The new year, the new decade, the new century, and the new millennium are milestones that offer opportunities to promote out-of-the-box thinking, to develop nursing science, and to enhance the professionalization of nursing.
The opportunities for out-of-the-box thinking are particularly apparent in the care of the aging client. As people live longer new challenges arise for nursing. Stereotypes of aging are debunked as people continue living active productive lives after age 65. Senior sporting events such as Senior Olympics, golfing, and tennis are commonplace. There are support groups that particularly focus on the needs of older adults, such as the Supportive Older Women's Network. (SOWN). 1 Services provided by SOWN include support and counseling, transportation, and crisis intervention for women ages 55 and older. Various religious senior citizens groups address spiritual needs of older adults. These groups also include social, recreational, and learning activities. Senior citizens centers are also present throughout the secular community. Some senior groups have a particular focus such as an emphasis on learning. For example, the Plato Society is a study group for older adults that seniors attend to learn for the sake of learning. 2 Educational seminars are common for the older adult. This trend will continue as Baby Boomers retire and live longer, healthier lives. Developmental tasks of aging such as dealing with the loss of a spouse, sibling, or friend; retirement; and integration of past life experiences present opportunities for growth and change in new directions. Nursing intervention using reminiscence and life review groups with older adults can focus on the strengths of older adults and foster health.
This issue of HNP focuses on the challenges and opportunities of aging from the nursing perspective. Many topics are relevant to nursing and aging. However, the articles in this issue present innovative ideas to approach our aging society.
Nursing literature and practice supports the promotion of health and wellness across the life span. Watson and Pulliam suggest that transgenerational health promotion using collegiate nursing students and older adults benefits the adult and the student. This article focuses on the developmental, situational, health-illness, and organizational transitions faced by older adults. The nursing students help the adult to integrate prevention and health promotion into their lives. This enhances self-care and provides more health care in the community. The student learns that aging can be a positive experience where the chance for empowerment and growth is present as long as one is alive.
One of the more distressing challenges for nursing is the environment of some nursing home residents, which may be lacking in social support. Institutionalization of an older adult poses dramatic changes of different norms, values, and rules from his or her typical lifestyle. Zurakowski's study tests the relationship between anomia, social support, and perceived health status in older nursing home residents. The results of this important study provide initial data that nurses can use to enhance health status for older adult clients residing in nursing homes. The findings suggest that one of the most important nursing interventions in long-term care may be providing social support.
Kain's work on the care of the older adult following a hip fracture focuses on a serious health problem of older adults. The fact that it is the leading cause of hospitalization for older adults forces us to ask the questions: Can it be prevented? What about postsurgical complications? The frequency of hip fractures in older adults requires scientific nursing interventions to address this grave health problem.
Elder abuse and neglect is a sad but common problem of older adults. It may be as common as other chronic illnesses of older adults, such as diabetes, pancreatic cancer, and cataracts. Wieland identifies the types of elder abuse and neglect and explains some causes for the occurrence of this tragedy. It presents a complex challenge for nurses because it may be interwoven with other forms of violence, such as family violence. It is particularly important for the nurse to understand the dynamic of elder abuse because of the increasing number of frail older adults. Nurses have a pivotal role to play in the prevention and treatment of elder abuse and neglect because they deal on a day-to-day basis with families who may experience transgenerational violence and caregiver stress. The tragedy of elder abuse and neglect is a challenge that must be met by nurses and other health care workers to protect vulnerable family members and to promote family health.
Family members as caregivers are central to the domain of nursing, as evidenced by the frequency with which it appears in the nursing literature. Families as caregivers require that nurses view the family as the client. Plowfield, Raymond, and Blevins have devised a nursing intervention schema for families as caregivers of frail older adults. The goals for intervention and strategies for implementation are identified that provide useful knowledge for nurse educators and clinicians to address the complex needs of families with frail aging members.
The holistic philosophy common to most nurses invites a variety of nursing interventions across the physiological, psychological, developmental, spiritual, and sociocultural variables. 3 However, these interventions are usually face-to-face or on the telephone in individual or group sessions. Using the Internet for nursing interventions may not be typical for most nurses, but the use of computers as a nursing intervention is growing. On-line capabilities can be perceived with anxiety in persons of all ages. Alexy's article presents information demonstrating that computers can be used with older adults and their caregivers in ways that enhance traditional face-to-face nursing practice. This innovative nursing intervention can aid in the delivery of patient care by including the benefits of worldwide science and technology.
Nurse educators frequently face the challenge of finding appropriate clinical placements for students. From proposes a clinical site that provides students access to an older adult population in a social work agency on aging. This out-of-the box thinking promotes autonomy in students while providing them with the necessary learning experiences to perform nursing interventions and meet their course objectives. The nursing faculty and social work staff at this agency agreed that the students achieved their learning objectives and that the clients received excellent care. This innovative approach to community health nursing with older adults bridges the gap between social work and nursing. The contributions of nursing and social work are mutually recognized and valued. The nursing students achieved the benefit of seeing this in practice rather than learning it by only hearing or reading. The end result of this collaboration is better patient care.
Benefits of maturity include generativity, wisdom, emotional and mental flexibility, and broadening of social relationships. Within the context of these benefits forgiveness often emerges as impacting maturity and enriching the transition into older adulthood. Festa and Tuck review the forgiveness literature and provide information that enhances psychosocial nursing practice. Incorporating forgiveness into the theory and practice of nursing can add an important dimension to the care of older adults and their families.
This issue of Holistic Nursing Practice provides a strong foundation of nursing that should enrich the practice of nurses caring for older adults and their families. It is my hope that the articles have stimulated nurses to continue excellence in innovative care for this important societal group.
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