While every patient is an individual and should be dealt with as such, there are general differences between age groups, especially at the younger and older ends of the scale.
Older patients, for example, will have health and wellbeing issues associated specifically with aging bodies and their lifestyle. Nurses who deal with this group are called adult-gerontology nurse practitioners. They are specialists in the care of adolescents, adults and the elderly.
The aging population
According to a 2018 report by the United States Census Bureau, people over 65 will make up 21% of the population of the US in 2030, and by 2060 nearly one in four Americans will be 65 years and older. As well as this, the number of people over 85 will triple and it is also estimated that there will be half a million citizens over 100 years old.
Individuals over 85 are the group most often needing assistance with basic personal care, and this will have an impact on healthcare provision and thus increase the need for more specialist nurses. It is also estimated that in 2019 more than 80% of elderly Americans had at least one chronic disease.
This growth in the aging population is not restricted to the US — it is reflected in the global population. A study by the World Economic Forum has found that by 2030 one in six people in the world will be over the age of 60.
Things to consider when looking after older adults
Given that everyone is different, there are strategies that can help nurses to deal with older people. According to the National Institute on Aging, ensuring you communicate well is vital as patients are more likely to stick to their treatments and have better outcomes if they are dealt with effectively by the health professionals looking after them.
For instance, it is important to use the correct language when talking to your patient — they may expect you to talk to them in a more formal way as they could have been brought up to expect that from the professionals they deal with, so it is a good idea to ask them if they prefer to be called Mr, Mrs or Ms, for example, before you start.
Establish rapport right from the beginning of your interaction by taking the time to introduce yourself clearly, and do not speak too quickly. Showing from your initial conversations that you want to listen to their concerns and ensure they are respected could pay dividends in the long run. If you are in a hospital setting, it is a good idea to explain what you do and outline your role. If they have more than one health issue they may be dealing with different individuals and departments.
Using your active listening skills is also important — face the patient, maintain eye contact and respond when necessary to make sure they know you are engaged and interested in what they are saying. Try not to hurry and take the time to talk to them about what is happening, so you can gather information that you need in order to help them with their issue.
Also, talk to people as your equals. The fact that someone is older and possibly frail does not say anything about their intelligence and engagement with the wider world. Keep abreast of popular culture and current information on a variety of subjects so you can chat with people in a casual way in order to break the ice and make them feel at ease.
Think about what you are saying about their condition and their treatment — it is easy to slip into using medical jargon but a term that seems commonplace to you may be unfamiliar to anyone, not just older patients. When you do talk about these things, check they understand what you are saying because being clear about their care plan or diagnosis is vital. It may be worth writing down the important things for them to keep and refer to when they get home.
Make sure older patients are comfortable, whether it be physically providing a nice seat in the waiting room or making them feel more in control by providing help with filling out necessary forms. Some people may also need to be escorted to exam rooms, offices and restrooms, and staff should check on them regularly if they have a long wait for their appointments.
Compensating for hearing loss and visual deficits
Approximately a quarter of people between the ages of 65 and 75, and half of those over 75, have experienced hearing loss, so it is important to take steps to ensure your communication is clear. For instance, check that your patient can hear you — you could ask if they have a working hearing aid or do a brief examination in case they have excess earwax that could impede what they can hear.
Avoid shouting or using a raised voice as this can distort language sounds and could make it appear that you are angry. High-pitched voices can also be difficult to hear. Facing the person directly will help them pick up visual cues or lip read and keeping your hands away from your face whilst you are talking is a good idea. Finally, background noises made by a variety of things such as office equipment can make it difficult for people to hear what you are saying, so trying to find a calm and quiet environment is useful.
Problems with sight become more common as we age, so it is useful to take that into consideration when interacting with new patients. Steps to make the appointment easier include making sure there is adequate lighting, checking that the person you are dealing with has brought and is wearing eyeglasses if they need them, and, when writing instructions, make them clear enough to read. Printed materials should have a clear font and large enough type so everyone can read them easily.
Connecting with other professionals in geriatric healthcare
Connecting with others with an interest in looking after the health of the aging population in order to monitor new developments and updated advice and to link with likeminded individuals and organizations will be a useful thing to do. The American Geriatrics Society, for example, hosts a range of programs including an annual scientific meeting and initiatives to help people with dementia and Alzheimer’s.
Responsibilities of an adult-gerontology nurse practitioner
Adult-gerontology nurse practitioners (AGNPs) look after adolescents, adults and seniors. They can either specialize in acute or primary care — with acute care NPs attending to patients with critical and chronic conditions, and primary care NPs dealing with general healthcare.
Responsibilities could include meeting with patients and assessing and diagnosing illnesses and other conditions. They could also be carrying out physical examinations, interpreting diagnostic tests, prescribing patients either independently or in collaboration with a physician, and diagnosing patients.
Many adult-gerontology primary care practitioners work in long-term care settings, private practices and hospital-based clinics. One of their roles may be to manage the transition between care settings, provide caregiver and patient education and to evaluate the competence of the caregiver.
Becoming an adult-gerontology primary care nurse practitioner
If you have decided that you want to become a nurse practitioner and specialize in looking after adults including seniors, then your first step is to get the right qualifications. The Online MSN Adult-Gerontology at Spring Arbor University will prepare students for their career with an online faith-based program that enables you to study online while working so you can get your degree in your own time.
The BSN to MSN Adult-Gerontology Primary Care Nurse Practitioner program will equip you with the skills and knowledge to care for adolescents, adults and the elderly. For more information on this CCNE-accredited course, which will prepare you to take the ACPC certification exam, contact one of the university’s advisors.
Care of patients in different settings
In a report released in 2019 The American Association of Nurse Practitioners (AANP) said that the most common workplace settings for adult-gerontology nurse practitioners includes outpatient hospitals, inpatient hospitals and private group practice as well as working in home healthcare and Medicare home health problems. They also work in nursing homes, community health centers and long-term care facilities.
So, for any healthcare professionals who want to specialize in working with older patients there are plenty of opportunities. According to the Bureau of Labor Statistics, the employment of nurse practitioners is expected to grow 40% between 2021 and 2031, which is faster than the average for all occupations.