Geriatrics In Health Care Geriatrics, derived from the Greek word “geras,” meaning “old age,” is a specialized field of medicine focused on the health care of older adults. This branch of medicine deals with the diagnosis, treatment, and prevention of diseases and conditions that predominantly affect the elderly population. As life expectancy increases and the population ages, the importance of geriatrics in healthcare continues to grow.
A board-certified medical practitioner in geriatrics is referred to as a geriatrician. This specialist is trained to understand the complex health issues faced by older adults, including multiple comorbidities, medication management, and functional decline. While the term “geriatrics” is sometimes used in a broader context to encompass general health care for older adults, it is crucial to maintain clarity regarding its specific focus on geriatric syndromes, such as frailty, cognitive impairment, and polypharmacy.
What Is Geriatric Care in Nursing?
Geriatric nursing, the nursing specialty devoted to the care of older adults, has evolved significantly over the past century. The first formal recognition of this specialty occurred in an editorial titled “Care of the Aged” published in 1925 in the American Journal of Nursing. The first nursing textbook on geriatric care was published in 1950, marking the beginning of organized educational efforts in this field.
The actual establishment of geriatric nursing as a recognized specialty occurred in 1962 when the American Nurses Association (ANA) formed the Conference Group on Geriatric Nursing Practice. This initiative led to the creation of the Division of Geriatric Nursing in 1966, which was later renamed the Division of Gerontological Nursing. The ANA also published the first set of Standards of Practice for Geriatric Nursing in 1970, formalizing the expectations and competencies required for nursing practice in this area.
Geriatric nursing encompasses a holistic approach to care, addressing not only the physical health of older adults but also their emotional, social, and psychological needs. It emphasizes maintaining functional independence, promoting quality of life, and ensuring dignity for older individuals.
Rejection of the Term
Despite the establishment of the terms “geriatric” and “gerontological” nursing, there has been considerable debate and rejection of these labels within the nursing community. Critics argue that the term “geriatrics” is too narrow and does not encompass the full spectrum of nursing care, which includes health promotion, disease prevention, acute illness care, and long-term management.
Many nursing professionals advocate for a term that reflects the art and science of nursing, emphasizing the importance of a holistic approach rather than a purely medical model. The linguistic confusion surrounding these terms has led to calls for more appropriate nomenclature that captures the essence of nursing practice with older adults.
Division of Gerontological Nursing
The ANA’s transition to the Division of Gerontological Nursing sparked further discussion regarding terminology. While some embraced this change, others criticized it for not accurately reflecting the clinical practice of nursing. Gerontology pertains to the scientific study of aging and the effects of aging on individuals, which some argue does not adequately represent the practical and clinical aspects of nursing care for older adults.
In an effort to address this issue, the term “gerontic nursing” emerged, defined by Gunter and Estes (1979) as a nursing specialty that includes the art and practice of caring for older adults. Proponents of gerontic nursing argue that it better incorporates both the scientific and artistic components of nursing. However, detractors maintain that this term still lacks a focus on health promotion and disease prevention.
Nursing Textbooks
The debate over terminology extends into nursing education, as reflected in the titles of popular nursing textbooks. Titles vary widely, including “geriatric nursing,” “gerontological nursing,” “clinical gerontological nursing,” and “gerontic nursing.” This lack of consensus can create confusion among students and educators regarding the focus and scope of geriatric nursing practice.
Interestingly, the National Institute on Aging at the NIH has acknowledged this terminology dilemma by naming its clinical research program the “Geriatrics and Clinical Gerontology Program.” This duality highlights the ongoing effort to bridge the gap between clinical practice and the scientific study of aging.
An ideal term for the nursing specialty would encapsulate the comprehensive nature of care provided to older adults across various settings and health statuses. The challenge remains to find terminology that resonates with practitioners while accurately representing the field’s focus.
Nursing Research and Geriatric Care
Despite the ongoing debate about terminology, nursing research related to geriatric care has made significant contributions to understanding and improving the health of older adults. Research efforts have focused on various aspects, including health promotion, chronic illness management, and end-of-life care.
As genetic knowledge and advancements in medical science continue to evolve, numerous unanswered questions about the prevention and treatment of chronic illnesses in older adults remain. Nurse researchers play a critical role in exploring these questions, utilizing evidence-based practice to inform their work.
Areas of Research Focus
- Health Promotion: Research in geriatric nursing often emphasizes strategies for promoting health and preventing disease among older adults. This includes studying the effectiveness of interventions that encourage physical activity, healthy eating, and social engagement.
- Chronic Illness Management: Many older adults live with chronic conditions, such as diabetes, hypertension, and arthritis. Research in this area explores best practices for managing these conditions, improving quality of life, and reducing hospitalizations.
- Mental Health: Cognitive decline and mental health issues, such as depression and anxiety, are common among older adults. Research efforts aim to understand these challenges and develop interventions to support mental well-being.
- End-of-Life Care: As the population ages, the need for effective end-of-life care becomes increasingly important. Research in this area focuses on improving palliative care practices, understanding the preferences of older adults regarding end-of-life decisions, and addressing the emotional needs of patients and families.
- Ethics and Policy: Ethical considerations are paramount in geriatric care, particularly in discussions around consent, autonomy, and resource allocation. Research in this area explores the ethical implications of care decisions and informs policy development to better serve older adults.
Conclusion
Geriatric nursing is a dynamic and evolving specialty that requires a nuanced understanding of the unique needs of older adults. As the population continues to age, the importance of effective geriatric care becomes increasingly evident. While the debate over terminology persists, the focus must remain on providing comprehensive, holistic care that promotes the health and well-being of older adults.
Nurses play a pivotal role in this specialty, contributing to research, education, and direct patient care. By embracing a holistic approach and advocating for the needs of older adults, nurses can help improve health outcomes and enhance the quality of life for this vulnerable population. The future of geriatric nursing depends on the commitment of nursing professionals to advance their knowledge, skills, and understanding of the complexities associated with aging.