Prepare More Nurses to Care for Elderly
Although there has been an enormous increase in the
number of older Americans, many nurses have little or no education or training in
gerontological nursing or chronic disease management.
One way to improve nursing care is to be sure
there are enough doctorally prepared gerontological nurses in academic settings to educate
the next generation of nurses, according to Jeanie Kayser-Jones, RN, PhD, UCSF professor
of physiological nursing and medical anthropology and director of a new center in the UCSF
School of Nursing.
She explained that in the United States,
there are about 15,000 nurses with doctorate degrees in nursing. Less than five percent of
these nurses (750) have training in gerontological nursing. The population of Americans 65
and older, however, has grown from 3.1 million in 1900 to over 34 million in 2000.
The UCSF School of Nursing has received a
$1.3 million, five-year grant from the John A. Hartford Foundation to establish a Center
for Gerontological Nursing Excellence. The UCSF center (one of five selected sites) will
prepare gerontological nurse scientists to provide academic leadership in teaching,
research and patient care.
"Our health care system has been slow to
respond to the needs of older people, and nurses who provide a substantial amount of care
to older people are in short supply. What this means is that there are very few nurses who
have been adequately trained to provide care to this rapidly growing population," she
said. "The academicians we train at the center will be responsible for educating
future nurses and conducting research to alleviate many of the problems that older,
chronically ill people face each day."
Much of that education and research will be
conducted in partnership with the UCSF Schools of Medicine, Dentistry and Pharmacy and
faculty members in the social and behavioral sciences who have expertise in gerontology.
"Aging is a complex process that
requires solutions from a variety of disciplines," said Kayser-Jones.
In the US, there are 34 million people who
are 65 years and older. Four million of these Americans are 85 years and older (the oldest
old). In California, 3.5 million people are over the age of 65, including a half-million
who are members of the oldest old.
People over age 85 constitute the fastest
growing segment of the population, according to Kayser-Jones. It is projected that by the
year 2050, 18 million people will be over the age of 85, a more than fourfold increase. In
California, by the year 2040, two million people will be over the age of 85. The increase
in the number of very old people is of concern to health care providers because as people
live to very old age, chronic illnesses become more prevalent, said Kayser-Jones. "In
1900, most people died before old age. Today, most Americans live into old age and will
die of chronic illnesses such as heart disease, cancer, stroke and Alzheimers
Older people with chronic illnesses often
need nursing care and have limitations in their daily activities, she explained. Some are
unable to walk. Others are unable to feed and dress themselves, and many have repeated
hospitalizations. By 2030, the number of people who have some limitations in their usual
activities of daily living is expected to triple. The number of days that older people
spend in the hospital will also triple, and the number of nursing home residents will
Along with associate directors Charlene
Harrington, RN, PhD, UCSF professor of social and behavioral sciences and Margaret
Wallhagen, RN, PhD, UCSF associate professor of physiological nursing, Kayser-Jones will
focus on the development of:
- A rigorous recruitment program;
- A Web-based course in gerontology to provide a
strong foundation for predoctoral and postdoctoral trainees;
- An interdisciplinary, collaborative program to
prepare doctoral students to conduct research in symptom management, transitions in levels
of care, and aging health care policy;
- A mechanism to attract faculty from other
specialties into the field by encouraging them to expand or redirect their existing
programs of research to gerontological nursing.
Other Centers of Gerontological Nursing
Excellence will be established at Oregon Health Sciences University, the University of
Arkansas, the University of Iowa and the University of Pennsylvania.
"We look forward to working closely with
the Institute for Health and Aging, the Philip R. Lee Institute for Health Policy Studies, the Center
for Excellence in Geriatric Medicine, and faculty in other schools and programs,"
The John A. Hartford Foundation, Inc. of New
York City is a private philanthropy established in 1929. John A. Hartford and his brother,
George L. Hartford, both former chief executives of the Great Atlantic & Pacific Tea
Company, left the bulk of their estates to the Foundation upon their deaths in the 1950s.
Since 1979, the Foundation has focused its support on improving the quality and financing
of health care and enhancing the capacity of the health care system to accommodate the
nations growing elderly population. The majority of the Foundations current
grantmaking relates to enhancing geriatric research and training and integrating and
improving health services for older adults.
School of Nursing
Jeanie S. Kayser-Jones
for Health and Aging