The first question a geriatric nurse asks when assessing an out-patient is not: Tell me about your health.
Judy Bianco admits that it can be a tough sell. “We have a hard time attracting nurses into gerontological nursing,” said Bianco, the head nurse in the Jewish General Hospital’s geriatric unit.
Then again, she added, many of the student nurses who do internships on her ward end up loving this specialized slice of the nursing profession that cares for the senior population.
“It’s so challenging,” Bianco said. “Unfortunately, no one makes TV shows about gerontologic nursing. It’s too bad, because this is a specialized part of nursing that spans the gamut.”
The “gamut” to which Bianco refers is the physical, psychological and social.
“When you’re nursing older adults, particularly those who are in failing health, the family is very involved in the care. In gerontologic nursing, we’re looking at bio-psycho-social care and the entire patient in the context of the family and the community.”
That’s why the first question a geriatric nurse asks when assessing an out-patient, for instance, is not: Tell me about your health, Bianco said.
“The No. 1 question is: What is a normal day in your life like? We want to know the nitty-gritty of how the person functions. We want to know everything, including how they’re going to get in and out of a bathtub. It’s a bit like detective work. Patients are often surprised at how much time we spend on these questions. Older people may have multiple health problems that require time to understand.”
Dealing with a vulnerable population, she said, means geriatric nurses must be advocates for their patients.
“We collaborate with CLSCs and other community services. Our role is to help people to stay as autonomous for as long as possible.”
Bianco works on a ward that is dedicated to acute care. Often, patients are admitted suffering the adverse effects of drug interactions.
“We take care of the acute medical problem and get them on their feet again,” she said.
About 35 per cent of the patients admitted to the unit are unable to return to their lives in the community and require chronic care, Bianco said. Others might require palliative care.
Gerontologic nurses work with the families of their patients.
“We do a lot of anticipatory guidance with families,” Bianco said. “When someone is diagnosed with dementia, for instance, we help the families understand it.”
Not all geriatric nursing takes place in hospitals. At Health Access, a Beaconsfield company that provides nursing and home care to help keep people autonomous at home, owner Donna Byrne says about 85 per cent of her clientele are seniors.
“Our nurses co-ordinate the care,” Byrne said. “They oversee the plan, which is carried out by our home-care attendants.”
In addition to evaluating the needs of the elderly clients, she said, Health Access nurses meet with the senior’s family members to “decide on the kind of care that’s needed.”
Byrne says the need for geriatric nursing will expand in the next couple of decades as baby boomers move into their senior years.
“There’ll be huge growth in this area. In the past, nurses weren’t that interested in geriatric nursing but there is such a need.”