time when society was even less accepting of homosexuality (Brotman et al., 2003).

Knowledge of a patient’s sexuality can be critical to high-quality patient care. A recent study estimated that approximately 100,000 adults ages 50 and older are HIV positive (ASA, 2007). Older adults with HIV/AIDS may be misdiagnosed because health care providers do not perceive HIV/AIDS to be a risk among older adults and because older adults often do not disclose the nature of their sexual activity to health care providers (AIDS InfoNet, 2007; NAHOF, 2007). Additionally, GLB older adults often do not have the same family support systems as heterosexual older adults, particularly since GLB older adults are less likely to have children and are more likely to live alone (Cahill et al., 2000).

The Continuum of Care

Geriatric education is highly variable in its level of comprehensiveness, and it often fails to address the health care needs of older adults across the continuum of care, ranging from preventive to palliative care. Health care professionals should be aware that older adults have a vast range of health care needs. Many students still are not taught about or exposed to older populations at either end of the continuum of care.


Health promotion/disease prevention Health promotion is beneficial for people of all ages and all health conditions, but it may be especially important to the growing cohort of healthy older adults—that is, the 20 percent of older Americans who have no chronic disease and who require only preventive and episodic care. Traditionally, the training of professionals in the care of older adults has focused only on the treatment of disease and has given little attention to the promotion of health. For example, poor nutrition is prevalent among seniors (IOM, 2000), but most professionals are still not trained in the nutritional needs of older adults (Bonnel, 2003; Rhee et al., 2004). Government agencies and professional societies have developed guidelines for health promotion and disease prevention in elderly populations which include goals typically promoted for other populations, including increased physical activity, smoking cessation, and weight management (Fields and Nicastri, 2004). These guidelines are based on research that shows the benefits of health promotion and disease prevention in elderly populations. For example, studies have shown that older persons who practice tai chi experience fewer falls (Li et al., 2002, 2005; Wolf et al., 1996).

Screening guidelines are important in nursing homes for the early detection of depression and pressure ulcers (McElhone et al., 2005). Unfortunately, prevention and screening guidelines often lump all elderly persons



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