Designed as a text or self-learning manual, this book offers nurses practical programs for discharge planning for the elderly. This program was developed by the Education Development Center and Boston's Beth Israel Hospital. The premise of the book is that nurses should be involved in the discharge planning process, along with other members of the health care team, from the first day of hospitalization. Topics include assessing the patient's physical, mental, and functional needs; assessing the caregiver and home environment; matching patient needs with appropriate resources in the community or institutional setting; patient advocacy; and ethics. Each chapter includes learning objectives, case studies, and clinical exercises. In addition, the many sample forms, charts, and diagrams help to clarify complex information.

Facilitating the transition of elderly patients from the hospital setting to their pre-hospital environment is a major challenge for health care providers. Adequate discharge planning has been mandated by the Joint Commission on Accreditation of Health Care Organization (JCAHO) and the American Hospital Association (AHA). However, reports from the literature indicate that some elderly patients on Medicare may be discharged "quicker and sicker" than in the past and that care-giving family members are often not included in the discharge planning process.The problem is that elderly patients may be discharged from the hospital before appropriate discharge planning is complete. The purpose of this pilot study was to determine elderly patients' and their family members' level of satisfaction and perceptions with the overall quality of hospital discharge planning. The study addressed the following questions:. 1. What is the level of satisfaction reported by the elderly patient and the family member regarding discharge planning? 2. What are the perceptions of the elderly patient and family member with the overall quality of discharge planning? A descriptive, telephone survey design was used to determine elderly patients' and family members' satisfaction with hospital discharge planning. A telephone questionnaire was administered to a convenience sample of ten patients and ten family members between five to ten days after the patient was discharged from the hospital. The questionnaire consisted of closed-ended and open-ended questions. Demographic and closed-ended questions were analyzed using descriptive statistics, while open-ended questions were group and summarized. Satisfaction ratings were measured on a ten point scale, with ten indicating the highest satisfaction.Findings of this pilot study indicated that elderly patients and their family members were satisfied with discharge planning and that nurses were often considered the most helpful in the discharge process. Average overall patient satisfaction was 9.6 and average family member satisfaction was 8.9. Areas receiving the highest satisfaction ratings included patients being involved in their discharge planning and instructions regarding medications, obtaining equipment and supplies, and wound care. Areas in need of improvement were identified as involving both patient and family member in the process, addressing activity level, inquiring about financial concerns and the possible need for additional help at home, and providing instructions about caring for the patient in the home environment.Limitations of the pilot study as well as implications for nursing practice and education are described.Recommendations for future research are discussed.

First published in 1992. Routledge is an imprint of Taylor & Francis, an informa company.

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

The WHO Falls Prevention for Active Ageing model provides an action plan for making progress in reducing the prevalence of falls in the older adult population. By building on the three pillars of falls prevention, the model proposes specific strategies for: 1. Building awareness of the importance of falls prevention and treatment; 2. Improving the assessment of individual, environmental, and societal factors that increase the likelihood of falls; and 3. For facilitating the design and implementation of culturally appropriate, evidence-based interventions that will significantly reduce the number of falls among older persons. The model provides strategies and solutions that will require the engagement of multiple sectors of society. It is dependent on and consistent with the vision articulated in the WHO Active Ageing Policy Framework. Although not all of the awareness, assessment, and intervention strategies identified in the model apply equally well in all regions of the world, there are significant evidence-based strategies that can be effectively implemented in all regions and cultures. The degree to which progress will be made depends on to the success in integrating falls prevention strategies into the overall health and social care agendas globally. In order to do this effectively, it is necessary to identify and implement culturally appropriate, evidence-based policies and procedures. This requires multi-sectoral, collaborations, strong commitment to public and professional education, interaction based on evidence drawn from a variety of traditional, complementary, and alternative sources. Although the understanding of the evidence-base is growing, there is much that is not yet understood. Thus, there is an urgent need for continued research in all areas of falls prevention and treatment in order to better understand the scope of the problem worldwide. In particular, more evidence of the cost-effectiveness of interconnections is needed to develop strategies that are most likely to be effective in specific setting and population sub-groups.