Gerontological nursing

Gerontological nursing is the specialty of nursing pertaining to older adults.^[1] Gerontological nurses work in collaboration with older adults, their families, and communities to support healthy aging, maximum functioning, and quality of life.^[2] The term gerontological nursing, which replaced the term geriatric nursing in the 1970s, is seen as being more consistent with the specialty's broader focus on health and wellness, in addition to illness.^[3][4]

Gerontological nursing is important to meet the health needs of an aging population.^[3] Due to longer life expectancy and declining fertility rates, the proportion of the population that is considered old is increasing.^[5] Between 2000 and 2050, the number of people in the world who are over age 60 is predicted increase from 605 million to 2 billion.^[6] The proportion of older adults is already high and continuing to increase in more developed countries. In 2010, seniors (aged 65 and older) made up 13% and 23% of the populations of the US and Japan, respectively. By 2050, these proportions will increase to 21% and 36%.^[7][8]

Scope

Gerontological nursing draws on knowledge about complex factors that affect the health of older adults.^[9][10] Older adults are more likely than younger adults to have one or more chronic health conditions, such as diabetes, cardiovascular disease, cancer, arthritis, hearing impairment, or a form of dementia such as Alzheimer's disease.^[4] As well, drug metabolism changes with aging, adding to the complexity of health needs.^[10]

Gerontological nurses work in a variety of settings, including acute care hospitals, rehabilitation, nursing homes (also known as long term care homes and skilled nursing facilities), assisted living facilities, retirement homes, community health agencies, and the patient's home.^[3] Depending on the conditions of the geriatric's health determines what type of facility one should reside in. Assisted living facilities are also known as a senior retirement home that provides care services depending on health conditions. Skilled nursing otherwise known as a nursing home is a place where they can reside and get provided with 24/7 cares.

Older adults have been referred to as "the core business of healthcare" by gerontological nursing experts.^[11][12] Population aging and the complexity of health care needs of some older adults means that older adults are more likely than younger people to use health care services.^[9] In many settings, the majority of patients are older adults. Thus, experts recommend that all nurses, not only those identified as gerontological nurses, need specialized knowledge about older adults. This position was endorsed by 55 US nursing specialty organizations.^[13]

History

Although nurses published articles about care of older adults as early as 1904, the specialty of gerontological nursing emerged beginning in the 1950s, with the publication of the first gerontological nursing textbook.^[4][14] Pioneers in the field of gerontological nursing include Vera McIver,^[15] Doris Schwartz,^[16] Mary Opal Walanin.^[17][18]

Elderly woman

A geriatric nursing specialty group was formed by the American Nurses Association in 1966, with the name changed to the Gerontological Nursing Division in 1976.^[4] In the US, the National Gerontological Nursing Association was founded in 1984 and in 1985 the Canadian Gerontological Nursing Association was founded.^[4][19] Standards of practice for gerontological nursing were published by the American Nurses Association in 1971.^[10] In the US, certification for geriatric nurse practitioners and clinical specialists were available in 1984.^[3]

The specialty has advanced significantly since the 1990s through large scale education and practice development initiatives funded by the John A. Hartford Foundation, including the Hartford Institute for Geriatric Nursing at New York University. Significant efforts to enhance nursing education have been made in the last decade.^[4] In 2010, the American Association of Colleges of Nursing and the Hartford Institute for Geriatric Nursing published the Recommended Baccalaureate Competences and Curricular Guidelines for the Nursing Care of Older Adults.^[20] Between 2007 and 2009 the Geriatric Nursing Education Consortium created teaching tools and trained educators in the US to improve gerontological content in nursing education.^[21]

Training and education

Gerontological nursing includes generalist and specialist practice. A generalist is a registered nurse or Licensed Practical Nurse. A gerontological nurse specialist is an advanced practice nurse or nurse practitioner who has graduate education in gerontological nursing.

National nursing organizations such as the American Nurses Credentialing Center, the Canadian Nurses Association offer certification in gerontological nursing. In order to be certified, the nurse must have a minimum academic preparation, experience as a gerontological nurse, and write a certification exam.^[22] Requirements for maintaining certification vary. Post graduate certificates in gerontological nursing are also available by completing continuing education courses through colleges and universities.^[23][24][25]

References