Geriatrics is a hard sell to many nurses, despite the fact that older adults make up the core business of hospitals, home care agencies, and long-term care facilities. Maybe it’s our youth-oriented culture, where even the covers of AARP’s Modern Maturity feature stars who don’t look their age. Or maybe the field suffers from enduring imprints of the indignities that many older adults have suffered at the hands of their caretakers. My first job, other than baby sitting, was working as an aid in a state long-term care facility where I saw patients abused, treated as baggage, and otherwise humiliated as society’s throw-aways. Who would want that?
Or could it be that older patients remind us that we are all mortals, destined to change in ways that are not always flattering and are sometimes painful. My own osteoarthritis makes my six-flight walkup to my apartment more and more difficult. I fear loss of vision as my husband has begun to lose his. My parents and his are gone, leaving us as the next generation to die. Not a pleasant thought.
But my work at AJN has taught me that aging can be a special time. While health problems are more likely to arise as we age, our experience with these health problems can be severely compounded by a health care system that is often insensitive to the differences between older and younger adults. These differences require a specific knowledge and skill set for nurses and other health care providers, such as recognizing that an elevated temperature may be a late sign of infection in older adults while an increased respiratory rate may occur early in the infection.
For over two years, AJN published a series of articles and videos on best practices in care of older adults called A New Look at the Old. The idea undergirding the series was that almost all nurses come in contact with older adults in their practice and need to expand their understanding of evidence-based practices geared toward this population. This was not a series for the specialist, but rather for the generalist, as well as specialists outside of geriatrics. Even school nurses come into contact with grandparents who may be the primary caregivers for older adults. Topics in this series range from how older adults present their illnesses in ways different from younger adults; how to bathe someone with dementia in ways that will make the experience less stressful for both patient and caregiver; managing incontinence, malnutrition and dehydration in older adults (something much too common in hospitalized elders); and determining adequate staffing in nursing homes. This series was supported in part by generous grants from Atlantic Philanthropies and completed in collaboration with the Geriatric Society of America.
We’re now publishing a series of articles on the use of assessment tools and models for various conditions in older adults, including depression, delirium, dementia, dysphagia, communication problems, sexuality, and others. The articles in the How To Try This series are accompanied by videos that demonstrate the use, scoring, and interpretation of the tools, along with how to communicate the findings to the patient, family, and health care team. Funded in part by a generous grant from the John A. Hartford Foundation, the project is a collaborative effort by AJN and New York University’s Hartford Institute for Geriatric Nursing (www.hartfordign.org), which produced the Try This series of tools and best practices on which the AJN series is based. If you read the articles online, you can click through to the entire video or to the chapter that demonstrates the administration of the tool, for example.
I hope you’ll take advantage of these free resources and tell others about them. Both the New Look at the Old and How To Try This series of articles and videos are available at www.NursingCenter.com/olderadults. And more resources to help nurses in any setting with care of older adults are available at www.ConsultGeriRN.org.
I’m not getting any younger and want to make sure that the nurses of tomorrow are ready to take care of me in a knowledgeable, skillful way. Let me know what you think of the series and what else you’d like to see us publish on care of older adults or any topic. Write to me
