Geriatric nursing
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Review
Practice recommendations for pain assessment by self-report with African American older adults.
Despite decades of education and clinical practice guidelines underscoring disparities in pain management, pain continues to be inadequately managed in older African American adults as a result of patient, provider, and systems factors. Critical factors influencing pain assessment in older African American adults has not been extensively examined, contributing to a lack of data to inform health care providers' knowledge on culturally-responsive pain assessment in older African Americans. ⋯ This paper presents an overview of patient-provider factors that affect pain assessment in older African Americans with a focus on this population's unique cultural beliefs and practices. Recommendations for best practices for performance of a culturally-responsive pain assessment with older African Americans are provided.
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Chronological age alone does not determine the vulnerability or frailty of an older adult. Frailty can, however, profoundly affect the quality of an older adult's life. ⋯ The principles of palliative care apply to any population that could benefit from a comprehensive, person-centered plan of care from the time of diagnosis through the illness trajectory. This article presents a conceptual overview of frailty and describes its clinical presentation and treatment options, including palliative care, an intervention used by gerontological nurses to improve the quality of life for frail older adults.
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Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Neurological, muscular, anatomical, and/or psychological factors may predispose a person to difficulty in swallowing. Difficulty in swallowing or dysphagia can lead to serious complications including aspiration pneumonia, malnutrition, and death if not diagnosed early. ⋯ In addition, health care costs would be reduced through decreased need for hospitalization, length of stay when hospitalized, and overall health care expenditures. This article provides a review of the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, and diagnostics. Implications for practice also are discussed.