Integration of gerontology content into curricula is paramount for meeting the needs of the population that students will be serving. One in 8 Americans is older than 65 years, and aging baby boomers will expand this number even more.1 Older adults are also living longer with advances in healthcare, with the population older than 85 years expected to increase from 4.2 million in 2000 to 7.3 million in 2020.1 A large portion of healthcare services are devoted to seniors. According to the Centers for Disease Control,2 57% of all visits to generalist physicians, 50% of hospital expenditures, 80% of home care visits, and 90% of nursing home care are for care of people older than 65 years. This population also has complex healthcare needs, with 90% of older adults having at least 1 chronic illness whereas most adults older than 75 years have at least 3 chronic conditions.2 The practicing nurse in the 21st century must be prepared to care for older adults.
According to a recent study, 85% of nursing programs evaluated did not require coursework in gerontology.3 To address these concerns, in the new Essential of Baccalaureate Nursing Education from American Association of College Nursing for accreditation of baccalaureate nursing program, gerontology education is clearly identified as a needed component in nursing programs.
In addition to being educated about gerontology, nursing students also need to be excited about care of the older adult. Most students in a traditional nursing program usually do not express an interest in working with the older adult. By creatively including a wide variety of gerontological assignments, students will gain knowledge and may become interested in gerontology. Attitudes of students toward older adults can influence their career choices in nursing in the future and enhance the care of the elderly.
Integration in the Clinical Setting
In the clinical setting, assignments should focus on the elderly, along with other adult populations. Positive attitudes of the student toward the older adult will be critical for having high-quality educated staff to care for the elderly. Faculty can focus on making assignments of older adults positive and one of collaboration with other disciplines. Collaborative practice is a way to show students how collaborative interaction among a variety of disciplines enhances care and viewpoint on caregiving, especially in populations with complex health needs, such as older adults. The complex issues of the seniors excited the students and they enjoyed working in collaboration with other members of the healthcare team. The team approach in gerontology is an approach that the millennial generation embraced.
Students in the clinical setting were required to do comprehensive interviews and assessments on their patients during the semester. I assign older clients to the students to complete their interview and assessment process. During this interview process, the students investigated the patients' "story about their life." Students were encouraged to tell their patients' stories in their assignment and to share it in postconference. This strategy helped the student see the patient from a personal perspective and helps them enjoy working with the elderly. The students discovered how much they have in common with other generations and see the older person from a positive perspective. Students typically told the story of the elderly patient with enthusiasm. Students were also required to complete a physical assessment on an elderly patient and helped the student learn about normal aging versus pathological findings.
The clinical faculty also plan postconference topics that enhance learning of gerontology. Topics such as end-of-life care, social needs of the older adult, and pharmacology with a gerontological focus were discussed in a conference. The students were given an opportunity to investigate and discuss these issues.
The clinical adult health course also had a service learning component where the students are required to provide service to the community. To continue to strengthen gerontology in this course, the students were provided with opportunities to do service learning projects that involved seniors, such as a health fair and a cooperative effort with a long-term care facility to carry out a Veteran's Day activity.
Students were given the option to have a booth at a local health fair where they address the needs of the older adults. Students performed hypertension, stroke, and diabetes risk assessment and provided information about medications and diet. The students also collaborated with a local long-term care facility to perform dementia screening and with a durable medical supplier regarding assistive devices. The students needed to research the subject matter to prepare a poster and hand-outs and also needed to be prepared to answer questions. The health fair audience targeted all ages, but the students in the adult health course targeted the older adult in their presentations. This health fair provides an opportunity to interact with older persons living in the community.
Another service learning project that the students became involved with was a project at the local retirement community. The faculty partnered with the recreational therapist at the retirement community. The students met with and interviewed older adults who were residents in a skilled nursing facility, assisted living complex, and retirement apartments about their experiences with World War II and constructed scrapbooks about the senior's story. The students planned a Veteran's Day event where they presented the scrapbooks to residents, told their stories, and played interactive games with the residents. The residents and the students enjoyed the day and interaction.
Conclusion
Gerontology does not have to be taught in a specific course; it can be integrated into various courses in the curriculum. This approach is also one strategy suggested by an initiative from the John A Harford Foundation to enhance gerontology content in baccalaureate courses. My experience teaching gerontology in an existing adult health course has resulted in the students gaining knowledge in gerontology to meet the needs and increased needs of the future. Some of the comments that students made after working with older adults are how much they enjoyed it and how much older adults are appreciative of the care that the students provided. These strategies have resulted in students having an increased knowledge of the care of older adults and seeing the elderly in a more positive way.
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