NURSING CARE OF OLDER ADULTS

Geriatrics, the study of old age, includes the physiology, pathology, diagnosis, and management of the diseases of older adults. The broader field of gerontology, or the study of the aging process, draws from the biologic, psychological, and sociologic sciences.

Because hospitalized patients are being discharged to home “quicker and sicker” than ever before, nurses in all settings, including hospital, home care, rehabilitation, and outpatient settings, need to be knowledgeable about geriatric nursing principles

and skilled in meeting the needs of elderly patients.

Gerontologic or geriatric nursing is the field of nursing that specializes in the care of the elderly. The Standards and Scope of Gerontological Nursing Practice were originally developed in 1969 by the American Nurses Association; they were revised in 1976 and again in 1987. The nurse gerontologist can be either a specialist or a generalist offering comprehensive nursing care to older persons by combining the basic nursing process of assessment, diagnosis, planning,

implementation, and evaluation with a specialized knowledge of aging. Currently, nurses from all nursing programs, including vocational programs (LPN/LVN), traditional hospital programs,

and college degree programs (ADN/BSN), as well as master’s prepared advanced practice nurses (clinical nurse specialists, nurse practitioners, and nurse anesthetists), care for older adults. Gerontologic nursing is provided in acute care, skilled and assisted living, community, and home settings. Its goals include promoting and maintaining functional status and helping older adults to identify and use their strengths to achieve optimal

independence. The nurse helps the older person to maintain dignity and maximum autonomy despite physical, social, and psychological losses. The nurse who becomes certified in gerontologic

nursing has specialized knowledge in the acute and chronic changes specific to older people. The use of advanced practice nurses (APNs) in long-term care has proved to be very effective:

when APNs using current scientific knowledge about clinical problems interface with nursing home staff, significantly less deterioration in affect and overall health issues has been demonstrated (Ryden et al., 2000). Because old age is a normal occurrence that encompasses all experiences of life, care and concern for the elderly cannot be limited to one discipline, but is best provided through a cooperative effort. An interdisciplinary team, through comprehensive geriatric assessment, can combine expertise and resources to provide insight into all aspects of the aging process. Nurses collaborate with the interdisciplinary team to obtain non-nursing services and provide a holistic approach to care.

from: Brunner and Suddarth's Textbook of Medical-Surgical Nursing