Background
Older
people constitute a majority - and growing - proportion
of people who receive nursing care in the United States.
Currently 13% of the nation's population, over 25 million
people, are over 65 years of age. This represents an eight-fold
increase in the last 80 years, triple that of the population
as a whole. By the year 2030, 20 percent of people will
be over 65; close to 10 percent of the population will
be over 80 years of age (AOA, 1998).
The
health status of older people is diverse. Health status
often is influenced by income level, living arrangements,
and need for physical and psycho/social supports. Many
of the ailments afflicting the elderly are represented
in the 22 priority areas identified as responsive to health
promotion and prevention activities in Healthy People
2010: National Health Promotion and Disease Prevention
Objectives (PHS, 1999). A major focus of health promotion
is to minimize the loss of independence associated with
functional decline and illness (Rowe & Kahn, 1999). The
predominant health problems of older people are chronic
rather than acute and are exacerbated by the normal changes
of aging and the increased risk of illness associated
with old age. Despite this picture, the majority of older
people report themselves to be in "good" health as measured
by level of function and general self-perception of health.
Of
the people who are sick and seek care in this country,
the overwhelming majority are elderly. Over 48 percent
of hospital patients, 80 percent of home care patients,
and 85 percent of all residents of nursing homes are elderly
(Mezey, 1996). In home care, the fastest growing area
of health care, the 5,600 agencies certified to receive
Medicare reimbursement made over 38 million visits to
approximately 1.6 million Medicare beneficiaries. Fifty-two
percent of these were nursing visits, while approximately
30 percent were for nursing aide services (Mitty & Mezey,
1999).
Despite
a 30-year effort on the part of academic and professional
nursing organizations, the number of master's prepared
geriatric nurses remains very small. Approximately 1,800
nurses nationally are certified by the American Nurses
Credentialing Center (ANCC) as Geriatric Nurse Practitioners,
and only 500+ are certified as Gerontological Clinical
Nurse Specialists (GCNS) (ANCC, 1999). Their small numbers
prevent geriatric nurse specialists from providing care
to those older persons who are at high risk or whose needs
are extremely complex. In addition, because nurses tend
to cluster in urban areas, few advanced practice geriatric
nurses are available to care for older persons living
in rural areas.
With
the exception of maternal-child and psychiatric mental-health
nursing, the overwhelming majority of nurses practicing
in this country today are, by default, geriatric nurses.
For this reason, entry-level professional nurses must
ensure that older people receive optimum nursing care.
Unfortunately, most nurses practicing today have limited
preparation in the principles of geriatric nursing care.
Only 23 percent of baccalaureate nursing programs have
a required course in geriatric nursing (Rosenfeld, Bottrell,
Fulmer & Mezey, 1999).
The
field of geriatrics/gerontology has matured to the point
where there is now a recognized body of literature on
care of older adults (Abraham, Bottrell, Fulmer & Mezey,
1999). There is now a consensus in geriatric nursing and
medicine as to what constitutes "best practice" in care
of older adults. Failure to implement these geriatric
care standards for older people is unacceptable.
The Association for Gerontology in Higher Education (AGHE),
the National League for Nursing (NLN), and the Bureau
of Health Professions have identified core curriculum
and terminal objectives for entry level professional nurses
in the area of geriatrics. The proceedings of a conference
of geriatric nurse educators funded by Merck and edited
by Fulmer & Matzo (1996) provide a critical review of
the literature on entry level geriatric nursing education.
The authors identify critical competencies that entry
level professional nurses need in order to care for older
adults and their families.
AACN's
The Essentials of Baccalaureate Education for Professional
Nursing Practice (AACN, 1998) provides a framework
for developing, defining, and revising baccalaureate nursing
curricula. This document addresses the professional values,
core competencies, core knowledge, and role of the professional
nurse. In addition, the document stresses the need for
course work and clinical experiences to prepare the graduate
to provide care across the lifespan, with particular attention
to changes due to aging. These core values, competencies,
and knowledge are vital in ensuring accessible, quality
nursing care for the growing geriatric population.
Thus,
an increasing focus of professional nursing education
and practice is on the care of healthy and frail older
adults. The purpose of this current document, Older
Adults: Recommended Baccalaureate Competencies and Curricular
Guidelines for Geriatric Nursing Care, is to help
nurse educators to incorporate specific geriatric nursing
content into baccalaureate nursing curriculum.
This
baccalaureate geriatric nursing competency document is
organized as follows:
A)
Competencies necessary for nurses to provide high-quality
care to older adults and their families
B) Geriatric competencies in relationship to the AACN
document The Essentials of Baccalaureate Education
for Professional Nursing Practice (AACN, 1998),
with suggestions for content and teaching strategies
C) Including competencies, content, and teaching strategies
in the curriculum
D) Resources to facilitate implementation of content
and teaching strategies
A. Competencies necessary for nurses to provide high-quality
care to older adults and their families
-
Recognize
one's own and others' attitudes, values, and expectations
about aging and their impact on care of older adults
and their families.
-
Adopt
the concept of individualized care as the standard of
practice with older adults.
-
Communicate
effectively, respectfully, and compassionately with
older adults and their families.
-
Recognize
that sensation and perception in older adults are mediated
by functional, physical, cognitive, psychological, and
social changes common in old age.
-
Incorporate
into daily practice valid and reliable tools to assess
the functional, physical, cognitive, psychological,
social, and spiritual status of older adults.
-
Assess
older adults' living environment with special awareness
of the functional, physical, cognitive, psychological,
and social changes common in old age.
-
Analyze
the effectiveness of community resources in assisting
older adults and their families to retain personal goals,
maximize function, maintain independence, and live in
the least restrictive environment.
-
Assess
family knowledge of skills necessary to deliver care
to older adults.
-
Adapt
technical skills to meet the functional, physical, cognitive,
psychological, social, and endurance capacities of older
adults.
-
Individualize care and prevent morbidity and mortality
associated with the use of physical and chemical restraints
in older adults.
-
Prevent
or reduce common risk factors that contribute to functional
decline, impaired quality of life, and excess disability
in older adults.
-
Establish
and follow standards of care to recognize and report
elder mistreatment.
-
Apply
evidence-based standards to screen, immunize, and promote
healthy activities in older adults.
-
Recognize
and manage geriatric syndromes common to older adults.
-
Recognize
the complex interaction of acute and chronic co-morbid
conditions common to older adults.
-
Use technology to enhance older adults' function, independence,
and safety.
-
Facilitate
communication as older adults transition across and
between home, hospital, and nursing home, with a particular
focus on the use of technology.
-
Assist
older adults, families, and caregivers to understand
and balance "everyday" autonomy and safety decisions.
-
Apply
ethical and legal principles to the complex issues that
arise in care of older adults.
-
Appreciate
the influence of attitudes, roles, language, culture,
race, religion, gender, and lifestyle on how families
and assistive personnel provide long-term care to older
adults.
-
Evaluate
differing international models of geriatric care.
-
Analyze the impact of an aging society on the health
care system.
-
Evaluate
the influence of payer systems on access, availability,
and affordability of health care for older adults.
-
Contrast
the opportunities and constraints of supportive living
arrangements on the function and independence of older
adults and on their families.
-
Recognize
the benefits of interdisciplinary team participation
in care of older adults.
-
Evaluate
the utility of complementary and integrative health
care practices on health promotion and symptom management
for older adults.
-
Facilitate
older adults' active participation in all aspects of
their own health care.
-
Involve,
educate, and when appropriate, supervise family, friends,
and assistive personnel in implementing best practices
for older adults.
-
Ensure quality of care commensurate with older adults'
vulnerability and frequency and intensity of care needs.
-
Promote
the desirability of quality end-of-life care for older
adults, including pain and symptom management, as essential,
desirable, and integral components of nursing practice.
B. Geriatric competencies in relationship to the AACN
document The Essentials of Baccalaureate Education
for Professional Nursing Practice, with suggestions
as to appropriate content and teaching strategies
AACN
Core Competency: Critical Thinking
1.
Recognize one's own and others' attitudes, values, and
expectations about aging and their impact on care of older
adults and their families.
2. Adopt the concept of individualized care as the standard
of practice with older adults.
Content:
Consideration of students and societal attitudes toward
aging, and how the myths that older people themselves, family
members, health care professionals, and society hold toward
older adults influence the health care that older adults
receive. Consideration of successful aging across a continuum
that promotes an appreciation of how aging has changed through
history and how aging is valued across cultures.
Teaching
Strategies: Print, audio, video, film and web-based
exercises to foster values clarification and critical thinking
about aging (examples appended).
AACN
Core Competency: Communication
3.
Communicate effectively, respectfully, and compassionately
with older adults and their families.
4. Recognize that sensation and perception in older adults
are mediated by functional, physical, cognitive, psychological,
and social changes common in old age.
Content:
Sensory changes in hearing, vision, smell, taste, speech,
touch, and movement that have a high potential to impair
communication with older adults, and compensatory actions
to assess and overcome or minimize these communication barriers.
Techniques to assist providers decipher the "meaning" behind
behaviors of cognitively impaired older adults.
Teaching
Strategies: Role playing or computer-assisted simulation
exercises that assist students to experience the sensory
changes common to older adults and to appreciate the effects
of sensory changes on older peoples' day-to-day ability
to carry out activities of daily living.
AACN
Core Competency: Assessment
5.
Incorporate into daily practice valid and reliable tools
to assess the functional, physical, cognitive, psychological,
social and spiritual status of older adults.
6. Assess older adults' living environment with special
awareness of the functional, physical, cognitive, psychological,
and social changes common in old age.
7. Analyze the effectiveness of community resources in
assisting older adults and their families to retain personal
goals, maximize function, maintain independence, and live
in the least restrictive environment.
8. Assess family knowledge of skills necessary to deliver
care to older adults.
Content:
Standard instruments to assess function, mental status,
falls, social support, sleep, depression, pressure ulcer
risk, and risk for complications during hospitalization;
analysis of the usefulness of these instruments in practice.
Modifications in history taking and physical examination
to encompass changes common to older adults. Assessment
of home and community living situations and analysis of
how services (e.g., transportation, location, and environmental
modifications) facilitate and impede independent living.
Assessment of relationships among intergenerational families,
the capacity and expectations of family members to provide
care, family knowledge of caregiving, and assessment of
family burden.
Teaching
Strategies: Role-playing, simulated patients, and patient
care situations to implement, validate, and critique assessment
instruments. Web-based experiences with sites such as American
Association of Retired Persons, the Alzheimer's Disease
Association, and the National Coalition of Nursing Home
Reform expose students to sources of information about family
caregiving, living options, and community resources for
older adults. In clinical experience, analysis of the medical
record for evidence of patient and family assessment and
use of assessments in care plans and clinical logs.
AACN
Core Competency: Technical Skills
9.
Adapt technical skills to meet the functional, physical,
cognitive, psychological, social, and endurance capabilities
of older adults.
10. Individualize care and prevent morbidity and mortality
associated with the use of physical and chemical restraints
in older adults.
Content:
Adaptation of technical skills (vital signs, physical assessment,
injections, and infusions, and use of assistive devices)
to accommodate changes common to older adults. Alternative
strategies to the use of physical and chemical restraints
in order to manage treatment interference in older adults.
Teaching
Strategies: Simulations, laboratory experiences, and
case studies that demonstrate adaptation of technical skills
and the untoward consequences of failure to modify technical
skills for older adults. Video and web-based learning that
demonstrate restraint free care (resources appended). Clinical
experiences that offer models of best practices and specific
strategies to avoid restraint use.
AACN
Core Knowledge: Health Promotion, Risk Reduction, and Disease
Prevention
11.
Prevent or reduce common risk factors that contribute
to functional decline, impaired quality of life, and excess
disability in older adults.
12. Establish and follow standards of care to recognize
and report elder mistreatment.
13. Apply evidence-based standards to reduce risk, screen,
immunize, and promote healthy activities in older adults.
Content:
Age recommendations in Healthy People 2010. Health
promotion for older adults, irrespective of age or living
environment: exercise; prevention of osteoporosis, injury;
iatrogenesis and polypharmacy; immunizations; nutrition
guidelines; and reduction of social isolation. Exposure
to instruments to detect physical, psychological, and financial
elder mistreatment and state guidelines for reporting elder
abuse (resources appended).
Teaching
Strategies: Participation in health fairs, brown-bag
medication reviews at senior centers and immunization campaigns.
Assignments that use health promotion web pages, such as
National Institutes of Health (NIH) National Institute for
Aging and Cancer Institute, and American Association of
Retired Persons (AARP). Use of elder mistreatment instruments
when risk is identified or suspected.
AACN
Core Knowledge: Illness and Disease Management
14.
Recognize and manage geriatric syndromes common to older
adults.
15. Recognize the complex interaction of acute and chronic
co-morbid conditions common to older adults.
Content:
Instruments and guidelines to identify and manage syndromes
common to older adults, e.g., falls, iatrogenesis, polypharmacy,
dementia and delirium, urinary incontinence, sleep disturbance,
problems of eating and feeding, pressure ulcers. Understanding
of how these syndromes present in older adults. Differentiation
among delirium, depression, and dementia and management
of acute and chronic pain in older adults. Consideration
of the interaction of chronic and acute illness on the expression
of symptoms and recovery from illness in older adults.
Teaching
Strategies: Clinical experiences that promote analysis
of the impact of underlying chronic illness on recovery
from acute illness and consideration of atypical presentation
of acute illness in the clinical setting. Use of instruments,
such as SPICES (Fulmer, 1998) to alert students to clinical
syndromes common to older adults.
AACN
Core Knowledge: Information and Health Care Technologies
16.
Use technology to enhance older adults' function, independence,
and safety.
17. Facilitate communication as older adults transition
across and between home, hospital, and nursing home, with
a particular focus on the use of technology.
Content:
Instruments and guidelines to prevent and recognize common
areas of communication impairments in older adults. Technologies
that directly impact function: hearing aids, assistive devices,
and adaptive equipment. Technologies that facilitate adherence
to treatment: electronic monitoring of clinical indicators
such as blood pressure; glucose; aids to medication and
treatment adherence; personal emergency response systems
useful in alerting frail older people and their caregivers
to potential untoward events.
Teaching
Strategies: Assignments that promote analysis and evaluation
as to the usefulness and availability of technologies. Direct
use and evaluation of technology, especially as older people
transition between health care settings (resources appended).
AACN
Core Knowledge: Ethics
18.
Assist older adults, families, and caregivers to understand
and balance "everyday" autonomy and safety decisions.
19. Apply ethical and legal principles to the complex
issues that arise in care of older adults.
Content:
Ethical issues that pose threats to the autonomy of
older adults, e.g., ability to live independently in the
community, self-medication, driving, and adherence to a
plan of care. Decision-making about health care for older
adults, e.g., decision-specific capacity, advance directives,
informed consent, refusal of treatment. Decisions critical
to older people as they transition between health care settings,
e.g., placement, use of physical restraints and feeding
tubes. Ethical dilemmas using age as a criterion for allocation
of scarce resources, i.e. access to organ donation and to
intensive care units. Role of ethics committees in clarifying
and resolving disputes around care of older adults.
Teaching
Strategies: Observations at ethics committees and ethics
case conferences. Exposure to the extant literature, films,
videos, and web resources that depict ethical dilemmas and
provide a framework for ethical decision-making concerning
frail older adults (resources appended).
AACN
Core Knowledge: Human Diversity
20.
Appreciate the influence of attitudes, roles, language,
culture, race, religion, gender, and lifestyle on how
families and assistive personnel provide long-term care
to older adults.
Content:
The ethnic, cultural, language, and socio-economic diversity
of patients, families, and paid caregivers (nurses, nurse
assistive personnel, physicians and therapists) who provide
long-term care to frail older adults. An analytic framework
for evaluating how the values and attitudes of frail older
people and of the people who provide their care impact on
when, how, and whether care is delivered, and the satisfaction
of both patient and provider with that care.
Teaching
Strategies: Readings, assignments, and simulations that
allow students to analyze their values and attitudes about
diversity in the care of frail older adults. Opportunities
to discuss and reflect on clinical experiences where diversity
has impacted on an older adult's care.
AACN
Core Knowledge: Global Health Care
21.
Evaluate differing international models of geriatric care.
Content:
Analysis of similarities and differences of global health
care models that favor community long-term care over institutional
care and that promote individualized care.
Teaching
Strategies: Direct observation of global health care
of older adults. Analysis of videos, simulations, and electronic
materials of global models for care of older adults.
AACN
Core Knowledge: Health Care Systems and Policy
22.
Analyze the impact of an aging society on the nation's
health care system.
23. Evaluate the influence of payer systems on access,
availability, and affordability of health care for older
adults.
24. Contrast the opportunities and constraints of supportive
living arrangements on the function and independence of
older adults and on their families.
Content:
The effects of an aging society on disease prevalence, morbidity,
and mortality. Evaluation of the consequences of an aging
society on health care utilization, resource allocation,
cost, and work force needs. Payment systems for older adults,
e.g., Social Security, Medicare, Medicaid, supplemental
and long-term care insurance, and capitation. How an aging
society and payment systems drive housing options for the
elderly, e.g., assisted living, continuing care retirement
options, home care, and nursing homes.
Teaching
Strategies: Opportunities to compare and contrast the
impact of the payment system on quality of services received
by older adults. Federal and state Web citations on papers
and in preparation for clinical.
AACN
Role Development: Provider of Care
25.
Recognize the benefits of interdisciplinary teams in care
of older adults.
26. Evaluate the utility of complementary and integrative
health care practices on health promotion and symptom
management for older adults.
Content:
The use of interdisciplinary teams to assess and deliver
care to older adults. Knowledge of how disciplines other
than nursing contribute to the well-being of older adults.
Complementary health practices, e.g., relaxation, massage,
pet therapy, reminiscence and life review, acupuncture used
by many older adults. Analysis of the relative merits of
teams and complementary health practices in improving care
for older adults.
Teaching
Strategies: Experience on teams assessing and delivering
care to older adults. Didactic and clinical experience that
foster analysis of the effectiveness of complementary and
integrative health practices on improving the health of
older adults.
AACN
Role Development: Designer/Manager/Coordinator of Care
27.
Facilitate older adults' active participation in all aspects
of their own health care.
28. Involve, educate, and when appropriate, supervise
family, friends, and assistive personnel in implementing
best practices for older adults.
29. Ensure quality of care commensurate with older adults'
vulnerability and frequency and intensity of care needs.
Content:
Assessment and education strategies to maximize older adults
and family participation in health promotion, disease prevention,
and illness management. Quality improvement strategies to
evaluate effectiveness of assessment and education activities
on older adults and on families. Assess, supervise, and
evaluate the care provided to older adults by licensed and
unlicensed assistive personnel. Conflict resolution skills
to redress conflicts among providers, older adults and families.
Teaching
Strategies: Clinical experience in community agencies
and senior centers where students can assess older people's
efficacy in self-care. Patient and family teaching assignments
that include evaluation of effectiveness of teaching older
people and families. Experiences to assess, teach, and evaluate
assistive personnel.
AACN
Role Development: Member of a Profession
30.
Promote quality preventive and end-of-life care for older
adults as essential, desirable, and integral components
of nursing practice.
Content:
The importance of illness prevention and end-of-life
care for older adults. Analysis of how membership in, and
participation on, boards of professional organizations and
lobbying and political activities promote integration of
prevention and end-of-life care for older adults into federal
and state legislation, regulations, and reimbursement streams.
Teaching
Strategies: Assignments requiring reference to organizations
promoting prevention and end-of-life care for older adults,
i.e., American Association of Retired Persons (AARP), National
Coalition for Nursing Home Reform, Alzheimer's Disease and
Related Disorders Association, Senate Committee on Aging,
State Area Agencies on Aging, National Hospice Association.
Evaluation of the effectiveness of professional nursing's
efforts to promote prevention and quality end-of-life care
for older adults.
C. Including competencies, content, and teaching strategies
in the curriculum
Competencies,
content, and teaching strategies should be incorporated
into separate courses in geriatric care and throughout the
curriculum. Adequate content on care of older adults is
dependent on a curriculum infusion and a sufficient number
of faculty prepared in geriatric nursing.
Free-Standing,
Required Course in Geriatric Care
Ideally,
the curriculum should include a free-standing, required
course in geriatric nursing that has both a didactic and
clinical component. The focus of the course should be on
health and deviations from health in older people. The clinical
should provide continuity experiences that allow students
to follow older patients and their family members across
health care settings. Interdisciplinary team exposure should
be an integral component of the course.
Health
Assessment
In
health assessment courses, students should be introduced
to the use of standardized assessment instruments common
to care of older adults. Such instruments include assessment
of functional and cognitive status, syndromes common to
older adults (e.g., sleep disturbance, depression, and urinary
incontinence), specific assessment parameters (e.g., pain),
and assessment for elder mistreatment. The timing of initial
and ongoing administration of instruments should be included.
Adult
Health Nursing Courses
Care
of older adults and their families should be addressed in
all adult health nursing clinical courses. Objectives, didactic
and clinical content, texts and readings, and evaluation
strategies should address modifications in communication
and assessment specific to older adults, individualized
care, risk factors common to old age, recognition and management
of geriatric syndromes, and the interaction of acute and
chronic co-morbid conditions common to older adults. Geriatric
nursing threads begun in life-span, nutrition, and pathophysiology
and pharmacology courses should be reinforced and expanded.
These clinical courses should operationalize exposure to
older adults at all levels of health, maximizing student
exposures to community and institutional settings serving
the elderly: home care, assisted living, continuing care
retirement communities, acute and long term care settings
and the issues that affect smooth transitions for older
people and their families as they move between health care
settings. Content should address end-of-life care issues
for the elderly, including decision making and advance directives.
Students should be exposed to theory and practice of the
use of interdisciplinary teams to assess and manage care
for older adults with complex health needs.
Community
Health Nursing
Students
in community health should have opportunities to assess,
compare, and contrast the living environments of older adults,
and to analyze the effectiveness of community resources
in assisting older adults and their families to retain personal
goals, maximize function, maintain independence, and live
in the least restrictive environment. Students should have
opportunities to assess, work with, and evaluate the care
provided by family members and assistive personnel. The
importance of health promotion for older adults and of involving
older adults as active participants in aspects of their
own health care and the evidence-based outcomes that stem
from these actions should be included in clinical community
rotations. Students should be encouraged to seek out experiences
that allow observation of complementary and integrative
health care practices on the health promotion and symptom
management for older adults.
Psychiatric-Mental
Health
Courses
that address communication, group dynamics, and psychiatric
mental health offer opportunities to address student attitudes
and values about older adults and aging, strategies to maximize
effective communication with older adults, and issues of
family dynamics as they apply to older adults. Students
should be exposed to the cognitive changes common to older
adults, particularly, dementia, delirium, and depression,
and to case finding and management of elder mistreatment.
Maximizing independence should be discussed in relationship
to maintaining older people in the least restrictive environment
and alternatives to the use of physical and chemical restraints.
Ethical/Legal
Content
Students
should apply, in free-standing courses or integrated into
nursing courses, the ethical and legal principles that underpin
the complex issues arising in care of older adults. They
should understand and apply concepts of decision-specific
capacity and have opportunities to assist older adults,
families, and caregivers in balancing everyday autonomy
and safety decisions. Content should include exposure to
alternative modalities to physical and chemical restraints.
Aspects of quality end-of-life care for older adults should
be addressed.
Nursing
Research
Courses
that address nursing research should include: 1) examples
of nursing research that have benefited the care of older
adults, and 2) evidence-based examples of management of
geriatric syndromes. Students should have opportunities
to participate in research studies that focus on care of
the elderly.
Professional
Issues/Health Care Settings
Courses
in professional ethics are ideal for incorporating content
and experiences in analyzing the impact of an aging society
on the health care system, and the impact of payer systems
on access, availability, and affordability of health care
for older adults. Students should be exposed to the advocacy
groups within and outside of nursing that promote quality
of care for older adults.
Support
Courses: Lifespan Development, Nutrition, Pathophysiology,
Pharmacology
Support
courses provide opportunities to expose students to alterations
in physiologic parameters that occur as people age, and
to the psychological and social changes associated with
aging. Lifespan development should encompass a thorough
consideration of the psychological and social changes that
occur as people age and the consequences of these changes
for the individual and the family. International models
of geriatric care should be provided along with opportunities
to analyze the impact of an aging society on the health
care system. Opportunities should be explored to thoroughly
address the nutritional needs of well and ill older adults.
Pathophysiology should take into account an older person's
susceptibility and response to illness and physiological
changes that influence illness recovery. Pharmacokinetics
of aging, issues of polypharmacy, and use of non-prescription
medications should be introduced early and reinforced in
relationship to specific pharmacological agents, cost of
medications, Medicare and Medicaid reimbursement for medications,
and issues of dosages and use of generic options.
D. Resources
to facilitate implementation of content and teaching strategies
Appendix
A includes a list of resources to assist in locating geriatric
nursing "best practices" and teaching strategies. It includes
reference books on geriatric content and core curricula,
journals, national associations and government agencies,
audio visual references and web sites.
References
Cited in Text
Abraham,
I., Bottrell, M., Fulmer, T., & Mezey, M. (1999). Geriatric
nursing protocols for best practice. New York: Springer
Publishing Co.
Administration
on Aging, U.S. Department of Health and Human Services and
the Program Resources Department of American Association
of Retired Persons. (1998). Profile of older Americans:
1998. Washington, DC: Author.
American
Association of Colleges of Nursing. (1998). Essentials
of baccalaureate education for professional nursing practice.
Washington, D. C.: Author.
American
Nurses Credentialing Center, (1999), unpublished data.
Fulmer,
T., & Matzo, M. (Eds). (1995). Strengthening geriatric
nursing education. New York, NY: Springer Publishing
Company.
Fulmer
T. (1991) The geriatric nurse specialist role: a new model.
Nursing Management. 22(3), 91-94.
Mezey,
M. (1996). Challenges in providing care for persons with
complex chronic illness. In R.H Binstock, L. E Cluff, &
O. Von Merix (Eds.), The Future of Long-Term Care
(119-142). Baltimore, MD: Johns Hopkins University Press.
Mitty,
E., & Mezey, M. (1999) Integrating advanced practice nurses
into home care: recommendations for a teaching home care
program. Nursing and Health Care Perspectives, Vol.
19 No. 6.
National
Center for Health statistics (1996). Healthy people 2000:
midcourse review and 1995 revisons [On-line]. Available:
http://hhs.gov/pubs/hp2000.
Rosenfeld,P.
,Bottrell, M. ,Fulmer,T., & Mezey, M. (1999). Gerontological
nursing content in baccalaureate nursing programs: findings
from a national survey. Journal of Professional Nursing,
15 (2), 84-94.
Rowe,
J., & Kahn, R. (1999). Successful aging. New York,
NY: Pantheon Books.
APPENDIX
A
RESOURCES
FOR GERONTOLOGY & GERIATRIC NURSING
From
the Hartford Institute for Geriatric Nursing at the Division
of Nursing, New York University Baccalaureate Nursing Program
Partners for Dissemination of Best Practices in Care for
Older Adults Program.
BOOKS
Abraham,
I., Bottrell, M., Fulmer, T., & Mezey, M. (1999). Geriatric
nursing protocols for best practice. NY: Springer Publishing
Company.
Abrams,
W., Beers, M., & Berkow, R. (Eds). (1995). The Merck
manual of geriatrics, 2nd ed. Whitehouse Station,
NJ: Merck & Company, Inc.
Ebersole,
P. & Hess, P. (1998). Toward healthy aging: Human needs
and nursing response (5th ed.). St. Louis: Mosby.
Eliopoulos,
C. (1997). Gerontological nursing (4th Ed.). New York: Lippincott.
Fulmer,
T.T. & Matzo, M. (1995). Strengthening geriatric nursing
education. New York: Springer Publishing Company.
Gallo,
J.J., Reichel, W., & Anderson, L.M. (1995). Handbook
of geriatric assessment (2nd ed.). Gaithersburg, MD:
Aspen Publications.
Ham,
R.J. & Sloane, P.D. (1997). Primary care geriatrics:
A case-based approach. (3rd ed.). New York: Mosby.
Katz,
P.R., Kane, R.L., & Mezey, M.D. (1999). Emerging systems
in long term care: Advances in long-term care, Volume
4. New York: Springer.
Katz,
P.R., Kane, R.L. & Mezey, M.D. (1995). Quality care in
geriatric settings. New York: Springer Publishing Company.
Lueckenotte,
A.G. (1996). Gerontological nursing. New York: Mosby.
Ludden,
A.S. (Ed.) (1996). Core curriculum for gerontological
nursing. New York: Mosby.
Maddox,
G. (Ed.). (1995). The encyclopedia of aging (2cd
ed.). New York: Springer Publishing Company.
Mariano,
C., Gould, E., Mezey, M., & Fulmer,T. (Eds.) (1999 second
edition) Best nursing practices for older adults: incorporating
essential gerontological content into baccalaureate nursing
education and staff development. New York: Hartford
Institute for Geriatric Nursing, Division of Nursing, New
York University.
Matteson,
M.A., McConnell, E.S., & Linton, A.D. (1997). Gerontological
nursing: concepts and practice (2cd ed.) Philadelphia:
PA: W.B. Saunders.
Mezey,
M.D., Stokes, S.A., & Rauckhorst, L.H. (1993). Health
assessment of the older individual (2nd ed.). New York:
Springer Publishing Company.
Mitty,
E. (1998). Handbook for directors of nursing in long-term
care. NY: Delmar Publishing.
Palmore,
E.B. (1998). The facts on aging quiz, 2nd edition.
New York: Springer.
Rowe,
J.W. & Kahn, R.L. (1998). Successful aging. New York:
Pantheon Books.
Schulz,
R., Maddox, G., & Lawton, M.P. (1998). Annual review
of gerontology and geriatrics, Vol. 18, Focus on interventions
research with older adults. New York: Springer.
Siegler, E.L., Hyer, K., Fulmer, T., & Mezey, M. (1998).
Geriatric interdisciplinary team training. New York:
Springer.
Strumpf, N.E., Patterson, J.E., Wagner, J.S., & Evans, L.K.
(1998). Restraint-free care; Individualized approaches
for frail elders. New York: Springer.
Teresi,
J.A., Lawton, M.P., Holmes, D., & Ory, M. (1997). Measurement
in elderly chronic care populations. New York: Springer
Publishing Company.
Yoshikawa,
T.T., Cobbs, E.L., & Brummel-Smith, K.B. (1998). Practical
ambulatory geriatrics (2nd ed.). New York: Mosby.
Geriatric
Web Sites
Aging
Associations/Societies/Institutes
Administration
on Aging
Alzheimer's
Association
American
Association of Retired Persons
American
Geriatrics Society
American
Society on Aging
Gerontological
Society of America
Hartford
Institute for Geriatric Nursing
Health
Care Financing Administration
National
Association of Geriatric Education Centers
National
Council on Aging
National
Gerontological Nursing Association
National
Institute on Aging
Case
Studies Caregivers
Webring
Senior
Webring
Curriculum
Guides
GeroNet
Health & Aging Resources for Higher Education
Hartford
Institute for Geriatric Nursing
Teaching
Gerontology Newsletter
Gerontology
Centers/Education Centers
Andrus
Gerontology Center
Brookdale
Center on Aging
Gerontological
Nursing Interventions Research Center
Reynolds
Center on Aging
Texas
Consortium of Geriatric Education Centers
Wayne
State University Institute of Gerontology
Wisconsin
Geriatric Education Center
Journals/Magazines/Educational
Resources
Age
of Reason
Age
and Aging-Online Services
ElderWeb
Gerontology
& Geriatrics Education
Geriatric
Nursing
Geriatric
Video Productions
The
Gerontologist
Journal
of Gerontological Nursing
Geropsychology
Central Abstracts and Journals
SeniorCom
Senior
Law Home Page
Senior
Net
ThirdAge
Statistics
Fastats
International
Year for Older Persons 1999
National
Center for Health Statistics
Statistical
Information on Older Persons
Listservs
GERO-NURSE
(Listserv for the Research Development and Dissemination
Core-University of Iowa Gerontological Nursiong Intervention
Project). Mailing List address: gero-nurse-request@list.uiowa.edu
GERINNET
(Gerontological Nursing Issues). Mailing List address: listserv@ubvm.cc.buffalo.edu
AGING-DD-
A discussion group for aging and developmental disabilities.
Mailing List address: listserv@lsv.uky.edu
(July
2000)
