Critical care nursing for older adults: pathophysiological and functional considerations

The Nursing Clinics of North America
Diane J Mick, Michael H Ackerman

Abstract

The aging of the population brings into health care practice, including ICUs, an increasing prevalence of people with chronic conditions with corresponding expectations of eventual decline in function. These age-related health problems, however, do not have a precise moment of onset, nor a single and unambiguous cause. By their nature, chronic conditions do not have an end that can be modified easily, and ordinarily, they are related to parameters other than physiology alone. Aged individuals often are distinguished as a medicalized cohort on the basis of sheer numbers of comorbidities and predisposition toward frequent hospitalizations, without regard for the potential for adaptation to life despite complex health factors. Some care providers, health economists, and bioethicists propose using the existence of chronic conditions and assumed physical decompensation asa valid basis for restricting individuals and groups, by means of rationing, from consideration for intensive care and treatment. In view of studies demonstrating that covert rationing of ICU resources to critically ill older patients already is taking place, there isa need to continue to examine institutional policies that permit care providers to act as gatekeeper...Continue Reading

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Citations

Feb 4, 2014·Critical Care Nursing Clinics of North America·Mandi WalkerMary Sebastian
Apr 18, 2008·AACN Advanced Critical Care·Catherine G Ferrario
Dec 26, 2013·Critical Care Medicine·Deena M KellyLinda H Aiken
Jul 9, 2010·Journal of Gerontological Nursing·Michele C BalasMary Beth Happ
Dec 20, 2014·Asia-Pacific Journal of Public Health·Hamid Jan B Jan MohamedJens Aagaard-Hansen
Jun 19, 2008·AACN Advanced Critical Care·Catherine G Ferrario
Jul 7, 2020·Journal of the Chinese Medical Association : JCMA·Tien-Hua ChenPei-Jiun Tsai

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