INTRODUCTORY REMARKS TOWARD QUALITY HEALTH CARE FOR THE AGED: EDUCATION, LEGISLATION, AND SERVICE

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Abstract
The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Marian Wolfe "Since nursing is the largest of the health care professions, it has the potential to exert a significant influence upon future health care policy... the responsibility for establishing and maintaining standards for quality nursing care of the aging in long-term care facilities rightfully belongs to the professional nurse " The process of aging is an inevitable facet in the development of our growing population. There are increasing numbers of elderly in our society today whose need for long-term institutional care or home health care continue to escalate in accord with their increasing numbers. The proportion of elderly Americans age 65 and over is increasing. The average age of nursing home residents is 82. Ninety-five percent are over 65, and 70 percent are over 70. These residents generally have four or more chronic disabilities. In the United States, 13 percent of those over 65 years, that is, three million people, are bedfast or housebound in institutions or at home. There are now more nursing home beds (1.2 million) and surgical hospital beds (1 million) in the United States today than general. Between 1960 and 1970, nursing home facilities increased by 140 percent, beds by 232 percent, and patients by 210 percent.1 Despite the increasing number of aged in our society who require long-term care, nurses prepared for leadership roles in these facilities continue to be in short supply. Of the 815,000 employed registered nurses in the nation, less than one-tenth of them are employed in long-term care facilities and the majority of their responsibilities are administrative. Consequently, 80-90 percent of the nursing care is provided by individuals who do not have the educational preparation consistent with the diverse and complex needs of the elderly. Reluctance of many professional nurses to accept responsibility in gerontological nursing may be due, in part, to the limited opportunity and/or incentive to gain knowledge and develop skills in the basic nursing curriculum. The results of a survey conducted by Senator Frank E. Moss, Chairman of the Special Committee on Aging of the Subcommittee on Long-Term Care, confirms that comparatively few schools of nursing emphasize geriatrics in their curriculum. Of the 1000 schools of nursing surveyed, only 27 offered geriatrics as a specialty. As of 1970, no graduate programs in geriatric or gerontological nursing existed. It was not until 1974 that the first masters program in gerontological nursing was established in Illinois. According to a survey conducted by the American Hospital Association in 1974, a disproportionate number of student nurses were seeking jobs in maternity nursing at a time when the nations birth rate was zero and few nurses showed any interest in geriatric care. Geriatric nursing ranked 16th among 22 specialty areas available to graduate nurses. Twenty-five percent of the students preferred maternity nursing as a chosen field. Less than one percent chose geriatrics. Prevailing stereotyped attitudes, formed largely by a youth oriented society, are unconsciously translated into overt expression of rejection, intolerance, and disrespect for our elderly population. What is it like to grow old in a society oriented towards the young, whereby the quality of life is measured by productivity? Long-term care is the most troublesome component of our health care system and is the direct result of societal attitudes rather than the biology of aging. A study of attitudes of student nurses toward the geriatric patient indicates that the students expressed more negative attitudes toward the aged at the end of the course than at the beginning.2 This raises the question of whether the course may not have served to reinforce and increase negative attitudes toward the aged. Assuming that working with older… 10.3928/0098-9134-19770301-04

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