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Based on biopsychosocial theories of aging, a tool was developed to assist nurses in conducting holistic adult admission assessments. The Adult Assessment Tool can facilitate comprehensive, best-practice decisions in caring for hospitalized middle-aged and older adults.
In order for theories to be useful in a practice discipline such as nursing, a direct application is needed to guide the nurse in caring for a specific population in a given setting (Dickoff, James, & Weidenbach, 1968). A decision for nursing care evolves from the nurse's assessment, which includes not only what the nurse observes but also the nurse's ability to perceive what might be actually "going on" in a person's life. If the nurse had more knowledge regarding the patient's circumstances and potential challenges, he or she would be able to ask questions that would be most valuable in performing a holistic assessment. Because adults greater than 65 years of age represent the largest population in health care (approximately 50% of all patients in hospitals, 85% of patients in home care, and greater than 90% of people living in long-term care facilities), the nurse needs to have as much knowledge as possible regarding this population in order to develop best-practice plans of care (Bednash, Fagin, & Mezey, 2003). The purpose of this article is to initiate the development of a framework to provide more holistic assessment and concomitantly guide care decisions with middle-aged adults, generally defined as 45-65 years, and older adults over 65 years.
Haight, Barba, Tesh, and Courts (2002) noted that the components of a "good theory must be holistic and take into account all that impacts a person throughout a lifetime of aging" (p. 14). Many agree that situation-specific theories regarding aging can assist in guiding practice (Bergland & Kirkevold, 2001; Haight et al., 2002; Miller, 1990; Putnam, 2002). Two theories of aging developed by nurses were located after reviewing CINAHL, National Library of Medicine, Web of Science, Psyc Info, and Sociological Abstracts.
Functional Consequence Theory asserts that aging adults experience environmental, sociocultural, and psycho-biological consequences that impact their functioning (Miller, 1990). The theory's focus is assessment of age-related changes as well as risk factors such as physical impairment and disability, and design of interventions directed toward reduction of risk and disability.
Theory...