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The Future of Gerontology

With advancements in technology, medicine, and surgical procedures, nurses who work with elderly adults are learning new ways to approach caring for their patients. New processes and treatments require nurses and adult gerontology nurse practitioners to change how they interact with those in their care. Additionally, new approaches to administering health care mean nurses must adapt to ensure their patients achieve the best possible outcome.
An elderly patient
Image via Flickr

Take a closer look at some trends that provide insights into the future of gerontology:

Special Space in Emergency Rooms

According to the U.S. Centers for Disease Control, the emergency department is a key provider of care to adults age 65 and older when they suffer from an acute medical problem. Among this age group, most went to the ER seeking treatment for an illness or injury. Because this population requires special care and is at a higher risk of being admitted to the hospital, more than 90 hospitals have opened a geriatric ER.

The nurses, doctors, and other staff working in geriatric ERs must embrace a different way of caring for patients. Nurses screen patients for cognitive abilities and signs of abuse. They also determine how likely the patient is to fall. In addition, nurses may be part of an interdisciplinary team consisting of traditional ER staff as well as a social worker, pharmacist, and physical therapist.

In addition to collecting specific information from their geriatric patients, ER nurses must know to look for different symptoms. Patients may not exhibit the classic symptoms of heart attacks or appendicitis when they show up at the ER, making it crucial for nurses to understand the symptoms may be more vague or nuanced than in the general patient population.

Coordinated Care for Elderly Patients

Many older adults face more than one health challenge. Multiple chronic conditions require a geriatric health care team to develop individualized, coordinated plans for providing care and treatment. Nurses are a key part of these teams and must help patients as they transition from different settings. For example, patients may move from their home to a nursing home or from a nursing home to a hospital for an inpatient procedure.

According to the American Geriatrics Society, there are several models for providing care coordination. Under the Guided Care Model, a highly skilled registered nurse manages geriatric patients for multiple doctors in a single practice. The nurse must be able to understand and address complex conditions that sometimes arise in older adults. For example, the patient might have a heart condition, mobility issues, and early onset Alzheimer’s disease.

Enhanced Treatment for Patients with Alzheimer’s Disease

Statistics from the Alzheimer’s Association show that 5.5 million Americans have the disease and it’s the sixth leading cause of death in the U.S. As more nurses confront this debilitating disease in their patients, it’s more important than ever that they understand the latest advances in Alzheimer’s treatment and care.

Often, it’s the nurse who helps set the tone and expectations for family members who serve as day-to-day caregivers for Alzheimer’s patients. Nurses demonstrate how to deal with frustrating health issues that arise from Alzheimer’s, such as lack of sleep, incontinence, and delusions.

It’s critical that nurses stay current on developments in the field. For example, a new report shows that benzodiazepines can increase the chances of an Alzheimer’s patient getting pneumonia. With many elderly adults receiving Valium, Xanax, and other widely-used drugs in this group, this latest finding is an important one. When nurses stay current on the latest developments in the field, they can be informed advocates for their patients as they coordinate care with other medical professionals and the patient’s family.

Better Care through Technology

With smartphones being so ubiquitous, it’s not surprising that there are many apps available to improve health care. If they’re aware of the apps and know how to leverage them, nurses can find support as they aim to keep their geriatric patients taking their medicine on time or keeping their doctor’s appointments.

According to a report from Medscape, one app called AlzhaTV allows family and friends of an Alzheimer’s patient to upload videos to a cloud. Then, the app enables the patient to easily access the videos and watch them on television in an assisted living facility. After following a group of patients who used the app for 90 days, researchers found they had less agitation and anxiety and took fewer PRN drugs. In addition, the medical team lowered the dosage of antipsychotic prescriptions, and hospital readmissions went down.

Maintaining a connection to loved ones is especially important for any person confined to a facility. As more apps become available, nurses help families learn how to use technology to improve the quality of life of an elderly adult.

Intentional Training for Informal Caregivers

Often, nurses are the last people to see elderly patients before they’re discharged from the hospital. A recent report in PsychCentral highlights the importance of training the patient’s informal caregiver before allowing the patient to leave. Ideally, nurses and other health professionals should use a system for educating the patient’s family member or friend on how and when the patient should take medication, possible side effects and complications to watch for, and relevant community resources.

The study outlined in PsychCentral shows that engaging caregivers in the discharge education for a patient reduced by 25 percent the likelihood of the patient returning to the hospital within 90 days. In the study, the majority of informal caregivers were either the patient’s spouse or adult children. Though using a learning validation method during discharge and writing instructions take time, nurses are sure to find their investment in this effort pays off. Patients are more likely to follow their treatment plan, follow up with their doctor, and recover.

As nurses look to the future of gerontology, it’s easy to see what exciting opportunities are ahead. With the intersection of medicine and technology, new approaches to care, and advanced treatments, nurses will be at the forefront of implementing the practices that will lead to better outcomes for patients.

Gerontology nurse practitioners often have a Master’s degree or higher. If you have your BSN and are interested in advancing your education and therefore your career, you may want to consider an accelerated, online Bachelor of Science in Nursing to Doctor of Nursing Practice degree program. An advanced degree can empower you to become a nurse leader in an ever-changing industry.

Sources:

http://www.kiplinger.com/article/retirement/T027-C000-S004-an-er-designed-for-older-patients.html

http://www.americangeriatrics.org/advocacy_public_policy/

http://www.americangeriatrics.org/advocacy_public_policy/care_coordination/

https://www.cdc.gov/nchs/products/databriefs/db272.htm#ref2

http://www.healthleadersmedia.com/quality/5-essentials-geriatric-emergency-department?page=0%2C2

http://health.usnews.com/health-care/articles/2017-04-10/xanax-valium-may-boost-pneumonia-risk-in-alzheimers-patients

http://www.medscape.com/viewarticle/878209

http://www.alz.org/facts/

https://psychcentral.com/news/2017/04/04/involving-caregivers-in-discharge-can-keep-elderly-from-returning-to-hospital/118612.html