Chapter 6 The Specialty of Gerontological Nursing

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 6

The Specialty of Gerontological Nursing

Chapter 6

The Specialty of Gerontological Nursing


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




• 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




• 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


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




• Principles:

– Scientific data regarding theories

– Biological and social sciences

– Nursing principles

– Guides care for gerontological nursing


Aging: A Natural ProcessAging: 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


Factors Influencing the Aging ProcessFactors 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


The Nursing Process FrameworkThe Nursing Process Framework

• Scientific data and knowledge of nursing

• Systematic approach to nursing care

• Holistic approach to individuals


Common Needs to Promote Health and Quality of Life

Common Needs to Promote Health and Quality of Life

• Core needs:

– Physiologic balance

– Connection

– Gratification

• Self-care practices


Optimal Health and WholenessOptimal 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


Nursing Actions to Promote Self-CareNursing Actions to Promote Self-Care

• Strengthening self-care capacity

• Eliminating or minimizing self-care limitations

• Providing direct services

• Promotion of maximum independence


Gerontological Nursing Roles: HealerGerontological 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


Gerontological Nursing Roles: CaregiverGerontological 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


Gerontological Nursing Roles: EducatorGerontological 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


Gerontological Nursing Roles: AdvocateGerontological 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


Gerontological Nursing Roles: InnovatorGerontological Nursing Roles: Innovator

• Inquisitive style

• Efforts to experiment to improve gerontological practice

– Thinks “out of the box”

– Takes risks

– Transforms visions into reality


Advanced Practice Nursing RolesAdvanced 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


Advanced Practice Nursing Roles 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


Future of Gerontological NursingFuture 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


Nursing ResearchNursing 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


Promote Integrative CarePromote Integrative Care

• Nurses must ensure that gerontological care is holistic

• Alternative and complementary therapies

• Inclusion of caregivers in the plan of care


Education of CaregiversEducation 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


Development of New RolesDevelopment 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


Balance Quality of Care andHealth Care Costs

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


Nurses’ Involvement in Cost-Containment EffortsNurses’ Involvement in

Cost-Containment Efforts

• Test creative staffing patterns

• Use lay caregivers

• Abolish unnecessary practices

• Ensure safe care

• Advocate for older adults

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Chapter 6 The Specialty of Gerontological Nursing