Beyond the Hospital: Where Nurses Are Needed to Care for Our Aging Population

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By ANA Career Center Staff – May 2015

As the U.S. population ages and the need for health care grows, providers expect to face a shortage of nurses. The number of jobs that provide services for the elderly and people with disabilities grew 70 percent from 2010 to 2013, according to a report by CareerBuilder and Economic Modeling Specialists International. The Bureau of Labor Statistics expects more than a million job openings for nurses by 2022.

Where will these openings be? Many will be in hospitals, but elder care providers such as nursing homes, home health providers and other services will also need nurses to help care for the aging population. Nurses in those settings will need specialized skills, says Joan Dacher, Ph.D., RN, GN, and professor of nursing at The Sage Colleges. They will need to know about the the biological and psychological changes of aging, the complexities of caring for individuals with multiple co-morbidities, managing complex medication regimes and other geriatric health issues, she says.

Here is an overview of the opportunities available to nurses who are interested in working with older populations.

Home Care Services

RNs and BSNs can earn certification as a Care Manager, Certified or Certified Case Manager and become a certified geriatric care manager, says Karen Campbell, CMC, founder of Innovative Aging LLC. Geriatric care managers work with clients and families to help find the best care plan possible, helping families make difficult decisions about their loved ones’ care. Geriatric care managers may work with existing home health agencies or open their own consultancy.

Home health nurses and home care services help older people “age in place,” providing care to seniors outside of nursing homes so they can continue living in their own homes longer.  Tiffany Willis, LPN and marketing representative for Sitters Etc., says her company staffs LPNs and RNs as caregivers for older people, working with seniors, dementia patients and surgery rehab patients who need daily nursing care at home, she says.

Nurses who have specialized training in gerontological issues can play a key role in transitional settings such as home health. For example, according to an article published in Home Healthcare Nurse, nurses are “pivotal” when it comes to identifying and managing medication discrepancies in settings such as home health.

Rehabilitation Centers

Specialized rehabilitation centers can help older people recover from injuries they may get from falls or other accidents. Nurses who work in these centers provide rehab services and ongoing care. The Association of Rehabilitation Nurses says that the role of a rehab nurse in this kind of setting is to be aware of and compensate for normal age-related changes and limitations when putting together a rehab plan due to illness or injury.

These centers may also employ nurses to help complete federally mandated
Minimum Data Set paperwork, Campbell says.

Assisted Living

Assisted living facilities provide a homelike atmosphere for older people who aren’t able to live in their own home but also don’t need a nursing home. According to the American Assisted Living Nurses Association, the scope and standard for assisted living nursing is relatively new. It says the assisted living nurse is an “even more autonomous decision maker and manager of care and systems as compared to the acute care nurse.” In this setting, according to the standards, the nurse’s role is to promote physical, mental and social abilities and to reduce risk of infection, trauma and mistreatment, as well as to work for policies that promote respect and value for seniors in the health care system.

Charge nurses in these positions are responsible for overseeing and managing patient medications and monitoring any changes in medical conditions, says Annie Zell, health services administrator at Emerald Heights Corwin Center. Charge nurses also coordinate and plan care for residents and analyze care plans to help residents meet individual goals, she says. Finally, nurse practitioners may also serve as the primary care provider for residents in these settings.

Hospice Care

Nurses in hospice settings may work with other health care professionals to provide care and support to patients facing terminal illness. Nurses’ training in compassionate caregiving makes them vital members of the hospice team, helping to manage pain and symptoms, as well as providing emotional support for patients and their families. In addition, they must continue their education and be aware of ethical and legal implications that can come with end-of-life care.

After working in many different areas of nursing for 25 years, Judy Flickinger, RN, says she found her favorite job when she became a hospice nurse. “Hospice nurses give so much of themselves but also get much in return,” she says. “I went into nursing for the joy of bedside nursing, and hospice provided that opportunity.” Now retired, she volunteers in the home of hospice patients.