Case Studies in Gerontological Nursing for the Advanced Practice Nurse

Case Studies in Gerontological Nursing for the Advanced Practice Nurse

Editors

Meredith Wallace Kazer, PhD, APRN, A/GNP-BC, FAAN

Leslie Neal-Boylan, PhD, RN, CRRN, APRN, FNP-BC

A John Wiley & Sons, Inc., Publication

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Library of Congress Cataloging-in-Publication Data

Case studies in gerontological nursing for the advanced practice nurse / editors, Meredith Wallace Kazer, Leslie Neal-Boylan. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-8138-2378-2 (pbk.: alk. paper) ISBN-10: 0-8138-2378-1 (pbk.: alk. paper) 1. Geriatric nursing–Case studies. I. Kazer, Meredith Wallace, PhD, RN. II. Neal-Boylan, Leslie. [DNLM: 1. Nursing Care–Case Reports. 2. Aged. WY 152]RC954.c42 2012618.97′0231–dc23 2011017809

A catalogue record for this book is available from the British Library.

Set in 10/12pt Palatino by Toppan Best-set Premedia Limited

1 2012

v

Contents

Contributors ixIntroduction xviiAbbreviationsandAcronyms xxi

Section 1 The Aging Population 1

Case1.1 RecipeforSuccessfulAging 3By Christine Tocchi, PhD(C), MSN, APRN, GNP-BC

Case1.2 CulturalCompetenceIsaJourney 15By Jina Ko, MSN, RN, ANP-C and Julie M. L. Lautner, MSW, MSN, RN

Case1.3 TheUglyFaceofAgeism 23By Shelley Yerger Hawkins, DSN, APRN, FNP, GNP, FAANP

Case1.4 IfOnlyWeHadNationalHealthInsurance 31By Philip A. Greiner, DNSc, RN

Section 2 Common Health Challenges of Aging 37

Case2.1 TheHeartofItAll 39By Jaclyn R. Jones, MSN, APRN, NP-C

Case2.2 IHaveThisThingonMySkin 47By Everol M. Ennis, Jr., MSN, APRN, A/GNP-BC

Case2.3 WhyIsMyMotherWearingaDiaper? 57By Annemarie Dowling-Castronovo, PhD(c), RN

Case2.4 MyAchingBack 65By Anne Moore, DNP, RN

vi    Contents

Case2.5 MoreThanJustConstipation 75By Frieda R. Butler, PhD, MPH, FAAN, FGSA

Case2.6 AreYouintheHospitalAgain? 85By Kimberly O. Lacey, DNSc, MSN, CNS

Case2.7 ItHurtsWhenIPee 93By Rebecca Herter, MSN, RN

Case2.8 TheHistoryRevealsAll 101By Devon Kwassman, MSN, RN

Case2.9 KneedlessPain 111By Maureen E. O’Rourke, RN, PhD, and Kenneth S. O’Rourke, MD

Case2.10 LifeafteraRightCVA 125By Cynthia S. Jacelon, PhD, RN, CRRN, FAAN

Case2.11 ItTakesMyBreathAway 135By Kathy Murphy, RN, BA, DipN, RNT, MSc, PhD,Dympna Casey, RGN, BA, MA, PhD,and Bernard McCarthy, MSc

Case2.12 What’sShaking? 145By Donna Packo Diaz, MS, RN, and Cathi A. Thomas, MS, RN, CNRN

Case2.13 TooMuchtoManage 153By Melanie J. Holland, BSN, MS

Case2.14 ThemBones,ThemBones 167By Ivy M. Alexander, PhD, APRN, ANP-BC, FAAN

Section 3 Health Promotion 181

Case3.1 NeverTooOldtoQuit 183By Geraldine Marrocco, EdD, APRN, CNS, ANP-BC and Amanda LaManna, MSN, RN, NP-C

Case3.2 ProtectionbyPrevention 189By Kimberlee-Ann Bridges, MSN, RN-BC, CNL

Case3.3 IsBeingCarefulEnough? 195By Bonnie Cashin Farmer, PhD, RN

Case3.4 SickandTiredofBeingSickandTired 203By Kathleen Lovanio, MSN, APRN, F/ANP-BC, Patricia C. Gantert, MSN, RN-BC, and Susan A. Goncalves, DNP(c), MS, RN-BC

Case3.5 ToScreenorNottoScreen 213By Meredith Wallace Kazer, PhD, APRN, A/GNP-BC, FAAN

Contents    vii

Section 4 Environments of Care 221

Case4.1 WhoSaysICan’tGoHome 223By Antoinette Larkin, RGN, H. Dip. Gerontology, and Claire Welford, RGN, DipNS, BNS–Hons., MSc, PGC–TLHE

Case4.2 RegressinginRehab 231By Kendra M. Grimes, MSN, APRN, GNP-BC

Case4.3 There’sNoPlaceLikeHome 239By Nicholas R. Nicholson, Jr., PhD, MPH, RN, PHCNS-BC

Case4.4 CaringfortheCaregiver 245By Evanne Juratovac, PhD, RN (GCNS-BC)

Case4.5 Transitions 253By Elizabeth McGann, DNSc, RN, and Lynn Price, JD, MSN, MPH, FNP-BC

Case4.6 ShiftingtheFocusofCare 261By Alison Kris, PhD, RN

Case4.7 WithoutaHome 267By Mary Shelkey, PhD, ARNP

Case4.8 APlaceCalledHome 277By Kelly Smith Papa, MSN, RN, and Eileen O’Connor Smith BSN, RN-C

Case4.9 AginginPlace 285By Karen Dick, PhD, GNP-BC, FAANP

Section 5 Cognitive and Psychological Issues in Aging 293

Case5.1 TheDiabolicalDs 295By Kathleen Lovanio, MSN, APRN, F/ANP-BC, Patricia C. Gantert, MSN, RN-BC, and Susan A. Goncalves, DNP(c), MS, RN-BC

Case5.2 WhataDifferenceaDayMakes 305By Cora D. Zembrzuski, PhD, APRN

Case5.3 IDon’tFeelGood 313By Evanne Juratovac, PhD, RN (GCNS-BC)

Case5.4 UnderstandingDistress 323By Eileen O’Connor Smith, BSN, RN-C, and Kelly Smith Papa, MSN, RN

Section 6 Issues of Aging and Independence 333

Case6.1 TooMuchofaGoodThing 335By Susan C. Frazier, MS, NP-C, GNP-BC

viii    Contents

Case6.2 DrivinginMyCar 343By Valerie C. Sauda, RN-BC, MS

Case6.3 SexDoesNotStopwithSeniority 351By Ashley Domingue, MSN, RN, ANP-BC, GNP-C

Case6.4 HiddenPathology 359By Marie Boltz, PhD, APRN, BC

Case6.5 TakingControlofthePain 367By Alison Kris, PhD, RN

Case6.6 TheRoadtowardEnd-of-LifeDecisionMaking:WhoHastheRightofWay? 373By Barbara L. Kramer, MSN, RN, CHPN, and Christine M. Goldstein, LCSW-R, OCW-C

Index 381

ix

Contributors

EDITORS

Meredith Wallace Kazer, PhD, APRN, A/GNP-BC, FAANAssociate Professor and Graduate Program DirectorSchool of NursingFairfield UniversityFairfield, CT

Leslie Neal-Boylan, PhD, RN, CRRN, APRN, FNP-BCProfessor and Graduate Program CoordinatorNursing DepartmentSouthern Connecticut State UniversityNew Haven, CT

CONTRIBUTORS

Ivy M. Alexander, PhD, APRN, ANP-BC, FAANProfessorDirector—Adult, Family, Gerontological and Women’s Health Primary

Care SpecialtyYale University School of NursingNew Haven, CT

Marie Boltz, PhD, APRN, BC Associate Director for Practice, Hartford Institute for Geriatric Nursing Assistant Professor, New York University College of Nursing New York, NY

x    Contributors

Kimberlee-Ann Bridges, MSN, RN-BC, CNLSurgical Unit Clinical Nurse LeaderDanbury HospitalDanbury, CT

Frieda R. Butler, PhD, MPH, FAAN, FGSAGerontological Consultant and Professor EmeritaCollege of Health and Human ServicesDepartment of Global and Community HealthGeorge Mason UniversityFairfax, VA

Dympna Casey, RGN, BA, MA, PhDAras MoyolaSchool of Nursing and MidwiferyNational University of IrelandGalway, Ireland

Donna Packo Diaz, MS, RNCoordinatorAPDA Parkinson CenterHospital of Saint RaphaelNew Haven, CT

Karen Dick, PhD, GNP-BC, FAANPGraduate Program Director and Clinical Associate Professor College of Nursing and Health Sciences University of Massachusetts Boston Boston, MA

Ashley Domingue, MSN, RN, ANP-BC, GNP-CFoundation Medical PartnersNashua, NH

Annemarie Dowling-Castronovo, PhD(c), RNAssistant Professor and Jonas ScholarEvelyn L. Spiro School of NursingWagner CollegeStaten Island, NY

Everol M. Ennis, Jr., MSN, APRN, A/GNP-BCNurse PractitionerCommunity Health Services, Inc. Hartford, CT

Contributors    xi

Bonnie Cashin Farmer, PhD, RNAssociate ProfessorSchool of NursingUniversity of Southern MainePortland, Maine

Susan C. Frazier, MS, NP-C, GNP-BCSteward Skilled Care TeamFall River, MA

Patricia C. Gantert, MSN, RN-BCMedical Educator/Diabetes Resource NurseSt. Vincent’s Medical CenterBridgeport, CT

Christine M. Goldstein, LCSW-R, OSW-CGood Samaritan Home Health AgencyBay Shore, NY

Susan A. Goncalves, DNP(c), MS, RN-BCNurse Manager Med/Surg UnitSt. Vincent’s Medical CenterBridgeport, CT

Philip A. Greiner, DNSc, RNAssociate Dean for Faculty Development in Scholarship and Teaching

and ProfessorCollege of Health ProfessionsPace UniversityPleasantville, NY

Kendra M. Grimes, MSN, APRN, GNP-BCYale University School of NursingNew Haven, CT

Shelley Yerger Hawkins, DSN, APRN, FNP, GNP, FAANPAssociate Professor of NursingCoordinator, Nurse Practitioner ProgramsUniversity of Arkansas Medical SciencesLittle Rock, AR

Rebecca Herter, MSN, RNA/GNP CandidateYale University School of NursingNew Haven, CT

xii    Contributors

Melanie J. Holland, BSN, MSAdjunct ProfessorQuinnipiac UniversityHamden, CTOutreach NurseSt. Vincent’s Medical CenterBridgeport, CT

Cynthia S. Jacelon, PhD, RN, CRRN, FAANAssociate ProfessorSchool of NursingUniversity of MassachusettsAmherst, MA

Jaclyn R. Jones, MSN, APRN, NP-CYale School of NursingYale UniversityNew Haven, CT

Evanne Juratovac, PhD, RN (GCNS-BC)Assistant Professor, Frances Payne Bolton School of NursingFaculty Associate, University Center on Aging and HealthCase Western Reserve UniversityCleveland, OH

Jina Ko, MSN, RN, ANP-CNurse PractitionerWhite Memorial Medical CenterLos Angeles, CA

Barbara L. Kramer, MSN, RN, CHPN Palliative Care CoordinatorGood Samaritan Home Health Agency and Catholic Home CareBay Shore, NY

Alison Kris, PhD, RNAssistant ProfessorFairfield UniversitySchool of NursingFairfield, CT

Devon Kwassman, MSN, RNA/GNP CandidateYale University School of NursingNew Haven, CT

Contributors    xiii

Kimberly O. Lacey, DNSc, MSN, CNSAssistant ProfessorDepartment of NursingSouthern Connecticut State UniversityNew Haven, CT

Amanda LaManna, MSN, RN, NP-CAdult Nurse PractitionerMiami University Student Health ServicesOxford, Ohio

Antoinette Larkin, RGN, H. Dip. GerontologyClinical Nurse Specialist in Elderly CarePortiuncula HospitalBallinalsoe Galway, Ireland

Julie M. L. Lautner, MSW, MSN, RNA/GNP CandidateYale University School of NursingNew Haven, CT

Kathleen Lovanio, MSN, APRN, F/ANP-BCAssistant Professor, VANAFairfield University School of Nursing Fairfield, CT

Geraldine Marrocco, EdD, APRN, CNS, ANP-BCAssistant ProfessorYale University School of NursingNew Haven, CT

Bernard McCarthy, MSc Lecturer School of Nursing and Midwifery National University of Ireland Galway, Ireland

Elizabeth McGann, DNSc, RN, GCNS-BCProfessor of NursingDepartment of NursingQuinnipiac UniversityHamden, CT