I interviewed a nurse in Long Beach (Andrea Alanis) who has a BSN with a certificate in gerontology, and is working towards becoming a Geriatric Nurse Practitioner. Andrea has been a friend of mine for many years and she currently works on the Critical Care Unit. Her patients range in age but her favorite ones have always been older adults.
One takeaway moment was how big of a role social isolation plays in both physical and mental health issues in older adults. Isolation can lead to depression, malnutrition, and even more rapid cognitive decline. She mentioned how often her elder patients in the unit are so isolated. The isolation aspect alone is a big cause of concern when the patients get discharged, and the patients are more likely to have been in and out of the hospital for some time, with the severity of the incident increasing with each visit. She also mentioned how sad it was to hear them discuss how their interactions with the hospital staff are the only social interactions they have had recently.
Another big takeaway was that geriatric care is not one-size-fits-all. Older adults have unique health needs, influenced by their life experiences, cultural backgrounds, and personal goals. She discussed how treatment varies so far and wide for each patient, and that people often think treatment may look the same for two individuals with similar diagnosis but their cultural background plays a huge part in different medical decisions that will be made. She also stressed that for a lot of elder adults- aggressive treatment may take away more from them than it may add to their quality of life.
Andrea pointed out as well that mental health conditions are often overlooked in general healthcare settings and without someone on staff who really understand geriatric medicine the patient may be misdiagnosed or ignored completely. At the same time, some patients themselves over look their mental conditions and write it off as "just getting older".
She also shared how her perspective on care has evolved.
In the CCU, the focus is on immediate survival, while geriatrics emphasizes long-term quality of life. She often has to think with a different mindset than some of her colleagues when coming up with treatment plans for patients. She has to balance medical interventions with the patient's personal values and goals that are also realistic for life after a severe medical incident.
My final "aha" moment came when I asked her what made her so interested in geriatric care other than elder patients being her favorite to work with. She shared with me that the sheer volume of patients entering in and out of hospitals was overwhelming, and then when she realized what the demographic of these numbers was- she herself had an aha moment. If we didn't start NOW, and people didn't start learning how to change how healthcare is managed not just treated that the people we loved the most were going to be treated just as how she saw the patients for many years- a number.
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