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GERONTOLOGICAL
NURSING
(NELECO02)—LEC

BRYAN C. ROBLES, MSN, RN

@brydgr8 brydgr08

COURSE • NELECO02 is designed to focus on the

DESCRIPTION application of the nursing process in the care
of older adult/elderly patients experiencing
varied conditions in the health care continuum
in a variety of health care settings.

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• List landmarks that affected the development of

gerontological nursing;
• Discuss major roles in gerontological nursing;
COURSE
• Identify standards used in gerontological nursing practice;
OBJECTIVES
• List principles guiding gerontological nursing practice ;
• Explain holistic gerontological nursing care;
• Contrast several major theories of aging;
At the end of the
• Discuss the importance of the Transcultural Nursing
discussion, the Society’s care standards and the culturally and linguistically
student nurses appropriate services (CLAS) in health care.

should be able to: • Apply the Cultural Care triad to the complex
interrelationships of the nurse, caregiver, and patient within
community and institutional (home or residential) settings.
• Create a plan of care for the older adult integrating Cultural
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Care. brydgr08

I. Foundations of Gerontological Nursing

A. Principles of Gerontology
COURSE B. Contemporary Gerontological Nursing
CONTENT
II. Challenges of Aging and the Cornerstones of
Excellence in Nursing Care
A. Cultural Diversity
B. Violence and Mistreatment
C. Care at the End-of-Life
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PRINCIPLES OF GERONTOLOGY @brydgr8

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DEVELOPMENT OF GERONTOLOGICAL NURSING

• 1935—Federal Old Age Insurance Law (better known as Social Security) was
passed.
• 1961—American Nurses Association (ANA) recommended that a specialty group
for geriatric nurses be formed.
• 1966—Division of Geriatric Nursing was formed.
• 1969—Standards for Geriatric Nursing Practice was developed.
• 1970—Standards for Geriatric Nursing Practice was published.

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• 1975—Certification of Excellence in
Geriatric Nursing Practice was achieved by
74 nurses
—birth of the Journal of Gerontological
Nursing
• 1976—the Geriatric Nursing Division
became the Gerontological Nursing Division

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INTRODUCTION
• GERONTOLOGY—is the holistic study of aging
processes and individuals as they mature
throughout the adult life span.

• GERONTOLOGISTS—professionals who focused

on gerontology.

• GERIATRICS—is the field more closely aligned with

medicine.
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GERONTOLOGICAL NURSING CARE SETTINGS

• Skilled nursing facility
• Retirement community
• Adult day care
• Residential care facility
• Transitional care units
• Rehabilitation hospital
• Community-based home care @brydgr8
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CORE VALUES AND PRINCIPLES OF

GERONTOLOGICAL NURSING
• Health promotion
• Health protection
• Treatment of disease

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AGING
• An inevitable and steadily progressive process that
begins at the moment of conception and continues
throughout the remainder of life.

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STAGES OF AGING
1. Antepartum 5. Adolescent
2. Neonate 6. Young Adult
3. Toddler 7. Middle Adult
4. Child 8. Old Adult

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SUBDIVISIONS OF OLD ADULT

1. Young-old 65-74 years
2. Middle-old 75-84 years
3. Old-old 85+ years

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GOAL OF GERONTOLOGICAL NURSING CARE

• To Improve the length and quality of life of older
adult (through provision of high-quality care).

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DEMORGRAPHICS AND AGING

• COUNTRIES WITH LARGEST NUMBERS OF
OLDER PEOPLE
• China 129M
• India 77M
• U.S. 40M
• Russian Federation 27M

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LIFE EXPECTANCY
• Is a number of years from birth that an individual
can expect to live.
• Japan 83.98 years
• Central African Republic 47 years

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LIFE EXPECTANCY OF OTHER COUNTRIES

(World Bank, Jul.6, 2018)
• Australia 82.5 years • U.K. 80.96 years
• Canada 82.3 years • Germany 80.64 years
• Sweden 82.2 years • U.S. 78.69 years
• Finland 81.78 years • Poland 77.45 years
• Netherlands 81.51 years

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• Arthritis
LEADING CAUSES • Hypertension
OF ACTIVITY • Heart Disease
LIMITATION • Diabetes
• Respiratory Disorders

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• Primary Prevention (Health Promotion)

NURSING
INTERVENTIONS • Secondary Prevention (Early Diagnosis and
TO PROMOTE Prompt Treatment)
HEALTH IN OLDER
PEOPLE • Tertiary Prevention (Restoration and
Rehabilitation)

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• Heart Disease • Diabetes Mellitus

LEADING CAUSES • Malignant Neoplasm • Influenza/Pneumonia
OF DEATH • Cerebrovascular • Nephritis/Nephrosis

(men & women) • Bronchitis/Emphysema/As • Accidents

thma • Septicemia
• Alzheimer’s Disease

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• Heart Disease
FIVE CHRONIC • Cancer
DISEASES • Stroke
(cause of death) • COPD
• Diabetes

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HEALTHY PEOPLE 2020

• A statement of national health objectives designed
to identify the most significant preventable threats
to health and to establish national goals to reduce
these threats.

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• Attain high-quality, longer life free of

preventable disease, disability, injury and
premature death;

• Achieve health equity, eliminate disparities, and

improve the health of all groups;
FOUR BASIC GOALS
• Create social and physical environments that
promote good health for all;

• Promote quality of life, health development and

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healthy behaviors across all life stages. brydgr08

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SENESCENCE
• Term used by Gerontologist when
characterizing the aging process
• Progressive deterioration of body systems

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• Brain loses some axon and neurons.

• Visual Changes: difficulty focusing, increased
sensitivity to glare, diminished nighttime
vision.
NORMAL • High frequency hearing loss.

CHANGES OF • Arteries stiffen and blood oxygenation levels

decline.
AGING
• Maximum breathing capacity in the lungs
declines.
• Heart muscle thickens with age, maximum
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pumping rate declines. brydgr08

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• Kidneys becomes less efficient at removing

waste from blood.
• Body fats increases in the trunk.
NORMAL • Bladder capacity declines.
CHANGES OF • Muscle mass is lost, especially in women who
usually have less baseline bone mass than
AGING
men.
• Muscle mass can decline rapidly without
exercise.
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• Bone mineral is lost and replaced throughout

life, but the loss outpaces the replacement for
NORMAL women at about age 35.
CHANGES OF • Older people who experience health
AGING problems, chronic illness, and pain are at risk
for depression and social isolation.

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ORGAN RESERVE
• Loss of the ability of a given organ to react quickly
and efficiently to physiological stress.

HOMEOSTASIS
• Ability to maintain equilibrium

HOMEOSTENOSIS
• Inability to restore homeostasis @brydgr8
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• BIOLOGICAL THEORIES
• Programmed Theories
• Error Theories
• PSYCHOLOGICAL AGING THEORIES
THEORIES OF • Jung’s Theory of Individual
• Erikson’s Developmental Theory
AGING
• SOCIAL AGING THEORIES
• Disengagement Theory
• Activity Theory
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• Continuity Theory brydgr08

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PROGRAMMED THEORIES
• Body’s genetic code contain instructions for the
regulation of cellular reproduction and death
BIOLOGICAL
THEORIES
ERROR THEORIES
• Body accumulate toxic by-products

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PROGRAMMED LONGEVITY
• Result of the sequential switching on and off of
certain genes
PROGRAMMED
THEORIES
ENDOCRINE THEORY
• Hormones control the pace of aging

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IMMUNOLOGY THEORY
• Decline in immune system functions lead to an
increased aging
PROGRAMMED
THEORIES

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WEAR-AND-TEAR THEORY
• Cells and organs wear out after years of use
• Body = Machine
ERROR THEORIES
CROSS-LINK THEORY
• Cross-linked proteins causes various problems

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FREE RADICAL THEORY

• Oxygen radicals cause loss of organ reserve

ERROR THEORIES SOMATIC DNA DAMAGE THEORY

• Aging increases genetic mutation that lead to cell
deterioration and malfunction

EMERGING BIOLOGICAL THEORIES

• Activated genes by enzymes increase aging @brydgr8
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JUNG’S THEORY OF INDIVIDUALISM

• The aged focuses away from the world but toward
the inner experience.
PSYCHOLOGICAL
AGING THEORIES
ERIKSON’S DEVELOPMENTAL THEORY
• Ego integrity versus despair

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DISENGAGEMENT THEORY
• Older person and society engage in mutual and
reciprocal withdrawal
SOCIAL AGING
THEORIES ACTIVITY THEORY
• Older adults should stay active and engaged

CONTINUITY THEORY
• Continue being the same person @brydgr8
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SCOPE OF PRACTICE
• A range of nursing functions that are differentiated
according to the level of practice, the role of the
nurse, and the work setting.

THREE ELEMENTS OF SCOPE OF PRACTICE

1. Quality
2. Evidence
3. Safety
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SCOPE OF NURSING PRACTICE

• Who: Registered Nurses and Advanced Practice
Registered Nurses
• What: Nursing
• Where: there is a healthcare consumer in need of
care, information, or advocacy
• When: need for nursing knowledge, wisdom, caring,
leadership, practice, or education
• Why: response to the changing needs of the society
• How: means, methods, and manners use to practice
professionally @brydgr8
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• Standard 1. Assessment
• Standard II. Diagnosis
• Standard 3. Outcomes Identification
• Standard 4. Planning
STANDARDS OF • Standard 5. Implementation
PRACTICE • Standard 5A. Coordination of Care
• Standard 5B. Health Teaching and Health
Promotion
• Standard 6. Evaluation
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• Standard 7. Ethics
• Standard 8. Culturally Congruent Practice
STANDARDS OF
• Standard 9. Communication
PROFESSIONAL
• Standard 10. Collaboration
PERFORMANCE
• Standard 11. Leadership

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• Standard 12. Education

• Standard 13. Evidence-based Practice and
Research
STANDARDS OF
• Standard 14. Quality of Practice
PROFESSIONAL
• Standard 15. Professional Practice Evaluation
PERFORMANCE
• Standard 16. Resource Utilization
• Standard 17. Environmental Health

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