Geriatric care in nursing homes

Globally, the fastest growth in the number of older people combined with chronic and age-related medical conditions experienced by the older adult placed great demand on geriatric care. Thus, nurses are required to be knowledgeable and have a desirable attitude toward geriatric nursing care. Therefore, this study aimed to assess knowledge and attitude toward geriatric nursing care and associated factors among nurses working at hospitals in Hawassa City, Ethiopia. Hospital-based cross-sectional study was conducted from June 30 to July 30, 2022, among 365 nurses. The hospitals and study participants were selected by using purposive and simple random sampling methods, respectively. Data were collected using self-administered questionnaires. Descriptive statistics were computed to generate descriptive results. Binary and multivariable logistic regressions were used to identify predictors at p-value <0.05. About 39.2% of nurses had good knowledge and 49.3% of the nurses showed a positive attitude toward geriatric nursing care. Nurses with BSc degree or above [AOR 2.5, 95% CI, (1.2-5.6)], having lived with older people [AOR 2.2, 95% CI, (1.4-3.6)], nurses with 6-10 years [AOR, 2.8, 95% CI, (1.4-5.57)] and >10 years of work experience [AOR 4.2, 95% CI, (1.6-10.8)] were more likely to have knowledge about geriatric nursing care. Having BSc degree or above [AOR 2.7, 95% C.I, (1.2-6)], 6-10 years [AOR 3, 95% CI, (1.48-6.3)], and >10 years [AOR 3.9, 95% CI, (1.4-10.99)] of work experience, living experience with older people [AOR 1.7, 95% C.I:1.05-2.7], knowledge about geriatric care [AOR 3, 95% CI,(1.85-4.92)], and having worked at adequate space [AOR 1.7, 95% CI: 1.009-2.8] increased odds of good attitude toward geriatric nursing care. Less than half of nurses demonstrated good knowledge and positive attitude toward geriatric nursing care. Higher level of education, higher work experience, living with older people were significantly associated with knowledge and attitude toward geriatric nursing care. Additionally, working in an adequate space and having knowledge about geriatric care positively influenced attitude toward geriatric nursing care. Therefore, nursing schools and hospitals should conduct training and consider incorporating more content about geriatric care into nursing education to enhance nurses' knowledge and attitude.

Guest Editorial: Response to “Preserving today with an eye on our future”

Objective To investigate the core competence, self-efficacy and correlation of geriatric clinical front-line nurses in Nantong medical institutions, and to analyze the influencing factors of the two, so as to provide reference for the formulation of training programs for geriatric clinical front-line nurses. Methods Using convenience sampling method, the geriatric clinical front-line nurses in Nantong medical institutions were investigated by Geriatric Nursing Competency Inventory (GNCI) and General Self-Efficacy Scale (GSES) from October to December 2017. Single factor analysis, Pearson correlation and multiple linear regression were used to analyze the correlation between core competence and self-efficacy of geriatric clinical nurses and the influencing factors. Results The score of GNCI was (2.51±0.64) , and the score of GSES was (2.60±0.65) . Pearson correlation analysis showed that core competence of geriatric nursing was positively correlated with self-efficacy (r=0.472, P<0.01) . There were significant differences in the scores of GNCI of geriatric clinical front-line nurses with different ages, working years, educational background, professional title, marriage, personnel nature, number of night shifts on duty, whether they were teaching, professional interests, whether accept advanced study in superior hospitals and family support (P<0.05) . There were significant differences in the scores of GSES among clinical front-line geriatric nurses with different ages, marriages, number of night shifts on duty, whether they were teaching, professional interests and family support (P<0.05) . Multivariate linear regression analysis showed that professional interest was the influencing factor of core competence of geriatric nursing (P<0.05) . Conclusions The core competence of clinical front-line nurses in Geriatrics Department is low, and their self-efficacy is moderate. There is a positive correlation between them. As a nursing administrator in Geriatrics Department, it is significant to strengthen the training of clinical front-line nurses, constantly improve the training curriculum and career planning, and improve the core competence and self-efficacy of geriatric nursing. Key words: Geriatric Department; Clinical nurses; Core competence; Self-efficacy

Assessing Emergency Nurses' Geriatric Knowledge and Perceptions of Their Geriatric Care

There was a projected growth of up to 80% between 1990 and 2025 in an older adult of Nigeria above 60 years of age. This projected growth assumes an increased workload for almost every healthcare provider to ensure optimal geriatric care. This study aimed to assess preventive geriatrics as a way of geriatric health care. Self-administered questionnaires were distributed among elderly people (60 years and above) residing in the Akure South Local Government Area for at least a year. The survey included several sections to assess multiple aspects such as sociodemographic information, assessment of primary preventive geriatrics, secondary preventive geriatrics as well as tertiary preventive geriatrics as methods of receiving geriatric health care. The response rate was around 96% of the respondents. The mean (± standard deviation) age of the cohort was 72.3 (±8.4) years. The primary (χ² =39.498, df = 12 p-value=0.000), secondary (χ² =58.5003, df = 12, p-value=0.000), and tertiary (χ² =35.8994, df = 12, p-value=0.000) preventive geriatrics were shown to be a way of geriatric health care. Geriatric health care should focus on prevention, medication use, personalized health management, fall prevention, and vaccination uptake. The study thus recommends that institutions in geriatric care provide educational programs, gratuitous medical evaluations, and social support strategies that can reduce the burden of preventive geriatric care for Nigerian elderly.

Background: Japan is getting older and older. More than 26% of the population is 65 years or over. Therefore, the needs and quality of geriatric nursing should be improved. At the same time, the standards and requirements in geriatric intermediate care facilities (GIFs) are also changing. However, the quality of geriatric care in Japan is not in a satisfied level. In order to improve the quality of geriatric nursing, reconsidering professionalism in nurses is crucial. Moreover, it is important to address appropriate working environment of nurses to develop, maintain and enhance their professionalism. Objectives: The aim of this study was to obtain insights to the professionalism of nurses in geriatric intermediate care facilities from the perspectives and experiences of geriatric care. Methodology: A qualitative exploratory descriptive research design was used in this study. The study participants were three clinical nurse specialists of geriatric nursing and five nurse managers from geriatric care facilities. A purposive sampling was used. Results: Five descriptive themes related to the professionalism of nurses in geriatric care facilities were identified: autonomy, comprehensive care, patient advocacy, educational activities, and work with other specialists. Conclusions: Professionalism identified in this study is similar to that of clinical nurses that was reported previous studies. However, some sub-categories indicate the characteristics of geriatric care facilities, such as decision making when a physician is absent, which is included in autonomy, and the life model, which is included comprehensive care.

The aging cohort of persons living with human immunodeficiency virus (HIV) in Canada has reached a critical point, with nearly half now 50 years age or older. Older persons living with HIV have specific needs which can be effectively addressed by geriatric specialists. However, the recognition of HIV care as a domain of geriatrics is recent, resulting in a lack of clinical recommendations and modern care models for delivering geriatric care to this population. Virtual care has been demonstrated to reduce existing barriers to accessing HIV care in some populations but before it can be adapted to geriatric HIV care a critical first step is to acknowledge and understand disparities in socioeconomic circumstances, technology access and ability and cultural differences in experiences. This protocol marks the initial step in a comprehensive program of research aimed at co-designing, implementing, and evaluating culturally-appropriate virtual geriatric care for diverse older adults living with HIV. The study employs qualitative methods with older adults living with HIV to lay the groundwork, to inform the future development of a virtual model of geriatric care. We will explore the perspectives of diverse groups of older persons with HIV on (1) The value and necessity of culturally-tailored virtual interventions for geriatric HIV care; and (2) Recommendations on how best to engage older persons with HIV in the future co-design of a virtual model of geriatric HIV care. Ultimately, a more culturally-appropriate approach to care will foster a more inclusive and supportive healthcare system for all individuals affected by HIV including those who are aging. Researchers can utilize this research protocol to employ qualitative co-design and participatory methods with diverse older adults living with HIV.

As the global aging population grows, addressing the mental health challenges of older adults has become increasingly important. Depression, anxiety, cognitive decline, and existential distress are prevalent among geriatric individuals, often exacerbated by social isolation, chronic illness, and end-of-life concerns. Religious and spiritual counseling has emerged as a significant intervention in geriatric mental health care, providing emotional support, resilience, and a sense of purpose for elderly individuals. This review explores the impact of religious and spiritual counseling on mental health outcomes in geriatric care, emphasizing its role in enhancing psychological well-being and overall quality of life. Spiritual counseling interventions, including chaplaincy services, faith-based group therapy, and individualized pastoral care, have been shown to alleviate depression, reduce anxiety, and improve emotional resilience. By offering comfort through religious rituals, prayer, meditation, and spiritual discussions, these interventions help aging individuals navigate the complexities of later life with greater peace and acceptance. Furthermore, spiritual support fosters social engagement, strengthening the sense of belonging and reducing feelings of loneliness among older adults in long-term care facilities and community settings. This also examines the challenges of integrating religious and spiritual counseling into geriatric mental health care, including ethical concerns, religious diversity, and institutional barriers. Strategies for effective implementation, such as interdisciplinary collaboration, culturally inclusive spiritual care models, and the use of digital technology for remote counseling, are discussed. By highlighting the benefits and best practices of religious and spiritual counseling in geriatric care, this review advocates for the recognition of spirituality as a crucial component of holistic elder care. Implementing structured spiritual support in healthcare systems can significantly improve mental health outcomes, enhance emotional well-being, and promote dignity and hope among aging populations.

BackgroundThe experiences and perceptions of geriatric specialist nurses are pivotal to understanding the complexities of managing delirium and to developing effective nursing interventions. This qualitative study aims to explore these experiences and perceptions to inform the enhancement of clinical geriatric nursing and care practices.MethodsUtilizing a qualitative exploratory design, this research engaged a convenience sample of geriatric specialist nurses at a tertiary hospital in Shanghai, China through focus groups and semi-structured interviews. Data were rigorously analyzed using Colaizzi’s phenomenological method, which facilitated the identification of themes that emerged from the narratives of the geriatric specialist nurses.ResultsThe thematic analysis yielded three major themes that encapsulate the nurses’ experiences and perceptions. Theme 1: Understanding of Delirium, highlighted the nurses’ awareness of the condition’s significance, yet it was often deprioritized due to the pressing demands of managing more acute and immediately life-threatening conditions. Theme 2: Barriers in Application, brought to light the multifaceted challenges faced by nurses, including language barriers, the frequency and consistency of delirium assessments, the social determinants of health, and the nurses’ own competencies in assessment. Theme 3: Evolution of Nursing Approaches, detailed the adaptive strategies employed by nurses, such as managing nursing adverse events, improving communication with patients’ families, and adopting a proactive stance towards long-term patient outcomes.ConclusionsThe findings suggest that while geriatric specialist nurses recognize the importance of delirium assessment, there are several barriers to effective application. The study underscores the imperative for the advancement of more refined delirium assessment and care protocols, tailored to address the unique requirements of geriatric nursing care.

Community health nursing courses in baccalaureate nursing programs in China: A descriptive study based on website information

Geriatric health care policy in the United States and Canada: A comparison of facts and values in defining the problems

Implementing Geriatric Models of Care: A Role of the Gerontological Clinical Nurse Specialist—Part I

Outcomes and lessons learned from the John A. Hartford Foundation Building Academic Geriatric Nursing Capacity Initiative Centers of Geriatric Nursing Excellence

Physical restraints (PR) are commonly used in geriatric long-term care. Restraint-free care should be the aim of high quality nursing care. To evaluate the effectiveness of interventions to prevent and reduce the use of physical restraints in older people who require long-term nursing care (either in community nursing care or in residential care facilities). The Cochrane Dementia and Cognitive Improvement Group's Specialized Register, MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, a number of trial registers and grey literature sources were searched on 7 September 2009. The following search terms were used: "physical restraint*", bedrail*, bedchair*, "containment measure*, elderly, "old people", geriatric*, aged, "nursing home*", "care home*", "geriatric care", "residential facilit*". Individual or cluster-randomised controlled trials comparing an intervention aimed at reducing the use of physical restraints with usual care in long-term geriatric care settings. Two reviewers independently assessed the retrieved articles for relevance and methodological quality and extracted data. Critical appraisal of studies addressed risk of bias through selection bias, performance bias, attrition bias, and detection bias, as well as critera related to cluster designa. We contacted study authors for additional information where necessary. PR were defined heterogeneously throughout the studies. Not all studies offered sufficient data for aggregated data meta-analysis, and therefore study results are presented in a narrative form. Five cluster-randomised controlled studies met the inclusion criteria. All of them investigated educational approaches. Two studies offered consultation in addition and two other studies offered guidance for nursing staff in addition. Four studies examined nursing home residents and one study residents in group dwelling units. No studies in community settings were included. Three studies included only one or two nursing homes per study condition. Overall, methodological quality of studies was low.The studies revealed inconsistent results. One study in the nursing home setting documented an increase of PR use in both groups after eight months, while the other three studies found reduced use of PR in the intervention groups after seven and 12 months of follow up respectively. The single study examining residents in group dwelling units found no change in PR use in the intervention group after six months whereas PR use increased significantly in the control group. There is insufficient evidence supporting the effectiveness of educational interventions targeting nursing staff for preventing or reducing the use of physical restraints in geriatric long-term care.

BackgroundAs the global population continues to age, social realities such as advanced age, disability and living alone are coming to the fore, and the demand for medical care and health services for the elderly is increasing dramatically, especially in geriatrics. Given the important role geriatric nurses play in the diagnosis and treatment of diseases and rehabilitation of elderly patients, and due to the uniqueness and complexity of geriatric work, this requires geriatric nurses not only to have the competencies that are available in general nursing, but also to ensure that they have sufficient geriatric core competencies in order to effectively meet the needs of the patients and accelerate their recovery. Although previous studies have investigated the core competencies of nursing staff, there has been little research on geriatric nurses’ core geriatric nursing competencies and their predictors. The aim of this study was to investigate the current status of the geriatric nursing competency inventory (GNCI) among geriatric nurses using latent profiling, to identify potential subgroups and their population characteristics, and to explore the factors that influence the potential subgroups.MethodsFrom January to March 2024, 1,313 geriatric nurses in Hefei City were selected by stratified cluster sampling method and surveyed with general information questionnaire, geriatric nursing competency inventory, and occupational coping self-efficacy scale for nurses(OCSE-N). Potential subgroups of GNCI differences among geriatric nurses were identified by latent profile analysis (LPA). Multiple logistic regression analyses were used to explore the factors influencing the GNCI of geriatric nurses with different latent profiles.ResultsGeriatric nurses’ OCSE-N was positively correlated with GNCI, and the GNCI score was 123.06(41.60), which indicated that geriatric nurses’ GNCI was at an intermediate level. The OCSE-N score was 35.44(7.34), which was at a relatively high level. There was heterogeneity in the GNCI of geriatric nurses, which was classified into three subgroups i.e., Low-competency group, Medium-competency group, High-competency group. The results of multiple logistic regression analyses showed that OCSE-N, title, whether or not they attended geriatric nurse specialist training, and specialist nurse status were predictors of GNCI among geriatric nurses (P < 0.05).ConclusionThe GNCI categorical characteristics of geriatric nurses are obvious, and nursing managers should adopt targeted interventions according to the characteristics of nurses in different profiles to improve the overall quality of care.