This lecture course focuses on understanding the basic concepts of aging, the normal physiologic and sensory changes that occur with age; functional health-maintenance or restoration, psychological aspects of aging and adaptation, and how these changes impact nursing care. This course also seeks to provide a sound knowledge base from which the Certified Nursing Assistant (CNA) can practice gerontological nursing and to cultivate within the CNA a respect and appreciation for the elderly patient/resident.

Roach, Sally S. (2001). Introductory Gerontological Nursing. Philadelphia, PA; Lippincott Williams & Wilkins.

NOTE:  To supplement your studies, go to the recommended geriatric web links

          http://www.geronurseonline.org/ 

1. The student is expected to possess knowledge, skills, judgements, values, and attitudes to develop the foundation for the listed program competencies.
    
    Adhere to the code of ethical conduct and apply this code to established state and federal laws, recommendations, regulations in the provision of care to the geriatric patient/resident
2. Perform self-assessment for life long learning to provide evidenced-based practice of geriatric nursing care
3. Understand and interpret the scientific literature and research as it relates to the evidence-based practice of geriatrics/gerontology.
4. Utilize current technology to enhance education, patient care, research and professional growth.
5. provides basic geriatric care to promote wellness, restoration and maintenance of functional and physiologic health, promote quality of living and dying with quality and dignity
6.  Systematically collect and record and report data findings to the Charge Nurse or Licensed Nurse
7.  Recognize and provide the appropriate care for a medical emergency within the GCT’s domain for residents/patients in the long-term and acute –care setting.
8. Identify patients/residents at risk for a medical emergency

This course will help students achieve the following institutional Student Learning Outcomes:
A. Critical Thinking: Analyze problems by differentiating fact from opinions, using evidence, and using sound reasoning to specify multiple solutions and their consequences.
Assessment: The students will provide nursing care for patients/residents during the clinicals. The nursing instructor will evaluate and guide the services provided by the students

B. Communication: Effectively communicate thought in a clear, well-organized manner to persuade, inform, and convey ideas in academic, work, family, and community settings.

Assessment: The students will provide nursing care services for patients/residents during the clinicals. The communication skills and interactions with patients/residents, nursing staff, peers and faculty will be evaluated.

C. Technical Competence: Utilize the appropriate technology effectively for informational, academic, personal and professional needs
Assessment: The students will utilize a variety of technological aides to provide nursing care services during the clinicals, such as Kaiser’s electronic computer systems and automatic vital signs equipment.  The technical application will be evaluated by nursing instructors.
D. Ethics: Practice and demonstrate standards of personal and professional integrity, honesty and fairness; apply ethical principles in submission of all college work.
Assessment: The students will work in the clinical setting utilizing professional and ethical values.

At the end of the course, the student will be able to discuss information acquired about normal physiological and sensory changes, common psychological disorders, common diseases and losses experienced by the elderly and will able to communicate these observations and findings in the clinical setting under the supervision of a nursing instructor. 

Through knowledge gained in lectures, interactive participation, videotapes and reading assignments, the student will:

1. Define the word “ageism” with at least two (2) examples of myths.
2. Differentiate the difference between chronological and functional aging.
3. Discuss the influence of culture on lifestyle behaviors, including self-care and health.
4. Differentiate between conservator ship and guardianship in California.
5.  List at least three (3) examples of age-related changes of the Integumentary system.
6. Identify factors that influence compromising the skin integrity.
7. List at least three (3) interventions related to skin care for everyday use, e.g., mild soaps, moisturizers and hydration
8. Define pressure ulcers or bedsores
9. List some common therapies and CNA interventions for pressure ulcers or bedsores, e.g. skin care, turning schedules, equipment, etc.
10. List factors that contribute to healing and care of skin and wounds.l
11. List at least three (3) examples of age-related changes of the respiratory changes.
12. Identify factors that influence compromising the respiratory changes.
13. Review the definitions of common respiratory conditions, such as common colds, bronchitis, community acquired pneumonia, etc.
14. List common over-the-counter (OTC) products and lifestyle behaviors that facilitate preventive strategies.
15. List at least three (3) interventions related to good oral hygiene, pulmonary toilet, handwashing and healthier lifestyle habits.
16. Identify safety precautions for oxygen delivery and equipment.
17. List at least three (3) examples of age-related changes of the cardiovascular system.
18. Identify factors that influence compromising cardiovascular changes.
19. Review cardiovascular definitions for coronary artery disease, hypertension and cerebral vascular disease
20. List and demonstrate all possible sites for palpating and taking a pulse
21. Describe normal vital sign values for the elderly patient/resident
22. List common signs/symptoms related to cardiovascular disease
23. Describe urgent interventions for any acute incident, e.g., semi-fowler’s position, administration of oxygen per physician’s orders, etc.
24. List at least three (3) examples of age-related changes of the gastrointestinal system.
25. Identify factors that influence compromising gastrointestinal changes
26. Review the definitions of common gastrointestinal conditions, such as GERD, anorexia and constipation.
27. Describe at least three (3) common treatment modalities for gastrointestinal diseases, i.e., diet, hydration, and OTC products.
28. List at least two (2) changes in relation to taste.
29. Explain what is “bowel retraining” and list at least three (3) key factors in a bowel retraining program.
30. List at least five (5) examples of age-related changes of the musculoskeletal system.
31. Identify factors that influence compromising musculoskeletal changes.
32. Review the definitions of musculoskeletal conditions such as osteoarthritis, rheumatoid arthritis, geriatric shoulders and decreasing ROM and balance.
33. Describe at least three (3) common treatment modalities for musculoskeletal diseases, i.e., good body mechanics and OTC products.
34. Demonstrate the proper use of  assistive devices: single cane, quad cane, pick-up walker and crutches
35. Describe and demonstrate active range of motion (AROM) and passive range of motion (PROM).
36. List safety precautions for use of restraints while patient/resident is in bed or wheelchair.
37. Describe options to enhance balance and strength towards falls prevention, e.g., Tai Chi classes
38. List at least five (5) examples of age-related changes of the genitourinary system.
39. Identify factors that influence compromising genitourinary changes.
40. Review the definitions of genitourinary conditions, such as various types of urinary incontinence, urinary retention, etc.
41. Describe at least three (3) common treatment modalities for genitourinary diseases.
42. List at least three (3) examples of age-related changes of the Central Nervous System (CNS).
43. Identify factors that influence compromising central nervous system changes.
44. Review the definitions of central nervous system conditions, such as Parkinson’s disease and cerebral function loss.
45. List common signs/symptoms related to cerebral dysfunction.
46. Describe at least three (3) common treatment modalities for central nervous system diseases, i.e., physical therapy, occupational and speech therapy.
47. Define basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs).
48. List at least three (3) examples of age-related changes of the endocrine system.
49. Identify factors that influence compromising endocrine system changes.
50. Review the definitions of endocrine conditions, such as: diabetes Type I and II, hypothyroidism, etc.
51. List common signs/symptoms related to endocrine conditions, e.g., diabetes, hypothyroidism, etc.
52. Describe at least four (4) different types of abuse experienced by the elderly.
53. Distinguish between passive and active neglect.
54. Define the role of the CNA as an advocate for the elderly, who presents as an abused victim.
55. Discuss the relationship between certain medications and dietary intake of certain foods, etc.
56. List diseases common in the elderly population.
57. Describe the primary signs and symptoms of these common elderly diseases.
58. Describe age-related disorders specific to the: integumentary, respiratory, gastrointestinal, musculoskeletal, cardiovascular, genitourinary, nervous and endocrine systems.
59. Describe normal sensory related changes in vision, hearing, taste, smell and touch.
60. Discuss the impact of sensory changes on the elderly's ability to maintain independence.
61. Compare and contrast the changes in hearing and aging, and identify appropriate intervention measures for hearing loss.
62. Discuss effective communication techniques with hearing and vision impaired older adults.
63. Describe changes in touch, vibration and pain sensitivity in the aged adult.
64. Discuss normal age-related changes in intelligence, cognition, learning capability and memory in the older adult.
65. Describe the aging process effects on the following characteristics: personality, attitude and self-concept/body image in the elderly patient.
66. Identify key characteristics of Alzheimer’s disease, and list appropriate nursing care measures.
67. Identify common causes and signs and symptoms of depression in the elderly.
68. Discuss therapeutic approaches to managing mental disorders in the elderly.
69. Discuss the impact of loss of: functional ability, independence of ADLs/IADLs, and social status and position in the older adult.
70. Describe physiological and malnutrition factors that affect the elderly’s nutritional status
71. Discuss the relationship between certain diseases and malnutrition in the elderly.
72. Recognize and identify signs of malnutrition in the elderly resident/patient.
73. List measures to improve the nutritional status in the elderly.
74. State nutritional measures when caring for the acutely ill elderly resident/patient.
75. Discuss normal age-related sexual organ changes in the older male and female.
76. Discuss society’s negative attitudes towards sexual behavior in the elderly.
77. Describe the CNA’s role in acknowledging the rights of the elderly to sexual expression.
78. Define reality orientation.
79. Describe the benefits of a reality-orientation program for institutionalized elderly residents/patients.
80. Identify and describe the key components of reality orientation process.
81. State the CNA’s role when implementing reality orientation measures.
82. List at least four (4) common disorders of the elderly that produce pain.
83. Discuss the CNA’s role in caring for elderly patients with chronic pain.
84. Discuss the impact of elderly chronic pain on the following modalities: ADLs, interpersonal relationships, ability to sleep, eat, work, and exercise and sexual performance.
85. State that the most accurate and reliable assessment of pain is the resident’s self-report.
86. List the various pain assessment instruments/scales utilized to assess a resident’s level of pain.
87. State how depression is associated with decreased reports of pain by the elderly.
88. Describe non-pharmacologic strategies for pain management in the older resident/patient, inclusive of exercise programs, acupuncture, acupressure, transcutaneous nerve stimulation (TENS), distractions to change focus away from pain, application of heat and/or cold, massage, relaxation, chiropractics, homeopathic, neuropathic and spiritual healing.
89. Review the definitions of: “CPR”, “ No Code Blue” and “Do Not Resuscitate”
90. Describe the “ABCs” in cardiopulmonary resuscitation (CPR).
91. Discuss and review the CNA’s role and responsibility when handling emergency equipment, inclusive of oxygen, crash cart, and suction machine and the defibrillator or Automatic External Device (AED).
92. Describe the levels of preventative patient care: primary, secondary and tertiary.
93. Define health and wellness.
94. Discuss the “Healthy People 2010” goals/objectives for the elder population.
95. Describe measures of wellness can be accomplished by the elderly.
96. Describe the “SPICES” assessment of the elderly resident/patient.
97. Describe attitudes toward death and dying.
98. Describe various types of grief,
99. Identify caring behaviors.
100. Discuss the dying process.
101. Discuss the needs of the dying resident/patient.
102. Describe the purpose of Advance Directives

Lectures, discussions, small group activities, skills laboratory activities, cooperative learning tasks, and clinical application of learned theory are used to conduct this course.  Student assignments of reading and reviewing relevant materials are integral to the learning process. Role-play will be used to illustrate clinical application, and the students will perform clinical procedures on peers in the skills laboratory

Students can earn a total of 300 points in the didactic.   The course letter grade will be based on the following points system:
 
270-300…………..A
269-240…………..B
239-210…………..C
190-209…………..D
Below 189…………F

Quizzes…………..105 points
Mid Term………… 70 points
Final exam……….125 points (students must pass with 75& or higher on Final Exam and perform satisfactory in the clinical performance in order to pass this course. The examinations will be multiple choice No makeup exams/quiz will be given. If an exam/quiz is not taken, the student will receive a failing grade for that exam. Each exam/quiz will be limited to questions on the material presented in lecture, videos (if applicable), and reading assignments of that module. The final exam will be comprehensive (include information from all modules).

ABSENCES: A student must attend both theory and clinical as scheduled, and be on time. Each student must sign in at each session.  Students must pass each clinical skill(s) performance evaluation at the satisfactory level in order to pass the course.  If a student fails the clinical, and has a passing grade in theory, the student will receive an “F” /Incomplete for the entire course (theory and clinical).

Students who are late twice are counted as an absence.  Unexcused absences will be handled in accordance with the West Los Angeles College (WLAC) Attendance Policy.