Introduction: Nursing care of older people

Geriatric nursing is the specialty that is concerned with the provision of nursing services to geriatric or older people. It is defined as specialized nursing care of older people in any setting in which nurses use their knowledge, expertise and caring abilities to promote optimal functioning of older people.

Nurses are crucial to ensure integrated person-centred health care for older people as direct care providers and care coordinators. They play a key role in deterring ageism and promoting active ageing through improvement in health literacy.

• To provide comprehensive and holistic care to older people
• To promote and maintain the functional status of older people
• To provide emotional and psychological support to older people and caregivers
• To provide emotional and psychological support to older people and caregivers
• To maintain the dignity and functional autonomy of older people
• To develop competency in identifying specific age-related problems and refer for further evaluation, when needed
• To identify the needs and problems of older people and their caregivers

Role of a geriatric nurse

Teacher

A specialist who helps older patients recover from illness or injury by providing practical and patient-centric care plans

Care provider

A specialist who helps older patients recover from illness or injury by providing practical and patient-centric care plans

Evidence-based care

Actively participates in updating and maintaining knowledge through continuous professional development, ongoing educational programmes and research activities to provide evidencebased care

Counsellor

Provides guidance and counselling services to older people, family members and other caregivers in the areas of need

Advocate

Advocates for and with older people and/or families to maintain their quality of life and, at the end of their lives, to experience a peaceful and dignified death

Manager

Supervises care delivered by other staff and the overall management of the hospital/home environment

• Patient (as older patients can get quickly irritated due to their complex health problems and psychosocial issues)
• Compassionate
• Strong attention to detail
• Creative
• Consistent

• Incorporate professional attitudes, values and expectations about physical and mental ageing in the provision of patient-centred care for older people and their families.
• Practice within a framework of professional accountability and responsibility.
• Assess barriers for older people in receiving and understanding the relevant health and rightsrelated information.
• Communicate eff ectively, respectfully and compassionately with older people and their families.
• Use valid and reliable assessment tools to guide nursing practices for older people.
• Conduct a systematic holistic assessment of the needs of older people, based on nursing theory and evidence-based practice, and identify their needs for nursing care.
• Assess the living environment as it relates to the functional, physical, cognitive, psychological and social needs of older people.
• Intervene to assist older people and their support network in achieving personal goals, based on the analysis of the living environment and availability of community resources.
• Identify actual or potential mistreatment (physical, mental, or financial abuse, and/or selfneglect) in older people and discuss with the medical team accordingly.
• Implement strategies to prevent and/or identify and manage geriatric syndromes.
• Facilitate ethical, non-coercive decision-making by older people and/or families/caregivers for maintaining an everyday schedule, receiving treatment, initiating advance directives, and implementing end-of-life care.
• Plan patient-centred care with the older patient and, where appropriate, the family, taking into consideration the therapeutic regimes of all members of the interdisciplinary team.
• Evaluate progress towards expected outcomes and review plans in accordance with evaluation data, in consultation with the older patient or family.
• Advocate for timely and appropriate palliative and hospice care for older people with physical and cognitive impairments.
• Implement and monitor strategies to prevent risk and promote quality and safety (e.g. prevention of falls, medication mismanagement, pressure ulcers) in the care of older patients.
• Utilize resources/programmes to promote functional, physical and mental wellness in older people.
• Apply ethical and legal principles to the complex issues that arise in the care of older people. The ethical principles of autonomy, beneficence, non-maleficence, justice, fairness, truthtelling and confidentiality are all integrated into the provision of nursing care.
• Use technology to enhance functional ability, independence, and safety of older people.
• Facilitate safe and eff ective transitions across diff erent levels of care, including acute, community-based, and long-term care (e.g. home, assisted living, hospice, nursing homes) for older people and their families.