Chapter 6 The Specialty of Gerontological Nursing

1. Chapter6The Specialty of Gerontological Nursing

2. Development of Gerontological Nursing • 1904: First article on care of the aged published in the American Journal of Nursing • 1935: Federal Old Age Insurance Law, or Social Security • 1962: First meeting of the ANA’s Conference Group on Geriatric Nursing Practice • 1966: Division of Geriatric Nursing— gerontological nursing as a nursing specialty

3. Development of Gerontological Nursing • 1970: published Standards for Geriatric Nursing Practice • 1975: first certification of nurses for excellence in geriatric nursing • 1975: Journal of Gerontological Nursing first published • 1976: Geriatric Nursing Division became the Gerontological Nursing Division

4. Development of Gerontological Nursing • Growth in the last few decades • Increase in gerontological nursing texts • Increase in journal articles • Gerontological nursing education • Certification in gerontological nursing • Subspecialization • Hartford Institute for Geriatric Nursing

5. Core Elements of Gerontological Nursing Practice • Evidence-based practice: • Systematic • Based on research • Standards for Nursing Practice: • Used to guide and evaluate nursing practice • ANA Standards

6. Core Elements of Gerontological Nursing Practice • Principles: • Scientific data regarding theories • Biological and social sciences • Nursing principles • Guides care for gerontological nursing

7. Aging: A Natural Process • Process of maturing or aging • Comments associated with aging • Aging is not a disease • Aging brings the opportunity for usefulness, fulfillment, and joy • Need for a realistic understanding of the aging process

8. Factors Influencing the Aging Process • Heredity, nutrition, health status, life experiences, environment, activity, and stress • Aging is individualized • General characteristics evident among most people in a given age category

9. The Nursing Process Framework • Scientific data and knowledge of nursing • Systematic approach to nursing care • Holistic approach to individuals

10. Common Needs to Promote Health and Quality of Life • Core needs: • Physiologic balance • Connection • Gratification • Self-care practices

11. Optimal Health and Wholeness • Aging as the process of realizing one’s humanness, wholeness, and unique identity • Self-actualization • Harmony with internal and external environment • Sense of purpose

12. Nursing Actions to Promote Self-Care • Strengthening self-care capacity • Eliminating or minimizing self-care limitations • Providing direct services • Promotion of maximum independence

13. Gerontological Nursing Roles: Healer • Recognizing the interdependency of body, mind, and spirit in health and aging • Staying well • Overcoming or coping with disease • Restoring function • Finding meaning and purpose in life • Mobilizing internal and external resources

14. Gerontological Nursing Roles: Caregiver • Utilization of gerontological theory in the application of the nursing process • Promotion of active participation of older adults and their significant others • Ensures care of the older adult is based on sound knowledge

15. Gerontological Nursing Roles: Educator • Takes advantage of formal and informal opportunities to share knowledge and skills related to care • Education extends to the general public • Requires effective communication techniques

16. Gerontological Nursing Roles: Advocate • Aids older adults in asserting rights and obtaining required services • Facilitation of a community’s efforts to effect change for the benefit of older adults • Promotes gerontological nursing

17. Gerontological Nursing Roles: Innovator • Inquisitive style • Efforts to experiment to improve gerontological practice • Thinks “out of the box” • Takes risks • Transforms visions into reality

18. Advanced Practice Nursing Roles • Preparation in unique principles and best practices for the older adult • Broad knowledge base • Capacity for independent practice • Leadership • Complex clinical problem-solving abilities

19. Advanced Practice Nursing Roles • Advanced practice nurses make a significant difference in the care of the older adult: • Improvement in quality of care • Reduction in cost of care • Acute care: reduction in complications, length of stay, and need for readmission

20. Future of Gerontological Nursing • Lessons from the past • Challenges for the future • Gerontological nursing as a dynamic specialty • Multitude of opportunities • Development of new practice models

21. Nursing Research • Need for a strong knowledge base • Support of research: • Network with nurse researchers • Support research efforts in practice • Support and testimony to funding agencies • Keeping abreast of new findings

22. Promote Integrative Care • Nurses must ensure that gerontological care is holistic • Alternative and complementary therapies • Inclusion of caregivers in the plan of care

23. Education of Caregivers • Caregivers at every level require competency in providing services to older adults • Nurses have the ability to influence the education of caregivers • Include family caregivers in educational efforts

24. Development of New Roles • Opportunities for nurses to develop new roles within the field of gerontological nursing • Need for creativity and leadership • Examples of new roles

25. Balance Quality of Care andHealth Care Costs • Increasing number of older adults necessitates diversity of health care services for the older adult • Effects of third-party insurers and changes in reimbursement policies • Nurses need to be involved in cost-containment efforts to promote quality services

26. Nurses’ Involvement in Cost-Containment Efforts • Test creative staffing patterns • Use lay caregivers • Abolish unnecessary practices • Ensure safe care • Advocate for older adults