Functional Performance in Older Adults Book

	Introduction	xxix
	PART I. NORMAL AGING	1
	SECTION 1. INTRODUCTION AND OVERVIEW	5
1.	Growing Old in the United States Bette R. Bonder	7
	Historical Definitions of Aging	9
	Current Definitions	11
	Current Attitudes	11
	Cultural Factors	12
	Place of Residence	19
	Gender	20
	Individual History	21
	Public Policy and Aging	21
	Summary and Implications for Service Providers	22
2.	Biological Theories of Aging: Implications for Functional Performance Wojtek J. Chodzko-Zajko	28
	Definitions of Aging	29
	Biological Theories of Aging	31
	The Structural and Functional Consequences of Aging	33
	Individual Differences and Aging	34
	Lifestyle Interventions and Aging	37
	Conclusion	39
3.	The Psychosocial Meaning of Activity Bette R. Bonder	42
	Defining Meaning	44
	Developing Meaning	44
	Meaning of Activities; Theories	46
	Toward and Integrated Model	51
	Implications for Health-Care Providers	55
	SECTION 2. THE AGING PROCESS	59
4.	Mobility Marilyn B. Wagner and Timothy L. Kauffman	61
	Muscle Strength and Aging	62
	The Skeletal System in the Older Adult	70
	Balance, Coordination, and Movement and Aging	71
	Summary	80
	Appendix 4-1: Exercise for Persons 55 Years Old and Older	85
5.	Cardiopulmonary Development Elizabeth Dean	86
	Age-Related Anatomic Changes in the Cardiopulmonary System and Its Function	89
	Age-Related Changes  in the Cardiovascular System and Its Function	90
	Other Factors that Affect Cardiopulmonary and Cardiovascular Function	92
	Functional Consequences of Age-Related Cardiopulmonary and Cardiovascular Changes	96
	Functional Consequences of Fitness in Older People	105
	Implications for the Management of the Care of Older People	108
	Customizing the Environment to Maximize Function	115
	Summary	115
6.	Sensory and Sensory Integrative Development Celia Routh Hooper	121
	Vision and Functional Performance	123
	Hearing and Functional Performance	126
	Taste and Smell: Physical Changes and Functional Performance	131
	Somesthesis and Touch; Physical Changes and Functional Performance	132
	Sensory Intergration: A conclusion	132
	Appendix 6-1	137
7.	Cognitive Development Kathryn Perez Riley	138
	Cognitive Changes in Normal Aging	139
	Other Cognitive Abilities	141
	Congnition and Activities in Normal Aging	144
	Future Directions	149
	SECTION 3. ACTIVITIES OF OLDER ADULTS	153
8.	Self-Care Charles H. Christiansen and Cindy Lynn Hammecker	155
	Defining Self-Care	156
	Person-Environment and Enablement Models	156
	Importance of Self-Care	156
	Functional Limitations Influencing the Performance of Self-Care	161
	Measuring Self-Care Performance	163
	Prevalence and Type of Limitations of Activities of Daily Living Among Elderly Persons	167
	Activity of Daily Living Intervention	168
	Summary	175
9.	Work and Retirement Harvey L. Sterns, M. Patricia Junkins and Janet G. Bayer	179
	The Older Labor Force	180
	Wellness Programs for Older Adults	183
	Older Worker Performance	184
	Obsolescence Versus Maintaining Competence	184
	Retirement	189
	Conclusion	192
10.	Leisure Anita C. Bundy	196
	Leisure and Aging	198
	Leisure as a Statement of Identity	200
	Elements of Leisure	201
	A Tentative Model	210
	Promotion of Leisure: Application of the Model	211
	Summary	214
11.	Sexuality in Late Adulthood Andrew W. Miracle and Tina S. Miracle	218
	Sex and the Elderly Population	219
	Age-Related Physical Changes and Sexual Functioning	224
	Effects of Disease on Sexuality	227
	Other Factors Affecting Sexuality	228
	Summary and Implications for Health Professionals	230
	Appendix 11-1: How to Obtain Additional Information	235
12.	Assessment of Functional Performance Seanne Wilkins, Mary Law and Lori Letts	236
	The Meaning of Assessment	237
	Assessment Philosophy	239
	Assesment Realities	241
	A Conceptual Framework for Assessment of Performance	242
	A Decision-Making Process to Guide Assessment	244
	Issues in the Assessment of Performance with Older Adults	244
	Assessment Methods	248
	Summary	250
	Assessment Examples	251
	PART II. INTERRUPTIONS IN FUNCTIONAL PERFORMANCE	257
	SECTION 4. FACTORS CONTRIBUTING TO  DYSFUNCTION IN OLDER ADULTS	265
13.	Falls Rein Tideiksaar	267
	Epidemiology	268
	Causes of Falling	270
	Clinical Assessment and Intervention	273
	Interventions	278
	Common Environmental Hazards	278
	Fear of Falling	279
	Alternatives to Physical Restraints	280
	Intervention Trials	281
	Summary	284
14.	Dementia Mary A. Corcoran	287
	Irreversible Conditions Resulting in Dementia	289
	The Notion of Excess Disability	290
	Assessing Functional Performance in Individuals with Dementia	293
	Managing Dementia-It takes a Team	296
	Summary and Future Directions	302
15.	Depression Kathryn Perez Riley	305
	Overview of Depressive Disorders in Older Adults	306
	Depression and Functional Status: An Interactive Relationship	310
	Treatment of Depression	313
	Cultural Factors in Depression	315
	Summary and Future Directions	315
	SECTION 5. INTERVENTION STRATEGIES	319
16.	Wellness Bette R. Bonder	321
	Defining Wellness	322
	Factors That Promote Wellness	323
	Theories of Behavior Change	330
	Designing and Funding Programming	332
	Model Programs	336
	Conclusion	336
17.	Community-Based Services Georgia J. Anetzberger	339
	Service Classifications	340
	Service Utilization	341
	Something to Do	344
	Someone to Care	353
	Someplace to Live	355
	Summary and Future Directions	358
18.	Home Health Care Ben J. Atchison	363
	Historical Development of Home Health Care	364
	Cost-Effectiveness of Home Care	365
	Qualifications for the Medicare Home Health Benefit	366
	Common Conditions Treated in Home Care	367
	Age and Functional Status of Home-Care Clients	367
	Caregiver Issues	368
	Core Competencies of Occupational Therapy Practice in Home Health Care	368
	The Therpeutic Process in Home Health Care	372
	Conclusion	378
	Appendix 18-1: Home Health Care	382
19.	Rehabilitation Lynnda J. Emery	390
	Geriatric Rehabilitation Priorities	391
	Evaluation in Geriatric Rehabilitation	391
	Factors to Consider in Treatment of Older Persons	394
	Conditions Frequently Treated In Rehabilitation	396
	Common Problems of Older Adults	398
	Rehabilitation Delivery Systems for Older Persons	399
	Reimbursement and Practice Management	400
	Summary	403
20.	Activities as Agents for Intervention and Rehabilitation in Long-Term Care Ruth E. Plautz and Cameron J. Camp	405
	Evolution of the "Modern" Nursing Home	406
	OBRA '87 Philosophy and Occupational Therapy	408
	Activities in  Long-Term Care	411
	Interdisciplinary Teams in Long-Term Care	412
	Therapies and Total Environment	414
	Regulatory and Reimbursement Issues	415
	Innovative Trends	415
	Summary and Challenges	420
	Appendix 20-1: Coding Sheet for Montessori Activities	423
	SECTION 6. SPECIAL TOPICS	427
21.	Technology William C. Mann	429
	Definitions and Concepts	430
	Aging and Functional Performance	431
	Assistive Technology for Older Adults	432
	Disability Impact Continuum: Difference in Assistive Technology Needs	441
	Appendix 21-1: Resources	447
22.	Driving and Older Adults Beth A. Ekelman, Steven Mitchell and Pam 0'Dell-Rossi	448
	Overview of National Statistics on Violations, Crashes, and Fatalities	449
	Neurosensory Model of Driving	449
	Age-Related Physiological and Disease-Related Changes Affecting Driving Performance	455
	Clinical Assessment and Intervention	459
	Suggestions for the Geriatric Clinician	470
	Losing the Ability to Drive-A Psychosocial Perspective	471
	Conclusions	474
	Appendix 22-1: Occupational Therapy Driving Evaluation	478
23.	Families and Professionals: Therapeutic Considerations Bette R. Bonder and Betty R. Hasselkus	487
	Factors Affecting Family Relationships	489
	Therapeutic Relationshops	490
	Techniques for Practice	493
	Addressing Family Issues in the Current Health-Care Environment	496
	Summary	497
24.	The End of Life Rosalind A. Bye, Gwynnyth M. Llewellyn and Karl E. Christl	500
	Understanding Terminal Illness	501
	Individuals' Experience of Terminal Illness	502
	Terminal Illness and the Older Person	503
	A Good Death	504
	Palliative Care	504
	Occupational Therapy and Physical Therapy-Our Role in Palliative Care	506
	Reframing Occupational Therapy and Physical Therapy for Palliative Care	507
	Therapy That Affirms Life and Helps Prepare for Death	508
	Reframing the Processes of Therapy	509
	Support Strategies for Therapists	516
	Conclusions	518
	Glossary	521
	Index	533