Beverly L. Roberts, PhD, FAAN, FGSA, Case
Western's project investigator reports that the timing
of the John A. Hartford Foundation award was indeed fortuitous.
It helped her reinforce her message to faculty colleagues
that gerontology is a separate and unique specialty, and
it coincided with the nursing school's hiring of gerontological
mental health specialist Dr. Diana Morris. The funding
enabled the nursing school to expand its four-semester
Gerontology Nurse Practitioner program by adding a fifth
semester specific to the Gerontology Clinical Nurse Specialist
role, thus creating their new GNP/GCNS track. Additionally,
Dr. Roberts carved out of the GNP program, two one-credit
gerontological mental health courses that Dr. Morris teaches.
The Hartford funding gave the school the perfect means
for transforming gerontology into a prominent, formal
and recognizable curricular strand. Dr. Roberts remarks
that faculty "enthusiastically supported the changes
to the GNP/GCNS specialty once they understood the growing
need for advanced nurses to be trained in geriatrics."
Mental Health of Older Adults focuses
on theories of aging related to common mental health conditions
of older adults, and Mental Health Interventions with
Older Adults addresses individual, family, and group
therapeutic strategies. At Dr. Morris' recommendation,
the courses are both offered during the GNP program's
first semester, effectively building on one another and
providing the perfect introduction to geriatric mental
health nursing. The theory course, taken during the semester's
first four to five weeks uses case studies to generate
mental health assessment and diagnosis; the intervention
course, offered during the semester's last four to five
weeks moves into the next phase of treatment: how/when
to intervene, make referrals and use consultants. This
course couplet gives students an excellent foundation
in gero-psychiatric nursing that serves them well throughout
their GNP experiences.
Dr. Morris incorporates usage of the Mini
Mental Status Exam, a cognitive function screening
device, knowledge of which students bring from a separate
class. Dr. Morris teaches them how to do a clinical mental
status exam for purposes of assessment and differential
diagnosis. She focuses on basic principles of cognitive
behavioral therapy, which is standard treatment with elderly
populations; for instance, she teaches her students to
observe and interpret language and behavior during their
assessments. She uses content from Egan's
Skilled Helper Model, a book about basic counseling
. Students develop their fundamental diagnostic skills,
as well as learn prevention, supportive interventions,
and follow-up strategies. She also exposes them to motivational
therapy, crisis and brief interventions.
Dr. Morris hopes for these two courses to
help her students become "adult learners and reflective
practitioners." The courses have been taken by 25
students to date. At the courses' finish, Dr. Morris instructs
her students to write narrative self-evaluations. Their
perceptions of their own learning give Dr. Morris much
more information than do standard evaluation forms; she
uses their feedback to continually modify course structure
and content. Their self-evaluations clearly indicate tremendous
learning that prepares them well for future clinical experiences
with senior citizens.
