The importance of nurses in gerontology

The approach to the treatment of older people is still largely based on medical data on the elderly population. In addition, studies involving older people are limited in value because they select certain study groups and exclude patients with severe comorbidities or frailty, thus limiting our understanding of older patients with cardiovascular disease.

Global experience shows that emergency-only care for older people is inefficient, due to the presence of chronic disabling conditions, and costly – the cost of treating acute conditions in older people is 4 times higher than in those of working age.

The geriatric nurse is a special kind of nurse. She not only helps the geriatrician by following the doctor's instructions (task-centred nursing), but also makes responsible decisions for his/her patients (patient-centred nursing or patient-centred care). The nurse knows his/her patients better than anyone else: he/she knows the living conditions, the family environment and relationships, medical diagnoses, psychological conditions, social support needs, etc.

For each of his/her patients, a geriatric nurse is:

-healer (performs therapy as prescribed by the doctor and evaluates its effectiveness, monitors clinical indicators and intervenes to control undesirable symptoms, provides first aid in acute conditions);

-caregiver (monitors the diet, nutrition, hydration and physiological needs, documents the physical and psychological condition, monitors the patient's oral cavity, assesses pain, tendency to falls and bedsores, takes measures to prevent undesirable conditions and ensure a safe environment, takes care of psychological comfort);

-mentor (informs and explains the need for interventions to both the patient and the family, teaches appropriate behaviour to prevent various disabilities);

-advocate (together with the social workers, defends the interests of the patient wherever required, including at official institutions – in determining disability groups, assigning and paying benefits, providing mobility aids, sight or hearing aids, etc.).

In a multidisciplinary team, a nurse:

-plays the role of a case manager, a professional who ensures coordination, communication and co-operation between all members of the team;

-consults with specialists on patients' problems;

-initiates multidisciplinary team meetings to discuss patient problems together and reach consensus on solutions;

-contacts with social services to develop a common patient management strategy.