The issue of our aging society is not a new topic. It is anticipated that by the year 2050, one in five Americans will be older than 60 years (Blazek, 2010). Care for this population will take place in many locations: home, adult day care centers, assisted living facilities, hospitals and nursing homes with various types of designated units. Care will be provided by many different providers, which may include nurses and direct care workers who may be a certified nursing assistant, home health aide, home care aide, or personal care assistant. In 2006, it was estimated that there were more than 2.7 million direct care workers who "provided the majority of paid hands-on care, supervision, and emotional support to the elderly and disabled in the United States." (Smith and Baughman, 2007)
Caring for the aging population is not an easy task. This group of patients often has many diagnoses that require management. Assuring that all care providers who interact with the elder population are knowledgeable and can safely manage the patient will be essential. Knowledgeable professionals who oversee direct care workers to be sure that elderly patients receive the appropriate care from the appropriate provider must occur.
How will the demand of the care required be met? Initiatives lead by the American Association of Colleges of Nursing, through the generous support of the John A. Hartford Foundation, to develop innovative educational programs to encourage nursing students in baccalaureate program to consider care of the older adult (Burbank, Dowling-Castronovo, Crowther, & Capezuti, 2006). Changing the attitude about gerontological nursing of nurses entering the profession may aid in the challenge ahead.
Providing information to health care providers will also be important. Orthopaedic Nursing will continue to publish manuscripts that will aid care providers to understand the challenges of caring for the elder population. Two articles in this issue-Staus in her article "Delirium in the Older Adult Orthopedic Patient: Predisposing, Precipitating, and Organic Factors" (page 231) and Thompson's "Orthopedic Nurses' Knowledge of Delirium in Older Hospitalized Patients" (page 241)-deal with one problem that many elderly patients are faced with: delirium. Both articles provide essential information in how to identify a patient who has delirium and understanding the impact that hospitalization has on the disease.
Issues that challenge nurses' knowledge of care of the elderly will be presented in Orthopaedic Nursing. It will be necessary for nurses in every specialty to understand the problems and concerns of this age group. Working with our gerontological colleagues to gain the knowledge needed to provide safe care to this population of patients should be a goal.
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