Chapter 6
The Specialty of
Gerontological Nursing
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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
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Development of
Gerontological Nursing
• 1970: published first 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
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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
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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
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Core Elements of
Gerontological Nursing Practice
• Principles:
– Scientific data regarding theories
– Biological and social sciences
– Nursing principles
– Guides care for gerontological nursing
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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
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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
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The Nursing Process Framework
• Scientific data and knowledge of nursing
• Systematic approach to nursing care
• Holistic approach to individuals
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Common Needs to Promote
Health and Quality of Life
• Core needs:
– Physiologic balance
– Connection
– Gratification
• Self-care practices
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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
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Nursing Actions to Promote Self-Care
• Strengthening self-care capacity
• Eliminating or minimizing self-care limitations
• Providing direct services
• Promotion of maximum independence
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Nursing Roles
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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
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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
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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
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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
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Gerontological Nursing Roles: Innovator
• Inquisitive style
• Efforts to experiment to improve gerontological
practice
– Thinks “out of the box”
– Takes risks
– Transforms visions into reality
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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
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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
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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
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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
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Promote Integrative Care
• Nurses must ensure that gerontological care is
holistic
• Alternative and complementary therapies
• Inclusion of caregivers in the plan of care
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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
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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
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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
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Nurses’ 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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