Holistic Guidebook Prepares Nurses for the Growing Geriatric Population

As the number of adults reaching age 65 years and older continues to grow at record pace, most nurses will be caring for older adults and the elderly across care settings. However, few practicing nurses have had formal coursework in gerontological nursing, and many nursing education programs do not teach separate courses in the care of older adults. To fill this gap and prepare practicing nurses and nursing students for the demands ahead, authors Theris A. Touhy, DNP, CNS, DPNAP, and Kathleen F. Jett, PhD, GNP-BC, recently published the fourth edition of Ebersole and Hess’ Gerontological Nursing & Healthy Aging. Annals of Long-Term Care^® (ALTC) had the opportunity to discuss this new resource and its applications for long-term care providers with Touhy and Jett.

ALTC: Please describe the intended audience of this book.

Touhy and Jett: All nurses need to be prepared to care for the growing number of older adults and to have the knowledge and skills to promote healthy aging for people of all ages. Although this text was written specifically with the ADN [Associate Degree in Nursing] and LPN [licensed practical nurse] in mind, it has been useful to the BSN [Bachelor’s of Science in Nursing] student as well. It is also meant to be a resource in the hands of long-term care leaders, particularly Directors of Nursing, who could share it with nursing assistants. The content addresses what we believe is the most basic but essential information that all nurses should have regarding the provision and coordination of care for older adults across settings. The intention was to write it in a straightforward manner in which any “jargon” specific to the field is explained rather than assumed. The text would also be valuable in designing in-service education programs for all levels of staff.

What are the core philosophies of care that provide the foundation for this book?

We use a wellness-based approach throughout the text. The focus is on enhancing wellness and quality of life for older adults in health, illness, and at the time of death. Even in the face of chronic illness, older people should be provided with an environment that maintains or enhances function and supports dignity and personhood. Far too much emphasis is put on illness, disability, and problems rather than on the potential for wellness, even in dying. The book is divided into four sections: Foundations of Healthy Aging; Fundamentals of Caring; Coping with Chronic Disorders in Late Life; and Caring for Elders and Their Caregivers. The document Healthy People 2020 and the framework of Maslow’s hierarchy of needs are prominent.

The Advanced Practice Registered Nurse Consensus Work Group and the National Council of State Boards of Nursing Advanced Practice Registered Nurses (APRN) Advisory Committee has decided to eliminate the gerontological nurse practitioner (GNP) track and its associated national certification exam by 2015. What does the loss of the GNP mean, and how does this book address it?

Advanced care GNPs have demonstrated unique worth and value over the years managing the health and social needs of older adults, particularly in long-term care settings. GNPs have been educated to provide specialty care to persons with complex needs due to the overlays of normal changes with aging, the development or exacerbation of health problems coupled with changing socioeconomic conditions and resources. There are no other advanced practicing nurses who have the depth of preparation for these tasks in the context of complex illness.

We continue to believe that the GNP is as much a specialty as the pediatric nurse practitioner or the women’s health care nurse practitioner and should be recognized as such. However, we also accept the reality that an interest in this field remains highly limited and will never be able to keep up with the need for such care. The new certifications will combine the content of the adult and the gerontological advanced practice preparation (for acute care, primary care, and clinical care), and we hope that this will increase the number of nurses with at least some of the knowledge and skills to meet a burgeoning need in the years to come.

What are the take-home points of the book?

Care for older adults must have a holistic focus—body, mind, and spirit. It is not just about illness. We have solid evidence-based protocols for a range of conditions and care processes that are seen more commonly in later life. Translating this evidence into daily gerontological nursing practice remains a challenge for both the bedside nurse and nursing leaders due to the paucity of formal preparation in this area. We hope that this text helps provides some of the information needed to prevent unnecessary disability and optimize the health of older adults. 

Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 4th Edition was published in March 2013 by Mosby.