| 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 |