By 2060, the number of Americans ages 65 and older is expected to increase to 95 million, up 83% from 2018, according to the Population Reference Bureau. The healthcare system isn’t ready for the unique healthcare needs of this rapidly aging population. While the number of people ages 65 and older who require geriatric care continues to increase, only about 6,000 specialist physicians are certified in gerontology, according to 2019 data from the Accreditation Council for Graduate Medical Education (ACGME).
To fill this widening gap, geriatric health specialists and advocates are leveraging the help and expertise of gerontological nurses, who are sometimes referred to as geriatric nurses. Nurses who are interested in becoming nurse practitioners who specialize in gerontological nursing can expand their knowledge by pursuing an advanced nursing degree.
Nursing professionals curious about what an adult gerontological nurse practitioner (AGNP) does and how to become one can consider pursuing an advanced degree, such as an online Master of Science in Nursing (MSN).
What Is an Adult Gerontological Nurse Practitioner?
Gerontology — the study of the aging process — examines the causes and effects of age-related illnesses in humans. The field examines the biological aspects of aging, such as artery walls stiffening in the cardiovascular system, and the unique psychological, social and physiological aspects of aging as well.
Adult gerontological nurse practitioners focus on the care and treatment of adults from later adulthood to end of life. This population has unique needs, as the body is no longer developing after the age of maturity. As patients age, the ability of their bodies to respond to stressors and heal declines. A few age-related changes in patients are:
- Decreased respiratory strength
- Reduced bone density
- Higher likelihood of infection
Gerontological Nursing Goals
A goal of a gerontological nurse is to provide the highest-quality care to older adults. Gerontological nurses focus on “the process of aging and the protection, promotion, restoration, and optimization of health and functions,” according to the American Nurses Association (ANA). This care includes preventing illness and injury, aiding the healing process, easing the effects of disease, and being advocates for the health of older adults.
What Does an Adult Gerontological Nurse Practitioner Do?
Gerontological nurse practitioners provide a well-rounded approach to care. They treat and prevent illness and address the cultural, psychological and social aspects of aging. With this comprehensive approach to health, gerontological nurses can deliver a care plan that the patient will understand and that family members or caregivers can support.
AGNPs are advanced nurse practitioners who specialize in either primary care or acute care. They can work with adults across the life span, starting in early adulthood. As baby boomers age, AGNPs will play a significant role in treating the growing number of patients with complex health issues related to age and chronic conditions.
The duties of an AGNP may vary depending on the needs of the patient. Nurses may assist with daily routines, such as eating, bathing, dressing and walking and may also administer medications and monitor health vitals, working alongside a physician.
Adult-gerontological acute care nurse practitioners (AGACNPs) play a specific role in the care of older adults by caring for patients with critical conditions and chronic illnesses. They operate out of various settings, such as intensive care units (ICUs) and long-term care facilities.
Health Issues in Older Adults
AGNPs assess older adults to identify the physical, social, economic, psychological and even spiritual factors that may influence the health of patients, as well as educate patients on how to improve health outcomes.
According to the National Council on Aging (NCOA), approximately 80% of older adults have at least one chronic disease, and 77% have at least two. In fact, cancer, heart disease, diabetes and stroke are four chronic diseases that are responsible for about two-thirds of deaths each year.
Diabetes alone impacts about 23% of all individuals older than 60 years old, according to NCOA. Those who are prediabetic can be at risk for several other chronic diseases, particularly heart disease and stroke.
Another chronic condition affecting older adults is obesity. As the metabolism slows and muscle tissue decreases, the chance for obesity in older adults rises. According to the Centers for Disease Control and Prevention (CDC), about 43% of adults 60 and older were obese as of 2017-18. Obesity has been linked to chronic conditions, such as heart disease, Type 2 diabetes, stroke and certain types of cancer.
Adult-gerontology nurse practitioners, particularly those working in acute care, provide emergency care for older patients dealing with other health issues not related to chronic diseases. According to the CDC, “In 2018, almost 7,700 older adults (aged 65+) were killed in traffic crashes, and more than 250,000 were treated in emergency departments for crash injuries.” Driving accidents make up a significant number of deaths and injuries annually. AGACNPs are responsible for treating the wounds of injured elderly patients and making treatment plans for their recovery.
Another common health issue for older adults is falling. As individuals age, start walking slower and begin to lose their balance, they become more prone to missing a step or slipping on a wet surface. NCOA reports that about “every 11 seconds, an older adult is treated in the emergency room for a fall.”
Falling can cause an elderly patient to fracture a hip, break an arm, bruise their face or harm their skull, among other issues. AGACNPs are involved in the process of assessing the conditions of patients after falling and analyzing their injuries.
Adult-Gerontology Acute Care vs. Primary Care
In the nursing field, adult-gerontology nurse practitioners have the option to work in acute care or primary care. To better understand what AGNPs do, it’s important to recognize the similarities and differences between acute care and primary care.
Education requirements are one of the similarities between AGACNPs and adult-gerontology primary care nurse practitioners (AGPCNPs). The path to becoming an adult-gerontology nurse practitioner begins when a nurse earns a Bachelor of Science in Nursing (BSN), passes the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and gains experience in the field as a registered nurse (RN). The essential next step is earning an MSN from a program accredited by the Commission on Collegiate Nursing Education (CCNE*) or the Accreditation Commission for Education in Nursing (ACEN).
AGACNPs and AGPCNPs are also required to earn certification through the American Nurses Credentialing Center (ANCC), the American Academy of Nurse Practitioners Certification Board (AANPCB) or another organization.
While some job locations can differ, both AGACNPs and AGPCNPs work in hospitals and clinics. As advanced practice registered nurses (APRNs), they can both prescribe medication for patients.
Another similarity between the two specializations is the skill set required. AGNPs working in acute care or primary care need effective communication skills, compassion, resourcefulness, decision-making and problem-solving skills, and leadership competencies.
A major difference between AGACNPs and AGPCNPs is that they focus on different specialties during their MSN programs as they’re preparing for different career paths. Prospective AGACNPs typically earn an MSN with an acute care concentration while AGPCNPs have a primary care concentration. AGACNPs can also specialize in certain areas, such as:
- Critical care
AGPCNPs can work as autonomous primary care providers for older adults. They typically work in private practices, ambulatory care, rehabilitation centers, clinics or hospitals. They meet regularly with patients to address their healthcare needs, prescribe medications and create treatment plans.
AGACNPs work in acute care: They deal with sensitive cases, such as patients who’ve been wounded in car accidents or been diagnosed with cancer. They typically work in emergency or trauma departments, acute care units, specialty clinics, or ICUs. They may not work with the same patients consistently, as they address and respond to emergency cases.
An essential step for adult-gerontology nurse practitioners is earning certification. AGACNPs and AGPCNPs should make sure that they earn their MSN degrees from programs that are accredited by the CCNE* or the ACEN to qualify for certification examinations.
Different organizations, such as the ANCC and the AANP, offer AGACNP and AGPCNP certifications. The examinations require nurses to have a clinical understanding of young adults, adults, older adults and the elderly. A typical competency-based examination will have 135–150 questions that require nurses to analyze information, make diagnoses for hypothetical patients, create treatment plans and assess outcomes.
After passing the AGACNP or AGPCNP examination, nurse practitioners become board certified in their fields. After obtaining their initial certification, AGACNPs and AGPCNPs must take 75 contact hours of courses and renew their credentials every five years.
Adult-Gerontology Nurse Practitioner Salary
Adult-gerontology nurse practitioners earn a median annual salary of around $98,000, according to January 2021 data from the compensation website PayScale. The salary can vary based on work environment, location and experience.
According to May 2019 data from the U.S. Bureau of Labor Statistics (BLS), hospitals pay the most, with nurse practitioners earning a median annual salary of $122,420, followed by outpatient care centers, which pay $118,530. Nurse practitioners in the educational services industry earn $108,790.
Experienced nurses with additional education also tend to earn a higher median annual salary. According to January 2021 data from PayScale, adult-gerontology nurse practitioners have a starting salary of about $89,000. However, when these professionals have five to nine years of experience, the salary jumps to around $106,000.
Skills of an AGNP
Across all healthcare settings, adult-gerontology nurse practitioners have improved the primary care of older adults, according to a study published in the International Journal of Nursing Studies. Alongside patience and compassion, gerontological nurses require other skills to be effective care providers.
With a shortage of primary care providers for older adults, AGNPs need to be strong advocates for their patients. They must be positive role models for providing quality care for aging patients and encourage fellow nurses to expand their knowledge about older adult care.
As patients age, their conditions and illnesses become more complex. AGNPs must have strong analytical skills to fully assess health needs. Gerontological nurses must thoroughly examine the health status, including looking at the medical history and evaluating environmental factors, such as home care and social activities, before creating a care plan. If the patient is unable to share health information, AGNPs may have to work with caregivers or family members to obtain it.
As health complexities increase with age, AGNPs must think through their care plans, constantly evaluating health status and recommending solutions to treat and prevent illness. They may also work with other health professionals, such as home care workers or physiotherapists.
Gerontological nurses must use various methods to communicate effectively with older patients, so the patients can understand, to the best of their ability, the care they’re receiving. For example, AGNPs may have to speak slowly and spend extra time with patients who have hearing loss. Nurses must also practice patience with older adults suffering from conditions such as delirium or memory loss. They may have to repeat care directions or speak with family members.
Developing AGNP Skills
Developing the required analytical, critical thinking and communication skills to be an AGNP takes time. However, advanced education from experienced, engaged faculty members can help aspiring gerontological nurses prepare for successful careers.
Earning an advanced degree, such as an MSN with an AGNP specialization, can provide the necessary education and training for RNs who are looking to take the next step in their careers.
An advanced education can help nurses develop the skills to evaluate the health needs of older patients using evidence-based practice guidelines for formulating different hypotheses and diagnoses in a clinical setting. Nurses with an MSN are also eligible to take certification examinations, such as the ACNPC-AG from the American Association of Critical-Care Nurses (AACN).
Where Do Adult Gerontological Nurse Practitioners Work?
Gerontological nurses work across the healthcare industry, from acute care facilities, such as hospitals, to long-term care facilities, such as nursing homes and hospice facilities. AGNPs can work in different settings associated with gerontological nursing.
In a hospital, AGNPs often work in acute care settings, treating older adults who require intensive or immediate care, such as patients who’ve experienced a severe fall or contracted pneumonia. Patients are required to be supervised until they’re discharged. Depending on the required treatment, patients may be allowed to go home or may be referred to a long-term care facility or nursing home.
Long-Term Care Facilities
Long-term care facilities support older adults who are recovering from an illness or injury or who need support in their daily activities, such as bathing, dressing and walking. Most long-term care begins with home health aides visiting patients at home during the day. Patients who require specialized equipment to move or need 24-hour care may move into a facility with AGNPs and other gerontological nurses on duty.
Assisted Living Facilities
Assisted living facilities, or independent living facilities, are another care option for older adults. AGNPs can fill a supervisory role at these facilities, assisting in regular patient checkups and delivering medications as allowed by state laws. However, many assisted living facility residents are still relatively independent and may not require the around-the-clock care that nursing homes can provide.
Nursing homes are designed to accommodate patients with a broad range of physical and mental conditions who require full-time care. They provide 24-hour patient supervision; prepare three meals a day; and assist with personal needs, such as bathing and eating.
Residents often have chronic or degenerative conditions, such as osteoporosis or dementia. AGNPs can act as primary care providers for patients, working with family members or caregivers to discuss care plans, prescribing and administering medications (depending on state laws), and evaluating ongoing conditions.
Pursue a Career as a Gerontology Nurse Practitioner
AGNPs strive to provide the best care for the unique needs of older adults. As more adults begin to present age-related illnesses and conditions, AGNPs play a significant role in improving health outcomes.
While great strides have been made in understanding the effects of aging, there’s much more to learn. Part of the responsibilities of a gerontology nurse involves standing at the forefront of treatment and advocacy for aging patients.
Duquesne University’s online MSN program and its Adult-Gerontology Acute Care Nurse Practitioner specialization offers nurses the opportunity to advance their skills and become gerontology care leaders.
Learn more about how Duquesne’s online MSN program can help you achieve your professional goals as an adult-gerontology nurse practitioner.
*The baccalaureate degree program in nursing, master’s degree program in nursing, Doctor of Nursing Practice program and the post-graduate APRN certificate program at Duquesne University are accredited by the Commission on Collegiate Nursing Education (http://www.ccneaccreditation.org).