Fundamentals of Caring for the Older Person: (Fundamentals)

A comprehensive guide to delivering high-quality care for older adults As older adults increasingly become the primary users of health and social care services, the need for health and social care professionals with specific knowledge in this area has never been greater. Fundamentals of Caring for the Older Person equips nursing students and healthcare professionals with the essential skills, knowledge, and attitudes needed to provide compassionate, evidence-based care for older individuals with complex needs. With real-world narratives, this practical guide offers a holistic approach, recognising that older people are not a homogenous group but individuals with unique experiences, strengths, and requirements. Written by experienced clinicians and academics, the book integrates key considerations across physical, psychological, and social dimensions of care, offering a clear and engaging foundation for anyone committed to enhancing the quality of care for older adults in diverse settings. Presents a person-centred approach to caring for older adults, featuring episodes of care, examples, and narratives to amplify the voice of older individuals in their own care and ensure practical application of theory Utilises a three-unit structure for ease of learning: key aspects of ageing, altered pathology and disease management, and care practices Addresses key policies and professional literature recommendations to improve care for older people Includes pedagogical tools such as key points, clinical investigations, pharmacology insights, and red/orange/green flags for pathological, psychological, and social considerations Designed for flexibility, with chapters functioning as standalone units, Fundamentals of Caring for the Older Person supports students and newly qualified practitioners alike. It is ideal for undergraduate and postgraduate programmes in nursing, allied health, and social care, particularly for courses in adult nursing and gerontology.

Table of Contents:
Contributors xiii Foreword xvi Acknowledgements xvii Unit 1 Principles of Caring for the Older Person 1 Chapter 1 Ageing and Ageing Populations 3 Elaine Francis Introduction 3 What Is Ageing? 4 What Age Is ‘Old Age’? 4 Trends in Population Ageing 4 Exploring Representations of Ageing and Older People 6 Interpersonal Ageism 7 Self- directed Ageism 8 Institutional Ageism 8 Ageing, Health and Society 9 Conclusion 10 References 10 Chapter 2 Healthy Ageing 13 Stuart Nicholson and Laura Graham Introduction 13 Healthy Ageing and Ageing Well 14 Public Health Approaches 16 Psychological Well- being 17 Positive Relationship Support (Sexuality and Sexual Relationships) 19 Social Prescribing 21 Conclusion 22 References 22 Further Reading 24 Chapter 3 Person- Centred Care – Caring for Older People 25 Sue Tiplady, Jane Murray, and Isabel Quinn Introduction 25 Person- Centred Care 26 Personhood 28 Person- Centred Communication 29 Cultural Considerations 32 Becoming More Person- Centred 33 Conclusion 33 References 34 Further Reading 35 Chapter 4 Legal and Professional Context of Care 37 James Mingham, Esther Clift, and Isabel Quinn Introduction 37 Professional Regulation 38 Professional Codes of Conduct 40 Duty of Care 40 Information Governance 40 Confidentiality 40 Information Sharing 41 Consent 41 Mental Capacity Act 42 Lasting Power of Attorney 43 Best Interest Decision- Making 44 Deprivation of Liberty Safeguards 44 Health and Social Care Act (2012) 44 The Care Act (2014) 45 Safeguarding and Raising Concerns 45 Conclusion 46 References 46 Further Reading 47 Chapter 5 Communication 49 Eilaine White Introduction 49 Communication, Ageing and Health 50 Cultural Considerations 52 Good Communication Practice When Assessing Older Adults 52 Shared Decision- Making 52 Health Literacy 53 Advocacy 54 Caring Conversations 55 Professional Communications Across Teams 56 Transitions of Care 57 Conclusion 57 References 58 Further Reading 58 Chapter 6 Approaches to Care for Working with Older People 59 Donna Massey, Hayley Bamber, Ursula Roberts, and Kirsty Marshall Introduction 59 An Outline of the Approaches to Care of the Older Person 60 Co- production 60 Multidisciplinary 60 Interdisciplinary 61 Transdisciplinary 61 Integrated Care 61 Technology- Enhanced Care and Its Role in Models of Care 62 Caring for a Person Living with Dementia in the Community: Discussion 63 The Importance of Comprehensive Assessment: Discussion 65 Conclusion 67 References 67 Chapter 7 Settings of Care 69 Stacey Louise Finlay, Philip Hodgson, and Kevin Murphy Introduction 69 Place and Importance of Place 70 Enablers of Ageing in Place 72 Adult Social Care 72 Alternative Housing 73 Community Support 73 Intermediate Care and Reablement 74 Emergency and Urgent Care for Older People 75 Urgent Community Response 75 Hospital at Home 75 Emergency Department 76 Same Day Emergency Care 76 Care Homes 76 Care of Older People in Prison 78 Conclusion 78 References 79 Further Reading 81 Chapter 8 Carer and Family Support 83 Elaine Francis and Judy Mattison Introduction 83 Definition 84 What Matters to Carers? 85 Caring for Carers 87 Wider Health and Care Issues 89 Health Care Costs and Accessibility 89 Conclusion 91 References 91 Further Reading 92 Chapter 9 Multimorbidity 93 Jenny Allen and Esther Clift Introduction 93 Definitions 93 Prevalence 94 Impact of Multimorbidity 94 Research and Impact on Care Guidelines 95 Conclusion 99 References 100 Further Reading 102 Chapter 10 Frailty and Comprehensive Geriatric Assessment 103 Stacey Louise Finlay and Claire Pryor Frailty as a Syndrome 103 Risk Factors 104 Ageism 105 Biological Sex and Frailty 106 Identification and Assessment of Frailty 106 Assessing Frailty 108 The Domains of the CGA 109 The Problem List 111 Care and Support Planning 112 Conclusion 113 References 113 Further Reading 114 Unit 2 Anatomy and Physiology of Ageing 115 Chapter 11 The Anatomy and Physiology of the Brain and Nervous System 117 Barry Hill and Alison Young Introduction 117 Structural Changes in the Ageing Brain 118 Functional Changes in the Ageing Brain 118 Clinical Implications 119 Delirium 120 Dysphasia 122 Altered Pathophysiology in the Older Person 122 Considerations of the Impact for People and Care 124 Caring for Carers 124 Epilepsy in Older People 125 Medicines Management 125 Stroke in Older People 126 Conclusion 128 References 128 Chapter 12 The Anatomy and Physiology of the Senses 131 Debbie Findlay Introduction 131 Anatomy and Physiology of Ageing on Hearing 131 Anatomy and Physiology of Ageing on Taste 133 Anatomy and Physiology of Ageing on Smell (Olfaction) 134 Anatomy and Physiology of Ageing on Touch 135 Anatomy and Physiology of Ageing on Vision 135 Anatomy and Physiology of Ageing on Cranial Nerves which Impact the Senses 136 The Impact of Sensory Changes with Ageing 137 Considerations of the Impact on People and Care 138 Conclusion 139 References 139 Chapter 13 The Anatomy and Physiology of the Cardiovascular System 143 Stuart Barker Introduction 143 The Heart 143 The Ageing Heart 144 The Conduction System of the Heart 145 The Ageing Conduction System 146 The Vascular System 147 Peripheral Vascular Disease 149 Coronary Artery Disease 149 Regulation of Blood Pressure 150 The Baroreceptor Reflex 150 Heart Failure 152 Conclusion 153 References 153 Chapter 14 The Anatomy and Physiology of the Respiratory System 155 Karen Corder and Elaina Henderson Introduction 155 The Respiratory System 155 Gas Exchange 156 Changes in the Ageing Body that Affect the Respiratory System 159 Psychological Considerations for People with Respiratory Diseases 161 The Impact for People and Care 163 Conclusion 164 References 164 Chapter 15 The Anatomy and Physiology of the Gastrointestinal System 167 Claire Norman Structures 168 The Small and Large Intestines 170 The Processing of Food 174 Circulation 175 Dysphagia 175 Bowel Care 176 Constipation 176 Conclusion 177 References 177 Chapter 16 The Anatomy and Physiology of the Renal and Genitourinary System 179 Barry Hill and Claire Pryor Introduction 179 The Renal System 180 Age- Related Changes 180 Renal Blood Flow and Filtration Efficiency 181 Electrolyte Imbalances and Fluid Overload 181 Excretion and Waste Management in Ageing 182 Anatomy and Physiology of an Ageing Genitourinary System 183 Reproductive Health and Sexual Health in Ageing 184 Medicines Management 185 Discussion 187 Conclusion 187 References 188 Chapter 17 The Anatomy and Physiology of the Endocrine System 191 Barry Hill and Dominic Simpson Introduction 191 Changes to the Endocrine System in Ageing 192 Understanding Hormonal Changes in Older People 193 Diabetes in Older People 196 Principle of Pharmacology 199 Conclusion 202 References 203 Chapter 18 The Anatomy and Physiology of the Immune and Haematological Systems 205 Helen Evans and Claire Pryor Introduction 205 The Ageing Immune System 206 B- Cell and T- Cell Lymphocytes 206 Dendritic Cells 207 Macrophages 207 Natural Killer Cells 208 The Innate and Acquired Immune System 209 Vaccinations in Older People 209 The Ageing Haematological System 210 Conclusion 212 References 212 Chapter 19 The Anatomy and Physiology of the Musculoskeletal System 215 Alex Hemsley and Sue Tiplady Introduction 215 The Musculoskeletal System and Age-Related Changes 215 Sarcopenia 216 Osteoporosis 220 Osteo-sarcopenia 223 Osteoarthtritis 224 Conclusion 226 References 227 Further Reading 228 Chapter 20 The Anatomy and Physiology of the Integumentary System 229 Sue Tiplady Introduction 229 Effects of Ageing on the Skin 229 Skin Care 234 Skin Assessment 234 Skin Tears 237 Moisture- Associated Skin Damage 238 Personal Hygiene 238 Considerations for Personalised Care Planning for Personal Hygiene 239 Conclusion 240 References 240 Further Reading 241 Unit 3 Care Management 243 Chapter 21 Assessing and Managing Pain in Older People 245 Isabel Quinn Introduction 245 Pain Classification 246 Pain Assessment in Older People 250 Pain Management 252 Conclusion 255 References 255 Chapter 22 Mental Health and Learning Disability in Ageing 257 Lynette Harper and Sarah Mackay Introduction 257 Functional Mental Health 257 Substance Misuse 259 Pain Assessment 260 Neurodiversity in Older Adults 263 Capacity and Consent for All 264 Conclusion 265 References 266 Chapter 23 Dementia 269 Shibley Rahman and Claire Pryor Introduction 269 Diagnosis 271 Prevention and Risk Reduction 273 Communication 274 Meaningful Activities and Independence 274 Living Well with Dementia 275 Carer Support 275 Distress and Communication 277 Medicines Management 277 Conclusion 279 References 279 Chapter 24 Nutrition and Hydration Care 281 Philip Hodgson, Sarah Docherty, and Glenda Cook Introduction 281 Nutrition Care: Assessment 282 Nutrition Care: Practices 284 Hydration Care: Assessment 285 Hydration Care: Practices 286 Conclusion 288 References 288 Chapter 25 The Recognition and Assessment of the Acutely Ill Older Person 291 Tony Conner, Deborah Leetham, and Sue Tiplady The Importance of Recognising Acute Illness in the Older Person 291 Atypical Presentation 292 The Influence of Comorbidities 293 The Importance of Social Support 293 The Assessment of the Acutely Unwell Older Person 293 Sepsis in the Older Person 297 Typical and Atypical Presentation of Sepsis in Older People 298 The Assessment of Sepsis 299 The Treatment of Sepsis 300 Prevention of Sepsis 302 Conclusion 303 References 303 Further Reading 305 Chapter 26 Pharmacology and Medicines Management 307 Joanne Dunn, Claire Pryor, Janet Wilkinson, and Patrick Dawodu Introduction 307 Anticholinergic Burden 312 Deprescribing 312 Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) and the Screening Tool to Alert to Right Treatment (START) 313 Concordance Support 313 Social and Support Consideration for Medication and Medication Optimisation 314 Conclusion 315 References 315 Chapter 27 End- of- Life Care 317 Nicola Payne and Isabel Quinn Introduction 317 Death and Dying in Older People 317 End- of- Life Care 318 The Relationship Between Supportive Care, Palliative Care and Terminal Care 318 When Is ‘End of Life’ 319 Advance Care Planning 321 Preferred Place of Death 322 Ethical Challenges 323 Emotional Support 323 End- of- Life Symptoms 324 Care in the Last Days and Hours of Life 324 Care After Death 326 Conclusion 326 References 326 Further Reading 327 Index 329

About the Author :
Claire Pryor is a Professor of Adult Social Care Nursing at the University of Salford. A registered nurse and independent and supplementary prescriber, she holds a PhD, an MSc in Advancing Healthcare Practice, and a BSc in Nursing Science. With extensive experience in both clinical practice and education, she supports both student nurses and nurses in their professional development, and works to enhance care for older adults through research and teaching. Sue Tiplady has had an extensive nursing career leading and managing the care of older people. Within her senior management roles in the NHS, she commissioned and designed services to improve care delivery for older people and their carers. As an Assistant Professor at Northumbria University, she contributed to a range of research focussed on Gerontology and Dementia Care, embedding the care of older people into the pre-registration nursing curriculum and designing specialist programmes for post-registration education delivery.