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Geriatric care offers a niche for nurses Nurse attending to elderly patient


September 2009

by Rosanne Fohn

Just as Baby Boomers initiated a cultural revolution in the 1960s, they are now redefining health care as they enter their golden years.

Due to medical advances, this generation is expected to live longer and in generally better health than previous generations, despite an increased risk for chronic illness and disability. Because of these health issues and the sheer number of people entering the 65-and-older age range, nursing schools around the country are responding by placing more emphasis on geriatric nursing.

At the UT Health Science Center San Antonio, Anthia Murray, R.N., M.P.H., M.S.N., a clinical instructor in the Department of Chronic Nursing Care, has been adjusting the School of Nursing's curriculum to include national geriatric nursing competencies. The results are innovative programs that include gerontology in all levels of the curriculum.

"I would say we are ahead of the pack because we provide gerontology content and clinical practice at both graduate and undergraduate levels, we have well-prepared faculty with specialization and great interest in aging, and we have a 100 percent pass rate among graduate nursing students taking the certification exam to become gerontological nurse practitioners," said Kelly Dunn, R.N., Ph.D., PHCNS-BC, who teaches the graduate minor in gerontology.

"This is an important indicator of a great academic nursing program," added Dr. Dunn, who is an associate professor and holder of the William F. Castella Distinguished Professorship in the Department of Family Nursing Care.

One way gerontology is being incorporated into the curriculum is the Senior Health Management Project. The pilot, conducted in fall 2007 and spring 2008, was part of the undergraduate Community Health Nursing course, but involved graduate nursing students as well. The undergraduates provide a variety of screenings and health education to help the elders improve their health and safety. The screenings were conducted at two San Antonio minority-based senior centers with funding from the Nursing Advisory Council and in partnership with the Alamo Area Council of Governments and the city of San Antonio Department of Elderly Services.

Graduate students led the undergraduates in collecting data on the types of issues the seniors face regarding safety and management of their health.

"Although this wasn't formal research, we did collect data about the seniors' needs and are planning to return this fall to follow up on the elders' progress and continuing health needs," said Murray, who organized the project in consultation with Dr. Dunn. "We plan to continue collecting data in hopes of receiving funding for more in-depth elder research in the future."

The experience also helped change the students' perceptions about older adults and their health. "We found that students demonstrated an increased understanding of elder health issues, more insight into their daily lives and greater sensitivity to elders' needs,"Murray explained.

Undergraduates kept journals reflecting their thoughts. One wrote, "I think this has helped me to understand how to care for seniors. In clinical practice, I have seen people speak louder than normal to seniors or not teach them at all because they feel that they won't understand. I was very impressed with how knowledgeable the seniors were and that they like to be proactive and informed."

Dr. Dunn, Murray and Della Wagner, M.S.N., RN, assistant professor in the Department of Chronic Nursing Care, are preparing a manuscript describing the project for publication and are evaluating the project for future integration into the curriculum.

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