Students will develop an understanding of the complexity, rewards and challenges of working with the older adult in the context of primary and secondary health care delivery systems. Theories of aging and expected developmental paths, along with de-mystification of long-held beliefs about aging will be examined. Students will develop an understanding of the challenges faced by older adults living in the community, as well as those residing in care facilities. In addition, students will acquire knowledge of treatment modalities and psychiatric nursing care related to mental health and physiological challenges facing the older adult with a focus on specific exemplars such as Alzheimer’s disease, delirium, depression, neglect abuse, and pharmacology. The student will understand the significance of the family and loved ones in planning care for the older adult. The role of the psychiatric nurse in providing care for the older adult at all levels of intervention/prevention will be explored within the context of the Douglas College Psychiatric Nursing Conceptual Framework for Nursing and psychosocial rehabilitation concepts. Ethical and legal implications will be discussed as well as issues of caregiver support and the needs of individuals, families, friends, and nurses working with older adult patients confronting end-of-life concerns.
SECTION 1: FOUNDATIONS
Describe the diversity of the older adult population group, along with pertinent facts and trends regarding:
- common concerns
- demographics, politics and power
- economics & education
- definitions of aging, along with myths and falsely-held beliefs and attitudes
- aging through history, theories of aging and models of care for the older adult
- development and aging
SECTION 2: GERONTOLOGICAL NURSING ROLES
Explain the range of nursing roles and an understanding of:
- the development of gerontological nursing
- principles and standards guiding gerontological nursing
- roles in acute and long term care settings as well as ones in the community
- primary, secondary and tertiary intervention as prevention in both community and inpatient setting
- discharge planning
- psychosocial rehabilitation concepts, environmental concerns
- psychiatric nurses as case/care managers
SECTION 3: HEALTH AND AGING
Identify and utilize key concepts related to how:
- how older adults learn, memory
- to plan care for the older adult, understanding that elder care is a specialized area of practice
- the nurse’s attitude and the client’s attitude influence assessments and care of the older adult
- language and sensory deficits can affect communication and care
- to deal with issues related to social supports, sexuality and spirituality
- to assist the older adult in developing strategies to avoid falls and other safety hazards through the use of prevention as intervention as a strategy
- to assist the older adult in developing strategies to prevent isolation and inactivity
SECTION 4: OLDER ADULTS AND INPATIENT SETTINGS
Describe and implement concepts and skills related to:
- identification of depression
- identification of delirium
- therapeutic environment, communication and socialization in inpatient settings
- appropriate nutrition, hydration regiments
- avoiding polypharmacy and drug-food interactions
- devising ways to ensure the older adult meets his/her sleep and rest requirements
- being able to teach stress reduction techniques to the older adult as well as be able to convey the importance of stress reduction to health living
- reducing risks for falls, along with identification and prevention of risk factors
SECTION 5: OLDER ADULTS AND THE COMMUNITY
For the exemplar of Dementia; Demonstrate a clear understanding of:
- the needs of the caregiver
- the strengths and stressors of the caregiver
- the trajectory of different caregivers’ experiences
- support systems for caregivers
- one example of community partnerships and caregivers
SECTION 6: PHARMACOLOGY AND AGING
Describe and analyze:
- pharmacodynamics, pharmacokinetics in relation to the aged
- age-related risk factors and adverse reactions to drugs and substances
- polypharmacy and the aged, along with food and drug interactions
- prevention of drug and substance abuse
- alternatives to drugs and other chemicals – teaching and learning
- how to respond to drug and substance misuse and abuse
- effective use of selected techniques and tools in substance use assessment
SECTION 7: LEGAL AND ETHICAL CONSIDERATIONS
Appreciation and implementation of nursing interventions with respect to:
- patient rights
- a values history
- the role of informed consent as well as advanced directives and representation agreements
- research and consent of older adults engaged in research
- elder abuse and neglect; along with the prevention of abuse and neglect
SECTION 8: END OF LIFE CONCERNS
Describe and utilize knowledge and interventions pertaining to:
- student’s own experiences with death and end-of-life issues
- family experiences with death and end-of-life concerns
- psychiatric nurses working with individuals facing end-of-life issues
- physical, psychological, emotional, developmental and spiritual needs of the dying patient
- the variety of settings where care for dying individuals can be provided
Methods Of Instruction
Students will acquire knowledge and skill and learn to apply concepts through a variety of means of instruction and activities, including: lecture, demonstration, audio-visual aids, case studies, debate forums, critical thinking exercises and teamwork.
Means of Assessment
The course evaluation is consistent with Douglas College evaluation policy. An evaluation schedule is presented at the beginning of the course.
This is a graded course.
Upon successful completion of the course the learner will be able to:
- Describe who makes up the gerontological population and confront discrimination of the elderly through the examination of long-held, inappropriate myths, beliefs and ageism.
- Articulate theoretical frameworks of aging and models for working with the elderly.
- Explain normal development and aging, along with some selected pathological changes that may occur.
- Consider the range of nursing roles in gerontology
- Understand and utilize new data collection and documentation skills, specifically designed for the older adult within the context of the Neuman Systems Model for Nursing.
- Understand the therapeutic and preventative measures needed for elders and the environments they live in, including hydration and nutrition, fall prevention and socialization.
- Integrate key theory and practice for individuals that present with exemplars such as: dementia, Alzheimer’s, delirium, substance misuse, neglect and abuse of all kinds, as well as depression, pharmacological considerations and others.
- Demonstrate awareness of the key role that psychiatric nurses can play in caregiver support.
- Work knowledgeably and sensitively with families, friends and nurses who have to deal with end-of-life concerns.
A list of required and optional textbooks and materials is provided for students at the beginning of each semester.