Although there has been an enormous increase in the number of Americans 65 and older in the past century (from 3.1 million in 1900 to over 34 million in 2000), many nurses have little or no education or training in gerontological nursing or chronic disease management, according to Jeanie Kayser Jones, RN, PhD, UCSF professor of physiological nursing and medical anthropology and director of a new center in the UCSF School of Nursing.
One way to improve nursing care is to be sure there are enough doctorally-prepared gerontological nurses in academic settings to educate the next generation of nurses. Kayser-Jones explained that in the United States, there are about 15,000 nurses with doctorate degrees in nursing. Less than five percent of these nurses (750) have training in gerontological nursing.
The UCSF School of Nursing has received a $1.3 million, five-year grant from the John A. Hartford Foundation to establish a Center for Gerontological Nursing Excellence. The UCSF center (one of five selected sites) will prepare gerontological nurse scientists to provide academic leadership in teaching, research and patient care.
"Our health care system has been slow to respond to the needs of older people, and nurses who provide a substantial amount of care to older people are in short supply. What this means is that there are very few nurses who have been adequately trained to provide care to this rapidly growing population," she said. "The academicians we train at the center will be responsible for educating future nurses and conducting research to alleviate many of the problems that older, chronically ill people face each day." Much of that education and research will be conducted in partnership with the UCSF schools of medicine, dentistry, pharmacy and faculty members in the social and behavioral sciences who have expertise in gerontology. "Aging is a complex process that requires solutions from a variety of disciplines," said Kayser-Jones.
In the United States there are 34 million people who are 65 years and older. Four million of these Americans are 85 years and older (the oldest old). In California, 3.5 million people are over the age of 65, including 1/2 million who are members of the oldest old.
People over age 85 constitute the fastest growing segment of the population, according to Kayser-Jones. It is projected that by the year 2050 18 million people will be over the age of 85, a more than fourfold increase. In California, by the year 2040, two million people will be over the age of 85. The increase in the number of very old people is of concern to health care providers because as people live to very old age, chronic illnesses become more prevalent, said Kayser-Jones. "In 1900, most people died before old age. Today, most Americans live into old age and will die of chronic illnesses such as heart disease, cancer, stroke and Alzheimer's disease."
Older people with chronic illnesses often need nursing care and have limitations in their daily activities, she explained. Some are unable to walk. Others are unable to feed and dress themselves, and many have repeated hospitalizations. By 2030, the number of people who have some limitations in their usual activities of daily living is expected to triple. The number of days that older people spend in the hospital will also triple, and the number of nursing home residents will nearly quadruple.
Along with associate directors Charlene Harrington, RN, PhD, UCSF professor of social and behavioral sciences and Margaret Wallhagen, RN, PhD, UCSF associate professor of physiological nursing, Kayser-Jones will focus on the development of:
· A rigorous recruitment program
· A web-based course in gerontology to provide a strong foundation for predoctoral and postdoctoral trainees
· An interdisciplinary, collaborative program to prepare doctoral students to conduct research in symptom management, transitions in levels of care, and aging health care policy;
· A mechanism to attract faculty from other specialties into the field by encouraging them to expand or redirect their existing programs of research to gerontological nursing.
Other Centers of Gerontological Nursing Excellence will be established at Oregon Health Sciences University, the University of Arkansas, the University of Iowa and the University of Pennsylvania.
The UCSF Center is guided by advisory committee members Christine Miaskowski, RN, PhD, chair of the UCSF department of physiological nursing; Caroll Estes, PhD, professor in the UCSF Institute for Health and Aging; Dorothy Rice, ScD, professor in the UCSF Institute for Health and Aging, Seth Landefeld, MD, UCSF professor of geriatrics; and Harold Luft, PhD, director of the UCSF Institute for Health Policy Studies. The managing committee is chaired by Shirley Chater, RN, PhD, professor in the UCSF Institute for Health and Aging, and includes William Holzemer, RN, PhD, chair of the UCSF department of community health systems and Maryline Dodd, RN, PhD, UCSF professor of physiological nursing.
"We look forward to working closely with the Institute for Health and Aging, the Institute for Health Policy Studies, the Center for Excellence in Geriatric Medicine, and faculty in other schools and programs," said Kayser-Jones.
The John A. Hartford Foundation, Inc of New York City is a private philanthropy established in 1929. John A. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic & Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950s. Since 1979, the Foundation has focused its support on improving the quality and financing of health care and enhancing the capacity of the health care system to accommodate the nation's growing elderly population. The majority of the Foundation's current grantmaking relates to enhancing geriatric research and training and integrating and improving health services for older adults.
NOTE TO THE MEDIA:
Jeanie Kayser-Jones, RN, PhD, is available for interviews. Contact Maureen McInaney at 415-476-2557 to arrange an interview.