Geriatrics, or geriatric medicine, is a specialty that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of elderly people. Rather, this decision is determined by the individual patient's needs, and the availability of a specialist. It is important to note the difference between geriatrics, the care of aged people, and gerontology, which is the study of the aging process itself. The term geriatrics comes from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". However, geriatrics is sometimes called medical gerontology.
The Institute of Mental Health has a long tradition of care for psychiatric patients. In 2006, the Institute of Mental Health compound was marked as Singapore's 83rd historic site by the National Heritage Board due to its history as Singapore's first mental institution. As such, the IMH is sometimes referred to as "Woodbridge" by locals.
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion, but does not provide the depth of expertise needed to recognize more complex conditions. According to the American Association of Nurse Practitioners, NPs are educated at the graduate level to provide "primary, acute, chronic, and specialty care to patients of all ages", depending on their field of practice.
An advanced practice nurse (APN) is a nurse with post-graduate education in nursing. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing.
An adult daycare center is typically a non-residential facility that supports the health, nutritional, social, and daily living needs of adults in a professionally staffed, group setting. These facilities provide adults with transitional care and short-term rehabilitation following hospital discharge. The majority of centers provide meals, meaningful activities, and general supervision. The care provided is often a social model or a medical model provided in order to improve participants health and guide their progress in the right direction.
A clinical nurse specialist (CNS) is an advanced practice nurse who can provide expert advice related to specific conditions or treatment pathways. According to the International Council of Nurses (ICN), an Advanced Practice Nurse is a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. Clinical Nurse Specialists are registered nurses, who have graduate level nursing preparation at the master's or doctoral level as a CNS. They are clinical experts in evidence-based nursing practice within a specialty area, treating and managing the health concerns of patients and populations. The CNS specialty may be focused on individuals, populations, settings, type of care, type of problem, or diagnostic systems subspecialty. CNSs practice autonomously and integrate knowledge of disease and medical treatments into the assessment, diagnosis, and treatment of patients' illnesses. These nurses design, implement, and evaluate both patient–specific and population-based programs of care. CNSs provide leadership in the advanced practice of nursing to achieve quality and cost-effective patient outcomes as well as provide leadership of multidisciplinary groups in designing and implementing innovative alternative solutions that address system problems and/or patient care issues. In many jurisdictions, CNSs, as direct care providers, perform comprehensive health assessments, develop differential diagnoses, and may have prescriptive authority. Prescriptive authority allows them to provide pharmacologic and nonpharmacologic treatments and order diagnostic and laboratory tests in addressing and managing specialty health problems of patients and populations. CNSs serve as patient advocates, consultants, and researchers in various settings [American Nurses Association (ANA) Scope and Standards of Practice (2004), p. 15].
A health professional may provide health care treatment and advice based on formal training and experience. The field includes those who work as a physician, surgeon, physician assistants, nurse, physiotherapist, dentist, midwife, psychologist, psychiatrist, or pharmacist or who perform services in allied health professions. A health professional may also be a public health or community health practitioner.
Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. Eligibility for PACE requires that individuals be 55 years old or older, certified by the state to need nursing home-level care, reside near a PACE program, and able to live safely in the community. Services include primary and specialty medical care, nursing, social services, therapies, pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health.
Gerontological nursing is the specialty of nursing pertaining to older adults. Gerontological nurses work in collaboration with older adults, their families, and communities to support healthy aging, maximum functioning, and quality of life. The term gerontological nursing, which replaced the term geriatric nursing in the 1970s, is seen as being more consistent with the specialty's broader focus on health and wellness, in addition to illness.
The American Geriatrics Society (AGS) is a non-profit professional society founded on June 11, 1942, for health care professionals practicing geriatric medicine. Among the founding physicians were Dr. Ignatz Leo Nascher, who coined the term "geriatrics," Dr. Malford W. Thewlis, who was named the first executive secretary of the Society, and Dr. Lucien Stark who was appointed the first AGS president.
Evidence-based nursing (EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using evidence-based practice (EBP) as a foundation. EBN implements the most up to date methods of providing care, which have been proven through appraisal of high quality studies and statistically significant research findings. The goal of EBN is to improve the health and safety of patients while also providing care in a cost-effective manner to improve the outcomes for both the patient and the healthcare system. EBN is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. The evidence used to change practice or make a clinical decision can be separated into seven levels of evidence that differ in type of study and level of quality. To properly implement EBN, the knowledge of the nurse, the patient's preferences, and multiple studies of evidence must all be collaborated and utilized in order to produce an appropriate solution to the task at hand. These skills are taught in modern nursing education and also as a part of professional training.
Ambulatory care nursing is the nursing care of patients who receive treatment on an outpatient basis, ie they do not require admission to a hospital for an overnight stay. Ambulatory care includes those clinical, organizational and professional activities engaged in by registered nurses with and for individuals, groups, and populations who seek assistance with improving health and/or seek care for health-related problems. The American Academy of Ambulatory Care Nursing (AAACN) describes ambulatory care nursing as a comprehensive practice which is built on a broad knowledge base of nursing and health sciences, and applies clinical expertise rooted in the nursing process.
Geriatric oncology is a branch of medicine that is concerned with the diagnosis and treatment of cancer in the elderly, usually defined as aged 65 and older. This fairly young but increasingly important subspecialty incorporates the special needs of the elderly into the treatment of cancer.
Guided Care is a model of proactive, comprehensive health care for people with several chronic conditions. A form of medical home, the model has been developed and tested by a multidisciplinary team of experts at the Roger C. Lipitz Center for Integrated Health Care in the Johns Hopkins Bloomberg School of Public Health. Guided Care is provided by physician-nurse teams in primary care practices to the physicians' most complex patients, mainly older adults with chronic conditions and complicated health needs. It is designed to increase patients' quality of care and quality of life, while improving the efficiency of their use of health care resources, thus reducing their overall health care costs.
Teresa Thomas "Terry" Fulmer, is the current President of the John A. Hartford Foundation. Prior to this, she was the distinguished professor & dean of the Bouvé College of Health Sciences at Northeastern University. She is known for her extensive research in geriatrics and elder abuse. She has received funding from the National Institute on Aging and the National Institute of Nursing Research for her research regarding elder abuse. In addition to being the active dean of the Bouvé College of Health Sciences, Fulmer has also served as a visiting professor at the University of Pennsylvania School of Nursing and adjunct professor at the New York University School of Medicine.
Herzog Hospital is a geriatric-psychiatric hospital in Jerusalem, Israel. It is the third largest hospital in the city. Herzog Hospital specializes in nursing care for the elderly. The director-general of the hospital is Dr. Yehezkel Caine.
As of 2017, approximately 1.4 million Americans live in a nursing home, two-thirds of whom rely on Medicaid to pay for their care. Residential nursing facilities receive Medicaid federal funding and approvals through a state health department. These facilities may be overseen by various types of state agency.
Pediatric Early Warning Signs (PEWS) are clinical manifestations that indicate rapid deterioration in pediatric patients, infancy to adolescence. PEWS Score or PEWS System are objective assessment tools that incorporate the clinical manifestations that have the greatest impact on patient outcome.
Mary Starke Harper was an African American nurse who worked in bedside nursing, nurse research and health policy. She spent several years working for the Department of Veterans Affairs. She performed clinical research on the geriatric psychiatric population and minority health. In 1972, Harper created the NIMH Minority Fellowship Program. She served on four presidential administration advisory panels with regards to mental health and health care reform. She died in 2006 as the recipient of several honors and author of over 180 publications.
Comprehensive geriatric assessment (CGA) is a process used by healthcare practitioners to assess the status of people who are frail and older in order to optimize their subsequent management. These people often have complex, multiple and interdependent problems (multimorbidity) which make their care more challenging than in younger people, or those with just one medical problem. CGA is the core work of specialists in the care of older people, although many other health care practitioners either have not heard of it, or are not aware of what it actually is. It is also called "multidimensional geriatric assessment."
