or primary clinical practice settings. a s e Key Features: d H • Encompasses the broad network of community health resources available to older adults e • Provides easy access to informational websites, tools, and resources a l t • Addresses the physical and psychological changes of aging h N • Focuses on advocacy and empowerment e • Serves as a comprehensive resource for new and seasoned gerontology nurses, t w educators, and mentors o r k Brenda L. Bonham Howe ISBN 978-0-8261-2701-3 11 W. 42nd Street New York, NY 10036-8002 9 780826 127013 www.springerpub.com The Gerontology Nurse’s Guide to the Community-Based Health Network Brenda L. Bonham Howe, MSN, RN, BSLS, is a nurse educator in the nursing program at Central Oregon Community College, Bend, Oregon. She has worked as a clinical instructor with first- and second-year nursing students. Currently, her main areas of teaching are in the certified nurs- ing assistant program as lecture, lab, and clinical instructor. Ms. Howe believes that a firm foundation in the fundamentals of nursing care results in more holistically cognizant clinical nurses. Ms. Howe earned a diploma of nursing in 1974 from Legacy Emanuel Hospital’s School of Nursing in Portland, Oregon. Twenty years later, she returned to school full time to pursue journalism and research writing. She completed her bachelor of science in liberal studies with the dual minors of social sciences and communication, graduating in 2005 from Eastern Oregon University in La Grande, Oregon. While working toward her BS, Ms. Howe was awarded Outstanding Journalism Student and was recognized among her instructors as a poetry, prose, and fiction writer. In 2002, she earned her master of science as a nurse educator from Gonzaga University in Spokane, Washington. Her work experience has included rural hospitals and clinics, and a large multispecialty clinic, followed by 7 years of home health and hospice nursing. She piloted and staffed the role of clinical nurse educator in two employment venues, which led to many public speaking engagements. During her home health and hospice work she piloted a foot and nail care clinic for the agency in 2006, which continues to serve hundreds of central Oregon residents. Her work in rural settings, especially as a home health and hospice nurse, inspired her desire to write a guide for nurses to assist clients with navigation of the community health network. The Gerontology Nurse’s Guide to the Community-Based Health Network Brenda L. Bonham Howe, MSN, RN, BSLS Copyright © 2015 Springer Publishing Company, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, [email protected] or on the Web at www.copyright. com. Springer Publishing Company, LLC 11 West 42nd Street New York, NY 10036 www.springerpub.com Acquisitions Editor: Elizabeth Nieginski Composition: Newgen Knowledge Works ISBN: 978-0-8261-2701-3 e-book ISBN: 978-0-8261-2702-0 14 15 16 17 / 5 4 3 2 1 The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. Because medical science is continually advancing, our knowledge base continues to expand. Therefore, as new information becomes available, changes in procedures become necessary. We recommend that the reader always consult current research and specific institutional policies before performing any clinical procedure. The author and publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for external or third- party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Library of Congress Cataloging-in-Publication Data Brenda L. Bonham Howe, author. The gerontology nurse’s guide to the community-based health network / Brenda L. Bonham Howe. p. ; cm. Includes bibliographical references and index. ISBN 978-0-8261-2701-3 — ISBN 978-0-8261-2702-0 (e-book) I. Title. [DNLM: 1. Geriatric Nursing--methods. 2. Home Health Nursing—methods. 3. Aged. 4. Clinical Competence. 5. Community Health Services. 6. Health Services for the Aged. WY 152] RC954 618.97’0231--dc23 2014028534 Special discounts on bulk quantities of our books are available to corporations, professional associations, pharmaceutical companies, health care organizations, and other qualifying groups. If you are interested in a custom book, including chapters from more than one of our titles, we can provide that service as well. For details, please contact: Special Sales Department, Springer Publishing Company, LLC 11 West 42nd Street, 15th Floor, New York, NY 10036-8002 Phone: 877-687-7476 or 212-431-4370; Fax: 212-941-7842 E-mail: [email protected] Printed in the United States of America by McNaughton & Gunn. To my parents, Virgil and Inella Bonham, who inspired me with their stories of surviving the Great Depression and World War II years. They remained strong in faith and love as they grew old gracefully together. And to my husband, Les, who encourages me to follow my calling. Contents Contributors ix Preface xi Share The Gerontology Nurse’ s Guide to the Community-Based Health Network PART I. GRowInG old In The UnITed STATeS 1. Psychosocial–Cultural Health 1 Brenda L. Bonham Howe 2. Health Care Delivery: Cultural Considerations 11 Brenda L. Bonham Howe 3. Health Care Delivery: Cultural Domains 21 B renda L. Bonham Howe, Maria Milagros Kneusel, and Jane A. Tiedt PART II. PhySIcAl And PSycholoGIcAl chAnGeS of AGInG 4. Theoretical Perspectives on Aging and Physical Changes 57 Jane A. Tiedt 5. How to Deal With Compromised Independence 77 Brenda L. Bonham Howe vii vviiiiii ccoonntteennttss PART III. The commUnITy-BASed heAlTh neTwoRk 6. Home-Style Adult Safety and Socialization Options 97 Brenda L. Bonham Howe 7. Home Health Services 111 Brenda L. Bonham Howe 8. Skilled Nurse Competency Requirements for Home Health Services 179 Brenda L. Bonham Howe 9. Hospice and Palliative Care Services 199 Stephanie Bernahl Barss 10. Skilled Nurse Competency Requirements for Hospice Services 211 Brenda L. Bonham Howe 11. Independent Living 217 Brenda L. Bonham Howe 12. Assisted Living 227 Brenda L. Bonham Howe 13. Long-Term Care 241 Kaye Conrath 14. Alzheimer’s and Memory Care 247 Brenda L. Bonham Howe 15. Additional Community Health Resources for the Financially Compromised 255 Brenda L. Bonham Howe PART IV. emPoweRInG The InneR AdVocATe 16. Why Must Clients and Caregivers Embrace Self-Advocacy? 261 Brenda L. Bonham Howe and Esther Freeman Index 287 Contributors Stephanie Bernahl Barss, FNP, Brenda L. Bonham Howe, MSN, MS, RN, CWOCN RN, BSLS Advance Practice Nurse Nurse Educator Partners in Care, Home Health Central Oregon Community and Hospice College Bend, Oregon Bend, Oregon Kaye Conrath, MSN, RN Maria Milagros Kneusel, MSN, RN Adjunct Professor Clinical Instructor Resource Center Specialist Visiting Nurses Association of Department of Nursing Colorado Gonzaga University Bloomfield, Colorado Spokane, Washington Jane A. Tiedt, PhD, RN, CDE Esther Freeman, MS, CTRS, Assistant Professor CPRP Department of Nursing Retired Gonzaga University Tacoma, Washington Spokane, Washington ix