Gerontological Nursing and the Aging Society Chapter objectives Specify demographic changes relate to aging Understand factors that affect the aging process Recognize the great diversity of older people Discuss strategies to prepare adequate eldercare workforce Identify factors influenced gerontological nursing Discuss various gerontological nursing roles Compare various gerontological roles © Ma'en Aljezwi

The study of aging Age year the number of aging people will increase in the future The view of the aging is that they ae frail, dependent, and waiting to die In fact, the majority of those aged 65 and older regard their health as good or excellent Many of them have close and meaningful relations The development period of elderhood is essential part of a healthy society © Ma'en Aljezwi

Gerontology Gerontology from Greek gero: old man Is the scientific study of the effect of time on human development, specifically the study of older persons In 1000 BCE the average life span was 18 years. Geriatrics: Medical care of the older adults. The focus now is of health promotion of older adults, this is why its gerontology not geriatrics. © Ma'en Aljezwi

How old is old Old is a relative concept based on how one acts and feels physically, mentally, socially, and culturally. Ones chronological age may or may not reflect the biological age (age of organs), or psychological age (feeling of old), and social age (roles and relationships) In the states a person who is 65 years or older is considered a senior citizen. © Ma'en Aljezwi

How old is old 65 years is also the age when persons can receive social benefits and retirement Further classification of old age: young-old (65-74 years), middle-old (75-84 years), old-old (85+). From gerontological nursing perspective; functional age, or the ability to perform acticities of daily livings, is a more essential measure of age than chronological age. © Ma'en Aljezwi

Aging concepts Nonagenarians: those people who are genetically hardy and reached 90 years of age and still active and mobile. Centenarians: people who reached 100 and are expected to be increasing in number (85 % are females). 50% of them are living in the nursing homes due to absence of living spouse or siblings © Ma'en Aljezwi

The future old Nurses musty consider the following when planning for older people care: Their diversity The uncertain political and economic future Changing the health care delivery system Progress in technology and medical management Shift in values and ethics that will affect life © Ma'en Aljezwi

Aging today Census data are the most important to identify demographics of the aging population In Jordan according to 2013 census the proportion of people over 65 years was 6.7% (3.3 males, 3.4 females). In the states 12.6% (42.4% males, 57.8% females) © Ma'en Aljezwi

Global aging United nations projects that by the year 2050 more people over 60 and older than people younger than 15 years. Japan (82.6), Hong Kong (82.2), Iceland (81.8) and Switzerland (81.7) have the highest life expectancy. In Jordan 73.3 years © Ma'en Aljezwi

Who will care for an aging society Workforce to care for older adults are understaffed The demand for Gerontological nurses and other heath care professionals is critical Eldercare is projected to be the fastest growing employment sector in the health care industry Improving the competency and adequacy of the eldercare workforce is essential to meet the needs and demands of a burgeoning aging population. © Ma'en Aljezwi

Development of gerontological nursing Different terms for nurses caring for older adults: Gerontic nurses Gerontological nurses Geriatric nurses © Ma'en Aljezwi

Development of gerontological nursing Gerontological nursing has emerged only in the past six decades as a circumscribed. Before that it was seen as a application of general principles of nursing The most influence in enhancing gerontological nursing was the promoting geriatric nursing excellence for nurses and community Other initiatives like the Nurse Competence in Aging, this initiative provided a grant and technical assistance for nurses and organizations © Ma'en Aljezwi

Gerontological Nursing Education Most nurses will care for older adults at least for sometime during their career Most schools of nursing do not have freestanding courses in gerontology Faculty with expertise in gerontological nursing are scarce, less than 30%. Many initiatives stand now to establish gerontological nursing as a speciality in nursing schools © Ma'en Aljezwi

Gerontological nursing roles Older adults are the major consumers of health care services in all settings The majority of nurses today are caring for older adults nowadays. In acute care older people comprise 60% of the medical surgical patients and 46% of the critical care patients Older people are the work of hospitals but most nurses do not say they specialize in geriatrics © Ma'en Aljezwi

Gerontological nursing roles A gerontological nurse may be a generalist or specialist Generalist functions in a variety of settings: hospital, home, subacute and long-term and community (retirement homes, assisted living facilities, adult day programme, senior housing). © Ma'en Aljezwi

Gerontological nursing roles National certificates is a way to enhance knowledge of acute care nurses who care for older adults To prepare student nurses for caring of the older adults it is important to provide expertise across the health care continuum This will assist them to develop a more positive attitude towards older adults © Ma'en Aljezwi

Gerontological nursing roles Specialist role: Has special preparation at the masters level Has advanced clinical expertise Has understanding of health and social policy, proficiency, planning, implementation and evaluation There is a large shortage in this speciality © Ma'en Aljezwi

Gerontological nursing roles Other speciality roles include: advanced practice gerontological nurse, geriatric nurse practitioners, gerontological nurse specialist Advanced practice nurses have demonstrated their skills in improving health outcomes and cost-effective The positive outcome for this role include increased patient and family satisfaction, decreased cost and improved quality of care. © Ma'en Aljezwi

Research on aging Although the older age ranges from 65-115 years, statistically in research they are usually grouped into one category Research often conduct studies of those over 50 years The study of Alzheimer’s disease has warded the largest amount of research funds © Ma'en Aljezwi

Research on aging Nursing research in this area developed best practice foundation in nursing Nurses have generated a large amount of research in this area and established a solid background for the practice of gerontological nursing Nursing research has significantly affected the quality of care of the older adults However, liitle research has been conducted in the community-based settings -© Ma'en Aljezwi

Future directions for gerontological nursing research Staffing patterns and the most appropriate mix to improve care The influence of culture on aging Health disparities and health literacy Demetia Drug and alcohol abuse Best practice protocols Interprofessional communication © Ma'en Aljezwi

The politics of aging One of the most important factors that affected by politics Funding for health and social services is often tied to stringent government requirements The passing of new laws for older-adults care has shifted the focus more into older people care © Ma'en Aljezwi

Key points Aging is a complex phenomenon with bio-psychological and spiritual aspects Older persons become more unique The current generation of older adults are healthier than previous generations The elder care workforce is critically understaffed Nurses were the first health care professionals to have a speciality in older people care © Ma'en Aljezwi