Chapter 1:

Introduction to
Gerontological
Nursing
 Learning Objectives
• Define important terms related to nursing and the
aging process.
• Outline significant landmarks that have influenced
the development of gerontological nursing as a
specialty.
• Identify several subfields of gerontology.
• Develop the beginnings of a personal philosophy
of aging.
• Describe the unique roles of the gerontological
nurse.
 Learning Objectives (cont’d)
• Discuss the scope and standards of gerontological
nursing practice.
• Examine core competencies in gerontological nursing
practice.
• Compare the nine essentials of baccalaureate nursing
education with core competencies in gerontological
nursing.
• Distinguish among the educational preparation,
practice roles, and certification requirements of the
various levels of gerontological nursing practice.
 Key Terms
• Ageism
• Attitudes
• Certification
• Core competencies
• Elder law
• Geriatrics
• Gerocompetencies
• Gerontological nursing
• Gerontological rehabilitation nursing
• Gerontology
• Landmarks in gerontological nursing
 History of
Gerontological Nursing
• 1960s: ANA forms gerontological nursing
specialty.
• 1970s: ANA creates the Standards of Practice
for Geriatric Nursing.
• 1980s: NGNA established.
• 1990s: Hartford Foundation Institute for Geriatric
Nursing established at NYU.
• 21st century: “Baby boomers” begin turning 65;
growing interest in gerontological care.
 Attitudes Toward Aging
and Older Adults
• Preconceived ideas about caring for older
adults.
• Negative attitudes toward aging or older adults
often arise in the same way from negative past
experiences.
• Examine your own thoughts, values, feelings,
and attitudes about growing older as this more
than likely will surface in your care.
 Definitions
• Gerontology is the broad term used to
define the study of aging and/or the aged.
• Geriatrics is often used as a generic term
relating to older adults, but specifically
refers to the medical care of older adults.
 Roles of the
Gerontological Nurse
• Direct-care provider
• Teacher
• Leader
• Advocate
• Evidence-based clinician
 Certifications
• Gerontology certification
− Entry level
− Having practiced the equivalent of 2 years full time as a
registered nurse
− Having a minimum of 2,000 hours of clinical practice in the
specialty area of gerontological nursing within the last 3 years
− Having completed 30 hours of continuing education in
gerontological nursing within the last 3 years
• Advanced practice certification
− Advanced practice register nurse (APRN)
− Gerontological nurse practitioner (GNP)
− Clinical nurse specialist (CNS)
 Scope & Standards of Practice
• Scope of nursing practice
– Defined by state regulation
– Influenced by the complex and multifaceted needs of the
population being served
– Depends on the setting in which the nurse practices
• Standards of nursing practice
– Developed by the nursing profession
– Divided into clinical care and the role of the professional nurse

Assessment Planning
Diagnosis Implementation
Outcome identification Evaluation
 Standards of Professional
Gerontological Nursing Performance
• Quality of care
• Performance appraisal
• Education
• Collegiality
• Ethics
• Collaboration
• Research
• Resource utilization
• Transitions of care
 Gerontological Nursing
Competency Statements
1. Incorporate professional attitudes, values, and expectations about
physical and mental aging in the provision of patient-centered care
for older adults and their families. (Essential VIII)
2. Assess barriers for older adults in receiving, understanding, and
giving of information. (Essentials IV & IX)
3. Use valid and reliable assessment tools to guide nursing practice for
older adults. (Essential IX)
4. Assess the living environment as it relates to functional, physical,
cognitive, psychological, social needs of older adults. (Essential IX)
5. Intervene to assist older adults and their support network to achieve
personal goals, based on the analysis of the living environment and
availability of community resources. (Essential VII)
 Gerontological Nursing
Competency Statements (cont’d.)
6. Identify actual or potential mistreatment (physical, mental, or
financial abuse, and/or self-neglect) in older adults and refer
appropriately. (Essential V)
7. Implement strategies and use online guidelines to prevent and/or
identify and manage geriatric syndromes. (Essentials IV & IX)
8. Recognize and respect the variations of care, the increased
complexity, and the increased use of healthcare resources inherent
in caring for older adults. (Essentials IV & IX)
9. Recognize the complex interaction of acute and chronic comorbid
physical and mental conditions and associated treatments common
to older adults. (Essential IX)
10. Compare models of care that promote safe, quality physical and
mental health care for older adults such as PACE, NICHE, Guided
Care, Culture Change, and Transitional Care Models. (Essential II)
 Gerontological Nursing
Competency Statements (cont’d.)
11. Facilitate ethical, noncoercive decision making by older adults and/or
families/caregivers for maintaining everyday living, receiving
treatment, initiating advance directives, and implementing end-of-life
care. (Essential VIII)
12. Promote adherence to evidence-based practice (EBP) of providing
restraint-free care (physical and chemical restraints). (Essential II)
13. Integrate leadership and communication techniques that foster
discussion and reflection on extent to which diversity (among nurses,
nurse assistive personnel, therapists, physicians, and patients) has
the potential to impact care of older adults. (Essential VI)
14. Facilitate safe and effective transitions across levels of care, including
acute, community-based, and long-term care (e.g., home, assisted
living, hospice, nursing homes) for older adults and their families.
(Essentials IV & IX)
 Gerontological Nursing
Competency Statements (cont’d.)
15. Plan patient-centered care with consideration for mental and physical
health and well-being of informal and formal caregivers of older adults.
(Essential IX)

16. Advocate for timely and appropriate palliative and hospice care for
older adults with physical and cognitive impairments. (Essential IX)
17. Implement and monitor strategies to prevent risk and promote quality
and safety (e.g., falls, medication mismanagement, pressure ulcers) in
the nursing care of older adults with physical and cognitive needs.
(Essentials II & IV)
18. Utilize resources/programs to promote functional, physical, and mental
wellness in older adults. (Essential VII)
19. Integrate relevant theories and concepts included in a liberal education
into the delivery of patient-centered care for older adults. (Essential I)
Nine Essentials of Baccalaureate Education
for Professional Nursing Practice
I. Liberal Education for Baccalaureate Generalist Nursing Practice
II. Basic Organizational and Systems Leadership for Quality Care
and Patient Safety
III. Scholarship for Evidence-Based Practice
IV. Information Management and Application of Patient Care
Technology
V. Healthcare Policy, Finance, and Regulatory Environment
VI. Interprofessional Communication and Collaboration for Improving
Patient Health Outcomes
VII. Clinical Prevention and Population Health
VIII. Professionalism and Professional Values
IX. Baccalaureate Generalist Nursing Practice
 Research in Gerontological Nursing

• Defined as the “diligent, systematic inquiry or

investigation to validate and refine existing
knowledge and generate new knowledge.”
• EBP defined as “the conscientious use of best
research evidence in combination with a
clinician’s expertise, as well as patient
preferences and values, to make decisions
about the type of care that is provided.”
 Summary
• Gerontological nursing is a specialty practice
focusing on the unique needs of older adults and
their families.
• Caring for older adults is influenced by many
factors, including recognizing one’s own attitude
about aging.
• The growth of the older population dictates that
more nurses are certified and specialize in
gerontological nursing.