Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

In January 2004, the Institute of Medicine (IOM) hosted the 1st Annual Crossing the Quality Chasm Summit, convening a group of national and community health care leaders to pool their knowledge and resources with regard to strategies for improving patient care for five common chronic illnesses. This summit was a direct outgrowth and continuation of the recommendations put forth in the 2001 IOM report Crossing the Quality Chasm: A New Health System for the 21st Century. The summit's purpose was to offer specific guidance at both the community and national levels for overcoming the challenges to the provision of high-quality care articulated in the Quality Chasm report and for moving closer to achievement of the patient-centerd health care system envisioned therein.

There is increased world-wide concern about the impact of multiple chronic conditions, especially among the rapidly aging population. Simultaneously, over the past decade there has been an emergence of state-wide and national initiatives to reduce the burden of chronic conditions that draw upon the translation of evidence-based programs (EPB) into community practice. Yet, little has been written about the national and international implementation, dissemination, and sustainability of such programs. This Research Topic features articles about EBPs for older adults, including a range of articles that focus on the infrastructure needed to widely disseminate EBP as well as individual participant impacts on physical, mental, and social aspects of health and well-being. Using a pragmatic research perspective, this Research Topic will advance knowledge that aims to enhance practice, inform policy and build systems of support and delivery in regard to the reach, effectiveness, adoption, implementation, and maintenance of evidence-based interventions for older adults. The focus is on knowledge transfer rather than knowledge generation but with a dual emphasis on the dissemination and sustainability of EBP that have been tested and shown effective as well as the adaptation of practice-based interventions into evidence-based programs. This Research Topic draws upon grand-scale efforts to deliver these programs, and include both U.S. as well as international examples. Commentaries discuss processes in the development and measurement of EBP and reflect perspectives from program developers and major national and regional funders of EBP as well as professionals and practitioners in the field. The full-length articles focus on four major programmatic areas: (1) chronic disease self-management programs; (2) fall prevention programs; (3) general wellness and physical activity programs; and (4) mental health programs. Additionally, articles are included to discuss cross-cutting issues related to building partnerships and the research infrastructure for the implementation, evaluation, and dissemination of evidence-based programming. The intent of this Research Topic is to enhance practice, inform policy, and build systems of support and delivery for EBP. It is written for a diverse audience and contains practical implications and recommendations for introducing, delivering, and sustaining EBP in a multitude of settings.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

The second edition of this landmark textbook is distinguished by its pioneering approach to encompassing disability and aging policies under one umbrella, in response to the newly developed Administration on Aging and Disability. It addresses policy changes impacting health and disability services resulting from the Affordable Care Act (ACA) and other new legislation, and offers a pioneering approach to transforming policy into practice applications. New to the second edition is current census data and new legislative mandates from the ACA and other policy organizations impacting aging adults and/or disabled populations. Also included is new coverage on Social Media, Motivational Interviewing, Health Literacy, Underrepresented Groups, LGBT, and Rural Communities. Podcasts, available as downloads, present the messages of advocates, lobbyists, policy experts, and consumers who address various aspects of relevant policies and policy development. Unlike other texts, the book focuses on triangulating skills, policies, and programs for graduate students in social work, public health, gerontology, and rehabilitation. It aims thus to enhance understanding of policy development through a critical analysis and review of policy framework, and promotes development of skills in shaping programs and implementing policy. The text lays out tools that facilitate policy and program development to include the media, coalition building, the use of an evidence base, and how each mandated policy addresses these programs and services. Chapters include learning objectives, case studies, review/discussion questions, and resources for additional information. An Instructors Manual, Test Bank, and PowerPoint slides facilitate the teaching process. New to the Second Edition: Addresses both disability and aging policies Includes updated census data Presents new legislation and mandates for the ACA, Veterans and the Military, Caregivers/Caregiver Support Act, Alzheimer Support, Health Lifestyles, Aging and Disability Resource Centers, Elder Justice Act, and Substance Use and Misuse Provides new coverage on Social Media, Motivational Interviewing, Health Literacy, Minorities, Incarcerated Individuals, Immigrants/Refugees, LGBT, and Rural Communities Offers podcasts of interviews with key consumers and policy experts Key Features: Lays out tools that facilitate policy and program development Examines major service areas for older adults Addresses philosophical, historical, and demographic challenges Enhances understanding of policy development through critical analysis Includes learning objectives, case studies, review questions, and instructor package

At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

This new edition of one of the premier references for geriatric nurses in hospital, long-term, and community settings delivers current guidelines, real-life case studies, and evidence-based protocols developed by master educators and practitioners. With a focus on improving quality of care, cost-effectiveness, and outcome, the fifth edition is updated to provide the most current information about care of common clinical conditions and issues in older patients. Several new expert contributors present current guidelines about hip fractures, frailty, perioperative and postoperative care, palliative care, and senior-friendly emergency departments. Additionally, chapters have been reorganized to enhance logical flow of content and easy information retrieval. Protocols, systematically tested by more than 300 participating NICHE (Nurses Improving Care for Health system Elders) hospitals‚ are organized in a consistent format and include an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion. Additionally, protocols are embedded within chapter text, providing the context and detailed evidence for each. Chapter objectives, annotated references,and evidence ratings for each protocol are provided along with resources for additional study. New to the Fifth Edition: Reorganized to enhance logical flow of information and ease of use Updated and revised Includes new contributions from expert educators and practitioners Provides new chapters on perioperative and postoperative care, general surgical care, care of hip fracture, palliative care, and the senior-friendly emergency department Key Features: Includes PowerPoints and a test bank for instructors Delivers evidence-based, current guidelines and protocols for care of common clinical conditions in the older person Illustrates the application of clinical protocols to real-life practice through case studies and discussion Edited by nationally known geriatric leaders who are endorsed by the Hartford Institute for Geriatric Nursing and NICHE Written for nursing students, nurse leaders, and practitioners at all levels, including those in specialty roles

Falls and fall-related injuries among older adults have emerged as serious global health concerns, which place a burden on individuals, their families, and greater society. As fall incidence rates increase alongside our globally aging population, fall-related mortality, hospitalizations, and costs are reaching never seen before heights. Because falls occur in clinical and community settings, additional efforts are needed to understand the intrinsic and extrinsic factors that cause falls among older adults; effective strategies to reduce fall-related risk; and the role of various professionals in interventions and efforts to prevent falls (e.g., nurses, physicians, physical therapists, occupational therapists, health educators, social workers, economists, policy makers). As such, this Research Topic sought articles that described interventions at the clinical, community, and/or policy level to prevent falls and related risk factors. Preference was given to articles related to multi-factorial, evidence-based interventions in clinical (e.g., hospitals, long-term care facilities, skilled nursing facilities, residential facilities) and community (e.g., senior centers, recreation facilities, faith-based organizations) settings. However, articles related to public health indicators and social determinants related to falls were also included based on their direct implications for evidence-based interventions and best practices.

Improve Service Delivery with New Evidence-Based Guidelines Geared to improve service delivery in the care of older adults, this new and more authoritative approach to practice and management is supported by the latest evidence-based guidelines from the leading experts in the field. For the first time, behavioral health care providers can gain access to a more reliable source for implementing and improving service delivery protocols and practices. This new guide applies evidence-based criteria to the following patient care and management needs to help you: Select an Evidence-Based Practice (EBP) Assess Feasibility Manage Quality Create a Culturally Grounded Practice Assess and Treat Depression, Anxiety, and Substance Use Disorders Assess and Treat Dementia and Schizophrenia Review by Service Delivery Process Review within Special Settings Create More Sustainable Services Written primarily for program administrators and clinical supervisors, health care professionals in mental health and geriatric services, and teachers and students in the field of geriatric health care, much of the timely information contained in this book can be used as a reference for evidence-based geriatric behavioral health by people who work with elderly clients with mental health needs.

A critical milestone in the evolution of evidence-based medicine Evidence-Based Interventions for Community Dwelling Older Adults presents an overview of significant evidence-based programs that can improve the health of seniors living in community-based settings. The book examines research conducted on a variety of health-related issues, including depression, care management, falls prevention, physical activity, and medications management. It also looks at research models that were translated into real-life practice settings, explores the benefits of implementing evidence-based models into care settings, and provides examples of how to adapt tested programs to meet local agency and population needs. The health care delivery system in the United States has embraced evidence-based medicine, largely based on its potential to reduce unwanted variations and keep a lid on escalating health care costs. But there are few resources available on how to gather information about model programs and even fewer on how to adapt them for practice. Evidence-Based Interventions for Community Dwelling Older Adults discusses how to effectively manage care beyond the hospital or clinic, as researchers, practitioners, policymakers, and academics provide an overview of evidence-based practice that works toward the best possible care for patients. The book also highlights the efforts of social workers, pharmacists, and case managers, and illustrates the importance of the leadership efforts of the Administration on Aging, National Council on Aging, and the Centers for Disease Control. Evidence-Based Interventions for Community Dwelling Older Adults examines: the effectiveness of geriatric care management medication management screening and intervention multifaceted intervention strategies to prevent and/or reduce falls among older adults physical fitness activities for the frail elderly population at home barriers to depression care and how to reduce them using Problem-Solving Therapy (PST) to address depression and other psychosocial issues using Diffusion of Innovation Theory to duplicate an end-of-life, in-home palliative care model and much more Evidence-Based Interventions for Community Dwelling Older Adults is an essential resource for anyone who works with seniors in medical and community-based settings, including case managers, geriatricians, social workers, pharmacists, and physical therapists. It's equally valuable as a professional aid for program directors, CEOs, and administrators of medical and community-based programs that target older adults.