Entering the field of nursing, one of the first things a student might consider is what specialty to pursue.
When it comes to geriatric care, however, choosing a specialty is only one aspect to explore.
“Every nurse in nursing school, as well as nurses who practice, need to know how to take care of geriatric needs, regardless of the specialty they choose — unless they’ve chosen obstetrics or pediatrics,” explained Herb Geary, Cottage Health’s vice president of Patient Care Services.
“Geriatrics isn’t a specialty, it spans all different specialties — so we have geriatrics in orthopedics, we have geriatrics in cardiac, we have geriatrics in general surgery, and geriatrics in critical care.”
And although there are such a wide range of specialties from which to choose within the field of geriatrics, it’s important to consider the ways in which they all work together to provide the best care for the often complex needs of aging patients.
In a recent interview, Sharon Callis, hospice clinical manager at Visiting Nurse & Hospice Care, pointed out how “this generation is more apt to have multiple health concerns and see a variety of practitioners for their health-care needs.”
Such health concerns, particularly for the elderly, are rarely isolated considerations, so collaboration and cooperation between specialists is essential to providing the best health-care treatments possible.
But geriatric health care doesn’t begin and end in the hospital or doctors’ office — it continues into the home, both through personal care regimens and in-home nursing visits.
Callis says she favors the opportunities that become available when working with patients in their homes, and how “the ability to see and care for people in their own home setting is invaluable.”
“I can glean a lot of health information by observing the way a patient lives in a day-to-day-way,” she noted.
She continued by explaining how “it is an honor to be a guest in someone’s home and personal space. It feels intimate, and allows me to ask private questions in a gentle way. Many of my patients have told me that they feel comfortable talking to me in the privacy of their own living room(s).”
And even when in-home care is not available, hospitals and doctors’ offices are doing their part to ensure that their elderly patients are not only receiving the care they need, but are being empowered with the information and learning tools to maintain the healthy lifestyle they desire.
“We have to look at every aspect of what they came in with, what their baseline was and what we are sending them home with,” Geary said.
Yet, receiving a packet of information, although proven to be effective, is certainly helped along by repetition.
“Learning (for) geriatric patients is different, and many of them need repetition in education (and) they need different forms of it,” Geary explained. “Some want to read it, some want to hear it — so we have to address things (for) when they leave the hospital and life is going to be different.”
Geary also noted how Cottage Health’s three hospitals — Santa Barbara, Goleta Valley and Santa Ynez — utilize a technique referred to as “teach-back” to ensure that patients understand not just how to take their new medications, but also what warning signs to look out for.
“We use teach-back every day,” he said. “We ask patients to tell us two side effects of the new medication they’re on for their high blood pressure, tell us two things about this medication that they should call their doctor for.”
It is through this type of repetition that doctors can get a better idea of how their patients are understanding their own care, and where they may need to work to fill in the gaps.
“We need to remember that we have many of the same nursing goals, no matter what the setting,” said Callis, emphasizing the complexities in caring for geriatric patients across multiple specialties and medical settings.
“We need to be able to be realistic about how much we can do in any one particular setting, and at any one particular visit.”
— Noozhawk contributing writer Kellie Kreiss can be reached at news@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkSociety, @NoozhawkNews and @NoozhawkBiz. Become a fan of Noozhawk on Facebook.