This document provides an overview of gerontological nursing and care of the elderly. It defines key terms related to aging and discusses the aging process. The roles of gerontological nurses are described, including providing care, education, advocacy, and leadership. Physiological changes in aging are reviewed along with theories of aging. Standards and scopes of practice for gerontological nursing are discussed.

1. NCM 114
CARE OF THE ELDERLY
“ImprovingTheir Quality
Of Life
For A Graceful Ageing”

2. “The end-of-life deserves
as much beauty, care,
and respect as the
beginning”

3. LEARNING OBJECTIVES
 Define important terms related to nursing and the aging
process.
 Describe the unique roles of the gerontological nurse.
 Discuss the scope and standards of practice in gerontological
nursing.
 Discuss different physiologic changes, assessment and its
management.
 Discuss the different theories of aging, nursing care
management, trends and issues facing Gerontological nursing.

4. OVERVIEW OF AGING
Fundamentals of Aging
Trends and Issues
Theories of Aging
Physiologic Changes

5. AGEING
Aging is a normal process of time related change,
begins with birth and continuous throughout life.
 It is a multidimensional process of physical,
psychological, and social change.

6. OLD AGE, ELDERLY
generally begins at the
age of 60 People in
this age group are
called……
Senior Citizens

7. WHO DEFINITION OF OLD AGE
According to WHO, most developed
countries have accepted the chronological
age of 65 years and above as a definition of
‘elderly’ or older persons.
According to UN: 60+ years will be referred
as the older population or elderly.

8. WHO DEFINITION OF OLD AGE
 Young old: 60 –74
 Middle old: 75 –84
 Very old: 85 – 100
 Elite old: Over 100

9. SENESCENCE
Senescence or biological aging is the
gradual deterioration of functional
characteristics in living organisms. The
word senescence can refer to either
cellular senescence or to senescence of
the whole organism.

10. GERIATRICS VS GERONTOLOGY
DEFINITIONS
 Geriatrics-generic term related into the aged but specifically
refers to medical care of the aged. Geriatrics ,from greek “
geras” (old age ) and “iatrike”(medicine), is the branch of
medicine concerned with medical problems and care of older
people
 Gerontology-broad term used to define the study of aging
and or the aged.

11. LONGEVITY
is the duration of a particular life beyond the
norm for the species. It is a noun, a thing to be
acquired, and desirable to many.
 NAST Monograph Series No.10

12. LIFESPAN
 is the maximum duration of existence of a
given species.
 Humans have a lifespan of 120 years.
NAST Monogaph Series No.10

13. LIFE EXPECTANCY
 The length of time that a person can be
predicted to live.

14. COMORBIDITY
The simultaneous presence of multiple
chronic conditions.

15. GERONTOLOGICAL NURSING
Gerontological nursing is the specialty of nursing
pertaining to older adults. Gerontological nurses work in
collaboration with older adults, their families, and
communities to support healthy aging, maximum
functioning, and quality of life.

16. GERONTOLOGICAL NURSING
Gerontological nursing focuses on the process of aging
and the protection, promotion, restoration, and
optimization of health and functions; prevention of
illness and injury; facilitation of healing; alleviation
of suffering through the diagnosis and treatment of
human response; and advocacy in the care of older
adults, carers, families, groups, communities, and
populations.”

17. GERONTOLOGICAL REHABILITATION
NURSING
Combines expertise in gerontological nursing with
rehabilitation concepts and practice. Nurses working in
gerontological rehabilitation often care for older adults
with chronic illnesses and long-term functional
limitations such as stroke, head injury, multiple sclerosis,
Parkinson’s disease, spinal cord injury, arthritis, joint
replacements, and amputations.

18. DEVELOPMENT OF
GERONTOLOGICAL NURSING
 1902- First article on care of aged in American Journal
Nursing written by a physician.
 1904- First article on care of aged in American Journal
Nursing written by a nurse.
 1925- AJN considers geriatric nursing as a potential
specialty.
 1950-First Gerontological nursing text published, Geriatrics
recognized as an area of specialization in nursing.

19. DEVELOPMENT OF
GERONTOLOGICAL 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
 1976- ANA changes name from Geriatric Nursing division
to Gerontological nursing division.

20. DEVELOPMENT OF
GERONTOLOGICAL NURSING
 1981- First international conference on Gerontological
nursing.
 1982- Development of Robert Wood Johnson teaching
Home Nursing Program.
 1984- Formation of National Gerontological Nursing
Association.

21. GERIATRIC OR GERONTOLOGIC
NURSING: BACKGROUND
 Florence Nightingale and Doreen Norton provided early
insights into the care of aged
 Nightingale was the first geriatric nurse
 ANA Established the Division of Geriatric Nursing Practice
in 1966 with a goal to create standards for quality nursing
care for the aged
 The standards and scope of gerontological nursing
practice were developed in 1969 by ANA.

22. GERIATRIC OR GERONTOLOGIC
NURSING: BACKGROUND
 The term gerontological nursing replaced the term
Geriatric Nursing in the 1970s
 Geriatric nursing is bound to be part of our professional
future.
 Older adults are the core business of health care
representing the majority visits, hospital admissions, and
long-term care residents

23. GERIATRIC OR GERONTOLOGIC
NURSING: BACKGROUND
 In Canada, one in seven Canadian seniors receives home
care.
 Seniors are re/admitted three times more than younger
Canadians
 With length of stay twice as long as younger Canadians

24. GERIATRIC OR GERONTOLOGIC
NURSING: BACKGROUND
 Thus, care of older adults is the “core business of health
care”
 Today a nurse’s typical patient is an older adult.
 So, every nurse graduating from a nursing program should
have a defined level of competency in care of elderly

25. AMERICAN NURSES CREDENTIALING CENTER ELIGIBILITY
REQUIREMENTS
FOR CERTIFICATION IN GERONTOLOGIC NURSING
 Gerontologic Nurse (Registered Nurse—Board
Certified [RN-BC])
 Adult – Gerontologic Acute Care Nurse Practitioner
(ACAGNP–BC)
 Adult-Gerontologic Primary Care Nurse Practitioner
(PCAGNP–BC)

26. QUESTION
1. Deterioration of the physical
body is called:

27. ANSWER
Senescence:
the condition or process of
deterioration with age.

28. QUESTION
2. Another name for
senescence is:

29. ANSWER
Biological aging:
Senescence or biological aging is
the gradual deterioration of
functional characteristics in living
organisms.

30. ROLES OFTHE GERIATRIC
NURSE

31. GERIATRIC NURSE
A geriatric nurse, or
gerontological nurse, is a type of
nurse that helps care for aging
and elderly individuals. Nurses
working in senior care perform
traditional nursing duties and have
special skills to understand many
older adults' special needs better.

32. ROLES OF GERIATRIC NURSE
 Healer
 Caregiver
 Nurse leaders
 Educators
 Patient advocates
 Administrators
 Researcher/Innovators
 Primary care providers
focus on –
 Health promotion
 Disease prevention
 Long-term management of
chronic conditions

33. ROLES OF GERIATRIC NURSE
Healer
Nursing plays a significant role in heling individuals
stay well, overcome or cope with disease restore
function and purpose in life and mobilize internal
and external resources.

34. ROLES OF GERIATRIC NURSE
Provider of Care/Caregiver
In the role of caregiver or provider of care, the
gerontological nurse gives direct, hands-on care to
older adults in a variety of settings.
Conscientious application of Nursing process to
care for elders.

35. ROLES OF GERIATRIC NURSE
Teacher/Educators
An essential part of all nursing is teaching.
Gerontological nurses focus their teaching on
modifiable risk factors and health promotion.
Essential to this role is effective communication
involving listening, interacting, clarifying, coaching,
validating and evaluation.

36. ROLES OF GERIATRIC NURSE
Managers/Nurse Leaders
Gerontological nurses act as managers during
everyday practice as they balance the concerns of
the patient, family, nursing, and the rest of the
interdisciplinary team.

37. ROLES OF GERIATRIC NURSE
Advocate/Patient Advocates
As an advocate, the gerontological nurse acts on
behalf of older adults to promote their best
interests and strengthen their autonomy and
decision making.

38. ROLES OF GERIATRIC NURSE
Researcher Consumer/Innovators
The appropriate level of involvement for nurses at
the baccalaureate level is that of research consumer.

39. ASSIGNMENT
Please write a reaction paper about this video:
Caring for the Modern Senior
https://youtu.be/ZtUCMVsadMA

40. QUESTION
Is the following statement true or false?
Nurses can advocate for older adults as they
facilitate a community’s or other group’s efforts to
affect change and achieve benefits for older adults?

41. ANSWER
True
Rationale:The gerontological nurse can function as
an advocate by aiding older adults in asserting their
rights , obtaining required services, and facilitating
in the community that will achieve benefits for the
older adult.

42. QUESTION
A female patient is being
discharged after cataract
surgery.After providing
medication teaching, the
nurse asks the patient to
repeat the instructions.
The nurse is performing
which professional role?
A. Manager
B. Educator
C. Caregiver
D. Patient advocate

43. ANSWER
 (B) Educator.
 When teaching a patient about medications before discharge, the
nurse is acting as an educator. The nurse acts as a manager when
performing such activities as scheduling and making patient care
assignments. The nurse performs the care giving role when
providing direct care, including bathing patients and administering
medications and prescribed treatments. The nurse acts as a
patient advocate when making the patient’s wishes known to the
doctor.

44. UTILIZE EVIDENCE-BASED PRACTICES
 Gerontological nurses can access literature upon which
evidence-based practice can be obtained from several sources.
 The Cochrane Collaboration (www.cochrane.org) publishes
Cochrane Reviews
 The National Guideline Clearinghouse (www.guideline.gov), as the
name implies, offers evidence-based guidelines
 The Hartford Institute for Geriatric Nursing (www.hartfordign.org)
offers many evidence-based resources to guide geriatric nursing
practice

45. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 1.ASSESSMENT
 The gerontological nurse collects comprehensive data pertinent to the
older adult’s physical and mental health or situation.

46. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 2. DIAGNOSIS
 The gerontological nurse analyzes the assessment data to determine the
diagnoses or issues.

47. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 3. OUTCOME
IDENTIFICATION
 The gerontological nurse identifies expected outcomes for a plan
individualized to the older adult or situation.

48. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 4. PLANNING
 The gerontological nurse develops a plan to attain expected outcomes.

49. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 5. IMPLEMENTATION
 The gerontological nurse implements the identified plan.

50. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 5A: COORDINATION
OF CARE
 The gerontological nurse coordinates care delivery.

51. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 5B: HEALTH
TEACHING AND HEALTH
PROMOTION
 The gerontological registered nurse employs strategies to promote
health and a safe environment.

52. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 5D: PRESCRIPTIVE
AUTHORITY ANDTREATMENT
 The gerontological advanced practice registered nurse uses prescriptive
authority, procedures, referrals, treatments, and therapies in accordance
with state and federal laws and regulations.

53. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
STANDARD 6. EVALUATION
 The gerontological nurse evaluates the older adult’s progress toward
attainment of expected outcomes.

54. STANDARDS OF PRACTICE FOR GERONTOLOGICAL
NURSING
Source:American Nurses Association. (2010).
Gerontological nursing scope and standards of
practice. Silver Spring, MD: Nursebooks.org. (A
full copy of the standards that includes the
measurement criteria and Standards of
Professional Performance for Gerontological
Nursing can be ordered from the American
Nurses Association, http://www.nursesbooks.org.)

55. COMPETENCIES
Nurses who work with older adults need
to have competencies specific to
gerontological nursing to promote the
highest possible quality of care to older
adults.

56. COMPETENCIES
differentiate normal from abnormal findings in the
older adult
assess the older adult’s physical, emotional,
mental, social, and spiritual status and function
engage the older adult in all aspects of care to the
maximum extent possible
provide information and education on a level and
in a language appropriate for the individual

57. COMPETENCIES
 individualize care planning and implementation of the
plan
 identify and reduce risks
 empower the older adult to exercise maximum
decision making
 identify and respect preferences arising from the older
adult’s culture, language, race, gender, sexual
 preference, lifestyle, experiences, and roles

58. COMPETENCIES
assist the older adult in evaluating, deciding,
locating, and transitioning to environments that
fulfill
living and care needs
advocate for and protect the rights of the older
person
facilitate discussion of and honor advance
directives

59. THE AGING
PHILIPPINES

61. SENIOR CITIZEN POPULATION
The Senior
Citizen today
account for
only 6.1% of
the population

62. SENIOR CITIZEN POPULATION
Currently, 8.2 million of the
country's 109 million people are
in the 60 and above age group,
with almost 5 percent of the
population aged 65 years and
above. (June 2020)

63. LIFE EXPECTANCY INTHE PHILIPPINES
MALE
68
FEMALE
74

68. COMPLEX HEALTH ISSUES OF OLDER PERSONS
 Current estimates indicate that approximately 80% of people
age 65 and older have at least 1 chronic illness, such as
heart disease, diabetes, or arthritis, and that the number of
older adults with multiple chronic illnesses is substantial.
(U.S. Census Bureau, 2005 & U.S. Department of Health and Human Services 2010)

69. COMPLEX HEALTH ISSUES OF OLDER PERSONS
People 65 and older visit health
providers twice as often as other age
groups and are hospitalized at 3
times the rate of any other age
group.

70. LEADING CAUSES OFTHE DEATH
INTHE PHILIPPINES
 1. Coronary Artery Disease
 2. Stroke
 3. Influenza/ Pneumonia
 4. Lung Diseases
 5.Tuberculosis
 6. Diabetes Mellitus
 7. Kidney Disease
 8. Hypertension
 9. Breast Cancer
 10.Asthma

71. TEN LEADING CHRONIC CONDITIONS AFFECTING
POPULATION AGED 65YEARS AND OLDER
 1.Arthritis
 2. High blood pressure
 3. Hearing impairments
 4. Heart conditions
 5.Visual impairments (including cataracts)
 6. Deformities or orthopedic impairments
 7. Diabetes mellitus
 8. Chronic sinusitis
 9. Hay fever and allergic rhinitis (without asthma)
 10.Varicose veins

72. TEN LEADING CAUSES OF DEATH FOR PERSONS AGED 65
YEARS AND OLDER
 Diseases of the Heart
 Malignant Neoplasms
 Chronic Lower Respiratory Diseases
 Cerebrovascular Disease
 Alzheimer’s Disease
 Diabetes Mellitus
 Influenza and Pneumonia
 Accidents (Unintentional Injuries)
 Nephritis, nephrotic syndrome and nephrosis
 Septicemia

73. RISK FACTORS (WHO)
 1. Harmful use of alcohol
 2. Physical Inactivity
 3. Salt/ Sodium Intake
 4.Tobacco Use
 5. Raised Blood Pressure
 6. Diabetes
 7. Obesity
 8.Ambient Air Pollution
 9. Household Air Pollution

74. MYTHS & FACTS ABOUT AGING

75. GERONTOPHOBIA
Fear of ageing
or the older
persons

76. THE OLDER PERSON
 People live longer than ever before.
 Chronic illness is common in older persons.
 Disability often results.
 Many older persons have at least one disability.
 Most older people live in a family setting.
 Some live alone or with friends.
 Some live in assisted living residences or nursing centers.
 The need for nursing center care increases with aging.

77. AGEISM
Ageism is a concept introduced decades
ago and defined as “the prejudices and
stereotypes that are applied to older people
sheerly on the basis of their age …” (Butler,
Lewis, & Sutherland, 1991).

78. MISCONCEPTIONS:
Old people are sick and disabled.
Most old people are in nursing homes.
Dementia comes with old age.
People are either very tranquil (calm) or
very cranky as they age.

79. MISCONCEPTIONS:
Old people have lower intelligence and are
resistant to change.
Old people are not able to have sexual
intercourse and are not interested in sex.
There are few satisfactions in old age.

80. FACTORS INFLUENCING AGING
Heredity
Nutrition/Diet
Health Status
Life Experiences
Environment
Activity/Exercise
Stress produce
unique

81. FACTORS CONTRIBUTINGTO A LONG
AND HEALTHY LIFE
Diet.
Activity.
Play and laughter.
Faith.
Empowerment.
Stress
management.

82. KEY FACTS OF AGEING
 Between 2015 and 2050, the proportion of the world's population
over 60 years will nearly double from 12% to 22%.
 By 2020, the number of people aged 60 years and older will
outnumber children younger than 5 years.
 In 2050, 80% of older people will be living in low- and middle-
income countries.
 The pace of population ageing is much faster than in the past.
 All countries face major challenges to ensure that their health
and social systems are ready to make the most of this
demographic shift.