Briefing Note: Improving Nursing Education to Combat Ageism Against Older Adults

Yashita Shetty

500897699

Ryerson, Centennial and George Brown Collaborative Nursing Degree Program

NSE 407: Nursing- professional issues and trends – Section 031

Dr. Lori Schindel Martin

Thursday, November 18th, 2021

Word count - 998

Introduction
Between 2015 and 2050, the world's population aged 60 and up will increase from 12 percent to

22 percent (Dahlke et. al, 2021). Along with ageing comes an increased incidence of chronic

conditions and as a result older people use a disproportionately larger amount of healthcare

services than any other population group (Dahlke et. al, 2021). It is vital that healthcare workers,

particularly nurses, who have the greatest interaction with older adults, are trained adequately to

offer quality care to this population. Ciriello & Cherry (2020) emphasizes knowledge deficit in

skills and communication with older adults as a major contributor in promoting negative ageist

attitudes and behaviors among nurses and nursing students which has significant effects on the

quality of nursing (Ciriello & Cherry, 2020). Ageism has harmful effects on the biopsychosocial

wellbeing of older adults which include untreated pain, increased risk for falls, loss of interest in

healthy behaviors, and impairs mental status (Ciriello & Cherry, 2020). Practices of ageism stem

from the inadequate gerontological teachings and skills in nursing education, particularly in

nursing undergraduate studies (Ciriello & Cherry, 2020). In order to improve healthcare for our

aging population, further curriculum and practice redevelopment is needed in order to foster a

sense of geriatric inclusion that is sufficient enough to promote positive ageist perceptions

(Ciriello & Cherry, 2020).

Position Statement

Undergraduate nursing programs tend to emphasize technical knowledge over gerontology-

focused or primarily caregiving roles, which perpetuates negative stereotypes related to older

persons (Hovey, Dyck, Reese, & Kim, 2017). Therefore, it is imperative for nursing school

education and curriculum to involve sufficient amount of resources, inclusion of newer evidence

based practice tools and interventions that will provide geriatric content efficiently in an

engaging manner (Hovey et. al, 2017). This is in accordance with the findings of Hovey et al.
(2017), explaining that nursing curriculums are less likely than other health fields to include

stand-alone gerontology courses (Hovey et. al, 2017). The adoption of gerontological nursing

competency frameworks, such as the Canadian Gerontological Nursing Competencies and

Standards of Practice 2020 (Canadian Gerontological Nurses Association, 2020) is also

problematic for nurses and nurse educators because the standards do not differentiate between

entry-to-practice competencies and competencies for experienced nurses (Canadian

Gerontological Nursing Association, 2020). This demonstrates inconsistency with

geronotological studies in nursing education and practice.

Implications Related to Ageism

Negativity toward elderly people is tolerated without repercussions, and as a result, it thrives as a

socially accepted form of discrimination in Canada (Dahlke et. al, 2021). Research has found

that older adults are commonly perceived as bad-tempered, depressed, isolated, unhealthy,

unable to learn, and with the idea that these perceptions are linked to normal signs of aging

(Dahlke et. al, 2021). Many nurses act on these ageist practices by prioritizing acute illnesses

related to physical health and underestimating older patients' mental and physical health concerns

(Dahlke et. al, 2021). Ageism and stigma drive the prevention of policy change for older adults'

physical and mental health practice (Dahlke et. al, 2021).

Recommendations

A recommendation to involve a mandatory 8-hour empathy skills training workshop on student

empathy and attitudes on ageism during the last year in undergraduate nursing programs is

strongly encouraged (Gallo, 2019). The Canadian Association of Schools of Nursing (CASN)

should take responsibility for initiating this delivery to nursing undergrad programs, and only

giving accreditation to nursing programs that involve this workshop. This workshop should be
developed in collaboration with the Truth and Reconciliation commission of Canada and the

Canadian Gerontological Nurses Association (CGNA) to develop a comprehensive training tool

to address ageing along with factors of intersectionality (Gallo, 2019). The entry-to-practice

nurse must also understand that many older adults require support and end-of-life care delivered

with an understanding of their culture and support networks (Canadian Gerontological Nurses

Association, 2020). The Truth and Reconciliation Commission of Canada has requested

Canadian nursing schools to prepare students with skills-based training in intercultural

competency, human rights, anti-racism (Gallo, 2019). Another recommendation would be to

have more research in caregiving strategies for delirium, dementia and Depression in older adults

as current literature is outdated for five plus years in BPG and RNAO practice documents

(Ciriello & Cherry, 2020). The under recognition and care for delirious and dementia patients

predetermined a vulnerability to higher levels of morbidity, and mortality in older adults. These

care strategies should offer nurses recommendations for practice that is current evidence-based

and reviewed by clinical experts. The last recommendation is CASN can utilize resources

organized by the Knowledge Exchange Institute for Geriatric Nursing Education that promotes

the Knowledge-to-Action model to help with knowledge translation in order to deliver evidence-

based interventions (Gallo, 2019). These resources have been effective as they can provide

comprehensive instructional abilities to nursing faculty on how to transfer new research

regarding geriatric care into the nursing curriculum and for practice (Gallo, 2019). Nurses as a

profession have sizable influence within healthcare and through their collective actions can either

maintain the status quo, or transform institutions. If nurses are not able to cater towards the needs

of older adults then we are not promoting an equitable, innovative health care system that meets

the expectations of all its users (Ciriello & Cherry, 2020). Adequate knowledge of all target
populations and organizational readiness for better and improved care practices, standards and

expectations is expected to deliver optimum health related outcomes.

Conclusion

Nursing education programs have a responsibility to prepare future nurses to care for the

growing number of older adults who will be accessing health care services. Preparation involves

ensuring students have the knowledge, skills and desire to provide quality care to older adults.

Without these resources and support tools, negative ageist perceptions related to older adults can

occur and this as a result can be detrimental to their health. Providing workshops that build on

skills mainly focused around geriatric care, learning more about caring for older adults with

altered mental status, and utilizing efficient knowledge translation tools can help reduce negative

stigma surrounding older adults and in effect improve overall healthcare.

References
Canadian Gerontological Nursing Association. (2020). Gerontological Nursing Standards of

Practice and Competencies 2020 (4th ed.). Toronto, Canada: CGNA

Ciriello, J., & Cherry, K. (2020). Striving for Gerotranscendence: Preparing Nursing Students to

Care for the Aging Population. Journal of Nursing Education, 59(9), 536-538.

http://dx.doi.org/10.3928/01484834-20200817-12

Dahlke, S., Hunter, K. F., Fox, M. T., Davidson, S., Perry, N., Laura, T. W., Lori, S. M., Butler,

J. I., Christy, R., Chasteen, A. L., McCleary, L., Boscart, V., & Moody, E. (2021).

Awakening Canadians to ageism: a study protocol. BMC Nursing, 20, 1-10.

http://dx.doi.org/10.1186/s12912-021-00713-0

Gallo, V. (2019). Ageism in nursing education: A review of the literature. Teaching and

Learning in Nursing, 14(3), 208-215. https://doi.org/10.1016/j.teln.2019.04.004

Hovey, S., Dyck, M. J., Reese, C., & Kim, M. (2017). Nursing students' attitudes toward persons

who are aged: An integrative review. Nurse Education Today, 49, 145- 152.

https://doi.org/10.1016/j.nedt.2016.11.018