Total Joint Arthroplasty in the Older Adult

 The early 21st century has been declared the "Bone and Joint Decade" by 35 nations

and 44 states. Currently, more than 425,000 total joint replacements are performed each

year in the United States, and this number is expected to reach 702,000 by the year 2030

as the baby boomer generation ages (Praemer, et al. 1999). The increase in the number of

aging Americans, the increase in the prevalence of arthritis for this age group, and the

desire to remain active have added to the increase in demand for total joint replacement

surgery (Healy, Iorio, & Lemos, 2001). Joint replacement surgery has been documented

to improve pain, functional ability, social function, and quality of life for the recipient

(Aarons, Hall, Hughes, & Salmon, 1996; McGuigan, Hozack, Moriarty, Eng, &

Rothman, 1995; Norman-Taylor, Palmer, & Villar, 1996; Ritter, Albohm, Keating, Faris,

& Meading, 1995).

 These findings demonstrate that osteoarthritis among older adults is a major cause

of chronic pain and functional impairment. Total joint replacement offers the older adult

pain relief and improved functional ability, particularly when there is failure with

conservative therapies.

Spirituality in Older Adults

 Behavioral management of pain includes the strategy of active coping. Spiritual

coping behaviors that include praying and church attendance have been recognized as

active coping behavioral strategies used often by older adults (Koenig, et al. 1998).

Burkhardt, (1989) defines the "spirituality" as the individual's belief in God or a higher

power that is concerned with his or her striving to achieve a sense of harmony with self

and others. Spirituality often involves a relationship with an organized religion,

interrelationships with others, and the search for the meaning of life. Affiliation and/or