Geriatric nursing

BY: MAMTA PARIHAR
MSC. NURSING 1ST YEAR
GERIATRIC NURSING

Robert
browning.
“Grow old along with me! The
best is yet to be”

INTRODUCTION:-
Aging, the normal process of time-
related change, begins with birth and
continues throughout life.
Gerontological nursing is the specialty
of nursing pertaining to older adults
who work in collaboration with older
adults, their families, and communities
to support healthy aging, maximum
functioning, and quality of life.

DEFINITIONS: -
Geriatrics: the study of old age
that includes the physiology,
pathology, diagnosis, and
management of the disorders and
diseases of older adults
Gerontology: the combined
biologic, psychologic, and

Gerontology /geriatric nursing:
The term gerontological nursing, which
replaced the term geriatric nursing in the
1970s, is seen as being more consistent
with the specialty's broader focus on
health and wellness, in addition to illness.
The field of nursing that specializes in the
nursing process as it relates to the
assessment, nursing diagnosis, planning,
implementation, and evaluation of older
adults in all environments including acute,
intermediate, and skilled care as well as

DEMOGRAPHICS OF AGING
 Between 2000 and 2050, the number of people in the world
who are over age 60 is predicted increase from 605 million
to 2 billion.

These data are showing that:
 The proportion of older adults is already
high and continuing to increase in more
developed countries.
 The share of India’s population ages 60
and older is projected to climb from 8% in
2010 to 19% in 2050, according to the
United Nations Population Division (UN
2011).
 By mid-century, India’s 60 and older
population is expected to encompass 323
million people, a number greater than the

The increasing
number of old
people is like a
challenge and
opportunity
both…….
Aging is a
process not a
disease……

FACTORS INFLUENCING
AGING
Heredity
Nutrition
Health status
Life experiences
Environment
Activity
Stress produce unique

CHANGES
1. Physiological
2. Psychosocial
3. Cognitive

PHYSIOLOGICAL CHANGES
1.Cardiovascular system
2.Respiratory Systems
3.Integumentary System
4.Musculoskeletal System
5.Genitourinary Systems
6.Reproductive System
7.Gastrointestinal System
8.Nervous System
9.Special Senses

PSYCHOSOCIAL CHANGES:
Retirement and Social isolation
Sexuality
Elder neglect
Elder abuse
Housing and environment
Death
Stress and Coping in
the Older Adult

COGNITIVE CHANGES
 Delirium: or an acute confusional state, is a
potentially reversible cognitive impairment that
is often due to a physiological cause
 Depression: It is the most common affective or
mood disorder of old age and is often
responsive to treatment. Its classification and
diagnosis vary according to the number,
severity, and duration of symptoms.
 Dementia: Dementia is generalized impairment
of intellectual functioning that interferes with
social and occupational functioning

PHARMACOLOGIC ASPECTS OF
AGING
 Absorption: Reduced gastric acid; increased
pH (less acid), Reduced gastrointestinal motility;
prolonged gastric emptying
 Distribution: Decreased albumin sites,
Reduced cardiac output, Impaired peripheral
blood flow, Increased percentage of body fat,
Decreased lean body mass
 Metabolism: Decreased cardiac output and
decreased, perfusion of the liver
 Excretion: Decreased renal blood flow; loss of

THE COMMON AGE RELATED
PROBLEMS
 Osteoarthritis Osteoporosis
 Cardiovascular disease Alzheimer‘s
 Diabetes

MYTH: FACT:
Most older people are pretty
much alike. They are a very diverse age group.
They are generally alone and
lonely.
Most older adults maintain close contact with
family.
They are sick, frail, and
dependent on others. Most older people live independently.
They are often cognitively
impaired
For most older adults, if there is decline in some
intellectual abilities, it is not severe enough to
cause problems in daily living.
They are depressed.
Community dwelling older adults have lower rates
of diagnosable depression than younger adults.
They become more difficult and
rigid with advancing years.
Personality remains relatively consistent
throughout the lifespan.
They barely cope with the
inevitable declines associated
with aging.
Most older people successfully adjust to the
challenges of aging.
AGING: MYTH VS. FACT

DEVELOPMENT OF
GERONTOLOGICAL NURSING
1950- 1st Gerontological nursing text
published, Geriatrics recognized as an
area of specialization in nursing.
1961- ANA recommends specialty group
for geriatric nurses.
1966- Formation of geriatric nursing
division of ANA
1969- Development of standards for
geriatric nursing practice

Cont….
1976- ANA changes name from Geriatric
Nursing division to Gerontological nursing
division.
1981- First international conference on
Gerontological nursing.
1982- Development of Robert Wood
Johnson teaching Home Nursing Program.
1984- Formation of National
Gerontological Nursing Association.

SCOPE
Gerontological nurses work in a
variety of settings, including
acute care hospitals,
rehabilitation, nursing homes
(also known as long term care
homes and skilled nursing
facilities), assisted living facilities,
retirement homes, community
health agencies, and the patient's

TRAINING AND EDUCATION
Gerontological nursing includes
generalist and specialist practice.
National nursing organizations such
as the American Nurses
Credentialing Center, the Canadian
Nurses Association offer certification
in gerontological nursing.
In order to be certified, the nurse
must have a minimum academic
preparation, experience as a

Developmental Theories of aging
 Acc to Erikson (1963) theorized that a person’s life
consists of eight stages,
 Each stage representing a crucial turning point in
the life span stretching from birth to death with its
own developmental conflict to be resolved.
According to Erikson, the major developmental
task of old age is to either achieve ego integrity or
suffer despair. Achieving ego integrity requires
accepting one’s lifestyle, believing that one’s
choices were the best that could be made at a
particular time, and being in control of one’s life.
 Despair results when an older person feels
dissatisfied and disappointed with his or her life,
and would live differently if given another chance.

Cont….
 Havighurst (1972) also suggested a list of
developmental tasksbthat occur during a
lifetime. The tasks of the older person
includebadjusting to retirement after a
lifetime of employment with a possible
reduction of income, decreases in physical
strength and health, the death of a spouse,
establishing affiliation with one’s age group,
adapting to new social roles in a flexible
way, and establishing satisfactory physical
living arrangements.

Cont…
 Combining the concepts of both Erikson and
Havighurst
 suggests the following developmental tasks for the
older adult:
 (1) Maintenance Of Self-worth,
 (2) Conflict Resolution,
 (3) Adjustment To The Loss Of Dominant Roles,
 (4) Adjustment To The Deaths Of Significant Others,
 (5) Environmental Adaptation, And
 (6) Maintenance Of Optimal Levels Of Wellness.

PRINCIPLES OF
GERONTOLOGICAL NURSING
PRACTICE
 Aging is a natural process common to all
living organisms.
 Various factors influence the aging process.
 Unique data and knowledge are used in
applying the nursing process to the older
populations.
 The elderly share similar self-care and
human needs with all other human beings.
 Gerontological nursing strives to help older
adults achieve optimum levels of physical,
psychological, social and spiritual and

Ana standards of gerontological
nursing practice (nursing care)
I. Assessment
II. Diagnosis
III. Outcome identification
IV. Planning
V. Implementations
VI. Evaluation
VII. Research
VIII. Resource Utilization

Life Care Plans for older adults
 Evaluation of the older ADLs
 Complete history
 Family issues
 Vocational/educational history
 Projected physical and
occupational therapy needs
 Future medical care
 Personal items
 Diagnostic testing
 Medical equipment and supply
needs
 Recreational equipment

ROLE OF DIFFERENTE AGENCIES
The Role of the
Family
Community Support
Services
Home Health Care
Safety and Comfort
in the Home
Environment
Hospice Services

Gerontological Nursing Roles
HEALER
CAREGIVER
EDUCATOR
ADVOCATE
INNOVATOR

HEALER
Overcome or cope with disease restore
function and purpose in life and mobilize internal and
external resources.
Recognizes that most human beings value
health, are responsible and active participants in
their health maintenance and illness management, and
desires harmony and wholeness with their
environment.
Holistic approach is essential viewed in context of
their biological, emotional, social, cultural and spiritual

CAREGIVER
Conscientious application of Nursing
process to care of elders.
Inherent in this role is the active
participation of older adults and their
significant others and promotion of highest
degree of self care in elderly.
Providing care, efficiency and best interest
that rob them of their existing

EDUCATOR
 Formal and informal opportunities to share
knowledge, skills related to care of older adults.
 Educating others including normal aging,
pathophysiology, geriatric pharmacology and
resources.
 Essential to this role is effective communication
involving listening, interacting, clarifying,
coaching, validating and evaluating.

ADVOCATE
Advocacy including aiding older adults
in asserting their rights and obtaining
required services, facilitating a
community or other group’s effort to
affect change and achieve benefits for
older adults.

INNOVATOR
Assumes an inquisitive style, making
conscious decisions and efforts to
experiment for an end result to improved
gerontological practices.

COMMON NEEDS
PHYSIOLOGIC
BALANCE
CONNECTION
GRATIFICATION

SUMMARY
 GERIATIC NURSING: it is the field of nursing
that specializes in the care of the elderly.
 Older people have increasingly been the focus
of health and social care policy.
 Health and social care policy impacts
significantly on older people, and in particular on
their continuing care needs.
 Changes in the boundaries of health provision
and pressures for cost containment have
profoundly affected older people as well as
service providers.

Geriatric nursing

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Geriatric nursing