Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

In January 2004, the Institute of Medicine (IOM) hosted the 1st Annual Crossing the Quality Chasm Summit, convening a group of national and community health care leaders to pool their knowledge and resources with regard to strategies for improving patient care for five common chronic illnesses. This summit was a direct outgrowth and continuation of the recommendations put forth in the 2001 IOM report Crossing the Quality Chasm: A New Health System for the 21st Century. The summit's purpose was to offer specific guidance at both the community and national levels for overcoming the challenges to the provision of high-quality care articulated in the Quality Chasm report and for moving closer to achievement of the patient-centerd health care system envisioned therein.

There is increased world-wide concern about the impact of multiple chronic conditions, especially among the rapidly aging population. Simultaneously, over the past decade there has been an emergence of state-wide and national initiatives to reduce the burden of chronic conditions that draw upon the translation of evidence-based programs (EPB) into community practice. Yet, little has been written about the national and international implementation, dissemination, and sustainability of such programs. This Research Topic features articles about EBPs for older adults, including a range of articles that focus on the infrastructure needed to widely disseminate EBP as well as individual participant impacts on physical, mental, and social aspects of health and well-being. Using a pragmatic research perspective, this Research Topic will advance knowledge that aims to enhance practice, inform policy and build systems of support and delivery in regard to the reach, effectiveness, adoption, implementation, and maintenance of evidence-based interventions for older adults. The focus is on knowledge transfer rather than knowledge generation but with a dual emphasis on the dissemination and sustainability of EBP that have been tested and shown effective as well as the adaptation of practice-based interventions into evidence-based programs. This Research Topic draws upon grand-scale efforts to deliver these programs, and include both U.S. as well as international examples. Commentaries discuss processes in the development and measurement of EBP and reflect perspectives from program developers and major national and regional funders of EBP as well as professionals and practitioners in the field. The full-length articles focus on four major programmatic areas: (1) chronic disease self-management programs; (2) fall prevention programs; (3) general wellness and physical activity programs; and (4) mental health programs. Additionally, articles are included to discuss cross-cutting issues related to building partnerships and the research infrastructure for the implementation, evaluation, and dissemination of evidence-based programming. The intent of this Research Topic is to enhance practice, inform policy, and build systems of support and delivery for EBP. It is written for a diverse audience and contains practical implications and recommendations for introducing, delivering, and sustaining EBP in a multitude of settings.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

The second edition of this landmark textbook is distinguished by its pioneering approach to encompassing disability and aging policies under one umbrella, in response to the newly developed Administration on Aging and Disability. It addresses policy changes impacting health and disability services resulting from the Affordable Care Act (ACA) and other new legislation, and offers a pioneering approach to transforming policy into practice applications. New to the second edition is current census data and new legislative mandates from the ACA and other policy organizations impacting aging adults and/or disabled populations. Also included is new coverage on Social Media, Motivational Interviewing, Health Literacy, Underrepresented Groups, LGBT, and Rural Communities. Podcasts, available as downloads, present the messages of advocates, lobbyists, policy experts, and consumers who address various aspects of relevant policies and policy development. Unlike other texts, the book focuses on triangulating skills, policies, and programs for graduate students in social work, public health, gerontology, and rehabilitation. It aims thus to enhance understanding of policy development through a critical analysis and review of policy framework, and promotes development of skills in shaping programs and implementing policy. The text lays out tools that facilitate policy and program development to include the media, coalition building, the use of an evidence base, and how each mandated policy addresses these programs and services. Chapters include learning objectives, case studies, review/discussion questions, and resources for additional information. An Instructors Manual, Test Bank, and PowerPoint slides facilitate the teaching process. New to the Second Edition: Addresses both disability and aging policies Includes updated census data Presents new legislation and mandates for the ACA, Veterans and the Military, Caregivers/Caregiver Support Act, Alzheimer Support, Health Lifestyles, Aging and Disability Resource Centers, Elder Justice Act, and Substance Use and Misuse Provides new coverage on Social Media, Motivational Interviewing, Health Literacy, Minorities, Incarcerated Individuals, Immigrants/Refugees, LGBT, and Rural Communities Offers podcasts of interviews with key consumers and policy experts Key Features: Lays out tools that facilitate policy and program development Examines major service areas for older adults Addresses philosophical, historical, and demographic challenges Enhances understanding of policy development through critical analysis Includes learning objectives, case studies, review questions, and instructor package

This new edition of one of the premier references for geriatric nurses in hospital, long-term, and community settings delivers current guidelines, real-life case studies, and evidence-based protocols developed by master educators and practitioners. With a focus on improving quality of care, cost-effectiveness, and outcome, the fifth edition is updated to provide the most current information about care of common clinical conditions and issues in older patients. Several new expert contributors present current guidelines about hip fractures, frailty, perioperative and postoperative care, palliative care, and senior-friendly emergency departments. Additionally, chapters have been reorganized to enhance logical flow of content and easy information retrieval. Protocols, systematically tested by more than 300 participating NICHE (Nurses Improving Care for Health system Elders) hospitals‚ are organized in a consistent format and include an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion. Additionally, protocols are embedded within chapter text, providing the context and detailed evidence for each. Chapter objectives, annotated references,and evidence ratings for each protocol are provided along with resources for additional study. New to the Fifth Edition: Reorganized to enhance logical flow of information and ease of use Updated and revised Includes new contributions from expert educators and practitioners Provides new chapters on perioperative and postoperative care, general surgical care, care of hip fracture, palliative care, and the senior-friendly emergency department Key Features: Includes PowerPoints and a test bank for instructors Delivers evidence-based, current guidelines and protocols for care of common clinical conditions in the older person Illustrates the application of clinical protocols to real-life practice through case studies and discussion Edited by nationally known geriatric leaders who are endorsed by the Hartford Institute for Geriatric Nursing and NICHE Written for nursing students, nurse leaders, and practitioners at all levels, including those in specialty roles