Adults over the age of 65 are the fastest-growing population in the United States. With average life expectancy on the rise and the majority of the oldest population reporting to have at least one disability, caregivers are an integral part of older adult lives.
But as the older adult population continues to grow at a rapid pace -- adults over the age of 65 are expected to more than double from 35 million to 71.5 million between 2000 and 2030 -- there is a dramatic shortage of geriatric caregivers across the country. The Eldercare Workforce Alliance estimates that care facilities will need an additional 3.5 million geriatric health care professionals by 2030.
To help reverse this trend, the Hartford Center of Geriatric Nursing Excellence at Penn State University Park campus is using technology to change how current and future nurses learn to care for older adults.
Ann Kolanowski, Elouise Ross Eberly professor in the College of Nursing, professor of psychiatry in the College of Medicine and director of the Hartford Center of Geriatric Nursing Excellence, thinks one of the main reasons for the shortage in the geriatric nurse population is a misconception of what it’s like to care for older adults.
“When people hear ‘geriatric’ they tend to think of very frail, older adults in nursing homes,” Kolanowski said. “And while that’s a very important piece of geriatric nursing, it isn’t the only piece. Older adults are living longer and have more active lifestyles.”
According to Kolanowski, another contributing factor in the shortage of geriatric caregivers is the lack of available geriatric care educational programs.
“Only 89 of the 300 nurse practitioner programs and 31 of the 198 certified nurse specialist programs in the U.S. focus on gerontological populations, despite the fact that these people are the core business of health care,” she said. “Older adults use more medical services than anyone, so this is a nationwide issue.”
As one of only eight centers in the nation to receive funding in 2007 from the John A. Hartford Foundation, which has a mission to improve the health of older adults in the United States, the Hartford Center at Penn State focuses on offering new and modern geriatric care educational programs to attract a new wave of nurses.
Realizing an opportunity to capitalize on the reach of the College of Nursing, which offers nursing programs to students at 12 campuses across the state and online through Penn State World Campus, the Hartford Center developed a master’s degree program in geriatric care in 2008 that is available both online and on campus.
“We thought it would be wonderful to use some kind of blended distance technology -- online courses and video conferencing to deliver this master’s program,” said Kolanowski. “Any student in this program can enroll without having to travel to University Park. These students can go right back into their communities and not only study there, but work there. And that is really part of the mission of the University, to serve the needs of the Commonwealth.”
The Commonwealth is benefiting in other ways, too. The Hartford Center partnered with Jay Cho and Kiseok Sung, graduate students from the Penn State Harold and Inge Marcus Department of Industrial and Manufacturing and Engineering, to develop an online informational toolkit, which contains educational materials for nursing homes to use to help improve the care given to older adults.
“The Centers for Medicare and Medicaid Services are taking a hard look at how many anti-psychotic medications, which have a lot of adverse effects, people in nursing homes are taking,” said Kolanowski. “This toolkit is a tremendous resource to reduce the number of these drugs being used -- it’s a roadmap for how to change the culture of care in nursing homes.”
Other Hartford Center initiatives extend beyond the Commonwealth. In 2007, the center began a partnership with the University of Virginia as a way to offer virtual journal club meetings to increase outreach efforts to students interested in geriatric nursing.
“We have staff from nursing homes, hospitals and medical centers, as well as students from other universities come together virtually using videoconferencing to discuss the clinical implications of a gerontological topic chosen from a healthcare journal article,” Kolanowski said. “Our journal clubs usually accommodate 40 to 50 people from all over the Eastern seaboard. We can hardly handle all the people who want to join these clubs.”
Karen Rose, assistant dean for research and innovation in the University of Virginia School of Nursing, is excited to see how far the journal clubs have come since their inception.
“Originally these clubs consisted of just the University of Virginia and Penn State, but with the Hartford Center’s help they expanded pretty rapidly,” said Rose. “There could be people from eight, 10, even 12 different locations signing in for each meeting. It’s been really good.”
Before each journal club meeting, held twice a semester and hosted alternatively between the University of Virginia and Penn State, the host university chooses a healthcare journal article related to the care of older adults. Discussion topics run the gamut of the gerontological spectrum -- dementia, medication reconciliation, mobility issues and nutrition, to name a few.
“We ask if participants are seeing anything in their clinical environments or research studies that they’re particularly interested in,” explained Rose. “What’s challenging for them? What have they come across in literature that resonated with them? What’s a hot topic for them right now? It really helps the participants because they’re so involved in the process.”
And both Rose and Kolanowski feel these journal clubs are beneficial for both current and future geriatric care givers.
“These clubs provide participants with new knowledge, and they build skills and camaraderie,” said Rose. “There have been opportunities where students in Virginia want to partner with students at Penn State and vise versa. It’s a networking opportunity for all of us and a great mentoring opportunity for future geriatric nurses.”