1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 6 The Specialty of Gerontological Nursing

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Core Elements of Gerontological Nursing Practice Principles: –Scientific data regarding theories –Biological and social sciences –Nursing principles –Guides care for gerontological nursing

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins The Nursing Process Framework Scientific data and knowledge of nursing Systematic approach to nursing care Holistic approach to individuals

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Needs to Promote Health and Quality of Life Core needs: –Physiologic balance –Connection –Gratification Self-care practices

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Actions to Promote Self-Care Strengthening self-care capacity Eliminating or minimizing self-care limitations Providing direct services Promotion of maximum independence

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Promote Integrative Care Nurses must ensure that gerontological care is holistic Alternative and complementary therapies Inclusion of caregivers in the plan of care

23. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Balance Quality of Care and Health 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. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nurses’ Involvement in Cost-Containment Efforts Test creative staffing patterns Use lay caregivers Abolish unnecessary practices Ensure safe care Advocate for older adults