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Nursing the elderly - more than just another role

Photo: Health Times
Nursing the elderly should require a specialist qualification as compulsory according to a Griffith University Menzies Health Institute professor.

Professor Wendy Moyle, Program Director, Healthcare Practice and Survivorship Queensland says there is currently no requirement for nurses to study gerontological nursing to work in aged care.

“We would never allow a nurse to work with babies and young children without adequate education and training,” says Professor Moyle.

“I am constantly surprised that we allow nurses with minimum education and training in the specialisation of gerontological nursing to provide nursing care for older adults.”

Alongside ageing, the elderly experience a decline of biological functions and the ability to adapt to metabolic stress, resulting in multiple disease complexities.
“There is the potential for these complexities to be accompanied by psychological and behavioural changes, the development of mental illness and or dementia, and for pharmacological treatments to require revisiting due to physiological changes as a result of ageing.

“Therefore, having a specialisation in gerontological nursing will help to ensure age appropriate nursing care, assessment and treatment, and allow greater work satisfaction.”

Professor Moyle says she believes the lack of regulation may be related to the stigmatisation of ageing and older people being seen as less worthy than younger people.

“Older people are complex and therefore they require specialist nurses to provide appropriate care for them.”

While most nursing degrees provide a generalist understanding of nursing care across the lifespan, many have ageing content covered in just one course or subject and this is often done at a basic level during year one, resulting in minimal devotion to gerontological nursing.

Professor Moyle says many nursing degrees use ageing as a means of helping nursing students understand ‘basic nursing cares’ such as hygiene and attending to activities of daily living.

“Unfortunately, in first year, nursing students do not have an adequate understanding of the physiological changes of ageing to be able to appropriately provide age appropriate care.

“First year nursing students are therefore focused on basic nursing care without the implications of ageing being taken into account.”

As Australia’s populations ages, specialist gerontological nurses are becoming increasingly sought after, particularly within acute care settings.

“The mean age of patients in many acute hospital settings is around 75 years and therefore gerontological nurses can provide guidance to nursing and other health professionals in the care of older adults both pre and post-surgery and also following major illness,” says Professor Moyle.

“Gerontological nurses can work in the community especially in the assessment of older adults and in rehabilitation services, as well as in specialist clinics such as pain and memory clinics and importantly, their services are essential in the assessment, care and treatment of older adults in residential aged care.”

Gerontological nurses are trained in understanding and managing the physiological and psychological changes that occur as we age.  In Australia, gerontological nurses have expertise in mental illness and dementia and therefore this enables them to work in a vast number of settings.

“A gerontological nurse practitioner and a gerontological nurse working in residential aged care settings regularly work in isolation from other health professionals.

“This requires them to have sophisticated skills and knowledge so that they can appropriately advise other health professionals in the care of the older adult.”

Unfortunately, a stigma persists regarding working with the elderly, and there are few gerontological nursing experts in Australia. However, the gap within this field provides an excellent opportunity for those who do choose to embark on this type of specialist training to quickly advance in their careers.

“The Australian population is ageing and therefore having expertise in gerontological nursing will be in demand as older adults will be found in all areas of nursing care,” says Professor Moyle. 

“Older people may be the patient or they may be grandparents in the case of younger families and require support in management of the family.

“If you enjoy trying to understand life history and problem solving then working with older people may be the perfect opportunity for you.

“Older people are living and we want to help them to live a quality of life.

“But they are also dying and specialist gerontological nurses can assist in helping older people to die with dignity and to support families during the process.

“It is a truly rewarding field of specialisation and one where the demand is advancing daily.”

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.