practice for gerontological nursing includes all older adults from the time of “old age” until death. Gerontological nursing is guided by standards of practice that will be discussed later in this chapter. Several roles of the gerontological nurse will be discussed in the following sections. ROLES OF THE GERONTOLOGICAL NURSE Provider of Care In the role of caregiver or provider of care, the gerontological nurse gives direct, hands-on care to older adults in a variety of settings. Older adults often present with atypical symptoms that complicate diagnosis and treatment. Thus, the nurse as a care provider should be educated about disease processes and syndromes commonly seen in the older population. This may include knowledge of risk factors, signs and symptoms, usual medical treatment, rehabilitation, and end-of-life care. Chapters 13, 14, and 15 cover management of common illnesses, diseases, and health conditions, imparting essential information for providing quality care. Teacher An essential part of all nursing is teaching. Gerontological nurses focus their teaching on modifiable risk factors and health promotion (see Chapters 9, 11, and 12). Many diseases and debilitating conditions of aging can be prevented through lifestyle 55805_CH01_0001_0025.qxd 2/19/09 1:01 PM Page 9 10 Chapter 1: Introduction to Gerontological Nursing modifications such as a healthy diet, smoking cessation, appropriate weight maintenance, increased physical activity, and stress management. Nurses have a responsibility to educate the older adult population about ways to decrease the risk of certain disorders such as heart disease, cancer, and stroke, the leading causes of death for this group. Nurses also may develop expertise in specialized areas and teach skills to other nurses in order to promote quality patient care among older adults. Manager Gerontological nurses act as managers during everyday practice as they balance the concerns of the patient, family, nursing, and the rest of the interdisciplinary team. Nurse managers must be skilled in leadership, time management, building relationships, communication, and managing change. Nurse managers may supervise other nursing personnel including licensed practical nurses (LPNs), certified nursing assistants (CNAs), technicians, nursing students, and other unlicensed assistive personnel (UAP). The role of the gerontological nurse as manager and leader is further discussed in Chapter 23. Advocate As an advocate, the gerontological nurse acts on behalf of older adults to promote their best interests and strengthen their autonomy and decision making. Advocacy may take many forms, including active involvement at the political level or helping to explain medical or nursing procedures to family members on a unit level. Nurses may also advocate for patients through other activities such as helping family members choose the best nursing home for their loved one or listening to family members vent their frustrations about health problems encountered. Whatever the situation, gerontological nurses must remember that being an advocate does not mean making decisions for older adults, but empowering them to remain independent and retain dignity, even in difficult situations. Research Consumer The appropriate level of involvement for nurses at the baccalaureate level is that of research consumer. Gerontological nurses must remain abreast of current research literature, reading and putting into practice the results of reliable and valid studies. Using evidence-based practice, gerontological nurses can improve the quality of patient care in all settings. Although nurses with undergraduate degrees may be involved in research in some facilities, such as assisting with data collecCase Study 1-1 Rose is a 52-year-old nursing student who has returned to school for her BSN after raising a family. She is the divorced mother of two grown children and has one young grandson. In addition to being a full-time student in an accelerated program, Rose also cares for her 85-year-old mother in her own home and occasionally helps provide childcare for her grandson while his parents work. Rose’s mother has diabetes and is legally blind. Rose is taking a gerontology