Caring for the Older Adult With Cancer in the Ambulatory Setting

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Preface vii
Acknowledgments ix
Chapter 1. Cancer and the Aging Population 1
Introduction 1
Aging Population 1
Cancer and Aging 2
Ambulatory Oncology Care 4
Role of the Ambulatory Care Oncology Nurse 4
Conclusion 6
References 6
Chapter 2. Physiology of Aging and Its Impact on the Older Adult 9
Introduction 9
Theories of Aging 10
Chronologic Age Versus Physiologic Age 10
Normal Aging 12
Altered Response to Physiologic Stress 13
Physiologic Changes of Aging 14
Pharmacokinetics 28
Cytochrome P450 30
Cytochrome P450 30
References 31
Chapter 3. Comprehensive Geriatric Assessment 37
Introduction 37
Definition and Development of a Comprehensive Geriatric Assessment 38
Rapid Assessment Instruments to Include in a Comprehensive Geriatric Assessment 47
Case Study Application of the Comprehensive Geriatric Assessment 48
Conclusion 50
References 51
Chapter 4. Symptom Management 57
Introduction 57
Anorexia and Weight Loss 58
Cognitive Impairment 62
Constipation 76
Dehydration 85
Dysphagia 89
Dyspnea 93
Fatigue 96
Pain 100
Sexuality 107
Conclusion 111
References 111
Chapter 5. Hospice and Palliative Care 125
Introduction 125
What Are Palliative Care and Hospice Care, and How Do They Differ? 126
Why Do Patients Need Access to Both Palliative and Hospice Care? 128
Transitions in Goals of Care and Communication 130
Ethical Issues 132
Symptom Assessment and Management 133
Examples of Palliative Care Symptom Management Procedures 133
Conclusion 138
References 138
Chapter 6. Survivorship Issues 143
Introduction 143
Demographics of the Older Adult Population 143
Transitioning to Survivorship Care 145
The Survivorship Care Plan: Facilitating Quality Care 146
Monitoring for Long-Term and Late Effects of Cancer and Cancer Therapy 147
Holistic Assessment: Integrating What We Know to Ensure Quality Care 150
Conclusion 153
References 153
Chapter 7. Psychosocial Issues 157
Introduction 157
Psychosocial Care 157
Psychosocial Assessment 158
Advance Care Planning 169
Conclusion 174
References 174
Chapter 8. Considering the Future of Nursing 177
Introduction 177
Ambulatory Oncology Care 178
Future Influences on Ambulatory Oncology Nursing Practice 178
Healthcare Reform and Effectiveness of Cancer Care 182
Leadership for the Future 183
Conclusion 185
References 185
Resources 191
Gerontology Centers 191
Associations and Societies 191
Statistics and Government Sites 192
Index 195
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