Evaluation and Management of Rectal Prolapse Among Geriatric Patients.

Evaluation and management of older adults within emergency care settings is often complex and has the potential for avoidable complications. In an effort to prevent harm to the patient, treatment strategies need to be multifactorial. For geriatric patients presenting with rectal prolapse, unique management strategies, including the use of granulated sugar and gentle pressure, may assist in the reduction of the prolapsed tissue. Additional interventions that are important to incorporate into the older adult's plan of care include gentle approaches to positioning, involvement of family/caregivers, avoiding harmful medications, reducing risk for delirium, and a successful transition of care. A manual reduction completed in the emergency department can relieve discomfort and prevent further complications while the patient awaits surgical evaluation and intervention. Prompt evaluation and management by the advanced practice registered nurse may not only expedite recognition of the prolapse, but can reduce iatrogenic complications that may occur from delayed treatment.

Knowledge and perceptions about aging and frailty: An integrative review of the literature.

A growing body of evidence indicates that biological aging or frailty is a determinant of health-related outcomes, however, frailty is likely poorly understood and under-recognized by the public-at-large. Using Whittemore and Knafl's methodology, we aimed to conduct an integrative review of research on public knowledge and perceptions of aging and frailty, and to create a conceptual model of our findings. Twenty-three studies are presented. The conceptual model suggests that culture, knowledge of aging, and stereotypes influence adults' beliefs and perceptions. Adults determine priorities about aging, and then subconsciously or consciously determine which parts of are controllable. If deemed controllable and important, they may participate in health behaviors to mediate aging. If deemed uncontrollable or less important, adults may aim to control their own peace of mind through acceptance. Scant findings suggest that frailty is a more subjective term in which participants often optimistically do not identify themselves as frail.