Module One Overview – Nursing Care of the Older Adult
1. History and Evolution
a. Older adults are one of the largest group of patients in acute care, long term
care facilities, and rehabilitation facilities.
b. As Baby Boomers age and the number of people living longer increases, the need
for those with an aging expertise grows.
c. The field of gerontological nursing has evolved over the past decades and its
specialty is in greater demand more now than ever before.
d. The history and evolution of gerontological nursing encompasses major
milestones from the day of primary care or private duty nursing to acute care and
now a shift to community based care.
e. The Nursing Competence in Aging initiative advocated for all nurses to have
greater knowledge, skills, and broader attitudes toward the older adult primarily
due to the prevalence and incidence of chronic health and functional issues in
older adult clientele.
f. The provision of quality healthcare and the complexities of the older adult are
ever growing challenges for the healthcare system.
g. Present day gerontological nursing
1. The present day of geriatrics as a specialized science, has never
presented a more opportune time to embrace gerontological nursing as the
healthcare system has considerably shifted due to increased life
expectancies, the aging of the baby boomer population, increased
complexities and rise of chronic disease in older adult client care.
2. Nurses can expect to care for a large number geriatric patients
in every clinical setting over the next decades.
3. Nurses are in prime positions to manage the complexities of older
adult client care and to promote health, wellness and disease prevention
Efforts should be directed toward health prevention, health screening,
and health maintenance and health promotion.
2. Older Adult Terminology
a. The terms Gerontology, Geriatrics and Gerontological nursing are often
used interchangeably, but there are distinct differences between the three.
b. Gerontology - study of social, cultural, psychological, cognitive, economic and
biological aspects of aging.
c. Geriatrics - Specialty that focuses on healthcare of elderly people specific to
disease and illness.
d. Gerontological Nursing - Specialty that involves assessment, planning,
implementing and evaluating care in older adult.
3. History of Gerontological Standards
a. Rise in certifications and specialties of older adult care.
b. Creation of Scope of Practice and Standards of Gerontological Nursing practice.
1. Although nurses published articles about the care of older adults as
early as 1904, the specialty of gerontological nursing really began to
emerge beginning in the 1950s.
, Module One Overview – Nursing Care of the Older Adult
2. The 1960s and 1970s marked a notable recognition for the need of
standards of practice in geriatric nursing, with the creation of the first
Standards of Practice for Geriatric Nursing documents in 1969, an effort
led by the American Nurses Association.
3. In the 1970s Medicare and Medicaid programs marked a
significant growth within the healthcare industry for the older adult
segment.
4. Gerontological Nurse Roles
a. Direct hands-on care to older adults in various settings.
b. Knowledge of disease processes, medical treatments, rehabilitation and end of life
care.
c. The 21st century has provided a resurgence in interest in gerontological
care. There are several types of nurses that work in this field.
d. Older adults often present with atypical symptoms that complicate diagnosis and
their plan of care and treatments.
1. Older adults are high risk for falls. The nurse must assess if
they have altered mobility, confusion, malnutrition, polypharmacy.
2. Skin breakdown - is associated with diagnoses of dementia,
osteoporosis, osteomyelitis
5. Gerontological Nurse Credentialing
a. Current American Nurses Credentialing Options:
1. Gerontological Nurse(Registered Nurse Board Certified(RN-BC)
2. Adult Gerontology Acute Care Nurse Practitioner (AGACNP-BC)
3. Adult-Gerontology Primary Care Nurse Practitioner (AGAPCNP-
BC)
4. Adult Gerontology Clinical Nurse Specialist
b. The certified gerontological nurse holds an active registered nurse license with at
least 2 years of full time practice, and has completed clinical practice at least
2000 hours in gerontologic nursing within the last 3 years … 30 contact hours of
continuing education applicable to gerontological nursing within the past 3 years
is an additional requirement.
c. In the US, certification for Gerontological Clinical Nurse Specialist –became
available in 1989 by the American Nurses Association
d. Current American Nurses Credentialing Options:
1. Gerontological Nurse (Registered Nurse Board Certified)
2. Adult Gerontology Acute Care Nurse Practitioner
3. Adult-Gerontology Primary Care Nurse Practitioner
4. Adult Gerontology Clinical Nurse Specialist
6. Gerontological Nursing Evolution
a. Approximately 85 percent of older adults have at least one chronic health
condition.
1. Arthritis and hypertension been claimed to be the most common.
1. History and Evolution
a. Older adults are one of the largest group of patients in acute care, long term
care facilities, and rehabilitation facilities.
b. As Baby Boomers age and the number of people living longer increases, the need
for those with an aging expertise grows.
c. The field of gerontological nursing has evolved over the past decades and its
specialty is in greater demand more now than ever before.
d. The history and evolution of gerontological nursing encompasses major
milestones from the day of primary care or private duty nursing to acute care and
now a shift to community based care.
e. The Nursing Competence in Aging initiative advocated for all nurses to have
greater knowledge, skills, and broader attitudes toward the older adult primarily
due to the prevalence and incidence of chronic health and functional issues in
older adult clientele.
f. The provision of quality healthcare and the complexities of the older adult are
ever growing challenges for the healthcare system.
g. Present day gerontological nursing
1. The present day of geriatrics as a specialized science, has never
presented a more opportune time to embrace gerontological nursing as the
healthcare system has considerably shifted due to increased life
expectancies, the aging of the baby boomer population, increased
complexities and rise of chronic disease in older adult client care.
2. Nurses can expect to care for a large number geriatric patients
in every clinical setting over the next decades.
3. Nurses are in prime positions to manage the complexities of older
adult client care and to promote health, wellness and disease prevention
Efforts should be directed toward health prevention, health screening,
and health maintenance and health promotion.
2. Older Adult Terminology
a. The terms Gerontology, Geriatrics and Gerontological nursing are often
used interchangeably, but there are distinct differences between the three.
b. Gerontology - study of social, cultural, psychological, cognitive, economic and
biological aspects of aging.
c. Geriatrics - Specialty that focuses on healthcare of elderly people specific to
disease and illness.
d. Gerontological Nursing - Specialty that involves assessment, planning,
implementing and evaluating care in older adult.
3. History of Gerontological Standards
a. Rise in certifications and specialties of older adult care.
b. Creation of Scope of Practice and Standards of Gerontological Nursing practice.
1. Although nurses published articles about the care of older adults as
early as 1904, the specialty of gerontological nursing really began to
emerge beginning in the 1950s.
, Module One Overview – Nursing Care of the Older Adult
2. The 1960s and 1970s marked a notable recognition for the need of
standards of practice in geriatric nursing, with the creation of the first
Standards of Practice for Geriatric Nursing documents in 1969, an effort
led by the American Nurses Association.
3. In the 1970s Medicare and Medicaid programs marked a
significant growth within the healthcare industry for the older adult
segment.
4. Gerontological Nurse Roles
a. Direct hands-on care to older adults in various settings.
b. Knowledge of disease processes, medical treatments, rehabilitation and end of life
care.
c. The 21st century has provided a resurgence in interest in gerontological
care. There are several types of nurses that work in this field.
d. Older adults often present with atypical symptoms that complicate diagnosis and
their plan of care and treatments.
1. Older adults are high risk for falls. The nurse must assess if
they have altered mobility, confusion, malnutrition, polypharmacy.
2. Skin breakdown - is associated with diagnoses of dementia,
osteoporosis, osteomyelitis
5. Gerontological Nurse Credentialing
a. Current American Nurses Credentialing Options:
1. Gerontological Nurse(Registered Nurse Board Certified(RN-BC)
2. Adult Gerontology Acute Care Nurse Practitioner (AGACNP-BC)
3. Adult-Gerontology Primary Care Nurse Practitioner (AGAPCNP-
BC)
4. Adult Gerontology Clinical Nurse Specialist
b. The certified gerontological nurse holds an active registered nurse license with at
least 2 years of full time practice, and has completed clinical practice at least
2000 hours in gerontologic nursing within the last 3 years … 30 contact hours of
continuing education applicable to gerontological nursing within the past 3 years
is an additional requirement.
c. In the US, certification for Gerontological Clinical Nurse Specialist –became
available in 1989 by the American Nurses Association
d. Current American Nurses Credentialing Options:
1. Gerontological Nurse (Registered Nurse Board Certified)
2. Adult Gerontology Acute Care Nurse Practitioner
3. Adult-Gerontology Primary Care Nurse Practitioner
4. Adult Gerontology Clinical Nurse Specialist
6. Gerontological Nursing Evolution
a. Approximately 85 percent of older adults have at least one chronic health
condition.
1. Arthritis and hypertension been claimed to be the most common.
