Nursing is one of the most important and rewarding careers an individual can choose today, particularly if they have a naturally empathetic and kind personality. Registered Nurses (RNs) become nurse practitioners with increased primary care autonomy to run their practice or work as the first line of support in a private practice. They can diagnose medical conditions and prescribe medications. They also order tests and analyze the results, referring patients to primary care practitioners or specialists where necessary.
This article explores the role of specialized nurse practitioners in adult gerontology.
Becoming a specialized nurse practitioner
Nurse practitioners can specialize in areas that align with their passions. The field of nursing demands continuous learning, as practitioners must stay current with new methods and technology. For ambitious RNs who want to make a difference, an accelerated online RN to MSN bridge program can be the perfect stepping stone to becoming an advanced nurse practitioner. Wilkes University’s RN to MSN program offers various specializations and clinical placement support. One of the concentrations offered is Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), also known as Adult-Gerontology Nurse Practitioner (AGNP).
A specialization in adult-gerontology
Adult gerontology is one area that nurses should consider as a specialization. With the rapid innovations in medical technology, people are living longer as science finds ways to manage their ailments and improve their comfort levels. Unfortunately, even though they are living longer, older adults are not free of chronic illnesses, and the need for medical intervention in hospitals, nursing homes, and assisted living facilities is growing. Improved medications and modern treatment methods have made life a whole lot easier for these patients. Healthcare can ease their pain and suffering while improving their comfort and mental well-being.
AGNPs care for their patients from the start of old age through end-of-life hospice care, providing primary care medical support and making life as comfortable as possible. AGNPs draw up treatment plans to manage long-term chronic ailments and ensure their elderly patients receive the correct care required, from specialized nursing to balanced meals, and more.
AGNPs in clinical settings
When elderly patients are admitted to hospitals and clinics, the experience can often be traumatic. Part of the AGNP’s role is to explain their symptoms, educate them on their illnesses, and provide them with the relevant treatment and medication. They do this as part of a team.
Multidisciplinary teams
When treating geriatric patients in a clinical environment, nurse practitioners may involve a team of multidisciplinary practitioners. As older adults generally suffer from multiple ailments at a time, they need specialized care from various practitioners and therapists simultaneously. Care must also be taken when prescribing medications, so they don’t clash or become ineffective. The multidisciplinary team assigned to the patient will confer on the medications to ensure they are all working together for the patient’s wellbeing. This team is generally organized by the AGNP, who coordinates everyone’s consultation times with the patient, ensures medicines are administered, and gives feedback on group communication.
Thanks to technology, setting up and coordinating a multidisciplinary team for patients is a lot easier today. Communication between team members is facilitated by online meetings on virtual platforms such as Zoom or Microsoft Teams, as well as through group emails and group chat platforms. This ensures everyone knows what treatment is being administered and progress is made.
Teamwork can include dietary interventions, physiotherapy, mental health counseling, respiratory therapy, and other assessments. This could consist of osteopathy, hearing, vision, continence, cognition, and mental health checks.
Long-term healthcare
Before being discharged from the hospital, a long-term treatment plan is drawn up and shared with the patient’s family or caregivers. Nurse practitioners explain the patient’s symptoms and diagnoses, teaching them how to handle the various ailments and ensuring that they understand the medications and when to administer them.
Patient records are updated as the treatments progress, noting the medications administered and the patient’s progress. This information is made available to the team and stored for further access by medical practitioners and nurses should the patient be readmitted to the hospital.
The nurse practitioner may get involved in helping the family or caregivers to cope with their elderly patient. Having multiple chronic ailments can involve a lot of physical effort on the part of the caregiver, not to mention the toll it takes on both the patient and caregiver from a mental and emotional perspective. AGNPs can alleviate some of this strain by teaching caregivers how to turn the patient, get them out of bed, dress them, and help them eat, among other basic tasks.
Many residents are plagued by dementia in varying stages, and this presents additional challenges for nursing staff. These patients must be watched constantly so that they don’t wander off or fall and hurt themselves. There are many natural remedies that may alleviate the symptoms of dementia, and in addition, providing the right foods and a regular exercise regime can prevent the onset.
Emergency situations
AGNPs in a clinical environment may also be expected to treat patients in emergency situations, although a separate qualification is available for acute care adult-gerontology nurses. If the AGNP has specific knowledge of the patient, their symptoms, and prognosis, they may be involved in the process of medical intervention on the patient’s behalf.
Long-term care facilities
Long-term care facilities take care of people who can no longer care for themselves. This can happen suddenly, when someone has a heart attack or stroke, but usually aging is the culprit. This is a slow process culminating when the person, or their family, realizes that it’s no longer safe for them to be alone.
There are different types of long-term care, and the type of home that is best depends on the state of their health and their mobility.
Nursing homes
Nursing homes cater mainly to people who need medical care and supervision 24 hours a day. These homes also offer rehabilitation services, which includes caring for younger generations as well. People in nursing homes are generally unable to look after themselves and rely on caregivers and nurses for everything they do, from dressing and bathing to eating and taking medication.
Assisted living
Assisted living facilities provide housing with meals and activities. Residents live in small apartments or rooms, sometimes sharing bathrooms and other living areas. They get three cooked meals a day and can join group activities such as fitness classes.
Assisted living does not generally provide healthcare, but there is often a qualified nurse on the premises who can supervise medication, dress wounds, take vital signs, and get further medical help when needed. Other staff help residents with dressing, bathing, and feeding, if necessary, although most people in this environment are still reasonably independent.
Independent living
Independent living in a long-term facility means that elderly people live in a room or apartment within the facility but are independent in most ways. They can cook for themselves but have the option of having meals in a dining room if they wish. There are recreational areas where they can take part in various activities, sit and read, or chat with fellow residents.
What is the AGNP’s role in long-term care?
The AGNP’s role in a long-term care facility is to provide primary care medical assistance to the residents. They consult with patients, diagnose illnesses, administer medication, and treat injuries such as sprains and fractures that are caused by falling. AGNPs draw up long-term care plans for the residents who have been diagnosed with chronic illnesses, prescribing medication and monitoring their patients’ progress. They also supervise the dietary needs of the patients and prescribe exercise regimes for those who are capable and willing to participate.
Mental stimulation is also important for the wellbeing of patients in this environment. Very often, people find themselves in a home without the support of family members, and they become depressed. Activities such as games, drawing lessons, and gym classes keep the residents occupied and encourage them to form friendships.
Long-term care can take the form of informal home-based care, where they live at home but are cared for by family, friends, or neighbors. In cases such as this, an AGNP may call in on a weekly basis or when required to do so.
Other options
Other long-term options include community and residential care facilities. The elderly person can attend a community day care facility that includes meals, exercise, and personal care such as manicures and pedicures, haircuts and styling, and massage. It depends on the facility as to what they offer: transport, medical services, and sometimes specialized care for patients with dementia are included.
Nurse practitioners in this environment would attend to the medical, exercise, and dietary needs of the residents.
Technical aids
AGNPs are also aided by technology for record-keeping, making use of telehealth and Artificial Intelligence (AI) to improve quality of care.
Record-keeping
Cloud-based solutions have become the norm in people’s lives today, and clinics and nursing homes are no exception. Patient records are efficient and easy to retrieve from cloud storage, meaning that medical staff can access patient information with the click of a button. This enables them to see what medication patients are taking and, historically, what they may have adverse reactions to. It also enables doctors and nurses to make a quick diagnosis based on the patient’s medical history. AGNPs keep their patients’ records up to date, including their treatment and wellness plans in the database, along with progress reports.
Telehealth
Many long-term residential homes do not have access to medical practitioners every day. This has been a concern in the past, as studies have shown that primary care providers who looked after residents in long-term care actually spent very little time at the care facilities. Having a dedicated primary care nurse practitioner working in a home for elderly people makes a lot of sense, and it would alleviate the need for frequent doctor’s visits.
With the advances in communications today, groups of nurse practitioners are advertising their services on a call-out basis, and this could be a solution for homes that are unable to acquire the services of a full-time nurse practitioner.
Wearable technology
Various devices that are worn on the body can be monitored remotely now. The data collected is used to prescribe treatment and stored in the patient’s medical file for future reference.
AGNPs can offer remote triage services and chronic illness management online. They can monitor blood pressure, pulse rates, and blood sugar online too. Based on this, they prescribe medication or refer patients to a clinical facility if necessary.
A big advantage of remote monitoring and intervention is that there is no need for patients to sit in busy waiting rooms, exposing themselves to infection and fatigue as they wait to see a practitioner.
AI
The collection of patient data can be used by AI software to analyze medical conditions based on mass data available on the subject. AI can make learning-based conclusions regarding specific geriatric conditions and devise evidence-based nursing interventions for future patient interventions.
The benefits and rewards
Research has shown that people who live in long-term care facilities are less likely to need clinical admission than those who live alone and try to cope on their own. The combination of balanced meals, exercise, mental and physical stimulation, and people who care makes life a lot more bearable for elderly folk. Without long-term care facilities with AGNPs, they would otherwise be home alone and focused on their aches and pains.
AGNPs continue to do good work in this area, helping elderly people and their families to cope and, ultimately, doing society a lot of good. In addition, there is the reward of seeing a wrinkled old face light up with a smile as they walk into their room!
