INTRODUCTION The broader field of gerontology is the study of ageing process includes the biologic, psychological and sociological

sciences .Gerent logical nursing is the field of nursing that specializes in care of the elderly. Standards and scope of gerent logical nursing practice were originally developed in 1969. and revised in 1976 and 19 7 by the !"erican nurses !ssociation. The nurse gerontologist can be either a specialist or a generalist offering co"pressive nursing care to the older person. Gerontology nursing can be provided in acute, chronic and co""unity settings. The nurse helps the older person to "aintain dignity and "a#i"u" autono"y despite physical, social psychological losses. $ecause older age is nor"al occurrence that enco"passes all e#periences of life, care and concern for the elderly cannot be li"ited to one discipline. %pti"al care of the elderly cannot be li"ited through a co&operative effort. 'urse collaborates with the interdisciplinary tea" to obtain non& nursing services and provide a holistic approach to care. DEFINITION [ACC. TO BRUNNER AND SUDDARTHS: 2001] GERIATRICS:-(t is the study of old age includes the physiology, pathology, diagnosis and "anage"ent of the disease of older adults. GERENTOLOGICAL NURSING:-(t is the field of nursing that specializes in the care of elderly. PSYCHOSOCIAL ASPECTS OF AGEING Successful psychological ageing is reflected in the older person)s ability to adapt to physical, social and e"otional losses and to achieve content"ent, serenity and life satisfactions. $ecause changes in life patterns are inevitable over a life ti"e, the older person needs residency and coping s*ills when confronting stresses and change. +ositive self i"age enhances ris* ta*ing and participation in new, untested roles. !lthough attitudes towards old people differ in ethnic subcultures, a subtitle the"e of ,ageis")& pre-udice or discri"ination against older people predo"inates our society. .ear of ageing and inability for "any to confront their own ageing process "ay trigger against beliefs. /etire"ent and perceived non productivity are also responsible for negative feelings. (f the elderly are treated with dignity and encouraged to "aintain autono"y, the 0uality of their lives will i"proved. STRESS AND COPING IN OLDER ADULT 1nowledge of success in younger adulthood helps a person develop a positive self& i"age that re"ains solid even with adversities of age. ! person)s ability to adapt to changes, to "a*e decisions and responds predictably is all

deter"ined by past e#periences. ! fle#ible, well& functioning person will probably, continue such co""on stressors of older age include nor"al ageing changes that i"pair physical function , activities and appearance2 disabilities of chronic illness2 social and environ"ental losses of inco"e ,roles and activities and the death of significant others. DEVELOPMENTAL THEORIES OF AGEING [ Eric !"#$1%&'] 3e delineated the "a-or develop"ental tas* old age as ego integrity versus despair. 4go integrity suggests an acceptance of ones lifestyle and a belief that choices "ade were the best that could be "ade at a particular ti"e. 5espair the opposite of ego integrity, i"plies that older person feels dissatisfied and disappointed with his or her life. SOCIOLOGICAL THEORIES OF AGEING (t atte"pts to predict and e#plain the social interactions and roles that contribute to the older adults successful ad-ust"ent to the old age ACTIVITY THEORY [ H()i*+,r!-$1%.2]:$(t popes that life satisfaction in nor"al ageing involves "aintaining the active lifestyle of "iddle age. CONTINUITY THEORY [A-c+/01$1%2%3 N0,*(r-0#$1%&1]:$(t proposes that successful ad-ust"ent to old age rests with the ability of person to continue across a life ti"e. COGNITIVE ASPECTS OF AGEING I#-0//i*0#c0:&6hen intelligence test scores fro" people of all ages are co"pared, test scores for older adults show a progressive decline beginning in "idlife2 however if has been de"onstrated that environ"ent and health have a considerable influence on a score and their decline, where as other types donot7 proble"&solving ability based on e#periences, verbal co"phrensive8 L0(r#i#* (#4 505"r1:$ The ability to learn and ac0uire new s*ills and infor"ation decreases in the older adult. 9any older people continue to learn and participate in varied educational e#periences. :o"ponents of "e"ory that include short "e"ory 7;&<sec8, recent "e"ory 71 hr&several day8 and long ter" "e"ory etc

DEMOGRAPHICS OF OLDER PEOPLE The older population nu"bered <;.9 "illion in =>><.!t closer loo* at the de"ographics of the generation revealed in =>>< a se# ratio of 1?> wo"en for every 1>> "en. 9inority populations of this generation represents today about 17.6 @ of all older adults, with pro-ections that the "inority co"position will double by =><>.9ost older adults live in a noninstitutional co""unity setting and a "a-ority 767@8 of the" live with so"eone else significantly as one ages. (n =>>? <7.? @ of noninstitutionalized older persons assessed their health as e#cellent to very good. IMPORTANCE OF GERENTOLOGIC CONSIDERATION IN NURSING 'urses are *ey providers of health and social care and as such their wor* has co"e under increasing scrutiny by policy "a*ers as well as service purchasers and providers in ter"s of cost effectiveness and 0uality of service. (t see"s i"portant therefore to establish the thoughts and views of the older people who are in recipient of continuing care services. 'urses who wor* with older people have produced the value and s*ills and continuing care. +atient regarded easy e#change of thoughts and ideas as essential part of therapy. %lder people appearly to feel especially strongly about professional attitudes and have indicated a strong need to be treated as individuals and with respect. The older people valued hospitality, social interaction, reciprocity and e#pected their doctor to be "ore paternalistic than the younger infor"ants did. To ascertain the value which the older people who are residents in continuing care settings, place on nursing. COMMUNITY BASED MODEL FOR GERENTOLOGICAL NURSING :o""unities are where older people live, wor* and socialize. %ften older people can re"ain in the setting of their choice by "odifying their environ"ent and obtaining support services. :o""unity health settings include public health depart"ents, nurse "anaged health centers, a"bulatory care clinics and ho"e health agencies. Aegislation that affects the health care syste" is a product of that culture. (n =>>> the organization that ad"inisters 9edicare and 9edicaid changed in na"e fro" health care financing ad"inistration to center for "edicine and 9edicaid services 9ost of the individuals to wish to stay in their own ho"es and co""unities and will be fre0uent consu"ers of health services. 'urses are involved in direct care, providing self care infor"ation, contributing the supervision of paraprofessionals, or collaborating with other disciplines to provide the "ost appropriate , high 0uality, cost effective care at the "ost appropriate level and location.

1nowledge of resources is a funda"ental part of caring for the older adult in any co""unity. The nurse assees the need for health and helps develop the sources CHANGES OF BODY SYSTEM C(r4i")(!c,/(r: $ 5ecreased cardiac output and increased blood pressure. R0!6ir(-"r1:$(ncrease in residual lung volu"e, decrease in vital capacity and decreased gas e#change. I#-0*,50#-:$5ecreased protection against trau"a and sun e#posure, decreased protection against te"perature. R06r"4,c-i)0 [M(/0]:$5ecreased size of penis and tests, slower se#ual response. [F05(/0] Baginal narrowing, decreased elasticity vaginal secretions and slower se#ual response M,!c,/"! 0-(/C&Aoss of bone density, "uscle strength and size. G0#i-",ri#(r1[M(/0]:$$enign prostate hyperplasia 7F05(/0]/ela#ed perineal "uscles, urgue incontinence, stress urinary incontinence G(!-r"i#-0!-i#(/:&5ecreased salivation, dysphagia, reduced gastrointestinal "obility, delayed esophageal and gastric e"ptying. N0r)",! !1!-05:$/educed speed in nerve conduction, increased confusion with physical illness loss of environ"ental cues and reduced cerebral circulation. S60ci(/ !0#!0! [H0(ri#*]:$ 5ecreased ability to hear high fre0uency sounds. [T(!-0 (#4 S50//]5ecreased ability to taste and s"ell . [Vi!i"#]:$(nability to tolerate glare, difficulty ad-usting to changes of light intensity2 decreases ability to distinguish colours. M0#-(/ +0(/-+:$:ognitive i"pair"ent, organic "ental disorder and !lzhei"er)s disease HEALTH ASSESSMENT 'urse in co""unity health e"phasize wellness with the goal of "aintaining opti"al function, physically, "entally, socially and spiritually as to be as independent as possible for as long as possible.

Functional assessment:!s a "easure of physical and "ental abilities to !5As functional assess"ent is an i"portant para"eter for deter"ining an elder)s ability for self care at ho"e. (n addition to self reports by the elder and fa"ily "e"bers , the ability to perfor" the !5As also need to be observed by the nurse by having the elder perfor" as "any of these activities as possible. P !sical assessment 4"phasis is placed on areas the "ost i"pact functional ability 7egCvision hearing and strength8The health history for older adult "ust include fre0uent en0uiries about e#ercise, nutrition, "edication use, substance use, incontinence, "e"ory, depression, social activities and isolation. (n addition to the usual height, weight, blood pressure needs to be chec*ed sitting, lying and standing for orthostatic hypotension, a co""on proble" in elders. !long with usual adult physical e#a"ination, vision and hearing, "outh, s*in, breast 7for wo"an8, and "en 7prostate8 and feet need to be assessed. :o"plete blood count, urine analysis, thyroid screen are done periodically depending on the situation. M0#-(/ (!!0!!50#(t is focused on "e"ory and "ood. :ognitive functioning2 orientation, registration, attention and calculation, recall and language and pra#is. 4lders with significant "ental or e"otional i"pair"ents are referred their pri"ary care provider for the evaluation and treat"ent. S"ci0#)ir"#50#-(/ (!!0!!50#These factors are asses to identify fa"ily and living situations, social support syste"s, financial status and environ"ent hazards.! ho"esafely chec*list "ay be ad"inisterd on the initial visit and periodicvally thereafter to "onitor for the hazards contributing to accidents, falls and in-uiries in elders. (n analyzing the findings of geriatric assess"ent, nurse "ust re"e"ber that effects of nor"al ageing are being redefined continuously. NEEDS 7 PROBLEMS OF THE ELDERLY PEOPLE I"PAIRE# "O$ILITY The co""on cause include par*insons osteoarthritis, sensory deficits etc. disease, diabetic neuropathy,

o 4lderly patients should be encouraged to stay as active as possible to avoid the the downward spiral of i""obility o Treat the e#isting proble" o $ed rest should be provided o The patient should perfor" active range of "otion e#ercise o .re0uent position changes hlp offset the hazards of i""obility #I%INESS %lder people fre0uently see*s help for dizziness. (t presents a particular challenge because there are so "any possible internal D e#ternal causes. The causes for these sensations range in severity fro" "inor, as in build up of ear wa#, to significant, as in dysfunction of the cerebral corte#, cerebellu" , brain ste" etc. o o o o o +rovide treat"ent for internal or e#ternal causes $ed rest should be provided Give plenty of water :hec* the vitals in between $e with the patient

FALLS & FALLING (t)s a co""on D preventable source of "ortality D "orbidity in older adults. ! result of "ultiple possible physiologic D iatrogenic disorders ,falls causes further negative se0uels. o Treat the underlying cause o /estraints in the for" of physical "odalitiesElap belts, geriatric chairs etcF o :he"ical "odalities E"edicationsF URINARY INCONTINENCE (t can be acute D develop during an illness, or it can develop chronically. %ver a period of years it "ay be due to neurological or structural abnor"alities. The pelvic floor serves as the supporting "echanis" or ,)3a""oc*)) for the bladder, uterus D rectu" (t "ay have beco"e wea*ened as a result of pregnancy, labor D delivery, prior pelvic surgeries. o o o o Treat the underling cause 4ncourage the patient to do *egal e#ercise 1eep urinal with the patient $ehavioral therapy

ALTER# RESPONSE TO ILLNESS o The interdisciplinary tea" D the nursing staff can help avert negative outco"es of being ac*nowledgeable about the physiologic D psychological responses of older adult to acute illness by planning D i"ple"enting "easures. o :areful D fre0uent assess"ent of vitals, "ental status, .luid balance, s*in integrity o +ro"otion of independent D self care D "obility o !ssistance with fre0uent positioning D deep breathing e#ercises D toileting ALTER# E"OTIONAL I"PACT The e"otional co"ponent of illness in older people "ay differ fro" that in younger people. 9any elderly people e0uate good heath with the absence of old age. o The nurse "ust recognize the i"plication of fear, an#iety D dependency in elderly patients o !utono"y D independent decision "a*ing are encouraged o ! positive D confident de"eanor in the nurse D the fa"ily pro"ote a positive "ental outloo* in the elderly patients OL#ER A#ULT IN A PROTECTE# ENVIRON"ENT o 9any housing co""unities for older people provide opportunities for socialization D recreation o Aife care co""unities offers all the features of refine"ent co""unities plus health care D s*illed nursing care units. o 'ursing ho"es offer a variety of health D personal services that include s*illed nursing care D rehabilitation. o The nurse D social wor*er can function as advocates, e"phasizing this point D encouraging a fa"ily decision that includes the patient. NEE#S IN FA"ILY o +lanning for care D understanding the psychosocial issues confronting the older person "ust be acco"plished within the conte#t of the fa"ily o (n the absence spouse, an adult child is usually assu"e caregiver responsibilities D eventually "ay need help in providing care D support o /egardless of the a"ount of responsibility D love the adult child e#hibits towards the dependent elderly patients, strains develop if care continues over a long period of ti"e.

NEE#S IN THE HO"E ENVIRON"ENT 1. SAFETY 7 COMFORT o (n-uries ran* 7th as a cause of death for older people. The nurse can encourages lifestyle D environ"ental changes that the older adult D his or her fa"ily can adopt o !de0uate lighting with "ini"al glare D shadow can be achieved through the use of s"all area la"ps, indirect lighting shear curtains to diffuse direct sunlight, dull rather than shiny surfaces D night lights. o Aoose clothing, i"properly fitting shoes, scatter rugs, s"all ob-ects D pets create hazards D increase the ris* of accidents 2. PERSONAL SPACE o %lder people needs a place of his or her own, a special location that can offer security, co"fort D privacy. The nurse can help the older person to "aintain his or her space. "E#ICATIONS & EL#ERLY 9edications have i"proved the health D wellbeing of older people by alleviating sy"pto"s of disco"fort, treating chronic illness D curing infectious process. The nurse ad"inistering "edications to older people "ust be aware of followingC& o 5osage often "ust be reduced o %verdoses D "edications to#icity at usual therapeutic dosages are co""on o /eview the "edication schedule periodically o 4ncourage hi" or her, ta*e the "edications regularly CO""UNITY PROGRA""ES & HEALTH SERVICE 3ospital D health services are used by the elderly "ore than by other age groups in the population. 5isabilities resulting fro" chronic illness create the need in elders for help with basic activities of daily living. :o""unity progra""es provide help beyond the capabilities of infor"al supports. Such valuable services as health care at ho"e or in an adult day care centre, opportunities for socialization, transportation D ho"e delivered "eals often *eep the older person in the co""unity D need for nursing ho"e 1. HOME CARE

o The older adults usually prefers to live independently, even if he or she has difficulty getting around the ho"e. This "ay be against the wishes of the persons adult children o The ho"e care include supports fro" fa"ily, friends, the "ail carrier church "e"bers D neighbors, telephone reassurance 2. HOSPICE SUPPORTS OR SERVICES o 3ospice has been described as a progra""e of supportive D palliative services for dying patients D their fa"ilies include physical, psychological, social D spiritual di"ensions of care o The fa"ily "ust agree to assist in the care of the patients D services are brought into the ho"e as needed. "ENTAL ILLNESS o o o o o o . Supporting cognitive functions +ro"oting physical safety /educing an#iety D agitation ("proving co""unication s*ills +ro"oting independence in self care activities +roviding for socialization D inti"acy needs NURSES ROLE IN COMMUNITY CARE SETTINGS

SENIOR CENTERS:-Senior centers were developed in the early 19?>s to provide social and recreational activities. 'ow "any centers are "ultipurpose, offering recreation, education, counseling, therapies, hot "eals and case "anage"ent, as well as health screening and education. 'urses have a uni0ue opportunity to provide services to a group of older persons who wish to re"ain independent in the co""unity. A#ULT #AY HEALTH:-This for individuals whose "ental or physical function re0uires the" to obtain "ore health care and supervision. (t serves as "ore of "edical "odel than the senior centre, and often individuals return ho"e to their caregivers at night. So"e settings offer respite care for short ter" overnight relief for caregivers. Support groups for care givers are offered by nurses. HO"E HEALTH:-(t can be provided by "ultidisciplinary tea"s. 'urses provide individual and environ"ental assess"ents, direct s*illed care treat"ent and short ter" guidance and instruction. 'urses often function independently in the ho"e and "ust rely on their own resources and *nowledge to i"prove and adapt care to "eet the clients uni0ue physical and social circu"stances. They wor* closely with the fa"ily and other caregivers to provide necessary co""unication and continuity of care.

HOSPICE:-(t represents a philosophy of caring for and supporting life to its fullest until death occurs. The tea" encourages the client and fa"ily to -ointly "a*e decisions to "eet physical, e"otional, spiritual and co"fort needs. ASSISTE# LIVING:-(t covers a wide variety of choices, fro" a single shared roo" to opulent independent living acco""odations in a full service, life care co""unity. The differences are related to the type and e#tend of the a"enities provided and the contract signed for the". The role of nurse varies depending on the philosophy and leadership of the "anage"ent of the facility. The nurse generally provides assess"ents and interventions, "edication review, education and advocacy. LONG TER" CARE:-'ursing ho"e provides a safe environ"ent, special diets and activities, routine personal care and the treat"ent and "anage"ent of health care needs for those needing rehabilitation, as well as those needing a per"ananent supportive residence. REHA$ILITATION:- (t is a co"bination of physical, occupational, psychological and speech therapy to "aintain or recover their physical capacities. /ehabilitation is typically needed for older adults after a hip fracture, stro*e or prolonged illness that results in serious reconditioning. ROLE OF NURSE IN HEALTH PROMOTION3 PREVENTION AND 8ELLNESS 'urses in the co""unity focuses on the prevention of disease and the pro"otion and "aintenance of health. To achieve these goals nurses are involved in client and co""unity education, counseling, advocacy and case "anage"ent. The goal is i"proving the health of the individual and the co""unity through collaborative practice with other "e"bers of the health care tea". !chieving this goal involves the nurse in all < levels of prevention. 'urses should be fa"iliar with the guidelines for preventive services and screening activities for individuals 6; yrs of age and older. The ter" 9:0//#0!!; was coined by Travis 7=>>?8 to help bring to "ind the idea of health as holistic rather than "erely the absence of disease or illness. (t includes physical, e"otional, "ental and spiritual co"ponents. Travis 7=>>?8 outlined five di"ensions of wellness. Sel' (es)onsi*ilit!:-The core of wellness, encouraging self strategies, ta*ing control of health and life choices and partnering with health care providers rather than abdicating control. Nut(itional a+a(eness:- Aearning about the selection and preparation of food and developing eating habits that lead to "ore balanced, nutritionally appropriate diet.

P !sical 'itness:-(nvolving aerobic capacity, body structure, body co"position, balance "uscle fle#ibility and "uscle strength. St(ess mana,ement:-5eveloping attitudes and ways to cope with events in life that see" beyond control and that cause negative physical and "ental proble"s. En-i(onmental sensiti-it!:-(nfluencing ones personal roo" or ho"e space2 physical earth, issues of conservation and pollution and social co"ponents of govern"ent, econo"ics and culture. NURSES ROLE IN ETHICAL AND LEGAL ISSUES AFFECTING OLDER ADULT Aoss of rights, victi"ization and other grave proble"s face the person who has "ade no plans for personal and property "anage"ent in th e event of disability or death. The nurse as an advocate encourage the older person to prepare advance directives for future decision "a*ing in the event of incapacitation. +ower of attorney is a legal agree"ent that authorizes a person who is designated by the older people to act in specific, outlined purpose on behalf of the signer. ! trust is another option that co"petent older person can consider. (f inco"petent older person can consider. (f inco"petence or disability occurs, "anage"ent of the property is underta*en according to the persons wish. [PSDA] +atient self& deter"ination act, a federally "andated law, was enacted to re0uire patient education about advance directives at the ti"e of hospital ad"ission docu"entation of education is also re0uired. +S5! is also "andated in nursing ho"es with the pri"ary goal of enhancing resident autono"y by increasing involve"ent in health care decision "a*ing. TRAINING AND SUPERVISION FOR ELDRELY PEOPLE IN THE HO"E: 3o"e safety assess"ent and e0uip"ent 9eals on wheels 3o"e "a*er and core services Telephone reassurance and friendly visitor +ersonal e"ergency response syste" +har"acies or grocers that develop !rea agencies on ageing services State health, legal , social, service depart"ents !dult protective services& city social services 3o"e health aide 3o"e health nurses and therapists 3ospice

IN THE CO""UNITY: o Specialized transportation for disabled o 9ultipurpose senior centers o 3ealth screenings, health fairs o :ongregate "eal services o :o""unity "ental health clubs o !dult day health care o /espite care o :o""unity nursing clinics o :o"phrensive geriatric "edical services o 9edicare and 9edicaid health "aintenance organizations o :are giver or disease G focused support groups o :ase or disease "anage"ent o 3ealth pro"otion or self care classes IN SPECIAL HOUSING: 4lder cottage housing opportunity 3o"e sharing !ccessory apart"ents .oster ho"e Group ho"e !ssisted living facility Aife care co""unity /etire"ent village (nter"ediate care facility S*illed nursing facility /ehabilitation hospital Sub acute unit or hospital !cute care hospital State "ental hospital AGENCIES AND 8ELFARE PROGRAMME FOR ELDERLY PEOPLE HEALTHY PEOPLE ./0/ FOR OL#ER A#ULTS : The goals are to "aintain their health and functional independence and co"press "orbidity and dependence into the shortest possible ti"e ob-ectives related to i"prove"ents in nutrition, tobacco use reductions, weight control, physical activity, i""unizations and health care visits are focused on all age groups. :o""unity health nurses can healp address the need for "ore health education and progra""es for older adults. FE#ERAL PROGRA""ES Social security act of older peoples, 19<; 5epart"ent of health and hu"an services ad"inistration on ageing State and area agencies on ageing

9ultipurpose senior centers Senior e"ploy"ent Bolunteer progra""es .oster grand parents Senior nutrition progra""e 3ealth education and prevention activities !d"inister 9edicare and 9edicaid insurance progra""es %ffer food and nutrition progra""e %ffer low&cost public housing for elders

NATIONAL PRIVATE AN# VOLUNTARY NON PROFIT PROGRA""E 'ational council on ageing,19 > as a national resources for infor"ation, consultation, sponsors publication, special progra""es, advocacy activities, research and training 3ealth pro"otion institute 'ational elder care institute of health pro"otion 4nhance *nowledge and s*ills of those wor*ing with older adults and their fa"ilies. 9ultidisciplinary professional and scientific organization for those wor*ing in the field of gerontology. :helating therapyC (t is used to treat atherosclerosis and other chronic TYPES OF ALTERNATIVE MEDICINES COMMONLY USED IN ELDERLY C elatin, t e(a)!: (t is used to treat atherosclerosis and other chronic degenerative disease through intravenous infusions of ethylene dia"enetetraacetic acid. C i(o)(actic me1icine: (t focuses on the spine as integrally involved in "aintaining health and balance. (t is pri"arily used to treat lower bac* nec* pain. N(-,r"6(-+1: (t is philosophy and a way of life that e"phasizes the body)s ability to heal itself by the use of re"edies such as nutritional counseling, ho"eopathy, herbs, "assage, yoga, hydrotherapy and fresh air and general avoidance of drugs and surgery. Acu)untu(e:(t is the practice of inserting needles into specific points along the body "eridian syste" to treat disease, relieve pain and the balance flow of energy in the body. REHABILITATION FOR OLDER PEOPLE (t is a co"bination of physical, occupational, psychological and speech therapy to "aintain or recover their physical capacities. /ehabilitation is typically needed for older adults after a hip fracture, stro*e or prolonged illness that results in serious reconditioning.

The nursing reflects a "inor participative approach to care which i"plies involve"ent of the client in establishing goals which reflect to so"e degree their needs and wants. /ehabilitation with older people is about being positive. (t doesn)t -ust ta*e place in special units, but continues in the persons own ho"e, in hospital, or in care ho"es. %lder people have the potential to i"prove or "aintain their health status, even if re"aining highly dependent on others. !ll "e"bers of the tea" should participate in the process of enabling and facilitating older people to ensure they are able to achieve the "a#i"u" "ove"ent and "obility. The nurses care plan should facilitate choice ion a range of activities that encourages physical activity. The nurse role, wor*ing with in the "ultidisciplinary tea" in any care ho"e setting, should ai" to prevent any further loss of "obility, "aintain and i"prove current ability, even on a very s"all scale, should always be striving to enhance 0uality of life. (n order to achieve these goals the nurse should have wor*ing *nowledge of the roles of the occupational therapists and chiropodist, on order to understand how their specialist s*ills can be used affectively to encourage good nursing. SUMMARY The geriatric consideration in nursing deals with health assess"ent, syste"ic changes, various "odels D theories, training D supervision for elderly, agencies D welfare progra""es for elderly D role of nurses in various levels. CONCLUSION Gerentologic nursing is the field of nursing that specializes in care of elderly. 4"phases of care is placed on pro"oting D "aintaining functional status, thus pro"oting independence. The nurse helps the older persons to "aintain dignity D "a#i"u" autono"y despite physical, social D psychological losses. %pti"al care of the elderly people can best be provided through a co& operative effort. !n interdisciplinary tea", through co"phrensive geriatric assess"ent, can co"bine e#pertise D resources to provide insight to all aspects of the ageing process. l BIBLIOGRAPHY $runner D suddarths E=>><F, Te#t boo* of "edical surgical nursing, 9 th edition, Aibrary of congress cataloging publication, +p noC1? &171 +otter D perryE=>>>F, .unda"entals of nursing,"osby)s publication,ist edition

+pnoC=?<&=69 9arcia StanhopeE=>>7F, +ublic health nursing, "osbys publication,7 th edition +p noC66?&6 = +hippsE=>>=F, 9edical surgical nursing,"osbys publication, 7 th edition,+pnoC ;=&7>