Geriatric Nursing NCM 114 ➢ In 2017 the ANA revised its statement
incorporating the Nursing: Scope & Standards
History and Evolution
➢ Burnside (1988) conducted an extensive review
of historical materials related to gerontologic
nursing.
➢ Researching the years between 1900 and 1940,
she found 23 writings with a focus on older
adults that covered such topics as
• rural nursing
• almshouses
• and private duty nursing
• early case studies
• and clinical issues addressing home care for:
o fractured femurs
o dementia
o delirium
➢ Stevens (1994), examined journal articles
between 1903 and 1990, looking for those with
a focus on nursing care of the older adult, health
concerns of the older adult, or other issues facing
older adults.
➢ Between 1903 and 1950, only one article was
published.
➢ Between 1960 and 1990, a steady increase in
literature with a focus on the older adult was
noted.
➢ In 1981 A Statement on the Scope of
Gerontological Nursing Practice was published.
➢ The revised Scope and Standards of
Gerontological Nursing Practice was
published in 1987, 1995, and 2010.
➢ In 2010 the revised Scope and Standards of
Gerontological Nursing Practice not only
reflected the nature and scope of current
gerontologic nursing practice but also
incorporated the concepts of:
• health promotion
• health maintenance
• disease prevention
• self- care
of Practice (3rd ed., revised 2015) and the Code
of Ethics for Nurses with Interpretative
Statements (revised 2015) to provide a resource
“of the duties that all registered nurses,
regardless of role, population, or specialty, are
expected to perform competently.
Those standards are identified in two
categories:
a) Standards of Practice that describe a
competent level of nursing practice as
demonstrated by the nursing process
b) Standards of Professional Performance
that describe a competent level of behavior in
the professional role
➢ Another hallmark in the continued growth of the
gerontologic nursing specialty occurred in 1973
when the first gerontologic nurses were certified
through the ANA.
➢ Certification is an additional credential granted
by the ANCC (a subsidiary of the ANA),
providing a means of recognizing specialized
knowledge and clinical competence
➢ From the initial certification offering as a
generalist in gerontologic nursing, to the first
GNP examination offering in 1979, to the GCNS
examination first administered in 1989, the
gerontologic nursing specialty has continued to
grow and attract a high level of interest.
Roles
The Generalist Nurse
➢ The generalist in gerontologic nursing has
completed a basic entry-level educational
program and is licensed as a registered nurse
(RN).
➢ A generalist nurse may practice in a wide variety
of settings, including home and the community.
➢ The challenge of the gerontologic nurse
generalist is to identify older adults’ strengths
and assist them to maximize their independence.
➢ Older adults should participate as much as
possible in making decisions about their care.
➢ The generalist nurse consults with the advanced
practice nurse and other interdisciplinary health
care professionals for assistance in meeting the
complex care needs of older adults.
The Clinical Nurse Specialist
➢ The AGCNS has the requirement of at least a
master’s degree in nursing and must be licensed
as an RN.
➢ The first clinical nurse specialist program was
launched in 1966 at Duke University.
➢ The gerontologic master’s program typically
focuses on the advanced knowledge and skills
required to care for younger through older adults
in a wide variety of settings, and the graduate is
prepared to assume a leadership role in the
delivery of that care.
➢ AGCNSs have an expert understanding of the
dynamics, pathophysiology, and psychosocial
aspects of aging.
➢ AGCNSs may be found practicing in acute care
hospitals, long- term care or home care settings,
or independent practices.
The Nurse Practitioner
➢ The Adult Gerontologic Acute Care or Primary
Care Nurse Practitioner (AGACNP/AGPCNP)
may be educationally prepared in various ways
but must hold a license as an RN.
➢ In the early 1970s the first AGNPs were prepared
primarily through continuing education
programs.
➢ Only since the late 1980s has master’s level
education with a focus on primary care been
available.
➢ AGNP conducts health assessments; identifies
nursing diagnoses; and plans, implements, and
evaluates nursing care for adult and older
patients.
➢ The AGNP has knowledge and skills to detect
and manage limited acute and chronic stable
conditions; coordination and collaboration with
other health care providers is a related essential
function.
➢ The acute care or primary care AGNP’s
activities include interventions for health
promotion, maintenance, and restoration.
➢ AGNPs provide acute or primary ambulatory
care in an independent practice or in a
collaborative practice with a physician; they also
practice in settings across the continuum of care,
including the acute care hospital, subacute care
center, ambulatory care setting, and long-term
care setting.
➢ In most states in the United States, AGNPs hold
prescriptive authority for most drugs.
Terminology
• Geriatrics- from the Greek geras, meaning “old
age,” geriatrics is the branch of medicine that
deals with the diseases and problems of old age.
Viewed by many nurses as having limited
application to nursing because of its medical and
disease orientation, the term geriatrics is
generally not used when describing the nursing
care of older adults.
• Gerontology- from the Greek geron, meaning
“old man,” gerontology is the scientific study of
the process of aging and the problems of older
adults; it includes biologic, sociologic,
psychological, and economic aspects.
• Gerontologic nursing- this specialty of nursing
involves assessing the health and functional
status of older adults, planning and
implementing health care and services to meet
identified needs, and evaluating the effectiveness
of such care. Gerontologic nursing is the term
most often used by nurses specializing in this
field.
• Gerontic nursing- this term was developed by
Gunter and Estes in 1979 and is meant to be
more inclusive than geriatric or gerontologic
nursing because it is not limited to diseases or
scientific principles. Gerontic nursing connotes
the nursing of older persons, the art and practice
of nurturing, caring, and comforting. This term
has not gained wide acceptance, but some view
 it as a more appropriate description of the
specialty.
Global Aging
➢ People aged 65 or older world wide is projected
more than a double.
Aging in the Philippines
Demographic Profile (2018)
➢ 103 million, less than 5% aged 65 years old and
older.
➢ 60 years and older population is expected to
increase by 4.2%, 80 years and older population
by 0.4% from 2010 to 2030.
➢ Population has grown by over 35% in the last 2
decades.
➢ Current expectancy 57.4 years for males, and
63.2 years for female
➢ Female- projected to have 4.0 year increase
➢ Male- 4.7 increase expectancy by 2030
Perceptions regarding Aging
➢ Many Filipinos perceive aging through direct
interactions within their multigenerational
household and community.
➢ Living in such environment shapes perception of
aging as a responsibility with established family
roles, adult workforce engagement, and strong
family social ties.
➢ Older Filipino generally maintain a positive
outlook on aging, considering it a period of
increased productivity and promising experience
despite acknowledge physical decline.
➢ For social resources, especially support from
relatives, contribute positive views of aging
among other Filipinos.
➢ Filipino elders’ perception of aging stem from
their unique life experiences.
Quality of Life
➢ Filipinos who reported higher
socioeconomic status and more
educational attainment also tended to
report better quality of life
➢ Increased age was directly correlated
with better subjective well-being in
Filipino Elder.
➢ Older Filipinos demonstrate reselience
coping with distressing events through
experiences of overcoming challenges.
➢ Higher access to community resources is
linked to better quality of life.
➢ Religion, particularly Christianity, serves
as protected buffer.
➢ Older Filipino view aging as a time of
increased activity and personal
fulfillment.
➢ Late adulthood is seen as opportunity for
creating new relationships and becoming
more engaged in the community.
➢ To enhance kife satisfaction, services
should be equally accessible to older
adults in low income or rural areas.
➢ Barries to accessing community and
heslth support services.
➢ Local government unit can plsy a ole by
offering wellness.
Family Caregiving
➢ Filipinos, Asian culture highly value filial piety
and the responsibility of caring for older adults.
➢ Predominately, catholic nature of Filipino culture
emphasizes family contribution.
➢ Even when living overseas, Filipino may travel
abroad to assist in caregiving for friends or
family.
➢ Caregiver is deeply ingrained in Filipino culture,
failure to provide care or resources to family
members in need is seen as shameful.
➢ Filipino caregivers use family resources for care
provision and less reliant.
➢ Social support that Filipino caregiver receive at
home and in community can migrate the negative
 impact of care recipient problematic behavior on
caregiver strain.
➢ The christian belief system, rooted in
Catholicism, reinforces the expectation that
caregiving is a duty of family members.

Key issues (Social Welfare and Health)

➢ Is a key policy focus for older Filipinos.

➢