Geriatric Care: Specialized Approaches for Older Adult Patients

Patients of all ages deserve attentive and compassionate care. How this plays out, however, can depend greatly on the unique needs of each patient — and it’s impossible to deny that these are determined, at least to some extent, by the age of the patient.¹

Aging is a big part of the clinical equation, especially amid demographic changes that spell huge implications for the broader healthcare system. After all, Census information shows that adults ages 65 and over make up 16.8 percent of the U.S. population.² They also see expanded healthcare utilization, accounting, for example, for over 40 percent of hospital visits.³

Older patients present unique concerns, but also promising opportunities for clinical professionals to make a difference. This can be an exceptionally compelling specialization for nurses, who enjoy connecting with seniors while helping them improve their health, well-being, and overall quality of life. Keep reading to discover the importance of geriatric care and explore relevant professional opportunities.

What Is Geriatric Care?

Geriatric care brings a specialized approach to working with older adults. The American Geriatrics Society (AGS) specifies that this involves “high-quality, person-centered care,” adding that this focuses on improving “health, independence, and quality of life” while also placing older individuals’ “personal values and preferences at the heart of care decisions.”⁴

So, what is geriatric care? This term describes a tailored healthcare model designed to address the challenges patients may face as they age. This brings a coordinated approach to managing both chronic conditions and acute illnesses.

The Importance of Geriatric Care

Geriatric care acknowledges that patients have different healthcare needs and preferences throughout their lifespans. Strategies that may seem safe or helpful for younger patients may no longer be sufficient as various physical, cognitive, and emotional issues associated with aging come into play.

Further complicating matters? The simple reality is that two patients will experience the same aging journey. Some may continue to remain highly mobile and active throughout their senior years, while others may need to manage multiple chronic conditions. Geriatric care respects the whole patient, addressing aging-related concerns while still showing respect and appreciation.

What Is Geriatric Nursing?

Geriatric nursing is a specialized field focused on the complex health issues associated with aging. Gerontological nursing, also known as geriatric nursing, is a specialized field that, while sharing commonalities with other nursing disciplines, focuses on specific clinical interventions. These interventions are designed to alleviate symptoms in older patients and help them sustain an optimal quality of life.

Although often described as a nursing specialization, geriatric care is comprehensive by nature, with the American Nurses Association (ANA) explaining that it “addresses the unique physiological, social, psychological, developmental, economic, cultural, spiritual, and advocacy needs of older adults.”⁵

ANA guidance adds that this delves into the “process of aging and the protection, promotion, restoration, and optimization of health and function,” all while alleviating suffering and facilitating healing.

A Framework for Excellence: The Five Ms of Geriatric Care

A well-regarded framework known as the 5Ms demonstrates the importance of holistic, patient-centered care. This model aims to avoid siloed strategies, instead using a coordinated approach to address seniors’ diverse needs.⁶ Key elements of the 5Ms include:

Mind

Centered around cognitive and emotional well-being, the first category in the 5Ms focuses on the detection of far-reaching concerns that can influence the patient’s mental state.

This calls for standardized cognitive testing but also requires clinical professionals to successfully distinguish delirium, dementia, and depression.⁷

Mobility

Many older adults experience impairments surrounding gait and balance, which may leave them vulnerable to falls. These, in turn, can prompt severe injuries and long-term suffering. Unfortunately, falls are common, with data from the Centers for Disease Control suggesting that this is the number one cause of injury in those ages 65 and over.⁸

In the second M, providers identify safety risks not only based on patients’ physical abilities but also on their environments. Through physical therapy and targeted adjustments within the home, providers can limit the risk of falls while helping seniors maintain independence.

Medications

Most seniors take multiple medications per day. Known as polypharmacy, this tendency must be acknowledged, in part, because the very medicines that patients require can spark potentially problematic interactions, which could cause unintended suffering.⁹

When this M is prioritized, clinical professionals pay greater attention to dosages and side effects, all while striving to simplify drug regimens so that patients find it easier to take medications safely and according to precise instructions.¹⁰

Multicomplexity

The concept of multicomplexity acknowledges that many older adults manage multiple chronic conditions. The interplay between these issues can be challenging to determine, but it’s clear that they impact one another.

For example, patients with diabetes may also experience complications such as neuropathy along with mental health challenges that can influence overarching treatment plans. Such interconnected challenges call for holistic, patient-centered care, rather than fixating exclusively on specific diseases.

Matters Most

The ‘M’ priorities discussed above play heavily into overall health and well-being, but these should not supersede the preferences of the patient. The concept of “matters most” captures the need to focus on the goals of the individual while respecting their values and dignity. This calls for transparency and open dialogue to ensure that care aligns with patients’ unique priorities.

Understanding the Types of Geriatric Care Services

Geriatric care influences many healthcare services and models, aiming to meet the diverse needs of older adults through preventive care, disease management, rehabilitation, and beyond. Throughout their senior years, patients may rely on these geriatric care services:

Primary and Specialty Care

Primary care emphasizes preventive care and general wellness, but it can also treat many common illnesses and conditions. With older populations, primary care often involves managing chronic conditions while monitoring for changes in health status.

Specialty care shifts the focus to specific conditions, calling for more profound expertise so specialists can spot subtle symptoms and develop targeted treatment plans. With geriatric care, these often involve high-risk concerns. Examples relevant to seniors may include oncology or cardiology.

Home Health Care

Home health brings care to patients’ homes. This can be an excellent option for seniors with mobility or transportation challenges. Tasks carried out in the home could include monitoring vital signs, administering medications, or even changing dressings. Nurses may also offer palliative care within the home.¹¹

These days, home health solutions often incorporate telehealth services or even wearables that can track blood pressure or trigger an emergency response in the event of a fall.

Assisted Living and Long-Term Care

Long-term care serves a residential function, offering a supportive space where residents enjoy considerable independence while also having access to care when needed. This provides the ultimate middle ground for seniors who desire some assistance but do not require the robust support offered within nursing homes.¹²

To prioritize healthy lifestyles, long-term care communities often incorporate wellness programs that encourage residents to exercise while also emphasizing self-care. In long-term care, geriatric nursing may also involve clinical assessments, monitoring, and medication management.

Palliative and Hospice Care

Palliative care aims to improve the quality of life among those with severe or terminal health conditions — but without the expectation of a cure. Instead, palliative and hospice nurses prioritize comfort and emotional well-being.¹³

Although available for patients of all ages, this is an increasingly common approach to addressing complex health conditions that become more prevalent with age. This may include congestive heart failure, for instance, along with certain types of cancer or Alzheimer’s.

What Types of Facilities Provide Geriatric Care?

Because older patients can experience such a wide range of health conditions and concerns, they require targeted care from many types of facilities. They may seek targeted services within facilities that serve the broader population and specialized care in settings specifically designed to meet seniors’ unique needs.

Outpatient Clinics

Outpatient clinics allow seniors to receive targeted care without spending the night. These include not only physicians’ practices but also specialty clinics that offer services ranging from neurology to gastroenterology.

Hospitals

Serving a diverse range of patients, hospitals offer acute and emergency care, along with overnight options to accommodate inpatient care. Seniors may require hospitalization in response to falls, strokes, or severe infections.

Because hospitals serve so many patients and address so many health concerns, geriatric care may be provided by dedicated teams or through targeted protocols that address seniors’ unique needs. Some providers have adopted evidence-based models known as Acute Care for Elders (ACE) units, which aim to preserve independence while limiting functional declines.¹⁴

Assisted Living Facilities

Assisted living facilities offer a wide range of long-term care services. These facilities, which involve group living arrangements, provide housing and meals along with basic clinical services.

Long-term care may also be provided within facilities known as continuing care retirement communities (CCRCs). These provide multiple arrangements at differing levels of care. One floor of a CCRC facility, for example, may be dedicated to assisted living, while another floor on the same campus could function as a nursing home.¹⁵

Skilled Nursing Facilities (Nursing Homes)

Dedicated facilities known as nursing homes resemble assisted living facilities in that they provide residential solutions. With nursing homes, there is a greater focus on intensive clinical care, often because residents are diagnosed with severe conditions that require round-the-clock attention.

Hospice Facilities and Home Hospice

Focused on providing palliative, comfort-focused care for terminally ill patients, hospice facilities prioritize pain management, striving to provide the best possible quality of life rather than finding a cure. While many patients seek care within dedicated hospice facilities, palliative home hospice services are also available, allowing patients to find comfort within familiar settings.

Prepare for a Career in Compassion at Carrington College

Pursue your calling for compassionate care with a career in geriatric or gerontological nursing. Discover the secrets to caring for diverse populations with a comprehensive nursing program that addresses the unique physical, emotional, and spiritual needs of older patients.

Carrington College’s nursing programs promote compassionate, patient-centered care through in-depth theoretical exploration and immersive learning experiences. Or, explore evidence-based practice and expand your nursing skill set while pursuing a Bachelor of Science in Nursing (BSN).

Source:

1. Jones, C. et al. “Healthcare on the brink: navigating the challenges of an aging society in the United States.” NPJ Aging. pmc.ncbi.nlm.nih.gov/articles/PMC10998868/
2. Caplan, Z., et al. “The Older Population: 2020.” United States Census Bureau. www.census.gov/library/publications/2023/decennial/c2020br-07.html
3. Adamowicz, D. et al. “Predicting and Improving Hospital Outcomes for Older Adults.” International Psychogeriatrics. pmc.ncbi.nlm.nih.gov/articles/PMC8842567
4. American Geriatrics Society. “About Geriatrics.” www.americangeriatrics.org/geriatrics-profession/about-geriatrics
5. Bickford, C. “A contemporary look at gerontological nursing.” American Nurse. www.myamericannurse.com/gerontological-nursing/
6. American Geriatrics Society Health in Aging Foundation. “The 5Ms of Geriatrics.” www.healthinaging.org/sites/default/files/media/pdf/HIA-TipSheet%20Geriatric%205Ms.July20_0.pdf
7. Canadian Geriatrics Society. “Aging Care 5Ms Competencies.” www.canadiangeriatrics.ca/aging-care-5ms-competencies
8. U.S. Centers for Disease Control and Prevention. “Older Adult Falls Data.” www.cdc.gov/falls/data-research/index.html
9. Jamshed, N. et al. “Prioritizing the 5Ms in Geriatric Care: A Holistic Approach to Care of the Older Adult.” American Family Physician. www.aafp.org/pubs/afp/issues/2024/0600/editorial-holistic-approach-geriatric-care.html
10. Monette, P. et al. “Optimizing Medications with the Geriatrics 5Ms: An Age-Friendly Approach.” Drugs & Aging. pmc.ncbi.nlm.nih.gov/articles/PMC10092911/
11. Hinck, S. “Home health nursing.” American Nurse. www.myamericannurse.com/home-health-nursing/
12. National Institutes of Health. “Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other ResidentialCare.” www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes
13. Minnesota Department of Health. “Palliative Care.” www.health.state.mn.us/people/palliative/index.html
14. Rogers, S. et al. “The Current Landscape of Acute Care for Elders Units in the United States.” Journal of the American Geriatrics Society. pmc.ncbi.nlm.nih.gov/articles/PMC9588489/
15. AARP. “How Continuing Care Retirement Communities Work.” www.aarp.org/caregiving/basics/continuing-care-retirement-communities/