geriatric in nursing

Geriatric Nursing 10 Care Plans (Older Adult)

As our population continues to age, the demand for geriatric care continues to grow. Geriatric nursing care plans are an essential component in ensuring the comfort and well-being of our elderly population. With a focus on personalized care and addressing the specific needs of the elderly, geriatric nursing care plans help nurses to provide the best possible care for their elderly patients.

Use this nursing care plan and management guide to provide care for geriatric clients. Enhance your understanding of nursing assessment , interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of geriatric clients.

Table of Contents

What is gerontology nursing, nursing problem priorities, nursing assessment, nursing diagnosis, nursing goals, 1. promoting safety and preventing falls & injuries, 2. improving gas exchange and respiratory function, 3. managing hypothermia, 4. promoting adequate sleep and improving sleep patterns, 5. restoring bowel function and managing constipation, 6. failure to thrive in older adults, 7. preventing aspiration, 8. preventing fluid imbalance, 9. promoting infection control and minimizing infections, 10. preventing pressure ulcer formation, recommended resources, references and sources.

Gerontology nursing or geriatric nursing specializes in the care of older or elderly adults. Geriatric nursing addresses the physiological, developmental, psychological, socio-economic, cultural, and spiritual needs of an aging individual.

As people age, they require more specialized care and attention to manage the various health challenges they face. Since aging is a normal and fundamental part of life, providing nursing care for elderly clients should not only be isolated to one field but is best given through a collaborative effort that includes their family, community, and other health care team. Through this, nurses may be able to use the expertise and resources of each team to improve and maintain the quality of life of the elderly.

Geriatric nursing care planning centers on the aging process, promotion, restoration, and optimization of health and functions; increased safety; prevention of illness and injury ; facilitation of healing.

Nursing Care Plans and Management

Nursing care planning and management for geriatric patients focuses on promoting optimal health, independence, and quality of life in older adults. It involves comprehensive assessments, addressing age-related changes and chronic conditions, promoting functional abilities and mobility, managing medications and promoting medication safety , providing education on healthy aging practices, and ensuring a safe and supportive environment.

The following are the nursing priorities for geriatric patients:

• Perform assessments and develop individualized care plans for older adults.
• Manage chronic conditions and promote cognitive health.
• Administer medications and treatments.
• Provide education and support for healthy aging.
• Assist with activities of daily living and promote mobility.
• Collaborate with interdisciplinary teams and community resources.
• Implement fall prevention strategies and ensure a safe environment.
• Offer emotional support and counseling.

Assess for the following subjective and objective data :

• Decreased mobility
• Balance issues
• Changes in cognition or memory
• Increased fatigue
• Changes in appetite
• Weight loss
• Sleep disturbances
• Mood changes
• Decreased vision or hearing
• Increased vulnerability to infections and slower wound healing

Following a thorough assessment , a nursing diagnosis is formulated to specifically address the challenges associated with geriatric clients based on the nurse ’s clinical judgement and understanding of the patient’s unique health condition. While nursing diagnoses serve as a framework for organizing care, their usefulness may vary in different clinical situations. In real-life clinical settings, it is important to note that the use of specific nursing diagnostic labels may not be as prominent or commonly utilized as other components of the care plan. It is ultimately the nurse’s clinical expertise and judgment that shape the care plan to meet the unique needs of each patient, prioritizing their health concerns and priorities.

Goals and expected outcomes may include:

• The patient will be free from falls.
• The patient and caregiver will implement measures to increase safety and prevent falls in the home.
• The patient’s respiratory pattern and mental status will be normal for the client.
• The patient’s pulse oximetry or arterial blood gas results will be within the patient’s normal limits.
• The patient’s temperature and mental status will remain within the patient’s normal limits, or they return to the patient’s normal limits at a rate of 1°F/hr, after interventions.
• The patient will obtain adequate rest. The mental status will remain intact for the patient.
• The patient will state that his or her bowel habit has returned to normal within 3 to 4 days of this diagnosis.
• The patient’s stool will appear soft, and the patient will not strain in passing tools.
• The patient will exhibit or verbalizes improvement in at least one of the following: increased functional ability, sense of hopefulness, weight gain , increased appetite, and peaceful death.
• The patient will swallow independently without choking.
• The patient’s airway will be patent and lungs are clear upon auscultation both before and after meals.
• The patient’s mental status, vital signs, and urine specific, color, consistency, and concentration will remain within normal limits for the patient.
• The patient’s mucous membranes will remain moist, and there is no “tenting” of skin.
• The patient’s mentation will return to normal for the patient within 3 days of therapy.
• The patient will be free from injury or harm as a result of mental status.
• The patient will remain free of infection as evidenced by orientation to person, place, and behavior within the patient’s normal limits; respiratory rate and breathing pattern within the patient’s normal limits; urine that is clear, has a straw-yellow color, and of characteristic odor; core temperature and heart rate within the patient’s normal limits; sputum that is clear to whitish in color, and skin that is intact and of normal color and temperature for the patient.
• The patient’s skin will remain non-erythemic and intact.

Nursing Interventions and Actions

Therapeutic interventions and nursing actions for geriatric patients may include:

Injury and fall prevention for geriatric patients involves several strategies, including conducting comprehensive assessments of the patient’s mobility, strength, and balance, implementing environmental modifications to reduce hazards, such as removing tripping hazards and improving lighting, providing assistive devices for mobility support, educating patients and caregivers on safe ambulation techniques, and promoting regular exercise programs to improve strength and flexibility. Reviewing and adjusting medication regimens to minimize side effects that could increase the risk of falls and ensure regular eye and hearing exams should be taken in consideration to address any sensory impairments that may contribute to falls.

Identify factors that increase the level of fall risk These factors will help in determining interventions necessary for the patient. Risk factors include age, presence of an illness, sensory and motor deficits, medication use, and inappropriate use of mobility aids.

Assess the patient’s environment for factors associated with an increased risk for falls. A patient who is not familiar with the placement of furniture in an area or who has inadequate lighting in the house increases the risk for falls.

Monitor the baseline level of consciousness (LOC) and neurologic status of the patient upon admission. Evaluate the mental status and pre- confusion functional abilities of the caregiver or significant others. Ask the patient to complete a three-step task. For example, “Put your right hand on your chest, wave with your left hand, and then raise your eyebrows” A component of the Mini-Mental Status Examination, this assessment tool provides a baseline for succeeding evaluation of a patient’s confusion . A three-step task is complex and is a gross indicator of brain function. Because it requires attention, it can also test for delirium .

Utilize the confusion assessment method (CAM) to determine the presence or absence of delirium/ confusion . Delirium is a serious problem for hospitalized older individuals and usually goes not identified. The CAM tool (Waszynski, 2007) can be administered in a short period of time. CAM is a simple standardized tool that can be used by bedside clinicians and has been validated in settings from medical- surgical areas to intensive care units. If your agency does not already employ this tool, there are several online sources that describe it in detail.

Determine the cause of acute confusion . Acute confusion is caused by physical and psychosocial conditions and not by age alone. For example, oximetry or arterial blood gas ( ABG ) values may reveal low oxygenation levels, serum glucose or fingerstick glucose may reveal high or low glucose levels, and electrolytes and complete blood count (CBC) will ascertain imbalances and/or presence of elevated white blood cell (WBC) count as a determinant of infection. Hydration status may be evaluated by pinching over the sternum or clavicle for turgor (tenting occurs with fluid volume deficit ) and observing for dry mucous membranes and a furrowed tongue.

Test short-term memory by showing the patient how to use the call light, having the patient return the demonstration, and then waiting at least 5 minutes before having the patient demonstrate the use of the call light again. Record the patient’s actions in behavioral terms. Describe the “confused” behavior. The inability to retain information beyond 5 minutes signifies poor short-term memory.

Assess the apical pulse and inform the physician of a newly discovered episode of an irregular pulse. If the patient is hooked on a cardiac monitor or telemetry, check for dysrhythmias; inform the physician accordingly. Dysrhythmias and other cardiac abnormalities may cause poor brain oxygenation , which can result in confusion.

Monitor the patient’s pain using a rating scale of 0-10. If the pain scale is not possible, assess for nonverbal cues such as frowning, grimacing, rapid blinking, clenched fists, and fidgeting. Ask for some assistance from the significant other or caregiver to help in identifying pain behaviors. Acute confusion can be a sign of pain.

Treat the patient for pain, as indicated, and monitor behaviors. If the pain is the cause of the confusion, the patient’s behavior should change accordingly.

Monitor intake and output every 8 hours. The output should equal intake. Dehydration can lead to acute confusion.

Assess kidney function by reviewing the patient’s creatine clearance result. Renal function plays an essential role in fluid balance and is the main mechanism of drug clearance. Blood urea nitrogen (BUN) and serum creatinine are influenced by hydration status and in older individuals show only part of the picture. Hence, to fully understand and assess renal function in older patients, creatine clearance must be examined.

Review current medications, including over-the-counter (OTC) drugs, with the pharmacist. High levels of some medications, such as digoxin , anticholinergic agents , and drug interaction can cause acute confusion.

If the patient has short-term memory problems, toilet or offer the urinal or bedpan every 2 hours while awake and every 4 hours during the night. Establish a toileting schedule and post it on the patient care plan and, inconspicuously, at the bedside. A patient with a short-term memory problem cannot be assumed to use the call light.

Keep the patient’s urinal and other routinely used items within easy reach for the patient. A confused patient may wait until it is too late to ask for help with toileting .

Have the patient wear glasses and hearing aid, or keep them close to the bedside and within easy reach for patient use. Glasses and hearing aids are likely to aid in reduced sensory confusion.

Encourage the patient’s significant other to bring items familiar to the patient, including a blanket, bedspread, and pictures of family and pets. Familiar objects may facilitate orientation while also producing comfort .

Check on the patient at least every 30 minutes and every time you pass the room. Place the patient close to the nurses’ station if possible. Provide an environment that is nonstimulating and safe. A confused patient requires additional safety precautions.

Attempt to reorient the patient to his or her environment as needed. Keep a clock with large numerals and a huge print calendar at the bedside; verbally remind the patient of the date and day as needed. Reorientation may lessen confusion.

Provide music but not TV. Patients who are confused about the place and time usually think the action seen on TV is occurring in the room.

Tell the patient in simple terms what is occurring. For example, “I will take your blood pressure on your left arm,” “This food given to you is healthy,” or “I’ll help you walk towards the prayer room.” Complex sentences may be hard to understand.

If the patient exhibits hostile behavior or misperceives your role (e.g., the nurse becomes a janitor or police), leave the room. Come back in 15 minutes. Introduce yourself to the patient as if it is your first time meeting. Start the conversation anew. Patients who are acutely confused have poor short-term memory and may not retain the previous encounter or that you were involved in that encounter.

If the patient becomes aggressive, hostile, or argumentative while you are trying to reorient, stop this approach. Do not question the patient or the patient’s understanding of the environment. State, “I get why you may seem to think about that.” This approach avoids the escalation of anger in a confused person.

If the patient has a permanent or severe cognitive deficit, check on her or him at least every 30 minutes and reorient to baseline mental status as indicated; however, do not question the patient about his or her understanding of reality. Arguing can cause a cognitively impaired person to become hostile and combative. Note: Individuals with severe cognitive (e.g., Alzheimer’s disease or dementia ) also can experience acute confusional states (i.e., delirium) and can be returned to their baseline mental state.

If the patient tries to leave the hospital, walk with him or her and attempt distraction. Ask the patient to tell you about the destination. For example, “That seems to be an interesting place! Can you describe it?” Keep your tone friendly and conversational. Resume walking with the patient away from doors and exit around the unit. After a few minutes, attempt to lead the patient back to the room. Offer snacks and naps. Distraction is a proven measure of reversing a behavior in a patient who is confused.

Have the patient’s significant others talks with the patient by phone or come in and sit with the patient if the patient’s behavior requires checking more regularly than every 30 minutes. These interventions by the significant other may help promote the patient’s safety.

If the patient tries to climb out of bed, offer a urinal or bedpan or assist to the commode. The patient may need to use the toilet.

Alternatively, if the patient is not on bedrest, place him or her in a chair or wheelchair at the nurses’ station. This action facilitates extra supervision to promote a patient’s safety while also supporting stimulation and limiting isolation .

Bargain with the patient. Attempt to establish an agreement to stay for a fixed period, such as until the health care provider, meal, or significant other comes. This is a delaying approach to mitigate anger. Due to poor memory and attention span, the patient may forget he or she wanted to leave.

If the patient is attempting to pull out tubes, hide them. Put a stockinette mesh dressing over intravenous (IV) lines. Secure feeding tubes to the side of the patient’s face using paper tape, and drape the tube behind the patient’s ear. Remember: Out of sight, out of mind.

Use medications being prescribed carefully for managing behavior. Follow the maxim “start low and go slow” with medications because older patients can respond to a small number of drugs. Neuroleptics, such as haloperidol , can be used effectively in calming patients with dementia or psychiatric illness (contraindicated for individuals with Parkinsonism). However, if the patient is experiencing acute confusion or delirium, short-acting benzodiazepines (e.g., lorazepam) are more effective in alleviating anxiety and fear . Anxiety or fear usually promotes destructive or dangerous behaviors in acutely confused older patients. Neuroleptics can cause akathisia, an adverse drug reaction characterized by increased restlessness.

Use restraints with caution and according to hospital policy. Patients tend to become more agitated when wrist and arm restraints are applied.

Evaluate the continued need for certain interventions. Some interventions may become irritating stimuli. For example, if the patient is now drinking, terminate the IV line; If the patient is eating, remove the feeding tube ; if the patient has an indwelling urethral catheter, remove the catheter and start a bladder training.

Secure a wristband identification to warn healthcare providers to implement fall precautions on the patient. Healthcare providers need to recognize patients at high risk for falls to implement measures to promote patient safety and prevent falls.

Place assistive devices and commonly used items within reach. Provides easy access to assistive devices and personal care items. Items such as call bells, telephones, and water should be kept close to avoid frequent reaching.

Review hospital protocols regarding transferring a patient. Hospital facilities should have clear policies and procedures during transfers that will ensure the patient’s safety.

Keep the patient’s bed in the lowest position at all times. Keeping the bed closer to the floor prevents injury and the risk of falls.

Answer the call light as soon as possible. This is to prevent an unstable patient from ambulating without any assistance.

Use side rails on the bed as needed Raising the side rails reduces the risk of patients falling out of bed during transport.

Advise the patient to wear shoes or slippers with non-slip soles when walking. Wearing non-slip footwear help prevents slips and falls.

Orient the patient to the surroundings. Avoid rearranging the furniture in the room. The patient should be familiarized with the bed, location of the bathroom, furniture, and other environmental hazards that can cause older patients to trip or fall.

Ensure the patient’s room is well-lit. Consider the use of a bedside lamp that is turned on at night. Providing lighting in key places can reduce fall risk and avoid obstacles during mobility.

Encourage the family and other significant others to stay with the patient at all times. Prevents the patient from accidentally falling or pulling out tubes.

Ensure the patient’s eyesight is regularly checked and explain the importance of wearing eyeglasses if needed. Make sure glasses and hearing aids are always worn. Hazard can be lessened if the patient utilizes appropriate aids to improve visual and auditory orientation to the environment. Visually impaired patients are at high risk for falls.

Instruct the patient how to ambulate at home, including using safety measures such as handrails in the bathroom. Help relieve anxiety at home and eventually decreases the risk of falls during ambulation .

Encourage the patient to engage in a program of regular exercise and gait training. Exercise can improve muscle strength, balance, coordination , and reaction time. Physical conditioning reduces the incidence of falls and avoids injury that is sustained when a fall happens.

Collaborate with other healthcare teams to assess and review patient’s medications that can contribute to the risk for falls. Identify the peak effects of the medications that can alter the consciousness of the patient. A review of the patient’s prescribed medications will recognize side effects and drug interactions that may enhance fall injury risk . The more medications a patient takes, the greater the risk for side effects and interactions such as orthostatic hypotension , dizziness, confusion, urinary incontinence , and altered gait and balance. Polypharmacy in older adults is a significant risk factor for falls.

Evaluate the need for physical and occupational therapy to assist the patient with gait techniques and provide the patient with assistive devices for transfer and ambulation . Initiate a home safety evaluation as needed. The use of gait belts provides a more secure means to safely assist patients when transferring from bed to chair. Assistive aids such as wheelchairs, canes, and walkers allow the patient to have stability and balance during ambulation. High toilet seats can facilitate safe transfer on and off the toilet.

Gas exchange and respiratory function in geriatric patients may be compromised due to age-related changes such as decreased lung elasticity, reduced chest wall compliance , and decreased respiratory muscle strength. These changes can result in decreased lung capacity, impaired cough reflex, and increased susceptibility to respiratory infections.

Monitor and record the following during admission and routinely thereafter: respiratory rate, depth, and pattern; breath sounds, cough , sputum, and mental status. Provides baseline data for subsequent assessments of the patient’s respiratory system.

Assess subtle changes in the patient’s behavior or mental status e.g., anxiety, disorientation , hostility, and restlessness. Check oxygen levels using pulse oximetry (higher than 92%) or reviewing ABG values (optimally Pao 2 80%-95% or higher). These changes in the sensorium can indicate decreasing oxygen levels. To comprehensively monitor pulse oximetry, the hemoglobin (Hgb) must be determined. Patients with low hemoglobin levels can have a higher pulse oximetry level and still exhibit acute confusion or restlessness. This happens as a result of diminished hemoglobin to deliver oxygen through the body.

Auscultate the lungs for adventitious sounds. When people get older, lung elasticity decreases. The lower portion of the lung is not sufficiently aerated resulting in the occurrence of crackles (usually heard in individuals 75 years of age and above). This sign alone does not imply the presence of a disease condition. Crackles (rales) that do not clear with coughing in an individual with no additional symptoms such as increased temperature, increasing anxiety, changes in sensorium, and increasing respiratory depth are considered benign.

Encourage breathing and coughing exercises . Instruct patient in the use of incentive spirometry if applicable. These measures provide alveolar expansion and remove the secretions from the bronchial tree, resulting in optimal gas exchange .

Encourage increased fluid intake (greater than 2.5 liters daily) unless contraindicated by a renal or cardiac condition. Adequate hydration promotes the mobilization of secretions.

Treat hyperthermia immediately, reduce pain, lessen pacing activity, and decrease anxiety. These measures decrease the demand for increased oxygen consumption.

Teach the patient the use of support devices such as nasal cannulas or oxygen masks. Knowledge about these medical devices promotes adherence to the treatment.

Hypothermia is a significant concern for geriatric patients due to age-related changes in thermoregulation and reduced ability to maintain body temperature. Geriatric patients often have decreased subcutaneous fat, diminished muscle mass, and impaired thermoregulatory responses, making them more susceptible to rapid heat loss and difficulty in maintaining a stable body temperature.

Monitor temperature through the use of a low-range thermometer if available. This assessment will indicate the presence of hypothermia. The normal temperature of an older adult is 35.5°C (96°F).

Monitor oral temperature by placing the tip of the thermometer far back in the patient’s mouth . Oral temperature provides the most accurate reading of a patient’s core temperature.

Assess and record the mental status of the patient. Increasing disorientation, altered sensorium, or atypical behavior may indicate hypothermia.

Watch out for the use of sedatives, muscle relaxants, and hypnotics (including anesthetics). These pharmacologic therapies can decrease shivering, hence putting patients at risk for environmental hypothermia. Furthermore, elderly people are at risk for environmental hypothermia at ambient temperatures of 22.22°-23.89°C (72°-75° F)

Make sure to give blankets to patients undergoing testing or x-ray examination. This measure will keep the patient warm and will help avoid hypothermia.

Initiate slow rewarming if the patient is mildly hypothermic. Increasing the room temperature to at least 23.89°C (77.5°F) is one method to reverse mild hypothermia. Additional measures include the use of warm blankets, head covers, and warm circulating air blankets.

Warm the patient internally by providing warm oral or IV fluids if the patient’s temperature drops below 35°C (95°F). This method is done to reverse moderate to severe hypothermia. Other methods include warmed saline gastric or rectal irrigations or the introduction of warmed humidified air into the airway.

Watch out for signs of excessive rapid rewarming. Irregular HR, dysrhythmias, and very warm extremities caused by vasodilation in the periphery, which causes heat loss from the core are some of the signs of excessive rapid rewarming.

Once the patient’s temperature fails to increase by 1°F/hr using these methods, anticipate laboratory request for WBC count for possible sepsis , glucose level for hypoglycemia , and thyroid test for hypothyroidism . Causes aside from environmental factors may be responsible for hypothermia.

Administer antibiotics as prescribed for sepsis, glucose for hypoglycemia , or thyroid therapy. Treating the underlying condition will help the patient’s temperature to return to normal.

Sleeping patterns in geriatric patients may be affected by various factors, including physiological changes, comorbidities, medication side effects, and environmental factors. It is common for older adults to experience changes in sleep architecture, such as decreased deep sleep and increased awakenings during the night.

Assess and record the patient’s sleeping pattern, gathering information from the patient’s significant others or caregiver. Elderly people usually sleep less than they did when they were younger and often awaken more frequently at night.

Gather inquiries regarding activity level and nap. Persons with a low level of activity and who take naps frequently sleep only 4 to 5 hours per night.

Monitor the patient’s activity level. If the patient complains of being tired after activities or displays behaviors such as irritability, yelling, or shouting, encourage napping after lunch or early in the afternoon. Otherwise, discourage daytime napping, especially in the later afternoon, because it can interfere with nighttime sleep.

Identify the patient’s typical nighttime routine and try to follow it. Emulating the typical nighttime rituals may promote sleep.

Try to arrange activities together such as doing vital signs, taking medication, and toileting . This lessens the frequency of interruptions and promotes rest and sleep.

Refrain the patient from drinking caffeinated coffee, cola, and tea after 6 pm. The effect of stimulants includes increased alertness, insomnia , and frequent nighttime awakenings to urinate.

Provide a calm and quiet environment and lessen interruptions during sleep hours. Exposure to bright lights, unnecessary noises, snoring roommates, and loud talking can result in sleep deprivation. Use of white noise sound generators may facilitate sleep.

Administer pain medications as ordered, provide back rub, and have a pleasant conversation at sleep time. These interventions promote comfort and thus enhance sleep.

Bowel function and constipation are common concerns among geriatric patients due to age-related changes, comorbidities, and medication use. As individuals age, there is a natural decline in the efficiency of the digestive system , leading to potential alterations in bowel habits. Constipation, characterized by infrequent or difficult bowel movements, can significantly impact the quality of life for older adults.

During admission, assess and record the patient’s normal bowel elimination pattern (frequency, time of day, associated habits, and previous measures to manage constipation). Discuss with the patient’s significant others or caregiver if the patient cannot provide this information. This assessment sets a baseline and identifies the normal bowel elimination pattern of the patient.

Quantify the amount of roughage to the severity of constipation. Excessive roughage taken too rapidly can cause gas, bloating, and diarrhea .

Assess hydration status for signs of dehydration . Maintain diet, fluid, activity, and continuation of routines. If there is an absence of bowel movement within 3 days, start with mild laxatives to attempt to reattain the normal bowel pattern. The use of osmotic medications can result in dehydration . Fluid volume deficit can result in hard stools, which are more difficult to pass.

Inform the patient that changes happening during hospitalization may increase the risk of constipation. Allow the patient to use effective nonpharmacologic management practiced at home as this problem is observed or prophylactically as needed. Constipation is not difficult to handle preventively as it is when present or prolonged.

Educate the patient about the connection between fluid intake and constipation. Encourage fluid intake (2500 ml/day) unless contraindicated. Assess and record bowel movements (amount, date, time, consistency). Increased consumption of fluids can make the stool soft and lessens the risk of constipation. Patients with renal, cardiac, or hepatic diseases may have a fluid restriction.

Instruct the patient to include roughage in every meal when possible. For patients with low tolerance to raw foods, encourage intake of bran via cereals, bread, and muffin. Having a roughage (raw fruits and vegetables, whole grains, legumes, nuts, fruits with skin) in the diet adds bulk to the stool, therefore, minimizes episodes of constipation.

Educate the patient about the connection between activity level and constipation. Support optimal activity for all patients. Institute and build an activity program to foster participation; include devices necessary to enable independence. Regular exercise stimulates peristaltic movement thus it can reduce or prevent constipation.

Encourage the patient to use his or her gastrocolic or duodenocolic reflex to promote colonic emptying, if the usual bowel movement happens in the early morning. If the patient’s bowel movement occurs in the evening, ambulate the patient just before the right time. Scheduling interventions that correspond with the bowel habits of the patient are more likely to increase bowel movements. Taking warm liquids in the morning, for example, also promotes peristalsis . Digital stimulation of the inner anal sphincter can trigger a bowel movement.

Try to use the patient’s previously effective measures. Follow the maxim “start low, go slow” (i.e., apply the lowest level of non-natural intervention and progress gently to a more powerful intervention). Aggressive measures may lead to rebound constipation and can hinder subsequent bowel movements.

When giving pharmacologic therapy to the patient, administer the more benign, oral methods first. The following hierarchy of laxatives is recommended:

• Bulk-forming additives such as bra, methylcellulose, psyllium
• Mild laxatives (apple or prune juice, Milk of Magnesia)
• Stool softeners (docusate calcium , docusate sodium )
• Potent laxatives or cathartics (senna, bisacodyl, cascara sagrada)
• Medicated suppositories (glycerin, bisacodyl)
• Enema (tap water, saline, sodium phosphate/biphosphate)

Older persons tend to focus on the loss of habit as an indicator of constipation rather than on the number of stools. Do not intervene pharmacologically until the older adult has not had a stool for three days.

Administer laxatives as ordered after diagnostic imaging of the gastrointestinal tract with the aid of barium. Laxatives are administered to facilitate barium removal. This will prevent rebound constipation due to severe disruption of bowel habits during the prep

Adult failure to thrive is a complex condition observed in geriatric patients that is characterized by unintentional weight loss , a decline in functional abilities, and an overall decline in health status. It is often multifactorial and can result from a combination of physical, psychological, and social factors. This condition poses significant challenges for both patients and nurses as it can lead to increased morbidity and mortality.

Conduct a comprehensive physical assessment . Evaluate the condition of chronic disease. A thorough system assessment provides a baseline for succeeding comparisons.

Examine laboratory and other studies such as CBC with differential, albumin, pre-albumin levels, thyroid-stimulating hormone (TSH), and basic metabolic panel (BMP). A study of laboratory information determines nutrients and electrolyte imbalances important for basic body function, protein status and thyroid function, and presence/absence of infection.

Gather essential information about the patient’s history; involve the caregiver as needed. Assess critical factors such as the death of a spouse or family member. Taking a patient’s history that concentrates on the timing of the change in behaviors and appetite, medications, and a reduction in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) will help determine contributing factors to the drop in function. Examples of these factors include depression, dementia , pain, and decreased sense of taste or smell.

Allow the patient to vent feelings of fear, anger, despair, frustration, and concerns about hospitalization and health. Supporting the patient and acknowledging that these feelings are normal often help lessen feelings of despair.

Explain age-related changes to the patient and significant others. When an individual normally ages, their physiologic reserve declines and affects multiple systems. Failure to thrive can occur from the interaction of three components: physical frailty, disability or decline in functional ability, and impaired neuropsychiatric function.

Frailty is defined as a state of increased vulnerability caused by a diminished physiologic reserve affecting multiple systems.

Disability is defined as difficulty or decrease in performing ADLs.

Neuropsychiatric impairment is a complex phenomenon that can occur from life circumstances leading to depression, physiologic disruption leading to delirium, or neurologic changes resulting in cognitive impairment .

Collaborate with other health care providers as needed.

• Speech therapists and dieticians They can help address issues such as swallowing or inadequate food and fluid intake.
• Physical and occupational therapist They can help assess physical strengths/limitations and the potential for improvement with a program or assistive tools.
• Social Services They can help assess support networks and readiness for end-of-life possibilities.

Aspiration, a common concern in geriatric patients, occurs when foreign substances, such as food or fluids, enter the airway and lungs instead of the digestive tract. This can lead to respiratory complications, such as pneumonia , and pose significant health risks for older adults.

Evaluate the patient’s swallowing reflex by putting your thumb and index finger on both sides of the laryngeal prominence and instruct the patient to swallow. Assess the gag reflex by gently touching one side and then the other palatal arch with a tongue blade. Record these findings. The ability to swallow and an intact gag reflex are important to avoid aspiration and choking before the patient puts foods/fluids in the mouth.

Monitor food intake. Record the patient’s food consumption (including amount and consistency), where the patient puts food in the mouth, how the patient manipulates or chews prior to swallowing, and the duration of time before the patient swallows the food bolus. This information can be useful for some caregivers during the succeeding feedings.

Monitor the patient during swallowing. This evaluation will help assess the patient’s swallowing ability without choking. Deficiencies may require aspiration precautions.

Monitor the patient for choking or coughing before, during, or after swallowing. Choking or coughing can happen within a few minutes following food or fluid placement in the mouth and indicates the aspiration of material into the airway.

Check for a wet or gurgling sound upon speaking after the patient swallow. Wet-sounding speech may signal a pulmonary aspiration and can indicate restricted or absent gag and swallow reflex.

Assess the patient for breath sound abnormalities (e.g., crackles [rales], rhonchi, wheezes), shortness of breath , dyspnea , cyanosis, increasing temperature, and a deteriorating level of consciousness). These are indicative of silent aspiration . For example, elder patients are at higher risk for silent aspiration since their sphincter fails to close completely between swallows.

Watch out for food retention on the sides of the mouth. This can signal poor tongue movement.

Check for drooling of saliva or food or the inability to close the lips when using a straw. These are signs of restricted jaw, lip, or tongue movement.

Anticipate a video fluoroscopic swallowing exam (VFSE) or modified barium swallow exam (MBS) to evaluate the patient’s gag and swallow reflexes This non-invasive procedure is used to determine whether patients are aspirating, the consistency of foods and liquid most likely to be aspirated, and the aspiration cause. Using four consistencies of barium, the radiologist and speech therapist check for the presence of decreased or impaired tongue function, reduced peristalsis in the pharynx , delayed or absent swallow reflex, and restricted ability to close the epiglottis that guards the airway.

Based on the results of the swallowing video, fluoroscopy, and thickened fluids may be prescribed. Thickening agents are added to the fluid to increase its viscosity and improve swallow safety. Likewise, mechanical soft, pureed, or liquid diets may be ordered to permit patients to take in food with a low risk for aspiration .

Anticipate the need for a speech therapist as indicated. This collaboration will address the problem of gag and swallow reflexes.

Tilt the head forward 45° during swallowing for patients with impaired swallowing reflexes.

Note: Tilt the head toward the unaffected side for patients with hemiplegia. This head position will help prevent inadvertent aspiration by closing off the airway.

Encourage adequate rest periods prior to meals. Low energy or exhaustion raises the risk of aspiration.

Put the patient in an upright position with the chin tilting down slightly during eating or drinking, and place pillows on the side to maintain the upright position. This position lessens the possibility of choking and aspirating by closing off the airway and promoting a gravitational flow of foods and fluids into the stomach and through the pylorus.

Make sure that the patient’s denture fits properly and stays in place. Chewing well decreases the risk of choking.

Instruct patients with dementia to chew and swallow with every bite. Watch out for retained food between the sides of the mouth. A patient with dementia tends to forget to chew and swallow.

Allow sufficient time for the patient to finish eating and drinking. Usually, patients with swallowing problems need twice as much time for eating and drinking as those whose swallowing is intact.

Allow someone to stay with the patient during meals or fluid intake. Promotes safety in case of choking or aspiration.

Encourage breathing and coughing exercise every 2 hours while awake and every 4 hours during the night. These measures facilitate lung expansion and help avoid infection.

Have the suction machine available in case of aspiration. Suction equipment should be readily available at the bedside, especially for patients with a high risk for aspiration.

If aspiration occurs, do the following measures:

• Assess indications of a complete airway obstruction based on the American Heart Association (AHA) guidelines such as signs and symptoms of poor air exchange, cyanosis, and inability to speak or breathe. Complete airway obstruction requires immediate intervention.
• Assess for any alterations in the breathing pattern and respiratory rate every 1-2 hours following a suspected aspiration. This assessment helps determine that a change in the patient’s condition has occurred.
• Encourage a patient with partial airway obstruction to forcefully cough as possible. This measure will relieve and clear the airway.
• Suction the airway using a large-bore catheter (e.g., Yankauer or tonsil suction tip) for unconscious or nonresponsive patients with partial airway obstruction. Suctioning will remove the obstruction.
• For either a complete or partial aspiration, notify the health care provider and get a request for a chest x-ray examination. X-ray findings and results will confirm if food or fluids obstruct the airway.
• Institute nothing by mouth (NPO) status until a diagnosis is established. NPO will lessen the risk to the patient.
• Anticipate the use of antimicrobial agents. A possibility of the occurrence of aspiration pneumonia .

Maintaining fluid balance is essential for the overall health and well-being of geriatric patients. Age-related changes, comorbidities, and medication use can impact fluid balance, leading to dehydration or fluid overload . Understanding the unique considerations of fluid balance in older adults and implementing appropriate interventions is important to prevent complications and promote optimal hydration status in this population.

Assess and record the amount, color, and frequency of any fluid output, including urine, diarrhea , emesis (vomit), or other drainages. This assessment allows a comparison of intake to output amounts. Dark-colored urine signals concentration and hence dehydration.

Assess and record skin turgor . Check hydration status by gently pinching a fold of skin over the forehead, clavicle, sternum, or abdomen. Skin that is prone to tenting usually signals dehydration. A furrowed tongue signifies severe dehydration.

Monitor fluid intake. Encourage fluid intake of 2-3 liters per day unless contraindicated. Indicate intake goals for the day, evening, and night shift s. These measures help to ensure proper and adequate hydration. Restrictions may apply to patients suffering from cardiopulmonary and renal disorders.

Assess the level of consciousness including orientation, ability to obey commands, and behavior. Inability to obey commands, decrease in orientation, and disorderly behavior can indicate dehydration.

Weigh the patient daily at the same time of day (usually prior to breakfast) using the same scale and clothing. Utilizing comparable measurements guarantees more valid comparisons. Wide variations in weight (e.g., 2.5 kg [5lb] or greater) can indicate increased or decreased hydration status.

Assess the patient’s ability to take and drink fluids by himself or herself. Put fluids within easy reach. Utilize cups with lids to lessen concern over spilling. These measures eliminate barriers to adequate fluid intake.

Monitor intake & output, especially for a patient receiving tube feedings or contrast medium. Check for evidence of third spacing of fluids, including increasing peripheral edema , especially sacral; output significantly less than intake (1:2); and decrease urine output (less than 30 ml/hr). These agents act osmotically to pull fluid into the interstitial tissue.

If the patient is on IV infusions, evaluate cardiac and respiratory status for signs of fluid overload . Assess the apical pulse and auscultate the lungs during vital signs monitoring. A fluid overload could lead to heart failure or pulmonary edema . Increasing heart rate (HR), crackles, and bronchial wheezes can be indicative of heart failure or pulmonary edema .

In dehydrated patients, anticipate a rise in serum sodium , blood urea nitrogen, and serum creatinine levels. An increase in these laboratory values is usually common with dehydration.

Ensure easy access to the toilet, urinal, commode, or bedpan at least every two (2) hours when the patient is awake and every four (4) hours at night. Answer the call light immediately. The duration between the acknowledgment of the need to void and urination declines with age.

Whenever in the room, give the patient fluids. Offer a variety of liquids the patient prefers, but limit caffeine since it acts as a diuretic . Aging individuals have a reduced sense of thirst and need encouragement to drink.

Geriatric patients are prone to infection due to age-related changes in the immune system, known as immunosenescence, which can impair the body’s ability to fight off infections. Underlying medical conditions, such as chronic diseases and impaired organ function, can further weaken the immune system. Age-related changes in skin integrity , decreased mobility, and increased use of invasive medical procedures also contribute to the higher risk of infections in geriatric patients.

Monitor baseline vital signs, including the level of consciousness and orientation. In addition, watch out for a heart rate greater than 100 bpm and a respiratory rate higher than 24 breaths per minute. Auscultate lung fields for adventitious sounds. Be aware, however, that crackles (rales) may be a normal finding when heard in the lung bases. Acute changes in mental status are indicative signs of infection in older individuals. Other signs of infection include increased heart rate and respiratory rate. Adventitious breath sounds may or may not be present until the late stages of the illness.

Assess the patient’s skin for tears, breaks, redness, or ulcers. Record the condition of the patient’s skin on admission and as an ongoing assessment. Skin that is not intact is prone to infection.

Assess the patient’s temperature, using a low-range thermometer if possible. Older adults may run lower temperatures due to decreasing metabolism in individuals with a sedentary lifestyle . They also are drawn to lose heat easily to the environment and may not be kept at the correct temperature. A temperature of 35.5°C (96°F) may be normal, whereas a temperature of 36.67°-37.22°C (98°-99°F) may be regarded as febrile.

Obtain temperature readings rectally if the oral reading does not match the clinical picture (i.e., skin is very warm, the patient is restless, mentation is depressed) or if the temperature reads 36.11°C (97°F) or higher. If the oral reading shows inaccuracy, rectal readings may help guarantee the patient’s core temperature is correctly determined.

Avoid the use of a tympanic thermometer if possible. The reliability of the electronic tympanic thermometer may be inconsistent because of improper use.

Assess the quality and color of the patient’s urine. Document changes when noted, and report findings to the health care provider. Also be alert to urinary incontinence , which can signal urinary tract infection (UTI). Urinary tract infection, as evidenced by cloudy, foul-smelling urine without painful urination and urinary incontinence , is the most common infection in older adults.

Limit urinary catheter insertion when possible. Urinary catheter poses a higher risk of infection.

Anticipate blood cultures, urinalysis, and urine culture. Cultures can identify the microorganisms (bacteria, fungi, or fungi) that are causing the infection.

Anticipate the request for a white blood cell count. An older patient with WBC count higher than 11,000/mm3 can be a late sign of infection since their immune system is slower to respond compared to young individuals.

If an infection is proven, expect the initiation of IV fluid therapy. Fluid therapy will improve hydration at the same time compensate for losses caused by fever and liquefy the secretions for less forceful expectoration.

Anticipate a chest x-ray examination as ordered if the patient’s lung sounds are not clear. This is requested by the physician to rule out pneumonia.

Anticipate the need for a broad-spectrum antibiotic regimen, antipyretic, and oxygen inhalation if an infection is proven. These actions will eradicate the infection, reduce fever, and improves oxygenation to the brain.  Fever raises cardiac workload as the body reacts to the infection. Due to a decreased physiologic reserve, older individuals may have a greater risk of heart failure or pulmonary edema as a result of prolonged tachycardia.

Geriatric patients are prone to skin breakdown and pressure ulcers due to factors such as decreased skin elasticity, thinning of the skin, reduced subcutaneous fat, impaired circulation, and limited mobility. Age-related changes in the skin, combined with comorbidities, immobility, and malnutrition , make these populations more vulnerable to developing pressure ulcers.

Assess the patient’s skin upon admission and regularly thereafter. This assessment provides a baseline for succeeding assessments of skin integrity .

Monitor skin over bony prominences for erythema. Skin that rests over the sacrum , scapulae , heels, spine, hips, pelvis, greater trochanter, knees, ankles, costal margins, occiput, and ischial tuberosities is at higher risk for skin breakdown due to excessive external pressures.

Observe skin for any areas of redness, changes in the texture or any breaks in the skin surface. Redness or breaks in skin integrity require aggressive skin care measures to avoid additional breakdown and infection.

Use a lift sheet or roll the patient during repositioning. Sliding, pulling, or dragging across sheets can result in shear injury.

Provide a turning schedule at least every two (2) hours. Turning shuffles the site of pressure and pressure relief.

Utilize waterbed, airbed, air-fluidized mattresses, alternating pressure mattresses, or other pressure-sensitive mattresses for older individuals who are unable to get out of bed or on bed rest . These mattresses promote comfort and protect skin from injury produced by prolonged pressure.

Pad bony prominences with pillows or pads, even when the patient is up in a wheelchair or sits for long periods. This measure keeps alternative positions and pads the bony prominences, hence protecting overlying skin. The ischial tuberosities are prone to breakdown when a patient is in a seated position. Gel pads for the chair or wheelchair seats help in dispersing pressure.

Use lotions generously on dry skin. Lotions provide moisture and can make skin smooth and supple. Lanolin-containing lotions are particularly helpful.

Assist the patient out of bed as frequently as possible. Amply utilize mechanical lifting devices to assist during patient transfers. If getting out of bed is impossible, provide support with position changes every 2 hours. These measures promote blood flow which can prevent skin breakdown.

Establish and provide a turning schedule on the patient care plan and at the bedside. Schedule raises awareness of the nurses and significant others of turning schedules.

Discourage placing tubes under the patient’s head or limbs. Place a pad or pillow between the patient and the tube for cushion support. Too much pressure from tubes can result in decubitus ulcers.

Use tepid water (32.2°-40.5°C [90°-105°F]) and super-fatted, nonperfumed soaps. Hot water can burn older adults, who have diminished pain sensitivity and reduced sensation to temperature. Super-fatted soaps prevent skin dryness.

Clean the patient’s face, axillae, and genital areas daily. Complete baths dry out the skin of an older adult and are preferably performed every other day instead.

Record the percentage of food intake with meals. Allow the significant other to provide foods the patient likes. Recommend nutritious snacks as indicated. Collaborate with a dietician as needed for nutritional advice. A diet that is high in protein and ascorbic acid protects the skin from breakdown.

Limit the use of plastic protective pads under the patient. When used, place at least one layer of cloth between the patient and the plastic pad to absorb moisture. For patients with incontinence , observe the pad at least every two (2) hours. Avoid the use of adult diapers unless the patient is ambulatory, going for a diagnostic test, or is up in a chair. Pads and diapers trap heat and moisture and can result in the breakdown of the skin (macerated associated skin damage).

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition) Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care  Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health   Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

Other recommended site resources for this nursing care plan:

• Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ! Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
• Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.

More care plans related to basic nursing concepts:

• Cancer (Oncology Nursing) | 13 Care Plans
• End-of-Life Care (Hospice Care or Palliative) | 4 Care Plans
• Geriatric Nursing (Older Adult) | 11 Care Plans
• Prolonged Bed Rest | 8 Care Plans
• Surgery (Perioperative Client) | 13 Care Plans
• Systemic Lupus Erythematosus | 4 Care Plans
• Total Parenteral Nutrition | 4 Care Plans

Here are the references and sources for this Geriatric Nursing Care Plan :

• Boltz, M., Capezuti, E., Fulmer, T. T., & Zwicker, D. (Eds.). (2016).  Evidence-based geriatric nursing protocols for best practice . Springer Publishing Company.
• Carpenito-Moyet, L. J. (2009).  Nursing care plans & documentation: nursing diagnoses and collaborative problems . Lippincott Williams & Wilkins.
• Gilje, F., Lacey, L., & Moore, C. (2007). Gerontology and geriatric issues and trends in US nursing programs: a national survey.   Journal of Professional Nursing ,  23 (1), 21-29.
• Mauk, K. L. (Ed.). (2010).  Gerontological nursing: Competencies for care . Jones & Bartlett Publishers. [ Link ]
• Wold, G. H. (2013).  Basic Geriatric Nursing-E-Book . Elsevier Health Sciences.

4 thoughts on “Geriatric Nursing 10 Care Plans (Older Adult)”

I’m an LPN for 30 years of med surg, rehab, surg, geriatric care, addiction, and psych care. I love my career of caring for people. I want to join a team that wants to continue to improve nurse care. Please keep me a part of your network. I also like to be called Penny.

very interesting..

It is very useful lesson for improving geriatric patient health care provision. I like it to have more. Or the whole course, if possible.

I utilize your web page/info on all of my care plans, thank you I am an LVN Case Manager for mostly geriatric and disabled members in managed care.

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Home / Nursing Careers & Specialties / Geriatric Nurse

Geriatric Nurse

What is Geriatric Nursing?

Geriatric nurses specialize in the care of older patients and are a crucial part of the healthcare team in helping older adults maintain their mobility, independence, and quality of life. They are trained to anticipate the needs of aging adults and work closely with primary care physicians, attending physicians, social workers, and families to provide individualized care to elderly patients. Geriatric nurses focus on age-related diseases and health concerns, including the following:

• Osteoporosis
• Alzheimer's disease/dementia
• Chronic pain
• Poly-pharmacy
• Medication tolerance
• Nutritional deficiency
• Impaired mobility
• Incontinence

Geriatric nurses can also address psychosocial issues. Older adults may have impaired mobility that can result in feelings of loneliness, depression, and isolation. Mental health is as significant in geriatric patients as physical health. Additionally, abuse (physical, psychological, and financial) and neglect are a concern among the elderly. In fact, an estimated 4 million older adults experience abuse and neglect, according to the American Psychological Association , and geriatric nurses can work as advocates for them and provide them the resources they need.

If you’re not quite sure whether or not geriatric nursing is right for you, you may be interested in these other types of professions that are similar:

How to Become a Geriatric Nurse

Those considering a position as a geriatric nurse should have experience and interest in caring for an aging population. These patients present a unique set of challenges and require a unique set of skills to address them. A nurse willing to act as an advocate, resource, and liaison is an added benefit.

What are the Schooling Requirements for a Geriatric Nurse?

Nursing students can begin their careers in geriatric nursing by completing courses in nursing programs. Many nursing schools have geriatric nursing modules that are incorporated into the program. Nursing students can also perform clinical rotations in healthcare facilities that specialize in geriatric nursing, such as skilled nursing facilities or geriatric-centered hospital units.

Any Certifications or Credentials Needed?

Practicing Registered Nurses can obtain certification in gerontological nursing. RNs must complete an examination for certification, which lasts five years. The American Nurses Credentialing Center (ANCC) offers certification for nurses who:

• Currently hold an RN license
• Have two years of full-time RN experience (or equivalent)
• Have a minimum of 2,000 hours of clinical practice in the specialty of gerontological nursing within the last three years
• Have completed 30 hours of continuing education in gerontological nursing in the last three years

What Does a Geriatric Nurse Do?

Geriatric nurses are trained to anticipate the needs of an aging patient population, and possess the skills needed to act on their behalf.

Where Do Geriatric Nurses Work?

Geriatric nurses can work in a variety of healthcare settings such as:

• Skilled nursing facilities
• Nursing homes
• Retirement centers
• Memory care centers
• Outpatient ambulatory care clinics
• In-home care/ Home health
• Clinical educators in healthcare facilities, universities, and community colleges
• Case management (BSN-prepared RNs)

What Are the Roles & Duties of a Geriatric Nurse?

The roles and duties of a geriatric nurse may include:

• Patient education
• Medication management
• Liaison between patients, family, and care providers
• Maintaining functional mobility
• Maintaining psychosocial health
• Bedside nursing care of geriatric patients

Geriatric Nurse Salary & Employment

While the field of nursing is rewarding in and of itself, specializing in geriatric nursing can be especially rewarding. In the United States, Baby Boomers are growing older and often account for more healthcare visits than younger Americans. This means the demand for geriatric nurses is increasing. The median salary for a geriatric nurse is $78,836 annually. However, salaries can vary depending on the state and city, years of experience, employer or facility, and degree and certifications held. Here’s a full breakdown:

Helpful Organizations, Societies, and Agencies

• The American Nurses Credentialing Center
• National Gerontological Nursing Association
• American Geriatrics Society
• Eldercare Workforce Alliance

Nursing Schools

Geriatric Nurse

A Geriatric Nurse is a nursing professional specializing in the care of elderly patients. These nurses are trained to understand and manage the unique healthcare needs and challenges of aging adults, including chronic conditions, mobility issues, and cognitive impairments. Their role is pivotal in ensuring the quality of life and health of the senior population. Let's delve into the Geriatric Nurse specialty, explore their work environment, outline their duties, learn how to become a Geriatric Nurse, education requirements, annual salary, and advancement opportunities for this nursing career .

What Is a Geriatric Nurse?

A Geriatric Nurse is a nursing specialty focused on caring for elderly patients. These nurses are skilled in addressing the complex health care needs and challenges associated with aging, including chronic diseases, mobility issues, mental health conditions like dementia, and the maintenance of overall health and well-being. Geriatric Nurses work in a variety of settings, such as hospitals, nursing homes, assisted living facilities, community centers, and patients' homes, providing not only clinical care but also support in activities of daily living, patient education, and advocacy for older adults. Their role is crucial in promoting the quality of life, independence, and dignity of the elderly population, requiring a deep understanding of gerontology, compassionate communication, and a patient-centered approach to care.

Where Does a Geriatric Nurse Work?

A Geriatric Nurse works in various settings, including hospitals, long-term care facilities, nursing homes, assisted living communities, and home healthcare. Each setting requires a nuanced approach to care, tailored to the specific needs and environments of the elderly patients. Their work environments are diverse, reflecting the various levels of care and support required by older adults.

The most common workplaces include:

• Hospitals: Providing acute care, managing chronic conditions, and assisting in rehabilitation.
• Nursing Homes: Offering long-term care, including medical and personal care, for seniors who cannot live independently.
• Assisted Living Facilities: Supporting residents with daily activities, medication management, and health monitoring, while promoting as much independence as possible.
• Home Health Care: Delivering nursing services in the patient's home, including post-hospitalization care and chronic disease management.
• Hospice Care: Providing compassionate end-of-life care focused on comfort and quality of life.
• Outpatient Clinics: Managing chronic conditions, providing preventative care, and educating on health maintenance.
• Community Health Organizations: Working in programs that promote senior health, wellness, and social engagement outside of traditional healthcare facilities.

These settings enable the Geriatric Nurse to apply their specialized skills in gerontology to improve the health outcomes and quality of life for older adults, whether they require intensive medical care, assistance with daily living, or support for a dignified aging process.

Duties of a Geriatric Nurse

The duties of a geriatric nurse are diverse and encompass assessing patient health, administering treatments, managing medication, and providing emotional support and education to patients and their families. They also play a critical role in developing care plans that address the physical, psychological, and social aspects of aging.

The most common duties for a Geriatric Nurse include:

• Assessing Patient Health: Conducting comprehensive evaluations to determine the physical, mental, and emotional needs of elderly patients.
• Developing Care Plans: Creating personalized care plans that address specific health conditions and goals for aging patients.
• Administering Medications and Treatments: Managing medications, administering treatments, and monitoring for side effects or interactions.
• Providing Wound Care: Managing chronic or acute wounds, often a concern for elderly patients.
• Monitoring Chronic Conditions: Keeping track of chronic health issues, such as diabetes , hypertension, and heart disease, and adjusting care as needed.
• Educating Patients and Families: Offering guidance on managing health conditions, promoting wellness, and making lifestyle adjustments to accommodate aging.
• Supporting Mental Health: Addressing cognitive changes and mental health issues, including dementia and depression, with appropriate interventions and support.
• Assisting with Daily Living Activities: Helping patients with activities of daily living (ADL), including bathing, dressing, and mobility, to maintain as much independence as possible.
• Advocating for Patients: Acting as a liaison between patients, families, and healthcare providers to ensure comprehensive care that respects the patient's wishes and needs.

Through these duties, the Geriatric Nurse plays a critical role in enhancing the care and support provided to elderly individuals, ensuring they receive compassionate and effective healthcare tailored to their specific needs.

How To Become a Geriatric Nurse

Becoming a Geriatric Nurse involves obtaining a nursing degree (either an ADN or BSN ), passing the NCLEX-RN examination to become a Registered Nurse (RN), and gaining experience in geriatric care. Many nurses also pursue additional certifications in geriatric nursing to enhance their skills and job prospects.

• Complete a Nursing Program: Earn an Associate's Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) from an accredited nursing school .
• Obtain Licensure: Pass the National Council Licensure Examination (NCLEX-RN) to become a Registered Nurse (RN).
• Gain Experience: Work in settings that provide care to elderly patients, such as hospitals, long-term care facilities, or home health care, to gain relevant experience.
• Pursue Specialized Education: Consider further education in gerontological nursing through continuing education courses, certification programs, or an advanced degree (e.g., Master of Science in Nursing ) with a focus on geriatrics.
• Earn Certification: Obtain certification in gerontological nursing through organizations like the American Nurses Credentialing Center (ANCC) to demonstrate expertise in the field.
• Engage in Continuous Learning: Stay updated with the latest practices in geriatric care through professional development opportunities and involvement in professional organizations.

By following these steps, nurses can specialize in geriatric care, developing the competence to address the complex health needs of aging individuals and improve their quality of life.

How long does it take to become a Geriatric Nurse? The time it takes to become a Geriatric Nurse can vary depending on factors such as the educational path chosen (ADN vs. BSN), the time it takes to pass the NCLEX-RN exam, and the length of time spent gaining experience and pursuing additional training. In general, it can take around 4 to 6 years to become a Geriatric Nurse after completing high school, including the time spent earning a nursing degree , obtaining licensure, and gaining relevant experience in geriatric care settings.

Education Requirements for a Geriatric Nurse

The minimum education requirement for a geriatric nurse is an Associate Degree in Nursing (ADN), but a Bachelor of Science in Nursing (BSN) is increasingly preferred by employers. Specialized geriatric nursing certifications, such as the Certified Gerontological Nurse (CGN), can also be pursued post-licensure.

How Much Does a Geriatric Nurse Make?

The annual salary for a Geriatric Nurse varies based on location, experience, education, and the type of healthcare setting. According to recent data, the average annual salary ranges significantly, with opportunities for increased earnings through advanced certifications and roles. A Registered Nurse (RN) in the United States earns a median annual salary of approximately $75,000. However, those specializing in geriatric nursing may see variations in this range:

• Entry-Level Geriatric Nurse might make around $50,000 to $60,000 annually, depending on their workplace and location.
• Experienced Geriatric Nurse certified in gerontological nursing or in a supervisory position can expect a higher annual salary ranging from $80,000 to over $100,000.
• Advanced Practice Nurse such as a Geriatric Nurse Practitioner can command even higher salaries typically between $90,000 and $120,000 or more.

These figures are meant to provide a general idea of what a Geriatric Nurse might earn and will fluctuate with market dynamics, individual credentials, and institutional factors.

Geriatric Nurse Career Advancement Opportunities

Geriatric nurses have various pathways for career advancement, including leadership positions such as charge nurses or nursing directors, specialized care roles, or further education for advanced practice roles like Nurse Practitioners (NP) with a focus on gerontology.

The Future of Geriatric Nursing

The future of geriatric nursing is promising, with an increasing need for specialized care for the aging population. Advances in healthcare technology, a focus on preventive care, and the development of new care models offer exciting opportunities and challenges for geriatric nurses.

Geriatric nursing is a fulfilling career that makes a significant difference in the lives of elderly patients and their families. With a solid educational foundation, a commitment to compassionate care, and a willingness to adapt to the evolving healthcare landscape, geriatric nurses play a vital role in the healthcare system. As the demand for skilled geriatric care professionals grows, so too does the opportunity for those interested in this specialized nursing path.

Last updated: February 12, 2024

Nursing Careers

References:

• Geriatrics as a Profession . American Geriatrics Society. Retrieved February 12, 2024.
• What is Geriatric Nursing . Joyce University Of Nursing & Health Sciences, May 3, 2022. Retrieved February 12, 2024.
• Gerontological Nursing Certification . American Nurses Association, American Nurses Credentialing Center. Retrieved February 12, 2024.
• Registered Nurses . Bureau of Labor Statistics, U.S. Department of Labor. Occupational Outlook Handbook. Retrieved February 12, 2024.
• What Is a Geriatric Nurse . Indeed, Career Guide. Retrieved February 12, 2024.
• Geriatric Nurse . Johnson & Johnson, Nursing Careers. Retrieved February 12, 2024.
• Nurse Geriatric . PayScale, Browse Jobs by Industry. Retrieved February 12, 2024.

How To Become A Geriatric Nurse: Everything You Should Know

Updated: Jul 31, 2023, 10:38am

Adults over the age of 65 are at a higher risk of developing various age-related illnesses. As a result, they often require medical assistance to maintain a comfortable lifestyle.

Geriatric nurses specialize in providing preventive and corrective medical care to older adults. They work closely with patients, families and care providers to ensure aging patients receive the necessary support to manage age-related health issues.

If you’re interested in pursuing a career in geriatric nursing, read on to discover how to become a geriatric nurse.

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What Is Geriatric Nursing?

Geriatric nursing involves treating and caring for older patients. This field of nursing encompasses both acute and palliative care. In essence, geriatric nurses provide instant treatment for sudden ailments and long-term care for patients with chronic illnesses.

The terms “gerontology” and “geriatrics” have similar meanings and are frequently used interchangeably in nursing as both areas focus on improving the lives of older adults. Gerontology focuses on the study of aging, while geriatrics specifically addresses the medical aspects of illness and disease in aging individuals. Geriatric nurses are also called gerontological nurses.

Geriatric nurses collaborate closely with doctors, therapists and patients’ families to support patients’ physical and mental well-being. Their day-to-day responsibilities include:

• Educating patients and their caregivers on common age-related health issues
• Assessing patients’ cognitive and motor skills
• Monitoring patients’ vital signs
• Collecting blood samples for laboratory tests
• Administering medications to patients
• Assisting physicians during surgical procedures
• Providing post-operative care
• Lifting and moving patients with impaired physical mobility

Gerontological nurses work in hospitals, nursing homes, hospices, retirement communities, private offices and patients’ homes. Working with this vulnerable population requires specialized soft skills such as reading non-verbal cues, effective communication, empathy and patience, plus a comprehensive understanding of geriatrics. Geriatric nurses should also possess physical stamina as they often need to assist with moving patients.

How to Become a Geriatric Nurse

Earn an accredited nursing degree.

To become a geriatric nurse, you must earn a college degree from an accredited nursing program. You can choose between an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). An ADN takes about two years to complete, while BSN programs take four years of full-time study to complete.

Most employers prefer to hire nurses with BSNs because the training they receive from these programs leads to better patient outcomes. BSN programs also equip students with leadership skills, meaning they are better prepared to oversee nursing teams and supervise student nurses during clinical rounds.

However, if you desire more career autonomy and want to increase your earning potential, consider adding a master of science in nursing (MSN) degree to your qualifications.

Obtain RN Licensure

A state-issued license qualifies you to practice legally as a registered nurse (RN). The first step in the licensure process is passing the Next Generation NCLEX (NGN).

The NGN exam is the updated version of the NCLEX exam that uses real-world case studies to evaluate nurses’ clinical judgment. We recommend reviewing NCLEX test prep resources and following a strict study plan to improve your chances of passing the NGN.

In addition to the licensure exam, nursing graduates must fulfill other requirements set by the state where they intend to practice. Visit your state’s board of nursing for current information.

Nurses who want to practice in various U.S. states can apply for a multistate license with the Nurse Licensure Compact (NLC). They must have an active RN license and live in an NLC-participating state to qualify.

Gain Nursing Experience

Securing a position in geriatric nursing directly out of nursing school is possible, especially if you have acute and critical care experience. However, gaining bedside experience in hospital settings is recommended. Working in critical care, pain management or emergency units can offer a preview of what a geriatric nursing career would involve.

Consider a Certification or Certificate

Although nursing certifications are not required to work in gerontology, they validate a nurse’s expertise and experience in the field. Nurses seeking certification can earn the Gerontological Nurse – Board Certified (GERO-BC™) credential issued by the American Nurses Credentialing Center (ANCC).

To obtain this credential, candidates must meet the following requirements:

• Hold an active RN license or legally recognized equivalent
• Have at least two years of full-time nursing experience
• Have at least 2,000 hours of gerontology clinical practice
• Have completed 30 hours of geriatric nursing education in the last three years
• Submit an application online
• Pass the computer-based exam

RNs must renew the GERO-BC™ certification every five years after meeting the ANCC’s renewal requirements.

Salary and Job Outlook for Geriatric Nurses

The U.S. Bureau of Labor Statistics (BLS) doesn’t report specific data on geriatric nurses; however, the BLS reports a median annual salary of $81,220 for all registered nurses as of May 2022.

The BLS projects a 6% increase in employment for RNs from 2021 to 2031 and around 203,200 job openings each year during that decade. The job outlook for registered nurses is comparable to the projected average for all occupations.

Frequently Asked Questions (FAQs) About Geriatric Nurses

What are the qualifications to be a geriatric nurse.

The requirements to become a geriatric nurse include earning an ADN or a BSN and RN licensure. Prospective geriatric nurses can also pursue certifications in gerontology and critical care.

What does a geriatric nurse do?

Geriatric nurses provide medical care to older adults. Their job duties typically involve conducting physical evaluations, administering medications and educating patients’ families on proper caretaking.

Is geriatric nursing stressful?

Geriatric nursing can present challenges, such as lifting patients and managing heavy workloads. Each day in this field can bring unique and rewarding experiences, especially when patients respond positively to treatments.

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Geriatric syndromes and their implications for nursing

Brown-O'Hara, Tricia MSN, RN

Tricia Brown-O'Hara is an assistant professor of nursing at Gwynedd-Mercy College in Gwynedd Valley, Pa.

The author has disclosed that she has no financial relationships related to this article.

GERIATRIC SYNDROMES are common clinical conditions that don't fit into specific disease categories but have substantial implications for functionality and life satisfaction in older adults. Besides leading to increased mortality and disability, decreased financial and personal resources, and longer hospitalizations, these conditions can substantially diminish quality of life. 1

According to a literature review, the five conditions most commonly considered geriatric syndromes are pressure ulcers, incontinence, falls, functional decline, and delirium. Malnutrition, eating and feeding problems, sleeping problems, dizziness and syncope, and self-neglect have also been classified as geriatric syndromes. 2

This article discusses geriatric syndromes and their impact. It describes how to assess older adults for these syndromes and directs nurses to appropriate resources.

Challenging patients

Geriatric syndromes will be an increasing concern for nurses because the population of older adults is growing exponentially. The number of those age 65 and older will more than double between 2000 and 2030, growing from 34.8 million to more than 70.3 million according to U.S. Census Bureau projections. 1 The “old-old” adults—those age 85 and over—is the fastest growing group of all; their numbers will double between 1995 and 2030 and increase fivefold by 2050. 1 About 82% of older adults have at least one chronic disease. 1 These startling numbers will drive dramatic changes in healthcare and society.

Older adults face many challenges, including behavioral and social issues, problems with functionality and activities of daily living, and the wide range of settings where care is provided. A focus on geriatric competence, emphasizing the unique features of common health conditions in older adults, is crucial in nursing practice, education, and research.

Assessing older patients

Geriatric syndromes are often defined by isolating the shared risk factors associated with them, including older age, cognitive or functional impairment, and impaired mobility. Signs and symptoms of geriatric syndromes are many patients' chief complaint and are usually what lead older adults to seek healthcare. Patients who aren't treated successfully can consume an ever-increasing amount of resources, causing frustration among patients, caregivers, and healthcare providers. When searching for an answer to their problems, older adults may change healthcare providers or specialists, visit various EDs and clinics, and be hospitalized multiple times. 2

When caring for older adults, perform comprehensive geriatric assessments to identify geriatric syndromes, especially for those older than 85. 1 Besides using the Mini-Mental State Examination, apply geriatric assessment tools to assess:

• functional and instrumental (higher level functional) activities of daily living.
• gait and balance.
• visual acuity.
• depression.
• skin breakdown. 1

The Hartford Institute for Geriatric Nursing websites offer many educational resources for practicing nurses, nurse educators, and researchers who assess and care for older adults. (See Tapping the Hartford Institute for Geriatric Nursing websites .) Review the “Try This” and “How to Try This” series available on these websites for 27 assessment tools considered best practice in nursing care of older adults. (See Finding “Try This” and “How to Try This” resources for assessment tools .) The “Try This” series, which is provided free through the John A. Hartford Foundation, demonstrates how to properly and effectively use these tools.

The “Fulmer SPICES: An Overall Assessment Tool for Older Adults,” one of the “Try This” tools, is an excellent beginning framework because it focuses on the six marker conditions that coincide with the five common conditions defined as geriatric syndromes. These six marker conditions are:

• S leep disturbances
• P roblems with eating and/or feeding
• I ncontinence
• E vidence of falls
• S kin breakdown.

Although the SPICES tool isn't all-inclusive, it can lead nurses to critical areas that need more in-depth assessment. Nurses can use it to identify nursing problems or diagnoses specific to older adults and then develop a comprehensive care plan focusing on these problems. Additional assessment tools can be incorporated as more geriatric syndromes are identified.

Treatment options

Look for substantial evidence based on published research about how to manage geriatric syndromes and diseases common in older adults. This evidence may appear in practice guidelines, quality indicators, and evidence-based reports. Geriatric nursing protocols for best practice can stimulate nurses to practice with greater knowledge and skill and improve the quality of care for older adults.

Evidence-based practice is a framework for clinical practice that integrates the best-available scientific evidence with the expertise of clinicians and patient preferences and values to make decisions about healthcare. 3 Evidence-based geriatric nursing protocols for best practice for pressure ulcers, incontinence, falls, functional decline, and delirium reflect assessment and intervention strategies by experts who've reviewed the evidence.

Look for journal articles and textbooks outlining evidence-based geriatric nursing protocols and online resources. One framework, Advancing Care Excellence for Seniors (ACES), was created by a partnership of the National League for Nursing (NLN) and Community College of Philadelphia with funding from the John A. Hartford Foundation, Laerdal Medical, and the Independence Foundation. The website http://www.nln.org/ACES introduces ACES as essential nursing actions to improve quality of life for older adults, coordinate care, decrease caregiver stress, and promote shared decision making.

Using the ACES framework, nurses assess function and expectations first, then coordinate care and manage clinical conditions using evolving knowledge about geriatric syndromes and the special needs of older adults. An interdisciplinary team can evaluate the risks and benefits of care decisions with the patients, families, and caregivers. The team makes recommendations based on the older adult's wishes, expectations, resources, strengths, and cultural traditions to treat geriatric syndromes, encourage adoption of healthy behaviors, and improve quality of life. 1

Practice prevention

Use best-practice exemplars of effective prevention programs to care for older adults. These exemplars incorporate an interdisciplinary team approach as well as a strong geriatric nurse-centered approach. Preventing falls and skin breakdown, reducing adverse drug events, and promoting oral health and adequate hydration can help prevent complications of geriatric syndromes. 3 Proven preventive strategies for delirium, falls, and skin breakdown have been identified in the nursing literature and translated into clinical practice and policy initiatives.

Assessing relative risk is the first step in a patient's plan of prevention. Failing to identify, diagnose, or treat underlying causes of geriatric syndromes such as sensory deficits, fragility, and risks for skin breakdown, can adversely affect an older adult's health and longevity. 3 Focusing on maintaining function, dignity, and individual control will promote health and quality of life.

Educating future nurses

Nursing students need intentional planned encounters using experiences such as simulation, unfolding case studies (as provided by the NLN's ACES framework), and clinical rotations in various settings such as hospitals, rehab centers, long-term-care facilities, and home-care and community settings. Best-practice geriatric nursing protocols must be introduced into nursing education, research, and practice settings. Nurses armed with knowledge about age-related changes and the use of proper assessment tools can play a vital role in improving geriatric standards of practice.

Nurses must also draw on other resources to meet the needs of older adults. Research has shown that interdisciplinary teams have dramatically improved geriatric patient care and outcomes. In The Institute of Medicine's report, Retooling for an Aging America: Building the Health Care Workforce , interdisciplinary collaboration was identified as a vital part of caring for the aging population. 4 “Each of us must work together and be committed to provide a culture of safety that vulnerable older adults need in order to receive the safest evidence-based clinical care with optimal outcomes.” 3

Expert practice

Nurses must recognize geriatric syndromes and apply best practices to the care of older adults to achieve the best outcomes possible.

Tapping the Hartford Institute for Geriatric Nursing websites

Hartford Institute for Geriatric Nursing: http://www.hartfordign.org .

Hartford Institute for Geriatric Nursing. ConsultGeriRN: http://www.consultgerirn.org .

Hartford Institute “Try This” Series: http://www.hartfordign.org/resources/Try_This_Series .

Hartford Geriatric Nursing Initiative: http://www.hgni.org .

Finding “Try This” and “How to Try This” resources for assessment tools

Tap into http://www.hartfordign.org/practice/try_this/ to find tools to explore these issues:

Issue 1: SPICES: An Overall Assessment Tool of Older Adults

Issue 2: Katz Index of Independence in Activities of Daily Living (ADL)

Issue 3: Mental Status Assessment of Older Adults: The Mini-Cog

Issue 4: The Geriatric Depression Scale (GDS)

Issue 5: Predicting Pressure Ulcer Risk

Issue 6.1: The Pittsburgh Sleep Quality Index (PSQI)

Issue 6.2: The Epworth Sleepiness Scale

Issue 7: Assessing Pain in Older Adults

Issue 8: Fall Risk Assessment

Issue 9: Assessing Nutrition in Older Adults

Issue 10: Sexuality Assessment for Older Adults

Issue 11.1: Urinary Incontinence Assessment in Older Adults: Part I—Transient Urinary Incontinence

Issue 11.2: Urinary Incontinence Assessment in Older Adults: Part II—Persistent Urinary Incontinence

Issue 12: Hearing Screening in Older Adults

Issue 13: Confusion Assessment Method (CAM)

Issue 14: The Modified Caregiver Strain Index (CSI)

Issue 15: Elder Mistreatment Assessment

Issue 16.1: Beers' Criteria for Potentially Inappropriate Medication Use in the Elderly: Part I—2002 Criteria Independent of Diagnoses or Conditions

Issue 16.2: Beers' Criteria for Potentially Inappropriate Medication Use in the Elderly: Part II—2002 Criteria Considering Diagnoses or Conditions

Issue 17: Alcohol Use Screening and Assessment

Issue 18: The Kayser-Jones Brief Oral Health Status Examination (BOHSE)

Issue 19: Horowitz's Impact of Event Scale: An Assessment of Post Traumatic Stress in Older Adults

Issue 20: Preventing Aspiration in Older Adults with Dysphagia

Issue 21: Immunizations for the Older Adult

Issue 22: Assessing Family Preferences for Participation in Care in Hospitalized Older Adults

Issue 23: The Lawton Instrumental Activities of Daily Living (IADL) Scale

Issue 24: The Hospital Admission Risk Profile (HARP)

Issue 25: Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)

Issue 26: The Transitional Care Model (TCM): Hospital Discharge Screening Criteria for High Risk Older Adults

Issue 27: General Screening Recommendations for Chronic Disease and Risk Factors in Older Adults

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What does a geriatric nurse do?

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What is a Geriatric Nurse?

A geriatric nurse provides care to older adults. Geriatric nurses work in a variety of settings such as hospitals, nursing homes, and rehabilitation centers. They have advanced training and knowledge in caring for the unique needs of elderly patients, including managing chronic conditions such as diabetes, dementia, and arthritis. Geriatric nurses may also work with patients who have suffered from strokes or heart attacks and require specialized care to help them recover.

In addition to providing medical care, geriatric nurses may also offer emotional support to their patients and their families. They may help patients cope with the challenges of aging, including loneliness and depression. Geriatric nurses may also work with other healthcare professionals to develop care plans that address the unique needs of elderly patients, and they may coordinate care between different healthcare providers to ensure that patients receive the best possible care.

What does a Geriatric Nurse do?

Geriatric nurses play a critical role in the healthcare system by providing specialized care to the elderly population. As the aging population continues to grow, the demand for geriatric nurses increases, as they are trained to address the unique healthcare needs of older adults.

Duties and Responsibilities Some of the key duties and responsibilities of geriatric nurses are:

• Assessment and monitoring: Geriatric nurses assess their patients' physical, cognitive, and emotional status to determine their healthcare needs. They monitor vital signs, administer medication, and evaluate the effectiveness of treatment plans.
• Care planning and management: Geriatric nurses develop care plans that address their patients' specific healthcare needs. They manage chronic conditions, such as diabetes, hypertension, and dementia, and provide wound care, palliative care, and end-of-life care.
• Patient education: Geriatric nurses educate patients and their families about their healthcare conditions, medication management, and lifestyle modifications. They provide guidance on nutrition, exercise, and fall prevention, among other things.
• Communication and coordination: Geriatric nurses act as advocates for their patients, communicating with family members, caregivers, and other healthcare professionals to ensure that they receive appropriate care. They also coordinate care between different healthcare providers, such as physicians, physical therapists, and social workers.
• Geriatric mental health: Geriatric nurses may specialize in mental health care for older adults, addressing issues such as depression, anxiety, and dementia-related behaviors. They work with patients, families, and other healthcare providers to manage mental health issues effectively.
• Safety and quality of care: Geriatric nurses ensure the safety and quality of care for their patients by monitoring their environment, ensuring proper infection control, and preventing falls and other accidents.
• Research and advocacy: Geriatric nurses may participate in research studies to advance the knowledge and understanding of geriatric care. They also advocate for older adults' rights and access to healthcare services.

Types of Geriatric Nurses There are several types of geriatric nurses, including:

• Certified Nursing Assistant (CNA) - CNAs work under the supervision of RNs and provide basic care to elderly patients, such as assisting with daily activities, monitoring vital signs, and helping patients with mobility issues.
• Geriatric Nurse Practitioner (GNP) - GNPs are advanced practice nurses who specialize in providing primary care to elderly patients. They can diagnose and treat illnesses, prescribe medications, and provide health education and counseling.
• Gerontological Clinical Nurse Specialist (GCNS) - GCNSs are registered nurses with advanced training in gerontology. They specialize in providing care to elderly patients with complex medical conditions and may work in hospitals, long-term care facilities, or hospice care.
• Geriatric Care Manager (GCM) - GCMs are not nurses but are professionals who specialize in managing the care of elderly patients. They may coordinate with healthcare providers, manage medication schedules, and arrange for in-home care or placement in long-term care facilities.

What is the workplace of a Geriatric Nurse like?

Geriatric nurses work in a variety of settings, including hospitals, nursing homes, assisted living facilities, and patients' homes. The workplace of a geriatric nurse is typically fast-paced, demanding, and highly rewarding.

One of the primary responsibilities of a geriatric nurse is to provide comprehensive care to elderly patients. This includes monitoring patients' vital signs, administering medications, assisting with daily activities, and providing emotional support. Geriatric nurses must also be knowledgeable about the unique medical conditions that affect elderly patients, such as Alzheimer's disease, dementia, and arthritis.

In addition to providing direct patient care, geriatric nurses often work closely with other healthcare professionals, such as physicians, physical therapists, and social workers. They may collaborate with these professionals to develop comprehensive care plans for patients, coordinate treatment plans, and monitor patient progress.

Geriatric nursing can be emotionally challenging, as nurses often work with patients who are dealing with chronic health conditions and end-of-life care. However, many geriatric nurses find their work highly rewarding, as they have the opportunity to make a positive impact on the lives of their patients and their families.

Frequently Asked Questions

Nursing related careers and degrees.

• Acute Care Nurse Practitioner (ACNP)
• Advanced Practice Registered Nurse (APRN)
• Certified Nurse Midwife (CNM)
• Certified Nursing Assistant (CNA)
• Clinical Nurse Specialist (CNS)
• Critical Care Nurse
• Geriatric Nurse
• Home Health Nurse
• Informatics Nurse Specialist
• Licensed Practical Nurse (LPN)
• Medical-Surgical Registered Nurse
• Nurse Anesthetist (CRNA)
• Nurse Educator
• Nurse Practitioner (NP)
• Nurse Researcher
• Obstetric Nurse
• Oncology Nurse
• Pediatric Nurse
• Psychiatric Nurse
• Public Health Nurse
• Registered Nurse (RN)
• Rehabilitation Nurse
• Trauma Nurse

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Geriatric Nurses are also known as: Geriatric Registered Nurse

Geriatric assessment: Essential skills for nurses

America’s elderly population is expected to rise from 34 million in 2000 to approximately 70 million by 2030. To ensure optimal health outcomes for older adults, nurses in all settings should be familiar with geriatric health problems and demonstrate proficiency in providing care. Assessing the health needs of elderly patients can reduce their hospitalization rate and enhance their quality of life and independence. Information you obtain from an accurate assessment serves as the foundation for age-appropriate nursing care.

The nursing process addresses the full range of human experiences and responses to health. To become proficient in geriatric assessment, you need to understand the physiologic changes unique to this population, as well as the differences between normal aging-related changes and health alterations caused by illnesses and social changes.

This article highlights essential skills to use when assessing geriatric patients in any clinical setting. After describing how to assess the integumentary system, head, neck face, and musculoskeletal system, it explains how to evaluate the older adult’s functional status.

Obtaining the health history

Before the physical assessment begins, collect the health history by interviewing the patient (and family members, if needed). The data you gather will help you focus on particular areas of concern during the physical examination. (See the box below.) Review the health history you’ve obtained before you start the physical examination.

Interviewing the geriatric patient

To promote an efficient information exchange and enhance rapport with the patient, minimize distractions and speak clearly. Put the patient at ease by explaining the reason for the interview and giving a brief overview of how you’ll proceed.

A systematic collection of subjective data, the health history includes both current and past health status. Elicit the chief complaint by asking why the patient is seeking health care. Find out when the present illness or symptom began. Ask about past illnesses that required medical attention, as well as hospitalizations and other procedures. Find out if the patient has a history of cardiovascular, respiratory, renal, or neurologic disorders; diabetes mellitus; cancer; injuries; or falls. Be sure to document all prescription and nonprescription medications the patient takes, including names, dosages, and frequency.

Integumentary system

Most aging-related integumentary changes are easy to see—for instance, graying hair and wrinkled skin. Nonetheless, these changes aren’t always related solely to aging; some may stem at least in part from lifestyle and environmental factors.

Assessing the skin

Wrinkled skin results from loss of elasticity and turgor. With age, the skin gradually thins and loses density, making it more susceptible to bruising and tears. Inspect the skin for lesions and moles. When examining moles, look for irregular shapes; ask the patient if any moles have gotten bigger or changed color. Positive findings indicate the need for further evaluation by a primary care provider or dermatologist. Keep in mind that excessive sun exposure exacerbates aging-related changes and may lead to skin cancers such as melanoma.

Check for pressure ulcers. According to the National Pressure Ulcer Advisory Panel, pressure ulcer rates in hospitals range from 10% to 18%; in long-term care facilities, 2.3% to 28%; and in home-care settings, 0% to 29%. Pressure ulcers are most common on the sacrum, heels, and trochanters. Most experts believe they are preventable and stem primarily from decreased mobility and activity, insufficient caloric intake, and incontinence. The Centers for Medicare & Medicaid Services (CMS) no longer reimburses for care related to hospital-acquired pressure ulcers, so clinicians must be able to quickly identify at-risk patients and implement preventive strategies.

Assessing the hair

An aging-related decline in melanin production makes the hair less vibrant in color, leading to graying. Also, the hair thins; many older adults lose their hair altogether. Dermal vascular beds diminish with age as well, altering hair distribution patterns. Some men are genetically predisposed to baldness and may experience hair loss at younger ages.

Assessing the nails

Regardless of the patient’s age, nail surfaces normally are flat or slightly curved. Note their color, length, and cleanliness. Check for abnormalities. For instance, clubbing may indicate a cardiac or pulmonary disorder; pitting and transverse groves may signify peripheral vascular disease, arterial insufficiency, or diabetes. Brittleness may stem from decreased vascular supply, whereas yellow or brown nails may signal a fungal infection.

Head, neck, and face

The essential purpose of the skull is to protect the brain and other sensory organs from direct injury. Note the general size and shape of the patient’s head; are they appropriate to body size?

The head rests on the seven flexible vertebrae of the neck; the neck gives the head maximum mobility. Limited range of motion (ROM), as from arthritis or muscle weakness, can cause pain and discomfort in older adults. As you evaluate neck ROM, stay alert for reports of pain or dizziness or jerky or abnormal movements; these may be clues to health problems, such as fractured vertebrae, Parkinson’s disease, a transient ischemic attack, or stroke.

Assessing the face

Each individual has unique facial features, but environmental, racial, genetic, emotional, and nutritional factors greatly affect facial appearance and functioning. Note whether the patient’s eyes, eyebrows, nose, and mouth are centered and symmetrical. Asymmetrical features suggest a stroke. Look for appropriateness of affect and behavior.

Check facial skin for dryness, sagging, looseness, and wrinkling, which result from aging-related decreases in elasticity, subcutaneous fat, and moisture. (See the box below for tips on assessing vision and hearing.)

Vision and hearing assessmentVision can deteriorate with age. Older adults should have 20/40 vision or better. Such conditions as changing eye shape (presbyopia), cataracts, and glaucoma typically worsen with age. Because of structural changes in the eye, older adults may be more sensitive to glare; as a result, shiny surfaces may increase the risk of falls and result in injury. Encourage adults to get annual eye exams.Hearing loss is common in older adults and usually affects both ears. In general, older adults have more trouble hearing high-frequency sounds, such as consonants (especially p, s, and t) than low-frequency sounds, such as vowels. Refer patients with hearing difficulty to an audiologist.

Musculoskeletal system and functional status

Investigate for abnormalities suggested by the health history data, such as loss of balance, gait disorders, postural abnormalities, or inability to transfer from a chair to a standing position. If the patient is weak, with poor coordination, you may need to allot additional time for the functional examination.

Evaluate muscle groups for atrophy, tremors, and involuntary movements. ROM tests in older adults are similar to those used in other age-groups. However, inflamed joints may limit ROM in older adults. Inspect joints of the hands, wrists, knees, hips, and shoulders—areas more prone to arthritis. Note warmth, swelling, tenderness, crepitus, and deformities.

Maintaining independent functioning as long as possible improves quality of life—a fundamental principle of geriatric nursing. Assess the patient’s ability to perform activities of daily living (ADLs), including bathing, dressing, toileting transfer, continence, and feeding. You may want to use such tools as the Katz Index of independence in ADLs or the Barthel Index for functional evaluation.

Also assess more complex functioning skills such as those needed to perform instrumental ADLs (IADLs). These are activities that enable an individual to live independently, such as the ability to use the telephone, travel, shop, prepare meals, do housework, take medication appropriately, and manage money. Using the Lawton IADL assessment model can help you evaluate these activities and develop an appropriate plan of care.

Evaluating the patient’s fall risk

Conditions such as osteoporosis can increase an older adult’s risk of falling. Falls may lead to injuries with devastating effects, including decreased function, fractures, and sometimes even death. When assessing the patient’s fall risk, use a valid and reliable tool, such as the Morse Fall Scale or Tinetti Gait and Balance Assessment. With CMS no longer reimbursing for care related to patient falls, fall risk assessment and appropriate interventions are especially important.

Use your assessment findings to develop an effective plan of care that focuses on geriatric-appropriate interventions and support services. Ongoing monitoring through routine follow-up gives you the chance to modify the plan as needed. If the patient’s assessment findings are abnormal, consider consulting a geriatric nurse practitioner or geriatrician.

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Gallo JJ, Fulmer T, Paveza GJ, Reichel W. Functional assessment. In: Gallo JJ, Bogner HR, Fulmer T, Paveza GJ, eds. Handbook of Geriatric Assessment . Sudbury, MA: Jones & Bartlett; 2000:109-110.

Hauer KA, Kempen GI, Schwenk M, et al. Validity and sensitivity to change of the Falls Efficacy Scales International to assess fear of falling in older adults with and without cognitive impairment. Gerontology . 2010;22:1-11.

Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffee MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA . 1963;185:914-919.

Linos E, Swetter SM, Cockburn MG, Colditz GA, Clarke A. Increasing burden of melanoma in the United States. J Invest Dermatol . 2009;129(7):1666-1674.

Lyder CH, Ayello EA. Pressure ulcers: a patient safety Issue. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses . Rockville, MD: Agency for Healthcare Research and Quality; 2008.

Mauk KL. Gerontological Nursing: Competencies for Care . 2nd ed. Sudbury, MA: Jones & Bartlett; 2009.

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Morse JM. Preventing Patient Falls: Establishing a Fall Intervention Program . 2nd ed. New York, NY: Springer Publishing Company; 2008.

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National Pressure Ulcer Advisory Panel Board of Directors; Cuddigan J, Berlowitz DR, Ayello EA, eds. Pressure ulcers in America: prevalence, incidence, and implications for the future. An executive summary of the National Pressure Ulcer Advisory Panel Monograph. Adv Skin Wound Care . 2001;14(4):208-215.

Naylor MD, Brooten DA, Campbell RL, et al. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. J Am Geriatr Soc . 2004;52(5):675-684.

Ngian VJJ, Ong BS, O’Rourke F, Nguyen HV, Chan DKY. Review of a rapid geriatric assessment model based in an emergency department. Age Ageing . 2008;37(6):696-699. doi:10.1093/ageing/afn160.

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Sahyoun NR, Lentzner H, Hoyert D, et al. Trends in causes of death among the elderly. Aging Trends . 2001;(1):1-10. www.cdc.gov/nchs/data/ahcd/agingtrends/01death.pdf . Accessed May 25, 2011.

Sainsbury A, Seebass G, Bansal A, et al. Reliability of the Barthel Index when used with older people. Age Aging . 2005;34(3):228-232.

Tinetti ME, Williams TF, Mayewski R. Fall Risk Index for elderly patients based on number of chronic disabilities. Am J Med . 1986;80:429-434.

U.S. Department of Health and Human Services. Agency on Aging. Aging statistics. www.aoa.gov/AoARoot/Aging_Statistics/index.aspx . Accessed May 25, 2011.

Wallace M. Essentials of Gerontological Nursing . New York, NY: Springer; 2007.

Wallace M, Shelkey M. Katz Index of Independence in Activities of Daily Living (ADL). The Hartford Institute for Geriatric Nursing, New York University, College of Nursing. Revised 2007. http://consultgerirn.org/uploads/File/trythis/try_this_2.pdf . Accessed May 25, 2011.

Michael Cary is a doctoral student at the University of Virginia School of Nursing in Charlottesville. Courtney H. Lyder is Dean and Professor at the UCLA School of Nursing in Los Angeles.

4 Comments .

This is a really great post! Thanks so much for sharing!

Who is the author?

Forgot to close your coding on vision and hearing assessment. Still needs

Nice article

Comments are closed.

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Future Nursing Research of Older Adults: Preserving Independence and Reducing Health Disparities

การวิจัยทางการพยาบาลในอนาคตของผู้สูงอายุ: สงวนรักษาอิสรภาพและ ลดความไม่เท่าเทียมทางสุขภาพ.

Nursing professionals are at the forefront of primary care and the largest segment of the health workforce, and nurse researchers can bring vital perspectives to aging research and clinical practice. Although healthcare systems are experiencing more work from the aging of populations, unfortunately there are limited nurse researchers trained in gerontological nursing. Future research in older adults needs to be based on the current needs of and for older adults. In this article, I identify potential future research of aspects for older adults by highlighting opportunities and examples to conduct culturally appropriate interventions that aim to reduce health disparities and preserve independence.

Because there is a complexity of health issues in older adults, nurse researchers need to pursue the best ways to address their needs, investigate and disseminate technology-based assessments, provide culturally appropriate interventions to promote independence, prevent chronic conditions, and enhance health equality. Nurses and nurse researchers also need to monitor the changes in functional status and health of older adults, especially as the global burden and costs of diseases and disability of this population grows, and to save unnecessary health care expenditure. To create new knowledge and discover best practices in aging care, nurse researchers lead multidisciplinary teams, develop innovative ideas with the potential for significant clinical impact, and use appropriate research approaches that steer to successful grant applications to national funding agencies. It is essential to establish a program for training or mentoring nurse researchers dedicated to caring for older adults, advocating, and disseminating innovative care to maximize the independence of older adults.

วิชาชีพพยาบาลเป็นด่านหน้าของการดูแลสุขภาพในระดับปฐมภูมิและเป็นกลุ่มที่ใหญ่ที่สุด ในทีมสุขภาพ นักวิจัยพยาบาลเป็นผู้น̊ามุมมองที่ส̊าคัญมาสู่การวิจัยด้านการสูงอายุและการปฏิบัติ ทางคลินิก ในขณะที่ระบบสุขภาพเผชิญกับกลุ่มประชากรผู้สูงอายุที่เพิ่มมากขึ้น แต่จ̊านวนนักวิจัยพยาบาล ที่ผ่านการฝีกทางด้านการวิจัยการพยาบาลผุ้สูงอายุยังมีจ̊านวนจ̊ากัด การวิจัยเกี่ยวกับผู้สูงอายุในอนาคต ขึ้นอยู่กับความจ̊าเป็นในปัจจุบันของผู้สูงอายุและเพื่อผู้สูงอายุ บทความนี้มีจุดมุ่งหมายเพื่อน̊าเสนอ แนวโน้มและโอกาสการวิจัยในผู้สูงอายุในมุ่งเน้นในสองเป้าหมาย คือ เพื่อสงวนรักษาอิสระภาพและ จัดกิจกรรมให้เหมาะสมกับวัฒนธรรม และลดความไม่เท่าเทียมทางสุขภาพ เนื่องจากความซับซ้อน ทางสุขภาพของผู้สูงอายุนักวิจัยพยาบาลจะต้องมุ่งหาวิธีการที่ดีที่สุดที่จะตอบสนองความจ̊าเป็นของ ผู้สูงอายุ ต้องทดสอบ และน̊าเสนอวิธีการประเมินสุขภาพโดยใช้เทคโนโลยีและจัดกิจกรรมให้เหมาะสม กับวัฒนธรรมเพื่อส่งเสริมการมีชีวิตที่อิสระ ป้องกันภาระเจ็บป่วยเรื้อรัง และสนับสนุนความเท่าเทียม ทางสุขภาพ นอกจากนี้นักวิจัยพยาบาลจะต้องเฝ้าติดตามการเปลี่ยนแปลงของสมรรถภาพและความ สามารถในการท̊าหน้าที่ของผู้สูงอายุต่อทุกขภาระและค่าใช้จ่ายของโลกโดยรวม เพื่อป้องกันการสูญเสีย ค่าใช้จ่ายทางสุขภาพในสิ่งที่ไม่จ̊าเป็น เพื่อบรรลุเป้าหมายในการสร้างองค์ความรู้ใหม่และค้นหาวิธีการ ดูแลผู้สูงอายุที่ดีที่สุด นักวิจัยทางการพยาบาลจะเป็นผู้น̊าทีมสหสาขาวิชาชีพ พัฒนาความคิดเชิงสร้างสรรค์ ที่มีความส̊าคัญและมีแนวโน้มที่จะท̊าให้เกิดผลลัพธ์ที่เด่นชัดในคลินิก โดยใช้ระเบียบวิจัยที่เหมาะสม และน̊าไปสู่การประสบความส̊าเร็จในการขอทุนวิจัยจากองค์กรระดับชาติ จึงจ̊าเป็นอย่างยิ่งที่จะต้องพัฒนา โปรแกรมเพื่อฝึกหัดหรือเป็นพี่เลี้ยงให้นักวิจัยพยาบาลที่มุ่งมั่นเพื่อการปกป้องดูแลผู้สูงอายุ และน̊าเผยแพร่การดูแลโดยใช้แนวคิดเชิงสร้างสรรค์ ที่ช่วยสร้างเสริมความเป็นอิสระภาพของผู้สูงอายุ

Nursing professionals are at the forefront of primary care and the largest segment of the health workforce. Nurse researchers bring vital perspectives to aging research and clinical practice that may be undervalued or overlooked by other disciplines. Whereas healthcare systems encounter population aging, there still are limited nurse researchers trained in gerontological nursing. As revised by the American Nurses Association (ANA) in 2018, the goals of gerontological nursing are to optimize health and functions, prevent illness and injury, facilitate healing, alleviate suffering, and advocate for older adults, families, carers, groups, communities, and populations. 1 Caring is a core nursing value and a desirable attribute that developed in nurses. Positive attitudes toward aging and caring behaviors in nurse researchers lead them to play an essential role in working with researchers in other fields (e.g., engineering, computer science) and interact with older adults and their families to better address complex health problems.

By 2030, the number of people aged ≥60 years is projected to grow by 56% (1.4 billion) and is expected to grow fastest in Latin America and the Caribbean, Asia, and Africa, respectively. 2 More than 1 billion adults aged 60 who live in low- and middle-income counties do not have access to essential resources and combat multiple barriers. 3 Extreme global poverty rose in 2020 as the disruption of the coronavirus disease (COVID-19) pandemic compounded the forces of climate change. 3 In addition, aging speeds up during middle adulthood (ages 40–65) and over half of adults aged ≥60 years live with two or more chronic health conditions. 4 A recent scoping review revealed that older adults with chronic conditions require care models and support services, especially older workers and older carers, since they have unmet care needs related to physical, psychological, social, and environmental factors. 5

Aging populations are more negatively affected by disasters, including climate change, and health emergencies such as the current COVID-19 global pandemic, and they are less likely to access resources to help mitigate the consequences. 6 This pandemic has magnified life’s uncertainty and inevitable health, social and economic consequences, 7 especially in older adults who experience health disparities and ageism. Physical/social distancing and lockdown have been adopted as a critical strategy to help reduce the further spread of COVID-19. However, prolonged periods of those strategies may worsen existing health problems, 8 , 9 including frailty and falls. As evidenced in a systematic review, social isolation is significantly associated with falls. 10

In many regions, the cumulative effects of chronic conditions, the COVID-19 pandemic, and climate change effects such as floods, have impacted and highlighted several existing gaps for populations of older people, including an inability to access healthcare resources and essential public services, and technology services such as telehealth, apps to manage health conditions. There is a need to address the differences in technological accessibility and improve digital literacy within impoverished communities. 6 Even in a high-income country like the United States, almost 22 million seniors (42%) do not have internet access at home, and 40% of COVID-19 deaths among older adults occurred when they were unable to access essential online resources at their place during the pandemic. 11 Older adults have been using technology to keep in touch with family and friends to reduce the adverse effects of prolonged social isolation. 6

Future nursing research in older people

Future research should be based on the current needs of older adults, so the role of nurse researchers is to identify potential topics, and highlight opportunities and examples to conduct research for this population aiming to 1) preserve independence and provide culturally appropriate interventions; and (2) reduce health disparities.

Preserving independence and providing culturally appropriate interventions.

Aging is a risk factor for functional decline and diseases, 12 and primary prevention is a public health priority. A prospective cohort study in the United States found that the number of extra disease-free years is around 10 for women and 7.6 for men compared to persons with no low-risk lifestyle factors. 13 It is never too late to change health behaviors to decrease the risk of chronic diseases by starting an early investment in health and wellness that centers on disease prevention and promotion across the life span are keys. As nurse researchers we need to try to understand future disease patterns better that are related to disability in later life. Health behaviors such as physical activity, diet quality, and appropriate body weight can extend lifespan, and postpone the onset of disability at older ages. For instance, several research studies revealed that older adults are less likely to participate in physical activity 14 – 16 and the lack of this activity is related to falls, chronic conditions, and poor quality of life. 17 , 18 Physical activity protects against frailty in men and women of all ages. 19 A longer life free from diseases such as type 2 diabetes, cancer, and cardiovascular disease is linked to healthy habits in middle age. 13 Strategies for promoting physical activity adherence among midlife and older age in real-world contexts are needed. A recent study in the United States shown that a culturally adapted exercise program helped Hispanic older adults to be more active and improve their physical function. 20

Assessment plays a vital component in aging research and is embedded in the nursing process. Utilizing innovative and cost-effective technologies to assess physical and cognitive, and other abilities associated with maintaining independence are needed. Additionally, an intense research effort is warranted to identify risks by using a combination of subjective measure and objective measure is likely to be more beneficial to older adults and health care providers in terms of assessment and tailor interventions. For example, using innovative portable technology (BTrackS Balance System) to assess discrepancies of physiological fall risk (objective measure) and perceived fall risk (subjective measure) and provide virtual physio-feedback based on an objective measure. 21 Novel physio-feedback technology is affordable, easy to use, provides visual presentation, and possibly encourages older adults to participate in the exercise program. 22

A systematic review indicated that technology-based exercise interventions have good adherence and may provide a sustainable method of promoting physical activity and preventing falls. 23 Integrating digital technology into interventions may increase accessibility and success of screening and tailor interventions based on older adults’ culture and context to increase adherence and drive improvement. Furthermore, connecting older adults with technology may be an effective way for older adults to maintain self-reliance without leaving their residence, 24 and enhancing technology-based assessments may facilitate better outcomes. 25 Innovative technology brings effective strategies to maintain independence, prevent disability, and increase access to quality care. For example, apps linked to a mobile phone can help with medication management and exercise adherence, and wearable technologies can track activities in real-time. Moreover, future research should provide the insights needed to facilitate a safer environment that encourages physical and psychosocial engagement and identifies safety risks at home or in neighborhoods to reduce falls and injuries.

Reducing health disparities

Health disparities are the differences between populations in their ability to access and achieve positive health outcomes. Several factors are associated with health disparities, such as age, gender, education, socioeconomic status, disability, ethnicity, race, and geographic location. For instance, in the United States, the National Institute on Aging (NIA) is accelerating efforts to understand how to prevent or lessen the effects of chronic conditions by designing more culturally appropriate interventions and discovering means to enhance healthy behaviors among ethnically diverse older adults. 26 , 27 In addition, the National Institutes of Health (NIH) has funded research activities that help communities disproportionately affected by COVID-19, build trust, and address barriers and challenges surrounding prevention and treatment. 28

As the number of frail older adults increases sharply and the demand for informal care by disabling older adults from their adult children is projected to rise faster than supply over the next 20 years, future research may gear to promote informal caregiving and support carers. Having an informal caregiver can improve older adults’ well-being and reduce depressive symptoms. However, the burden on caregivers and changes in their health status may be related to earlier institutionalization for older patients. We need to have a better understanding of how caregiving impacts older patients and caregivers’ health issues.

In conclusion, regarding the complexity of health, not only in “normal’ situations but also in global pandemics and disasters, nurse researchers pursue the best ways to address the needs of older adults, investigate and disseminate technology-based assessments and culturally appropriate interventions to promote independence and enhance health equality. We also need to monitor the changes in functional status and health of older adults on the global burden and costs of diseases and disability as the older population grows to save unnecessary health care expenditure. To create new knowledge and discover best practices in aging care, nurse researchers lead multidisciplinary teams, develop innovative ideas with the potential for significant clinical impact, and use appropriate research approaches that steer to successful grant applications to national funding agencies. It is essential to establish a program for training or mentoring nurse researchers dedicated to caring for older adults, advocating, and disseminating innovative care to maximize the independence of older adults.

Acknowledgments

National Institutes of Health/National Institute on Aging (NIH/NIA 1R03AG06799-0)

Learning Institutes for Elders (LIFE) at the University of Central Florida (26038A06)

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Nursing MSN & DNP

| 22 October 2021

Exploring a Career in Geriatric Nursing

The United States is currently home to more than 54 million adults over age 65—a population that is projected to rapidly grow to 80.8 million by 2040. ((Administration for Community Living, “Projected Future Growth of Older Population,” last revised May 25, 2021: https://acl.gov/aging-and-disability-in-america/data-and-research/projected-future-growth-older-population )) Known as the “silver tsunami” due to an average of 10,000 Americans turning 65 each day, this wave of aging Baby Boomers is expected to crest in 2030. ((Conor Killmurray, “Nurses Face Challenge of Closing Gap in Geriatric Care,” Oncology Nursing News , Feb. 16, 2020: https://www.oncnursingnews.com/view/nurses-face-challenge-of-closing-gap-in-geriatric-care ))  

As the demand for healthcare increases, so too does the need for nurses and other healthcare practitioners trained to care for our aging population—a specialty known as geriatrics . Roles in this specialty field range from physicians to social workers, physical therapists, occupational therapists, and nurses. ((American Geriatrics Society, “Why Geriatrics”: https://www.americangeriatrics.org/geriatrics-profession/why-geriatrics )) This post focuses on geriatric nursing: what the job entails, the types of opportunities available, and the steps to becoming a geriatric nurse.

What Is a Geriatric Nurse?

A geriatric nurse, also known as a gerontological nurse , is a registered nurse (RN) who is trained to address common health situations facing older adults. They are typically experts in interprofessional team collaboration, given that more than half of Americans over age 65 are managing two or more chronic conditions that may require treatment across healthcare disciplines. ((American Geriatrics Society, “Why Geriatrics”: https://www.americangeriatrics.org/geriatrics-profession/why-geriatrics ))

What Is the Field of Geriatrics?

Geriatrics is defined by Merriam-Webster as “a branch of medicine that deals with the problems and diseases of old age and the medical care and treatment of aging people.” ((Merriam-Webster, “Geriatric,” accessed Aug. 27, 2021: https://www.merriam-webster.com/dictionary/geriatric )) The field of gerontology focuses on the aging process, examining the societal, physical, and mental changes that occur as people age. ((The Gerontological Society of America, “What Is Gerontology?”: https://www.geron.org/about-us/our-vision-mission-and-values/what-is-gerontology ))

Job Responsibilities

Because the needs of older patients vary greatly from person to person, geriatric nursing responsibilities cover a broad range of tasks that may go beyond traditional nursing duties. ((Indeed, “What Is Geriatric Nursing?” Feb. 22, 2021: https://www.indeed.com/career-advice/finding-a-job/geriatric-nursing ))

• Health assessment
• Assessing common geriatric health issues, such as dementia, fall risks, incontinence, and insomnia
• Assisting doctors with physical exams and tracking the patient’s cognitive function and mental health
• Monitoring the patient’s ongoing ability to perform routine self-care and daily activities
• Taking the patient’s history and vital signs for documentation in medical records
• Patient care
• Managing and administering medications; if a nurse practitioner (NP), prescribing certain medications 
• Creating and supervising care plans
• Assisting with exercise and physical therapies
• Supporting basic needs such as eating, bathing, and dressing
• Encouraging the patient’s independence in completing daily tasks 
• Patient advocacy
• Teaching the patient and family about diagnosed health conditions, strategies for continued self-care, and best practices for staying active and healthy
• Collaborating and coordinating with other healthcare team members to provide well-rounded care
• Addressing palliative and end-of-life care planning with the patient and loved ones
• Observing for signs of elder abuse

Which Patients Need Geriatric Medical Support?

According to the American Geriatrics Society , there are three potential indicators that a patient could benefit from a trained geriatrics healthcare professional:

• An older person’s condition causes considerable impairment or frailty. This is common after age 75 or when multiple health conditions are present.
• Family, friends, or other caregivers begin experiencing high levels of stress-related to care of the older individual.
• It becomes too overwhelming for the patient or caregivers to work directly with many different medical professionals treating multiple health issues.

The AGS clarifies that these indicators are by no means rules, because each patient’s case is unique.

Where Do Geriatric Nurses Work?

The field of geriatrics offers nurses a wide variety of work environments to consider. Settings include primary care offices, hospitals, home health services, assisted living communities, senior centers, nursing homes, and rehabilitation and long-term care facilities. 

Depending on the practice setting, some geriatric nurses may have the chance to specialize further in areas such as palliative care, mental health, pain management, or orthopedics. The work is often interdisciplinary, involving a care team that may feature doctors, physical and occupational therapists, social workers, nutritionists, and more. ((American Geriatrics Society, “Training for Geriatric Nurse Practitioners”: https://www.americangeriatrics.org/geriatrics-profession/training-requirements/training-geriatric-nurse-practitioners ))

Geriatric Nursing Salary and Career Outlook

The median salary of a geriatric RN is $72,659, ((Salary.com, “Staff Nurse – RN – Geriatric,” accessed Oct. 14, 2021: https://www.salary.com/tools/salary-calculator/staff-nurse-rn-geriatric?view=table )) on par with the median salary of registered nurses: $64,490. ((Salary.com, “Registered Nurse (RN), Level 1,” accessed Oct. 14, 2021: https://www.salary.com/tools/salary-calculator/registered-nurse-rn-level-1 )) Geriatric NPs earn an average salary of $108,406, ((Salary.com, “Geriatric Nurse Practitioner,” accessed Oct. 14, 2021: https://www.salary.com/research/salary/recruiting/geriatric-nurse-practitioner-salary )) in comparison to the $112,470 ((Salary.com, “Nurse Practitioner Salary in the United States,” accessed Oct. 14, 2021: https://www.salary.com/research/salary/benchmark/nurse-practitioner-salary )) salary of general NPs. And given that the silver tsunami is coinciding with the ongoing nursing shortage , job opportunities for geriatric nurses are abundant.

Earning a nursing role specialty or certification in gerontology or a related specialty could lead to the potential for higher rates of pay. Less than 1% of nurses are geriatric certified, leaving the field open for those who pursue additional training. ((Conor Killmurray, “Nurses Face Challenge of Closing Gap in Geriatric Care,” Oncology Nursing News , Feb. 16, 2020: https://www.oncnursingnews.com/view/nurses-face-challenge-of-closing-gap-in-geriatric-care ))

How Can I Become a Geriatric Nurse?

Like other nursing specialties such as pediatrics and public health , the path to a career in geriatrics begins with nursing school, where you can earn your Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree. Next, you must pass the RN-NCLEX and meet any additional state licensing requirements to become a licensed RN. Continuing your education and completing a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) program will improve your chances for career growth. During your master’s degree studies, you can earn a role specialty in adult gerontology , typically concurrent with your nurse practitioner credential. 

Several organizations offer gerontology certifications that can enhance your expertise in the field. Nurses must have a current, active RN license, have completed continuing education courses in this specialty, and satisfy certain clinical experience requirements to be eligible for certification. Find out more about the options:

• Gerontological Nursing Certification
• Adult-Gerontology Clinical Nurse Specialist Certification
• Adult-Gerontology Acute Care Nurse Practitioner Certification
• Adult-Gerontology Primary Care Nurse Practitioner Certification
• Gerontological Specialist – Certified

As the proportion of the American population over age 65 continues to rise, a nursing career in geriatrics enables you to meet the growing demand—and help elders live longer and healthier lives.  

The University of St. Augustine for Health Sciences (USAHS) offers a Master of Science in Nursing (MSN) program, a Doctor of Nursing Practice (DNP) program, and Post-Graduate Nursing Certificates designed for working nurses. Our nursing degrees are offered online, with optional on-campus immersions* (scheduled to resume in 2022). Role specialties include Family Nurse Practitioner (FNP), Nurse Educator,** and Nurse Executive. Additional role specialties are coming soon within the MSN program: Adult-Gerontology Nurse Practitioner (AGNP) and Primary Care Mental Health Nurse Practitioner (PCMHNP). The MSN has several options to accelerate your time to degree completion. Earn your advanced nursing degree while keeping your work and life in balance.

*The FNP role specialty includes two required hands-on clinical intensives as part of the curriculum.

**The Nurse Educator role specialty is not available for the DNP program.  

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Geriatric Nurse

By EveryNurse Staff on January 12 , 2023

A geriatric nurse is an entry-level registered nurse that specializes in the care of older adults. They typically care for frail and elderly patients with long-term, chronic medical conditions that are not related to an acute illness or injury. Their primary role is to provide holistic and individualized care for patients and families.

In this role, a geriatric nurse is responsible for carrying out the treatment plans determined by physicians and other members of a multi-disciplinary team. They help develop a plan of care that enhances the quality of life for those receiving treatment, with a goal of maximizing patient comfort, promoting safety, preventing deterioration, maintaining current functional status, and preventing new problems.

What Is a Geriatric Nurse? 

Geriatric Nurses are employed in a variety of settings, including hospitals, nursing homes, and home health care. While the specific nature of their duties can vary depending on where they work, their primary job functions include working directly with other healthcare professionals to meet patients’ needs; providing direct patient care, such as administering medications and inserting catheters; and planning for ongoing care needs while guiding families through the process.

Geriatric Nurse Job Description

• Preparing and giving medications (oral tablets or capsules, liquids, intravenous fluids) via injection or other methods, such as IV pumps.
• Recognizing and acting on possible adverse drug reactions, including allergies and other harmful responses to medications and treatments.
• Monitoring patient’s condition and reporting any changes (such as pain, fever, unusual behavior) to the appropriate individuals.
• Providing supportive therapy for patients in order to minimize stress or pain.
• Assisting in personal hygiene tasks, such as bathing, dressing, grooming, and skincare.
• Administering treatments in accordance with orders from doctors or nurses in charge of patient care.
• Evaluating emergency situations that require an immediate response.
• Educating patients about treatment plans they are responsible for and medication regimens they need to follow.
• Assisting in the preparation of patients for diagnostic procedures and surgeries under the supervision of a doctor.
• Participating in discharge planning activities that help coordinate patient care after hospitalization.

Geriatric Nurse Certification

Registered nurses who are actively involved in the care of older patients can become certified in gerontology. A certification in gerontology is available through the American Nurses Credentialing Center (ANCC) and is awarded to registered nurses who meet specific requirements, including having at least three years of experience working with aging patients. Other prerequisites for this certification include:

• A current, unencumbered RN license
• At least two years of full-time practice as a registered nurse
• A minimum of 2,000 clinical practice hours in gerontology nursing within the past three years
• A minimum of 30 continuing-education hours focused on gerontological issues

Geriatric Nurse Jobs

As the population of older adults continues to grow, the need for qualified nurses with specialized knowledge in geriatric nursing is expected to increase dramatically. In 2019, the U.S. population age 65 and older numbered 54.1 million – a 36% increase from the 39.6 million counted in 2009. By 2040, this number is expected to reach 80.8 million – nearly 50% more than the current population.

The aging population has a major impact on both healthcare and employment opportunities because older adults require a considerable amount of medical attention as they age. In particular, many older adults will experience chronic conditions that require ongoing care. These illnesses and conditions can be complex and difficult to manage, which can increase the value of nurses with specialized knowledge and expertise in geriatric nursing.

To take advantage of this growing demand, you can pursue a number of different careers in the field of geriatrics. The most common career paths for Geriatric Nurses include:

Geriatric Nursing Assistant

Geriatric staff nurse, geriatric nurse practitioner, home health nurse, hospice nurse.

Geriatric nursing assistants provide support and personal care for patients. They may assist with bathing, dressing, grooming, toileting, laundry, and other basic activities of daily living. Geriatric nursing assistants typically work under the supervision of a registered nurse or licensed practical nurse who is responsible for overseeing all aspects of patient care.

Geriatric staff nurses provide support to both patients and doctors. They help patients with activities of daily living, monitor patients’ conditions, and assist doctors in diagnostic procedures and surgeries. They work with patients who have complex medical conditions and those with long-term or chronic illnesses. Geriatric staff nurses also provide support and supervision to other nurses, nursing assistants, and orderlies.

Geriatric nurse practitioners are advanced practice registered nurses who have completed a graduate-level nurse practitioner program. They typically provide advanced assessments of patients’ health needs and conditions, develop individualized care plans, and recommend treatment options to other healthcare professionals. In some cases, they may be in charge of supervising the work of nurses and other nursing staff members.

Home health nurses are responsible for administering various patient care services outside of the traditional healthcare setting. They may provide supportive care, teach patients about managing their conditions, assist in rehabilitation efforts, and help with activities of daily living. Home health nurses may help with patients’ basic needs, such as bathing and meal preparation, or they may focus on providing support to those who need it for specific conditions, such as wound care.

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Geriatric Nurse Salary

Geriatric nursing is an area of specialization for registered nurses, which means that their salaries are generally comparable to that of other RNs. According to the BLS , the mean annual wage for RNs was $80,010 in May 2020. The bottom 10% of RNs earned approximately $53,410 per year, while the top 10% made more than $116,230 annually – these figures are based on over half a million RNs who were respondents to the 2020 BLS survey.

Highest Paying States for Geriatric Nurses

Additional Resources for Geriatric Nurses 

• Geriatric Journal
• ConsultGeriRN.org
• GeroNurseOnline.org
• American Society on Aging (ASA)
• American Assisted Living Nurses Association (AALNA)
• Hartford Institute for Geriatric Nursing
• National Association of Professional Geriatric Care Managers (NAPGCM)
• The Gerontological Society of America
• The Gerontological Society America (GSA)
• The American Geriatrics Society (AGS)

Geriatric Nurse FAQ

The average salary for a geriatric nurse is $71,487 per year according to Glassdoor.com. There are factors that impact salaries such as years of experience and geographic location. Geriatrics is a growing field with significant financial upside.

Yes, geriatric nursing is a specialty. Geriatric nurses are expected to have knowledge of gerontology, history of aging, care for older adults with impairment or chronic illness, and interventions that can help older adults maintain optimal health.

A geriatric nurse can enter the field after earning a two-year associate degree or a four-year BSN followed by receiving an RN license. A geriatric nurse will then earn additional certifications to work in geriatrics. Earning a gerontological nursing certification (RN-BC) can increase employment opportunities. The certificate requires two years of RN experience and 2,000 hours of practice in gerontological nursing.

A geriatric nurse is a registered nurse that specializes in healthcare for the elderly. They should understand the aging process, be compassionate, have excellent communication skills, and have patience and empathy. Some nurses may also specialize in the care of people living with dementia or Alzheimer’s Disease.

Geriatric nurses work specifically with the elderly to manage their healthcare needs. Geriatric nurses must have specialized training in the diseases, conditions, and treatments that are common in this segment of the population.

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How to Become a Geriatric Nurse

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The demand for geriatric nurses continues to grow. Each day 10,000 baby boomers will reach retirement age until 2030, and people over 65 use healthcare services more often. Roughly 80% have at least one chronic condition and 68% have two or more.

Geriatric nurses have the opportunity to help senior adults live independently. You can work in several settings, such as hospitals, community centers, and doctor’s offices. Your skills are needed in preventive care, rehabilitation, acute care, mental health, and intensive care.

There is also opportunity for educational and professional growth. Discover the steps it takes to become a geriatric nurse. Your education, licensure, and certification all play an important role in job opportunities and career advancement.

What Is a Geriatric Nurse?

Geriatric nurses specialize in the clinical care of senior adults. They work closely with physicians, social workers, therapists, and families to address the physical and psychosocial needs of the elderly. Geriatric nurses are responsible for working as a member of a multidisciplinary team to develop a plan of care to enhance the life of the patient.

They are challenged with caring for adults who may have conditions that make it difficult to talk, care for themselves, or remember instructions. Geriatric nurses can be generalists, or they can focus on a specific age-related disease common in the elderly. This could include dementia, osteoporosis, nutritional deficiency, or arthritis.

Adults with impaired mobility are at higher risk of negative health outcomes and poor quality of life. Impaired mobility increases the risk of depression, anxiety, and limited social activity. Geriatric nurses play a unique role in prevention and treatment that improves their patient’s level of comfort and well-being.

Steps to Becoming a Geriatric Nurse

Your journey as a geriatric nurse begins by earning your nursing degree and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN), which is necessary to get your license. The path you choose after these steps can help determine your career development, job opportunities, and clinical settings where you practice.

Most employers require RNs to be certified in basic life support. Depending on your job setting, advanced cardiac life support certification may also be required. Learn more about a geriatric nurse career .

Earn an associate degree in nursing (ADN) or bachelor of science in nursing (BSN) degree.

There are two ways to become an RN. You may earn an ADN . This is generally a two-year degree and the fastest route to becoming an RN.

You may also earn a bachelor of science in nursing degree, which generally takes four years. Nurses who choose to start their careers quickly can enroll in an RN-to-BSN program . You can find in-person and online nursing programs that allow you to complete your BSN degree while working.

Pass the NCLEX to Receive RN Licensure

The NCLEX exam is a nationwide test required to get your state nursing license. The examination is a comprehensive test of your clinical skills. Most students take the test within 1-2 months after graduation.

It is important to prepare for the NCLEX exam by studying the concepts and taking practice tests. The practice tests ensure you aren’t surprised by the types of questions or format used on test day.

The NCLEX exam uses computerized adaptive testing to customize the test to the test-taker. This reduces the number of easy or difficult test questions and provides a reliable measurement of competence.

Gain Experience in Geriatric Nursing

Becoming a geriatric nurse requires experience, but it is possible to be hired by a gerontology unit directly out of nursing school.

Employers are seeking nurses with acute and critical care experience. This improves your assessment skills and ability to react quickly to emergency situations. You may also gain experience in medical-surgical units or step-down units.

Nurses who want to advance their education and become gerontology nurse practitioners must have at least one or two years of clinical experience before starting a master of science in nursing program .

Consider Becoming a Certified Geriatric Nurse

The American Nurses Credentialing Center’s gerontological nursing board certification validates your specialty knowledge. Nurses must meet eligibility requirements. These include holding an active RN license with two years of clinical experience. You must also have had at least 2,000 hours of clinical practice in gerontology in the last three years and 30 hours of continuing education nursing credits in the last three years.

Geriatric Nurse Education

The minimum degree required to become a geriatric nurse is an ADN. While this is the quickest route, most employers prefer BSN-prepared nurses. However, an ADN offers students the opportunity to graduate within two years and start working. ADN-nurses can earn a BSN using an RN-to-BSN bridge program.

An ADN program teaches nurses the foundational clinical tasks necessary to care for patients. It is best suited for students who don’t have the time or financial resources to attend a four-year program directly. It is the minimum eligibility requirement for the NCLEX.

Admission Requirements

High school diploma or GED certificate; school transcripts, prerequisite college-level classes; pre-entrance exam like the Test of Essential Academic Skills (TEAS); criminal background check; cardiopulmonary resuscitation certification; drug screening

Program Curriculum

Hands-on learning experiences and coursework in English, communications, chemistry, biology, and foundations in nursing

Time to Complete

Two years for full-time students; 15-month schedule for accelerated programs

Skills Learned

Taking blood pressure; inserting a foley catheter; giving an injection; suctioning a tracheostomy

Many employers prefer BSN-prepared nurses because care is linked to better patient outcomes and lower mortality. BSN-prepared nurses are also better equipped to manage teams and supervise students.

The BSN program is best suited for students who can take the four years before working. This is the minimum degree required to be eligible for a graduate program.

Prerequisite college courses if applicant is not a direct admission from high school; high school diploma or GED certificate; minimum GPA; TEAS examination; criminal background check and fingerprinting; drug screening

Hands-on clinical hours; courses in math, English, communication, anatomy/physiology, physical assessment, U.S. political systems, critical thinking, pharmacology, informatics, and culture

Four years for full-time students; faster if you take a heavier class load and longer if you attend part time

Foundational nursing tasks; leadership skills; evidence-based practice; management; public health

Geriatric Nurse Licensure and Certification

How you become a geriatric nurse begins with being licensed by the state to practice nursing. The requirements may vary depending on the state board of nursing. However, each state requires nurses to submit an application and have passed the NCLEX exam . Other requirements can include fingerprint cards, submitting official transcripts, or providing social security numbers.

There is no requirement to be certified in gerontology. However, earning board certification as a gerontological nurse can demonstrate experience and knowledge in the specialty and helps job-seekers differentiate themself from competitors.

To become certified, a nurse must hold an active and current RN license in the U.S. and have at least two years of experience. The nurse must also have 2,000 hours of clinical experience in gerontology nursing in the last three years and 30 hours of continuing education hours in the last three years.

Working as a Geriatric Nurse

Geriatric nurses may find employment in different settings. However, before seeking a job outside of a hospital setting, it’s advisable for nurses to get at least two years of clinical experience.

Many community-based job opportunities require nurses to operate autonomously. Clinical experience is helpful to solidify your clinical, assessment, and intervention skills. You can find employment opportunities in hospitals, nursing homes, home care agencies, senior centers, rehabilitation facilities, and retirement communities.

Responsibilities vary depending on the setting. For example, geriatric nurses in retirement communities assist patients with medications, answer questions, and provide preventive care interventions. In a rehabilitation facility, a geriatric nurse helps patients relearn how to care for themselves, improve strength and coordination, and educate patients on preventive care.

According to the U.S. Bureau of Labor Statistics , the median annual salary for an RN in 2021 was $77,600. Experts estimate the job growth at 9% till 2030, which is as fast as the average job outlook. This may be adjusted in the coming year as more nurses reach retirement age and the nursing shortage grows.

According to Payscale , an RN with geriatric nursing skills makes an average base annual salary of $70,290 as of July 2022. This does not include bonuses or profit sharing.

Frequently Asked Questions About Becoming a Geriatric Nurse

How many years does it take to become a geriatric nurse.

It takes 4-6 years to become a geriatric nurse. Included is the time it takes to earn your RN license and gain bedside experience with the geriatric population.

What skills are needed to be a geriatric nurse?

Geriatric nurses must understand the aging process and have patience and empathy with their patients. They must also understand how to read nonverbal communication and be adept at caring for patients with the common chronic illnesses and diseases that affect the elderly.

What is the difference between geriatrics and gerontology?

Both are in the same field and focus on elderly adults, but they serve different functions. Geriatrics focuses on the health of senior adults and treatment, while gerontology is a field of study that focuses on the physiological, biological, and psychological changes that occur with age.

Do geriatric nurses get paid well?

A geriatric nurse’s salary depends on the practice setting. The average annual geriatric nurse salary is higher than that of the average professional. Factors that influence salary are geographical location, practice setting, certifications, and experience.

Page last reviewed July 12, 2022

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What Is Geriatric Nursing?

The aging population is a leading reason for why registered nurses have such a strong job outlook. “Demand for healthcare services will increase because of the aging population , given that older people typically have more medical problems than younger people,” according to the Bureau of Labor Statistics (BLS). “Nurses also will be needed to educate and care for patients with various chronic conditions, such as arthritis, dementia, diabetes, and obesity.”

Learn more about the roles and responsibilities of geriatric nurses, as well as salary and outlook figures.

Geriatric Nursing Care: Roles and Responsibilities

Geriatric nurses work at healthcare facilities like nursing homes , hospitals, hospices and home healthcare service providers to care for elderly patients, who have a higher risk of developing chronic health conditions and diseases such as osteoporosis, arthritis, congestive heart failure, Alzheimer’s disease, cancer and diabetes. Geriatric nurses help patients cope with and prevent these types of issues.

Specific responsibilities include the following.

• Administering medications and making adjustments when needed
• Creating and evaluating care plans
• Exercising and massaging patients
• Conducting routine physical and mental exams
• Helping rehabilitate patients after injuries
• Watching for signs of elder abuse
• Giving advice on disease prevention and personal safety tips
• Connecting patients with local resources
• Transporting patients to doctor’s visits and other appointments
• Helping patients with daily needs, such as dressing, bathing and using the bathroom

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Geriatric Nurse Salary

Geriatric nurses are required to be registered nurses. The median annual wage for registered nurses is $68,450, according to the BLS. The highest 10 percent earn more than $102,990 and the lowest 10 percent earn less than $47,120. The mean annual wage for registered nurses in Kentucky is $59,810 .

Salary information is available for registered nurses in the top industries in which they work.

• Government: $73,980
• Hospitals: $70,590
• Home healthcare services: $64,140
• Offices of physicians: $61,730
• Nursing and residential care facilities: $60,950

Employment of registered nurses is projected to grow 16 percent by 2024, which is much faster than the average for all occupations. In addition to growth due to the aging population, there is financial pressure for hospitals to discharge patients as soon as possible. This will result in more people being admitted to long-term care facilities and outpatient care centers, as well as a greater need for healthcare at home.

Education is paramount for nurses. “Overall, job opportunities for registered nurses are expected to be good,” according to the BLS. “However, the supply of new nurses entering the labor market has increased in recent years. This increase has resulted in competition for jobs in some areas of the country. Generally, registered nurses with a Bachelor of Science degree in nursing (BSN) will have better job prospects than those without one.”

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An online RN to BSN from Campbellsville University can help you pursue employment opportunities in geriatric nursing or another specialty. Develop the skills you need to improve care for patients. Learn in a rigorous environment with a convenient, flexible schedule that fits into your busy life.

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Is a Geriatric Nursing Career Right for You?

September 27, 2021  |  9 Min Read

Our elders need excellent care.

That’s always been true, and recent years have only shined a greater spotlight on the need for excellence in geriatric medicine. It’s a critical part of the health care field, and geriatric nurses are the engine that drives care for the elderly.

Whether as a lifetime calling or just a season in a nurse’s career, caring for the elderly is also tremendously rewarding, both personally and professionally. By working with patients with complex medical needs, you will grow and hone your skills as a nurse. Even more significantly, geriatric nursing is an opportunity to make a real difference in the lives of patients who need empathetic care now more than ever.

Geriatric Nurse Job Responsibilities

Geriatric nurses provide day-to-day direct care for elderly patients to maintain both their physical health and quality of life. Because elderly people often have complex medical needs, the responsibilities of a geriatric nurse are many. Core job responsibilities include:

• Developing treatment plans for elderly patients in collaboration with physicians and other medical professionals.
• Administering medications and medical devices.
• Providing treatment for medical conditions that commonly affect the elderly, both cognitive (e.g. Alzheimer’s disease) and physical (osteoporosis, arthritis, heart disease, diabetes, and so on).
• Assisting with activities of daily living (ADL), such as bathing, toileting, dressing, eating, and drinking.
• Monitoring for signs of infection, fractures, and other acute health issues and providing appropriate treatment.
• Monitoring for signs of elder abuse and neglect.
• Preparing and reviewing paperwork related to government regulations and insurance claims.
• Educating patients and their caregivers on ways to handle age-related conditions.

These responsibilities can be quite taxing, both physically and mentally. Assisting patients with their activities of daily living often requires lifting or physically supporting them. Patients need to be turned in bed to prevent pressure ulcers (bedsores) from forming, and many require physical assistance with activities such as bathing or dressing. Part of the job of a geriatric nurse is to be an extra set of arms and legs for patients with limited mobility or coordination.

In addition, geriatric nurses need a deep well of patience, compassion, and empathy as they help their patients navigate the challenges of aging. Recognizing both verbal and nonverbal cues is essential to communicate effectively with patients who may have lost some of their ability to speak. Geriatric nurses must be prepared to listen sympathetically to patients who are frustrated with their own physical decline and may be uncooperative or even combative toward caregivers. However, beyond those challenges is the opportunity to form meaningful connections with patients, meet their complex needs, and grow as a nurse and as a person.

Where Do Geriatric Nurses Work?

Long-term care facilities are the most prominent employers of geriatric nurses, but any medical facility or agency that cares for elderly patients needs a geriatric nurse’s skill set. Most geriatric nurses work in one of the following settings:

• Nursing homes, memory care facilities, and similar sites. Geriatric nurses in long-term care create treatment plans, monitor patients for medical issues such as bedsores and infections, assist with rehabilitation, administer medications, and provide other medical care to residents as needed. Nursing homes are required by law to have a nurse on-site at all times, so there is a constant need for qualified nurses in this setting.
• Hospitals and medical clinics that care for elderly patients. In addition to providing direct patient care such as medication administration, geriatric nurses in these settings help to educate elderly people and their caregivers about their care options.
• Home health agencies that provide care to elderly and disabled patients in their homes, including those with permanent conditions such as dementia and paralysis. Geriatric nurses in these agencies help patients recover from surgery and medical procedures, provide medication administration, and assist with activities of daily living such as hygiene and nutrition.

These are the “big three,” but there are numerous other opportunities for geriatric nurses across the health care industry. Geriatric nurses may work in government and academia, rehabilitation facilities, or private doctors’ offices. They may work in the insurance industry or for medical supply companies. As the population continues to age, more and more organizations have a need for experts in geriatric care.

In nearly any setting, though, geriatric nursing often involves working with patients’ families (such as adult children and even grandchildren) in addition to patients themselves. One of the more rewarding aspects of the career is the opportunity to form relationships across generations and see the difference good nursing care can make for both elderly patients and their families.

Career Benefits of Working With the Elderly

Elderly patients have complex medical needs. Many are on multiple medications and suffer from both physical and cognitive conditions. Diagnosing and treating an elderly patient is often challenging and requires critical thinking on the part of the geriatric nurse. Physiological differences play a role; for instance, elderly people often have lower baseline body temperatures than the general population, so an aging patient with a seemingly normal temperature may actually be feverish. Likewise, cognitive decline presents challenges in caring for the patient’s physical health: if a patient struggles with speech or memory, diagnosing physical conditions based on the patient’s self-reported symptoms may be impossible.

The upshot of these challenges is that they force the geriatric nurse to develop strong treatment skills and pharmacological skills when working with these patients. There is no better real-life laboratory to grow as a nurse than working with elderly patients who have multiple medical conditions, and those skills are transferable to most health care settings.

Beyond those “hard” skills, geriatric nurses need to develop their patience, understanding, compassion, and bedside manner. There are numerous challenges and barriers to communication for elderly patients, including difficulties with speech, memory loss, and cognitive decline — not to mention the inherent challenges of the generation gap between aging patients and nurses who may be several decades younger. Bridging that gap means learning to communicate with all sorts of patients, listen actively and empathetically, and take adversity and even combativeness in stride.

In short, working with the elderly is an incredible opportunity to grow as a nurse, while making a meaningful difference for an under-served population.

How to Become a Geriatric Nurse

Employers generally prefer to hire registered nurses who hold a Bachelor of Science in Nursing (BSN) compared to just holding an Associate Degree in Nursing (ADN).

If you want to become a geriatric nurse after earning your BSN, it’s a good idea to take elective classes on the unique needs of aging adults. Coursework in critical care nursing is important, too, because it prepares aspiring geriatric nurses for the types of illnesses and interventions that are often needed by geriatric patients.

It’s typically not hard to find a job in geriatric nursing once you have your BSN; the job is in high demand and that demand will only grow over time. According to the Bureau of Labor Statistics, overall employment in nursing jobs is expected to grow by 7% from 2019 to 2029, faster than the national average. The BLS notes that one of the main drivers of the increase in demand for health care workers is the aging population. This means trained and experienced geriatric nurses will be increasingly important in the field.

Many employers will hire geriatric nurses straight out of nursing school, especially if they have sufficient critical care experience. The more bedside experience you have, the more opportunities will be open to you.

Aspiring geriatric nurses need to pass the National Council Licensure Examination (NCLEX) examination to become a registered nurse. While not required, many pursue additional certification: the American Nurses Credentialing Center (ANCC) offers the Gerontological Nursing Certification (GERO-BC) to eligible nurses. In order to be eligible for this certification, you must have:

• A current, active RN license in any U.S. state or territory (or the equivalent in another country).
• The equivalent of two years of full-time practice as a registered nurse.
• A minimum of 2,000 hours of clinical practice in gerontological nursing in the last three years.
• 30 hours of continuing education.

Career Outlook for Geriatric Nurses

The long-term career outlook for geriatric nurses is bright. As the population continues to age and more and more people transition into elder care facilities, more nurses will be needed to provide skilled nursing care. The health care industry in general and the geriatric care industry in particular are growing quickly, and the need for skilled nursing staff will only increase as patients’ needs grow more complex and care methods and technology become more advanced.

A geriatric nurse with a Bachelor of Science in Nursing (BSN ) is well-positioned to pursue continuing or graduate education and explore additional career opportunities over time. An experienced geriatric nurse may have the opportunity to move into a leadership role in geriatric nursing, such as director of nursing at a long-term care facility, or transition into a different nursing specialty. Some natural long-term career paths for geriatric nurses include:

Orthopedic nurse: Skilled nurses are needed to care for patients with musculoskeletal problems and improve their mobility and independence. Musculoskeletal problems are most common in the geriatric population, so nurses with a background working with older patients can easily transition into this specialty once they have the right certification.

Adult-gerontology nurse practitioner: Increasingly, nurse practitioners are providing primary care services to many patient populations, including in senior communities. Becoming a nurse practitioner requires a master of science in nursing (MSN) and a national certification exam. An adult-gerontology nurse practitioner can work in private practice in addition to seeking employment in a health care facility.

Nurse researcher: Researchers with a background in geriatric nursing are well-suited to conduct research on disorders that affect seniors, such as Alzheimer’s and dementia, and the need for research in this field is only going to grow. Becoming a researcher typically requires a graduate degree.

Nurse educator: The next generation of nurses will likewise need to work with an aging population, and that means they will need to learn from people with firsthand experience. To become a nurse educator, you need a Master of Science in Nursing (MSN) degree with an appropriate specialty.

Take the Next Step in Your Nursing Career

Whether geriatric nursing is your long-term path or merely one season of a multifaceted nursing career, your time caring for the elderly is time well spent. Being a geriatric nurse means honing your communication skills and bedside manner. It cultivates tremendous patience, empathy, and compassion. While it’s challenging and sometimes heartbreaking work, caring for elderly patients is also an opportunity to form strong, meaningful relationships across generations and access the years of experience, stories, and perspectives that our elders have.

For people with the right skills and right mindset to succeed, caring for the elderly is incredibly fulfilling. To provide high-quality care and improve outcomes in elderly patients with complex medical needs, you need to sharpen your nursing skills by learning from instructors with real-world experience. Take your next step, in balance with your career and home responsibilities, with the online RN to BSN program at Methodist University. Interested in other health care degrees? Explore all the online health care programs we offer at Methodist University.

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The effectiveness of the comprehensive geriatric assessment for older adults with frailty in hospital settings: A systematic review and meta-analysis

Affiliations.

• 1 School of Nursing, Jilin University, Changchun, China. Electronic address: [email protected].
• 2 The First Hospital of Jilin University, Changchun, China. Electronic address: [email protected].
• 3 School of Nursing, Jilin University, Changchun, China.
• 4 School of Nursing, Jilin University, Changchun, China. Electronic address: [email protected].
• 5 School of Nursing, Jilin University, Changchun, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China. Electronic address: [email protected].
• 6 School of Nursing, Jilin University, Changchun, China. Electronic address: [email protected].
• PMID: 39146609
• DOI: 10.1016/j.ijnurstu.2024.104849

Background: Comprehensive geriatric assessment (CGA) is performed by a multidisciplinary team and includes systematic comprehensive team assessment and treatment. Comprehensive geriatric assessment has become a fundamental component of geriatric nursing, as a multidimensional approach is necessary to achieve the best diagnosis and therapy for older adults with frailty.

Objective: The aim of our review was to analyze the effects of comprehensive geriatric assessment interventions on older adults with frailty in hospital settings.

Methods: The PubMed, Web of Science, Embase, CINAHL and Cochrane Library databases were systematically searched from inception to February 28, 2024. Only randomized controlled trials were included in the analysis. The risk ratios (RRs) or standardized mean differences (SMDs) were calculated to determine the pooled intervention effects. Sensitivity analyses and publication bias analyses were also conducted. Methodological quality and evidence were assessed using the RoB2 tool and GRADE pro online tool.

Results: A total of 18 randomized controlled trials were included in this review. The results showed that participants in the intervention group had a lower risk of having decreased activities of daily living than did those in the control group (RR = 0.55, 95 % CI: 0.33 to 0.92, P = 0.021, low certainty evidence). Comprehensive geriatric assessment was associated with a reduced mortality risk (RR = 0.85, 95 % CI: 0.73 to 0.99, P = 0.038, high certainty evidence).

Conclusion: In conclusion, this systematic review analyzed the available literature, and the results showed that comprehensive geriatric assessment had significant benefits in terms of increased independence and was associated with a reduced mortality risk for older adults with frailty in hospital settings. However, the evidence was limited. Thus, more research is needed in the future to further enrich the evidence in the field of comprehensive geriatric assessment interventions for older adults with frailty.

Keywords: Acute care; Comprehensive geriatric assessment; Frailty; Meta-analysis; Older adults; Systematic review.

Copyright © 2024 Elsevier Ltd. All rights reserved.

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Conflict of interest statement

Declaration of Competing Interest None.

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What is geriatric care, how to find a geriatrician, when to see a geriatrician, how to choose a geriatrician.

Geriatric care is specialized medical care and support for older adults, typically adults over age 65. Aiming to improve overall quality of life and promote healthy aging, geriatric care usually designs custom care plans for complex medical needs. These plans may involve managing multiple health conditions at the same time. 

Common health issues include:

• Cognitive decline, often Alzheimer’s disease and other types of dementia .
• Chronic diseases, including cancer, heart disease, osteoporosis, etc.
• Mobility issues.
• Sensory impairments.
• Mental health issues (anxiety, depression, etc.).
• Malnutrition.
• Polypharmacy (regularly taking multiple medications).
• Insomnia or sleep issues.
• Urinary incontinence.

Medical care starts with a comprehensive health assessment. Often this means pinpointing chronic conditions and cognitive function. It may also involve preventative care like vaccinations and medication management. Other recommendations might include guidance for healthy lifestyle changes .

Along with medical care, a geriatric care plan may take emotional support into account. Common ways to support emotional well-being in a care plan include counseling, therapy, support groups , etc.

While they may sound similar, there are major differences between geriatricians and gerontologists. Unlike geriatrics, which involves the care of older adults, gerontology is a field of study that explores how humans age throughout their lives. Gerontologists study a variety of disciplines — sociology, psychology, public health, research, etc. — but might not identify as a geriatrician. In contrast, a geriatrician might also consider themselves a gerontologist. Gerontology professionals look at the aging process as a whole and tend to have a more personal relationship with their patients. Geriatrics, on the other hand, centers around the diagnosis, treatment and prevention of diseases afflicting older adults.

Geriatricians may specialize in cognitive decline, specifically Alzheimer’s and other dementias. Keep an eye out for early warning signs and symptoms of Alzheimer’s disease, which impact memory, reasoning or decision-making abilities. While a geriatrician can be a helpful part of your care team, consider getting more support from additional care providers : geriatric nurses, social workers, physical therapists, aging life care managers and other health care professionals.

When looking for a geriatrician, your primary care physician or health care provider is a good starting point. Go over your specific care needs and preferences, then ask for a referral to a geriatrician.  You can also search health care provider directories. Insurance companies typically offer an online directory allowing you to search for geriatricians. Search based on location, specialty, gender and accepted insurance plans. If there’s a "specialty" option, add the terms "geriatrician" or "geriatric doctor". Geriatric medicine departments or academic medical centers might also help narrow your search. Look for departments specialized in geriatric medicine. Some may even have experienced geriatricians, onsite and available to help. Another option is the Community Resource Finder , a database of dementia and aging-related resources that makes it easy for individuals and families to find programs and services in your area. Not sure where to start your search for a geriatrician? Talk to a dementia expert with our free 24/7 Helpline at 800.272.3900.

Picking a geriatrician starts with figuring out what type of care is best for you or your family member. Specific age-related medical concerns with cognitive decline, mobility or chronic illness are best suited for a geriatrician. Understanding how much help you or your loved one needs for daily activities might also lead you to seek the care of a geriatric physician. This might mean figuring out how much extra support is needed for medication management, daily movement (standing, walking, getting in and out of cars, etc.) and routine personal hygiene like showering or brushing teeth. Once you’ve decided to take the specialized care of a geriatrician, look for board certification in geriatrics. Search certification websites for board-certified family doctors and narrow your search under additional qualifications for “geriatric medicine.” Take into account how many years of experience the geriatrician has. Find out if they treat age-related conditions most relevant to you or the person in your care.  When choosing a geriatrician, consider these questions:

• Are they accepting new patients?
• Are their specialties relevant to you or the person you're caring for? (e.g., Alzheimer's and other dementias, balance disorders, heart disease, etc.)
• Does their office work with your insurance?
• Is their office location convenient?
• Do they offer telemedicine? (This is a good option for follow-up appointments and/or if mobility is a concern.)
• Is their office easy enough to get to? (Consider distance, traffic, parking, etc.)
• How easy is it to make appointments?
• Does their office answer the phone often? 
• Does their staff follow up promptly? 

Not sure whether a geriatric doctor is the right choice? Learn more about choosing care providers .

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