GERONTOLOGICAL NURSING

By: Meredith Wallace
The increased numbers of older adults in the United States undoubtedly has
a major impact on the demand of this population on the health care system.
The Alliance for Aging Research (2002) reports that the average older
adult has three chronic medical conditions. Consequently, more nurses are
needed to care for the increasing number of older adults with chronic illness.
It is commonly assumed that any nurse can take care of older adults.
However, with the increasing population of older adults there has been an
increase in the amount of specialized geriatric nursing knowledge needed
to care for this population. Not only are more nurses needed to care for
older adults, but nurses competent in the care of older adults will be needed
to meet the enhanced needs of the older population. Rosenfeld, Bottrell,
Fulmer, and Mezey (1999) report that “Today, a nurse’s typical patient is
an older adult,” and “it behooves the nursing community to ensure that
every nurse graduating from a baccalaureate nursing program has a defined
level of competency in care of the elderly”.
Despite the increased need, as well as the substantial growth in geriatric
nursing science, the fi eld of gerontological nursing has been slow
to gain recognition as a nursing specialty. While more and more nursing
programs are offering courses in geriatric nursing or integrating best
geriatric nursing practices throughout programs, geriatric nursing is still
not a popular specialty area among nursing students. Moreover, there is
currently a nursing shortage that affects all areas of care, including older
adults. The overall shortage of nurses along with the increase in older adults requiring care has resulted in a critical shortage of nurses prepared
to care for older adults. A recent article in the American Journal of Nursing
challenges whether or not nurses are prepared to meet the needs of
this increased population of older adults (Stotts & Dietrich, 2004).
The terms geriatric nursing, gerontological nursing, and gerontic
nursing have been used interchangeably to describe the role of nursing
care of older adults. However, these terms have different meanings. Geriatric
nursing refers to the nursing care of older people with health problems,
or those requiring tertiary care. Gerontological nursing includes
health promotion, education, and disease prevention (primary and secondary
care). Gerontic nursing, although not a commonly known term,
encompasses both of these aspects (Hogstel, 2001). The past several
decades have seen a great increase in gerontological nursing knowledge.
Rauckhorst (2003) reports that these changes began in 1966 when the
American Nurses Association (ANA) fi rst recognized geriatric nursing as
a specialty. Standards to guide the practice of gerontological nursing were
fi rst published by the ANA in 1976 and later revised in 1987 and 1995.
The educational foundation in gerontological nursing has expanded
greatly over the past two decades. Many more associate, baccalaureate,
and certifi cate programs in nursing contain geriatric content than previously.
The development and integration of geriatric content into nursing
programs was greatly supported by the Kellogg, Robert Wood Johnson,
and John A. Hartford foundations. However, despite the great progress
in gerontological nursing, Kovner, Mezey, and Harrington (2002) report
that 58% of baccalaureate nursing programs do not have geriatric-certifi
ed faculty. Gilje, Lacey, and Moore (2007) report that only slightly
more than half of baccalaureate programs surveyed offered a stand-alone
geriatric course.