More than 70 million baby boomers are fast approaching retirement age and with that comes a growing need for gerontological nurses. Gerontology, the study and care of aging adults, is poised to become a top medical specialty in the next two decades. Unlike geriatrics which focuses on the treatment of disease in the elderly, gerontology considers the entire spectrum of wellness issues older Americans face, and it’s a task professional nurses are uniquely positioned to address.
Who are the Baby Boomers?
America experienced a steep rise in birth rates between 1946 and 1964. World War II had just ended, the economy was thriving, and couples took the opportunity to start families. Today, children born in this generation, the so-called Baby Boomers, are in their 50’s, 60’s and early 70’s, and as the largest single demographic group in the United States, their evolving healthcare needs will necessarily change the landscape of medicine in the coming years.
How do Gerontological Nurses Fit In?
Getting older has its share of both medical and non-medical issues, but most are inexorably linked. Aging is not an illness, but it is associated with greater susceptibility to disease and loss of functional capacity due to a perfect storm of physical, psychological and social issues.
Aging adults like Baby Boomers have health goals. They want to:
• Age in place in the comfort of their home
• Remain independent and active as long as possible
• Manage their healthcare expenses effectively
• Receive care that is less medicalized and more focused on quality of life
Achieving this, however, requires coordinated care. Unlike younger patients, older adults face a wider range of medical issues including:
• High rates of chronic disease
• Increased vulnerability to acute illness
• Impaired mobility
• Cognitive and sensory decline
But they also face economic and social challenges that impact their ability to care for themselves such as:
• Homes that aren’t mobility-friendly
• Lack of access to shopping and transportation
• Social isolation
• Limited financial resources
• Lack of family support
The role of a gerontological nurse is to manage this full range of complex vulnerabilities that affect older adults’ quality of life and independence. As millions of baby boomers enter the healthcare system as medical consumers, they are needed more than ever. Gerontological nurses work in:
• Rehabilitation centers
• Assisted living communities
• Nursing homes
• Public health departments
• Private medical practices
From managing acute illness and preventing chronic disease to advocating for safe housing and promoting elder nutrition programs, gerontological nurses are taking a leading role in meeting the needs of aging adults wherever they are.
Common Issues Affecting Older Adults
Consider these distinct health issues older adults at home face from a gerontological nursing perspective. The include Alzheimer’s disease, arthritis, diabetes, and influenza.
Alzheimer’s is a degenerative brain disease. Its course is different for everyone, and in its early stages, symptoms like forgetfulness and changes in vision are manageable. However, when combined with unfavorable environmental and social circumstances, it can prematurely rob seniors of their independence.
Memory lapses and changes in depth perception, for example, can lead to:
• Medication errors
• Loss of ability to drive or cook safely
• Inability to manage finances
• Social isolation
These relatively minor symptoms, for an older adult without regular family or community support, can then lead to:
• Acute illness
• Falls with catastrophic injuries
Gerontological nursing treats this type of problem not just as an illness, but as wellness issue that impacts elder independence, recognizing that by addressing co-occurring medical and social concerns, both health and quality of life improve. To help a patient age in place in a case like this, a gerontological nurse might recommend:
• Home adaptations that allow a client to avoid using the stairs
• A medicine reminder system
• Grocery shopping and meal preparation support
• Transportation services for shopping and doctor’s appointments
• A peer support group
Arthritis is a leading cause of disability in older adults, and it can impact life in unexpected ways. Impaired mobility makes self-care difficult, increases the risk of falls and can lead to social isolation as seniors struggle to keep up with healthier peers. Pain, when severe, can also lead to changes in mood, depression and overuse of potentially addictive medications that can cause dangerous cognitive side effects. What could a gerontological nurse do for a client in this situation?
• Explore physical therapy, home modifications and the use of adaptive equipment
• Determine if prescribed medications are a risk factor for injury and ask about safer alternatives
• Help the patient to identify meaningful activities that are less physically challenging
Managing diabetes requires attention to both nutrition and medication, and that can be especially tough for older adults. Seniors who don’t drive may struggle to get food, medicine and exercise while others may lack the financial resources to buy critical medications. Adults with cognitive impairment may be unable to manage complex medication regimens. For seniors with arthritis, even self-administering insulin injections can be difficult.
Gerontological nurses help by identifying and addressing these types of challenges on an individual basis. Potential interventions include:
• Obtaining in-home assistance with personal care
• Working with physicians to simplify medication regimens
• Seeking alternative funding for life-saving drugs
• Exploring elder nutrition support programs
Nearly a quarter of a million patients annually are hospitalized in the United States due to influenza, and of those, more than half are over age 65. With age, seniors become more susceptible to dehydration and secondary infections, such as pneumonia, as a result of the flu. Gerontological nurses can help prevent hospitalizations by:
• Education seniors about hand washing and the importance of getting a flu shot
• Offering in-home immunizations or help with getting transportation to a doctor’s office
For older adults who want to live out their retirement at home, these interventions are just some of the many ways gerontological nurses can help.
For seniors with an acute illness or chronic medical conditions that require more care than can be safely provided at home, the same wellness-based gerontological principles are applied in hospitals, assisted living communities, nursing homes and hospices. The goals always remain the same, to optimize health, maintain quality of life and maximize independence.
Top Skills for Gerontological Nurses
Gerontological nurses have a broad scope of practice, and the ability to think critically is a must. Every day presents challenges that require sound decision-making skills, and to be successful, it takes the ability to analyze data, assess complex situations and make logical connections between the many issues affecting older adults.
Every patient is an individual with the right to self-determination. Patients will have vastly different thoughts about wellness and may make choices that are not always aligned with nursing recommendations. Only by remaining open-minded can nurses help patients make healthcare decisions that best reflect their goals.
Compassion is more than kindness. It’s the ability to feel a patients’ suffering and the impact it has on lives from a holistic perspective. The elderly are particularly vulnerable and need nurses who can support them through times of physical, mental, or emotional pain as whole persons, not just as the sum of their symptoms.
Tips for Caring for Older Adults
Seniors are unique individuals with diverse needs and preferences, but they also share common characteristics and generational personality traits that affect the way nurses should approach care. To build a strong professional relationship with their clients, gerontological nurses should consider these tips.
Recognize Sensory Issues
With age, most seniors lose some visual and hearing acuity. Adaptive equipment including glasses and hearing aids can help, but it’s vital to recognize how these impairments affect the lives of patients, their ability to communicate and take care of themselves.
Older adults have paid their dues and deserve respect. Despite needs that may appear child-like, seniors should never be treated like children. The aging brain does lose some fluidity with age, and it can be harder to learn new things, but the knowledge and wisdom associated with extensive life experience rarely fade.
Keep Things Simple
The older generation is from a simpler time, and while that doesn’t mean they can’t or don’t want to learn new things, they rarely appreciate complexity for its own sake and prefer healthcare providers who give them concise, actionable information.
Build Trust and Rapport
Research shows that older adults are more likely to take action on healthcare advice when the information comes from a trusted source. By building personal rapport over time and demonstrating both knowledge and goodwill, gerontological nurses can be that source. Since nurses are the providers most likely to be on the front lines of care, a trusting relationship is the gateway through which medical recommendations are most likely to be accepted.
Support Their Autonomy
Older adults often feel like their independence is undermined by well-meaning healthcare providers who assume they can no longer make their own decisions. As a group, they are affected by negative stereotypes and struggle to communicate with doctors, nurses and even family members who have different points of view. As a patient advocate, it’s one of a gerontological nurse’s primary obligations to both respect and support aging adults’ right to autonomy to every extent possible.
As a generation, baby boomers are experiencing better health because of advances in medicine, yet many fear that they won’t age successfully because of social, cultural and economic challenges. These challenges include a healthcare system burdened with rising costs and capacity constraints. The good news is that gerontological nurses may be the solution. Their unique blend of medical skills and personal accessibility makes them the perfect front line healthcare providers to bring older adults the comprehensive, cost-effective, high-quality care they deserve.
Did learning about gerontological nursing interest you? The Associate of Science in Nursing degree program at Gwinnett College provides training to prepare college graduates to enter the nursing profession as a registered nurse. Classroom theory, challenging assignments, skill labs, simulations, and clinical experiences help to prepare college graduates for an entry-level nursing position.
Upon successful completion of the program and demonstrated nursing competence, the college graduates will be eligible to apply to take the NCLEX-RN licensure examination.* Upon graduation and licensure, college graduates will be eligible to seek employment in hospitals, clinics, private duty, urgent and acute care centers, and various other medical or business facilities requiring the services of registered nurses.
*While Gwinnett Institute provides test preparation and review assistance to college students, it cannot guarantee any college student will be able to take or pass any type of licensure exam. College students must be mindful throughout their entire training program that licensure is a pre-requisite for employment as a nurse and to diligently prepare themselves to meet this important requirement.
Contact us today to learn more about becoming an RN at Gwinnett College.