Course description
This distance learning course explores the complexity, rewards and challenges of working with the elderly. Theories of aging and expected developmental paths, along with de-mystification of long-held myths and beliefs about aging, will be examined. A key function of this course will be to look at very comprehensive assessment approaches and techniques, both for the elder living in the community, as well as those residing in care facilities. Planning and treatment will be discussed, especially around specific exemplars such as Alzheimer’s Disease, depression, neglect and abuse, and pharmacology – in concert with family and loved ones. Psychiatric nursing roles will be explored as will all levels of prevention. Ethical and legal implications are dealt with at length as well as issues of caregiver support and the needs of individuals, family and friends, and nurses working with patients confronting end-of-life concerns.
Course content
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 and 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 aged
- 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 care settings as well as ones in the community
- primary, secondary and tertiary prevention in both community and inpatient settings
- discharge planning
- rehabilitation nursing, environmental concerns
- nurses as case/care managers
SECTION 3: HEALTH AND AGING
Identify and utilize key concepts related to how:
- elders learn, what their attention span is
- to plan a comprehensive, holistic assessment
- to tailor assessments – being flexible
- the nurse’s attitude and the client’s attitude influence assessments
- language and other barriers affect assessment
- to conduct an holistic, comprehensive assessment
- to perform a physical exam on an elder
- to deal with issues related to social supports, sexuality and spirituality
- to help the older adult avoid falls and other safety hazards
- to avoid the dangers of isolation and inactivity
SECTION 4: OLDER ADULTS AND INPATIENT SETTINGS
Describe and implement concepts and skills related to:
- therapeutic environment, communication and socialization in inpatient settings
- appropriate nutrition, hydration regiments
- avoiding polypharmacy and drug-food interactions
- sleep and rest requirements and stress reduction techniques
- reducing risks for falls, along with identification and prevention of risk factors
- utilizing the OBRA RAI-MDS Tracking form for collection and analysis of assessment information.
SECTION 5: OLDER ADULTS AND THE COMMUNITY
For the exemplar of Depression; Demonstrate a clear understanding of:
- the approaches needed to assess depression in the older adult
- working with elders who are depressed
- utilizing selected tools used in depression screening for older adults
- clinical guidelines for depression and elders
For the caregiver: Describe:
- 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
- the safe promotion 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 drug/substance assessment
SECTION 7: LEGAL AND ETHICAL CONSIDERATIONS
Appreciation and implementation of nursing interventions with respect to:
- patient rights
- a values history
- the role of consent/informed consent as well as advanced directives and wills
- research and consent of older adults engaged in research
- restraints
- 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 issues
- nurses working with individuals facing end-of-life issues
- physical, psychological, emotional, developmental and spiritual needs of the dying patient
- a variety of setting that care for dying individuals
Means of assessment
Evidence of learning is demonstrated through:
- application of concepts to self;
- application of concepts to clinical practice or field work; and
- application of concepts to others.
The selection of evaluation tools for this course is based on:
- Adherence to college evaluation policy regarding number and weighting of evaluations – a course of three credits or more should have at least three separate evaluations
- A developmental approach to evaluation that is sequenced and progressive
- Evaluation is used as a teaching tool for both students and instructors
- Commitment to student participation in evaluation through such processes as self and peer evaluation, and program/instructor evaluation.
Learning outcomes
Upon successful completion of the course the learner will be able to:
- Describe who makes up the gerontological population and confront discrimination for 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 a range of nursing roles in gerontology.
- Conduct and analyze very comprehensive assessments on elders.
- Understand and utilize new data collection and documentation skills, specifically designed for the older adult.
- Plan therapeutic and preventative measures 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, 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 in sensitive ways with families, friends and nurses who have to deal with end-of-life concerns.
Textbook materials
Textbooks and Materials to be Purchased by Students
Elipoulos, C. (2001) Gerontological nursing (5th ed.) Philadelphia. Lippincott
Andrews, Hudson. (2002). PNUR 3723: Psychiatric gerontological nursing. New Westminster, BC, Canada: Douglas College.