Slide 1Learning OutcomesGerontologyGerontological NursingGerontological NursingGerontological NursingGerontological NursingGerontological NursingGerontological NursingGerontological NursingSlide 11Older Adults in HospitalsOlder Adults Are a Hospital’s CORE BusinessOlder Adults in HospitalsOlder Adults Experience More Adverse or “Never Events”Slide 16Alzheimer's Facts & FiguresDementia + Chronic Illness Compounds Complication RatePatient Outcomes Related to Use of Geriatric Best PracticesKey ConceptsTheories of AgingBiological Theories of AgingCellular FunctioningProgrammed Aging TheoriesError TheoriesClues to AgingPsychological Theories of AgingDevelopmental Theories of AgingPhilosophies of Aging [Dahlke, 2011]Philosophies of AgingSummarySummaryCommunicationAgeism & CommunicationCommunication CompetenciesSensory Impairment in USOlder Adults with Sensory ImpairmentsCommunicating with Older AdultsHealth Literacy & CommunicationKey ConceptsTamatha Arms DNP, NP-C Module 2Gerontological Nursing Theories and Philosophies of AgingCommunicating with Older Adults2Learning Outcomes Identify several factors that have influenced the development of gerontological nursing as a specialty practice. Discuss geriatric nursing resources available to nursing students & practicing RNs Understand the many factors that facilitate or hinder the aging process. Recognize the great diversity of older adults. Discuss strategies to prepare an adequate and competent eldercare workforce to meet the needs of the growing numbers of older people. Identify the major theories and philosophies of aging. Compare and contrast the biological and psychosocial theories of aging.  Explain the rationale for using multiple theories of aging to explain the complex phenomenon of aging. Understand how health literacy affects communications and learning.GerontologyScientific study of the effects of time on human development, specifically the study of older persons.“Geriatrics” coined in 1900 by an American physician who recognized that the medical care of older people involved special considerations.34Gerontological NursingGiven your readings for this week -Consider this comment:“The eldercare workforce is dangerously understaffed and unprepared for the growing numbers of older adults.”What do think the nursing profession is &/or should be doing to address these concerns?5Gerontological NursingWhat aspects of gerontological nursing roles do you think nurses find most gratifying?6Gerontological NursingWhy do so few registered nurses choose gerontological nursing as a field of practice? What factors might encourage more interest in this specialty?7Gerontological NursingIn her article, Dahlke talks about the history of “geriatric nursing” and our profession’s historical interest in the care of older adults.She also states that, “ Health care systems were designed for efficient & rapid recovery of younger peoples’ acute illnesses and thus do not meet the needs of an aging population with chronic illness.” What are your thoughts on this statement?8Gerontological NursingIssues today ---Use of interventional best-practices with older adultsWhy do you think nurses continue to use care strategies that are ineffective or even detrimental to older adults?Basis for our NDx Validation work9Gerontological Nursinghttp://www.nursingcenter.com/lnc/static?pageid=73038810Gerontological NursingSo, how will the aging of the population and its increasing cultural diversity affect nursing practice?http://hartfordign.org/uploads/File/hosp_competencies.pdfLet’s take a look at some data points that will help us answer this question ---11Currently Much of All Health Care Is Devoted to Care of Older Adults57% of all visits to generalist physicians50% of hospital expenditures 80% of home care visits 90% of nursing home care12Older Adults in HospitalsOf all adult patients, people >65 make up:47% of patients with anemia53% of patients receiving respiratory therapy64% of patients with heart disease66% of patients with urinary tract infections70% of patients with pneumonia78% of patients with HF13Older Adults Are a Hospital’s CORE BusinessSlow & progressive “aging” of who occupies hospital bedsMake up 52% of non-obstetric hospital days Longer lengths of stay (7.8 vs. 5.4 days)Higher rates of re-admission within 30 daysDocumented functional declines and medical errors during & after hospitalizations14Older Adults in Hospitals60% of medical-surgical patients46% of CCU patients 50% of ICU days60% of all visits to cardiologists63% of visits to oncologistsIn EDs, 26% of hospital admissions after trauma15Older Adults Experience More Adverse or “Never Events”88% of older people have chronic conditionsCommon adverse events (IOM Report, 1999)Pressure ulcersMedication errorsDeliriumFallsPhysical restraint useHospital Acquired Conditions &/or Infections16Older Adults Most at Risk of Long LOS, Re-Admission, & High ED Use1. Dementia2. Physical and cognitive co-morbiditiesLOS of older patients with dementia and HF, IHD, diabetes, COPD is 3 times longer than for patients with physical illness alone3. Complex diagnosis:10-30% of older patients4. Behavioral problems - 51% of older patients (in one study)17Alzheimer's Facts & FiguresOne in eight people aged 65 and older (13 percent) have Alzheimer’s diseaseEvery 69 seconds, someone in America develops Alzheimer’s. By mid-century, someone will develop the disease every 33 seconds18Dementia + Chronic Illness Compounds Complication Rate19Patient Outcomes Related to Use of Geriatric Best PracticesReduced morbidityDeliriumFallsUse of physical restraintsShorter lengths of hospital staysFewer re-admissions to the hospital & longer time between discharge and re-admissionHigher patient and family satisfactionKey ConceptsAging must be studied as a complex phenomenon with biopsychosocial and spiritual aspects affecting the manner in which an individual ages.Although the population as a whole is aging, the greatest categorical increase by group percentage is occurring among those 85 years old and older.The eldercare workforce is dangerously understaffed and unprepared to care for the growing numbers of older adults.Requirements for accreditation of nursing programs should include solid evidence