From Geriatric Nursing Education
Welcome to the Geriatric Nursing Education Wiki
The purpose of this Wiki is to share resources and tools to improve gerontological and geriatric nursing education. The Wiki was created as a result of the Knowledge Exchange Institute for Geriatric Nursing Education, and the Knowledge Exchange Institute for Geriatric Nursing, Social Work, and Medical Education held at Brock University May, 2009 and May, 2011. The Knowledge Exchange Institutes was sponsored by the National Initiative for Care of the Elderly (NICE) and the Canadian Institutes for Health Research (CIHR) and organized by Lynn McCleary (Brock University), Kathy McGilton (Toronto Rehab and University of Toronto), Abram Oudshoorn (University of Western Ontario), Veronique Boscart (University of Toronto), Lynn McDonald (NICE and University of Toronto), Trish Woo (McMaster University), and Peter Donahue (Renison University College, University of Waterloo). The Knowledge Exchange Institutes are part of NICE's work to enhance gerontological education in nursing, social work, and medicine.
The Wiki is a way to continue to share knowledge, resources, and tools and for others to join in the process of knowledge exchange with us.
The Wiki started with resources and links to resources that were shared with the Knowledge Exchange Institute participants. Feel free to add new information. See the help and tips for contributing to the wiki section below.
 Web-based Resources for Teaching Gerontology & Geriatrics
The National Initiative for Care of the Elderly (NICE) has knowledge transfer tools related to family caregiving, dementia care, elder abuse, end-of-life issues, mental health, and consent and capacity assessment. The tools were developed for Canadian family carers and health professionals. Click on tools at the top of the NICE home page. The tools are free to download. Contact NICE through their website to request paper copies.
The Registered Nurses Association of Ontario (RNAO) Nursing Best Practice Guidelines are available for free download. Many of the 29 clinical practice guidelines are very relevant to nursing care of older persons. The guidelines are updated regularly and more guidelines are produced every year. Resources include the guidelines, fact sheets, and implementation resources such as e-learning modules and online videos. All free to download or view online. The Toolkit Implementation of Clinical Practice Guidelines would be relevant for research and leadership courses. Paper copies and additional implementation resources can be purchased.
The RNAO has a website dedicated to Implementing and Sustaining Change in Long Term Care. The website, called a Best Practices Toolkit, has resources for five priorities identified in Ontario: Client Centred Care; Continence and Constipation; Falls; Pain; and Pressure Ulcer. For each topic, there are relevant best practice guidelines and standards, assessment, planning, implementation, and quality improvement tools, and educational resources.
The Ontario based Alzheimer Knowledge Exchange (AKE) website provides links to online resources about Alzheimer's and Related Dementias, Communities of Practice, library services for paid caregivers in Ontario, and Knowledge Brokers.
CDRAKE, the Canadian Dementia Resource and Knoweldge Exchange, provides in-person and virtual knowledge exchange, through blogs, question and answer with Knowledge Brokers, links to resources, and online events. See the CDRAKE website.
The Canadian Coalition for Seniors' Mental Health has best practice guidelines, guides, case-based tutorials, and toolkits available to download. Hard copies of some of the products can be ordered via their website. Topics include:
- Suicide assessment and prevention
- Mental health issues in long-term care homes
- Mental health in cancer care
The Ontario Regional Geriatric Program (RGP) Central website has extensive resources including PowerPoint files, information sheets, case studies, quizzes, pocket cards, links, and more. You can search by topic area or key word. Resources about 45 topics including delirium, dementia,elder abuse, falls,deconditioning, caregiving, spiritual care, aging with developmental disability, person centred care, and many more topics. The newsletter and presentations page includes a series of 2 page mythbusting BP Bloggers summarizing evidence on key topics for Long-Term Care.
The Change Foundation website includes chart packs (charts that you can download and insert into a PowerPoint presentation, reports, puzzles, archived presentations and other resources related to their funded projects. Topics include, Alternate Level of Care (ALC), Congestive Heart Failure, and Palliative Care Home Care Patients and Caregivers. Available at the Change Foundation website.
At the GERO T.I.P.S. Online Learning at the Hartford Centre of Geriatic Nursing Excellence at PENN Nursing website there are tools for teaching, assessment, and research. There 10 topics with teaching modules for long term care with 10 topics. Resources include streaming videos, leacture/teaching planning resources, PowerPoint slides with lecture notes, handouts, and evaluation forms.
The Geriatric Mental Health Training Series from the John A. Hartford Centre of Geriatric Nursing Excellence at the University of Iowa. Training modules for six core topics available to download including learning objectives, lecture notes, PowerPoint slides are available at the website. Additional training modules are described but do not seem to be available for download.
The Hartford Institute for Geriatric Nursing has so many resources and links that it's difficult to summarize them all here. The website is a portal that can be searched according to user category (e.g., nursing faculty. Many of the resources are accessed by linking to their ConsultGeriRN.org website.
- Try This series of 2 page summaries of evidence based practices. The first page summarized the evidence. The second page is the evidence based practice recommendations or tool. There are 26 topics for care of older persons plus 11 topics specific to dementia care. Most of the Try This summaries have an accompanying How to Try This article (published in AJN free download) and streaming videos that explain and demonstrate their use in more detail (can be saved).
- ConsultGeriRN.org "an evidence based online resource for nurses in clinical and educational settings."
- Geriatrics and advanced practice web bases case studies
- e-learning resources including Elder Mistreatment Course, Certification Review Course, Clinical Teaching Modules, Advanced Practice Case Studies, and Nursing Home modules
- NICHE - Nurses Improving Care for Healthsystem Elders, a national U.S. nursing program that provides tools and evidence based resources for health system improvement.
- Podcast lectures. Lectures to view online or download. Based on the AACN’s Older Adults: Recommended Baccalaureate Competencies and Curricular Guidelines for Geriatric Nursing Care.
GNEC State of Science Papers, are available for the following topics, through the Hartford Insitute for Geriatric Nursing website. There are also supporting podcasts:
- Assessment and Management of Older Adults with Complex Illness in the Critical Care Unit
- Complex Care Needs in Older Adults with Common Cognitive Disorders - Section B: Assessment and Management of Delirium
- Mental Health Issues in Aging
- Complex Care Needs in Older Adults with Common Cognitive Disorders - Section A: Assessment and Management of Dementia
- Assessment and Management of Type 2 Diabetes in Older Adults with Complex Care Needs
- Models of Care and Inter-Professional Care Related to Complex Care of Older Adults
- Assessment and Management of Heart Disease Related to Complex Care of Older Adults
- Assessment and Management of Older Adults with Urinary Incontinence
- Critical Thinking Related to Complex Care of Older Adults
- Modification of Assessment and Atypical Presentation in Older Adults with Complex Illness
- Assessment and Management of Cancer Related Care of Older Adults with Complex Care Needs
- Sexuality and Older Adults
- Spirituality and Older Adults
Plus, a module on Cultural Competence and Chronic Disease Management in Older Adults.
Geriatric Interdisciplinary Team Training Program (GITT) from The John A. Hartford Foundation. "Good teams don't just happen.. that's where GITT comes in." Products include videos, training tools, books, brochures, and more. The Team Observation Tools and Team Fitness Test could be used by students in almost any clinical setting. Available for download at the GITT website.
North Carolina Learning Objects Repository (NCLOR) at Duke University Geriatric Nursing Innovations in Education. "The Learning Objects Repository (LRB) is a searchable database that contains an array of resources useful for anyone teaching geriatric nursing content using strategies that promote learner-centered instruction. Contents include but are not limited to: face-to-face and online lesson plans that promote active, student-directed instruction, sample cases for discussion and role play, relevant journal articles, PowerPoint presentation of faculty development workshops, hand-outs, learning contracts, and more. The LRB is an evolving clearinghouse for reusable resources that is continually augmented, evaluated and udated for continual use." Login as a guest at http://www.explorethelor.org/ then search using the term "nursing".
POGOe Portal of Geriatric Online Education. According to the website "The Portal of Geriatric Online Education (POGOe) is a free public repository of a growing collection of geriatric educational materials in various e-learning formats, including lectures, exercises, virtual patients, case-based discussions, simulations, as well as links to other resources. Funded by the Donald W. Reynolds Foundation, POGOe is managed by Mount Sinai School of Medicine, Department of Geriatrics and Adult Development, on behalf of the Association of Directors of Geriatric Academic Programs (ADGAP). The site is a partnership between Mount Sinai and Vanderbilt University School of Medicine, Departments of Biomedical Informatics and Division of Geriatrics". Mainly resources for medical education. After you create a free account, you can search among the 100's of products and create bookmarks.
Geriatric Pain Toolkit. According to the website: hosted by The Honor Society of Nursing, Sigma Theat Tau International it provides "Free evidence-based tools and best pratices for nurses who work in nursing homes". The resources are also appropriate for nurses working with older persons in other settings. For example, the pain tools and assessment recommentations are based on consensus recommendations on assessment of pain in older persons, not just older persons in nursing homes. The Education section includes educational tools for health care providers (PowerPoint files, videos, a Pain Jeopardy Game). To access you need an account. Creating an account is free.
The Murray Alzheimer Research and Education Program (MAREP) By Us For Us(c) Guides could be used for teaching about partnership and power of persons with dementia. They are a "series of guides created by a group of talented and passionate persons with dementia. The guides are designed to equip persons with dementia with the necessary tools to enhance their well being and manage daily challenges". They are available for free download. Other MAREP resources available for puchase are described in another section of the wiki.
sagelink.ca is the website of the Centre for Studies in Aging & Health (CSAH) at Providence Care in Kingston, Ontario and is affiliated with Queen's University. It has a number of resources, that are free to download, including:
- Geriatric eToolkit with tools for screening, assessment, and decision support in primary care, emergency, acute care, community care, specialized care, and long term care settings
- Introduction to Behavioural and Psychological symptoms of Dementia (BPSD): A Handbook for Family Physicians, a handbook developed for clinicians and physicians who contribute to education of families, care providers, and physicians. Also the BPSD Toolkit and case studies.
- Education resources related to abuse & neglect, addictions, advance directives, aging, behavioural and psychological symptoms of dementia, cancer, capacity assessment, caregivers, chronic illness, delirium, dementia, depression, driving, falls, hearing loss, nutrition, occupational therapy, pain, patient advocacy, physiotherapy, prevention, urinary incontinence, and vision loss. It's a bit tricky to navigate to the education resources but persistence pays off.
Resources for Teaching Gerontologic Nursing- GeroNursingEd website is a free public collection of geriatric nursing education resources for school of nursing faculty who want to include content on older adults in their undergraduate and associate degree curricula. The following are included:
- Topical assignments, such as functional status assessment, that can be integrated into existing courses
- Complete gerontological nursing theory and clinical courses
- Media resources such as movies, books and web-based materials with annotations and suggestions for use in specific courses
- Case Studies
- CD-ROM "Care of the Older Adult", a wide variety of learning activities based on 9 geriatric nursing competencies
- Links to other gerontological websites
GeroNursingEd is a product of the Northwest Coalition for Geriatric Nursing Education website and funded by the John A. Hartford Foundation Center of Geriatric Nursing Excellence website at Oregon Health & Science University and by the schools and colleges of nursing in the NW Coalition for Geriatric Nursing Education.
CSWE Gero-Ed Center has 274 resources for infusing gerontology into teaching. The data base is searchable by resource type (e.g., case study, experiential exercises, lectures, syllabi, etc.) and topic area.
Terra Nova Films offers free streaming videos on caregiving and issues for caregivers, dementia, stroke, and aging. At the videocaregiving website.
 Beyond the Textbook: Research Based Gerontology & Geriatrics Education Resources to Purchase
The Murray Alzheimer Research and Education Program (MAREP) at the University of Waterloo has produced some great education tools. They are available to purchase at a reasonable price via their website. Some of the products include:
- I’m Still Here DVD and Teaching-Learning Guide. A “powerful research-based play that deepens understanding of the dementia journey from the perspective of persons living with dementia and their family partners in care”. In addition to being valuable content, as an example of using a play to disseminate research findings, this is a great resource for a research course.
- Dementia Care Education Series. CD including education resources and workbooks.
- Managing and Accommodating Responsive Behaviours in Dementia Care. “A video vignette series to illustrate ten of the most intense behaviours experienced by staff in long term care homes … practical strategies and interventions for managing those behaviours.”
- Breaking the Silence: Giving Voice to Persons Living with Dementia, a “video presenting the realities of dementia from the perspectives of those with it.”
Geriatrics at Your Fingertips. According to the website "Geriatrics At Your Fingertips (GAYF) is an annually updated reference that provides immediate access to the comprehensive information needed to care for older adults in a variety of healthcare settings." Online, PDA, and paper versions are available for purchase on the GAYF website.
The P.I.E.C.E.S.™ manual is available for purchase at the shopforlearning.ca website. It includes: • a guide for assessment and intervention planning • information about brain and behaviour • information about psychotropic medications, including monitoring their use and the risks and benefits of their use • copies of assessment tools • information about dementia and mental health disorders • information about how biochemical changes affect cognitive and physical abilities of older adults • worksheets about abnormal lab values – health problems they’re associated with, symptoms, why older adults are more affected, masquerading features, and care plan actions • information about enabling practice in the P.I.E.C.E.S.™ approach • learning strategies • additional resources.
 Gero Teaching Strategies to Share
Feel free to add tips, strategies, and teaching tools.
Aging Facts Flip Cards Activity. I used this activity to present facts and statistics about aging to colleagues and students. There was lots of discussion and noise as groups worked to figure out the answers and win goofy prizes. There are 5 sets of flip cards: Canadian demographics; chronic conditions among older adults; seniors at home; seniors in hospital; and well-being. The flip cards, "hint sheets", tables with questions and answers, and instructions are uploaded here[].
Add your tip, strategy or tool here.
 Mass Media Stories About Older People and Gerontological Issues
The Globe and Mail multimedia series Dementia: The problems, solutions and human toll includes personal stories and online videos, editorials,articles about living with dementia, the toll on caregivers, and public policy. The multimedia feature is available in the Globe Life website.
CBCnews Seniors and Drugs: Prescribed to Death webpages feature investigative reports on problems with prescribing for seniors in Canada. Includes summaries of the investigation of increasing use of atypical antipsychotics among the elderly, links to information about Beer's list,and audio clips. To help students understand the personal experience of seniors and their relatives, there are two radio reports The Accidental Addict and On the Road to Recovery that tell the story of a woman's struggles after being prescribed an anxiolytic for years.
The CBCnews Nursing Homes: Fear and Violence (2007) webpages report an investigation of nursing homes in Canada. Links to Casa Verde inquest recommendations, audio files of radio reports about nursing homes and a blog are included.
The Globe and Mail series Breakdown: Canada's Mental Health Crisis included a feature article about aging with a mental illness called "When mental illness tarnishes your golden years".
 Positive Images of Aging
Geriatric Photos are available for free download at the Hartford Institute for Geriatric Nursing website.
"See me, nurse" video, streaming at Hartford Centre of Geriatric Nursing Excellence, UAMS College of Nursing.
When I Grow Up (I wanna be and old woman). Kaiser Permanente women get mammograms television commercial, on YouTube.
Images page of the Bandwidth online.org website of the John A. Hartford Foundation.Includes links to other image databases.
Positive Images of Aging DVD available for purchase from the Assocation for Gerontology in Higher Education at their website.
Terra Films has free streaming videos at their videocaregiving website, including short films about healthy aging and aging issues - great for triggering class discussion.
Know of other sources of positive images? Add a link here.
 How to Integrate Gerontological Content and Evidence in Teaching & Curriculum Resources
Integrating gerontological content & curriculum resources including information about how to change curriculum, how to use research in teaching, how to engage students, how to engage faculty. Strategies that have worked for nursing and social work faculty.
The RNAO Educator's Resource: Integration of Best Practice Guidelines is available for free download. Paper copies of the binder can be purchased.
The July 2010 issue of the Journal of Gerontological Nursing is a special issue Geriatric Nursing Education Consortium: Improving Care for Older Adults Starts in the Classroom. It includes articles about successful teaching strategies, resources, and educational tools.
Caring for an Aging America: A Guide for Nursing Faculty, published by the American Association of Colleges of Nursing/John A. Hartford Foundation in 2006, through the Enhancing Geriatric Education in Undergraduate and Advanced Practice Nursing Programs initiative. The monograph includes sections to help nursing programs: (1) develop faculty expertise; (2) "Gerontologize" curriculum; (3)enhance curriculum with technology; (4) cultivate community and clinical partnerships; and (5) create and support student interest.
Resources for clinical faculty for integrating care of older adult patients in student clinical rotations in hospitals are available through the Hartford Institute for Geriatric Nursing. It includes tips for integrating content into clinical assignments, pre-conference, bedside teaching, post-conference, charting, and evaluation.
The CSWE Gero-Ed Center websitehas lots of resources for curricular change and innovation. Developed by and for social work educators, they are relevant to other professions. Resources include:
- program infusion resources (curricular and organizational change process, definitions of curriculum change, guidelines for infusing gerontology into syllabi, and characteristics of a sustainable gerontologized program)
- Lessons learned about curricular and organizational change and infusion of gerontology contents (faculty engagement, student recruitment, and community partnerships)
- Assessment tools to measure student, faculty, and practitioner knowledge, attitudes, perceptions, and interest in gerontology
- Innovationsand in curriculum infusion
The CSWE Gero-Ed Center also has 5 streaming videos about how to teach about gerontological issues (conveying course objectives, encouraging student autonomy, facilitating the learning environment, providing feedback,and supporting diversity).
 Gerontological & Geriatric Core Competency Recommendations
Older Adults: Recommended Baccalaureate Competencies and Curricular Guidelines for Geriatric Nursing Care is a set of 30 core competencies for graduates of U.S. baccalaureate nursing education, developed by the American Association of Colleges of Nursing (AACN, 2000). According to the AACN website, the purpose of the document "is to help nurse educators to incorporate specific geriatric nursing content into baccalaureate nursing curriculum". The core competency document can be downloaded. A supplement, published in September 2010, is available at the AACN website.
GNEC Curriculumn Survey and Content Mapping Tool: Recommended Competencies for Geriatric Nursing Care. Based on the work of Dr. Kathleen Blais at Florida International University, this tool helps faculty evaluate the extent to which curriculum addresses the AACN Older Adults Recommended Baccalaureate Commpetencies and Curricular Guidelines for Geriatric Nursing Care. This survey was used to prepare participants prior to attending the Knowledge Exchange Institute for Geriatric Nursing Education. Download from the AACN website.
CGNA-NGNA Joint Position Statement: Prescriptions for Excellence in Gerontological Nursing Education. A joint position statement of the vision for nursing education of the Canadian Gerontological Nursing Association (CGNA) and the U.S. National Gerontological Nursing Association (NGNA). Available from the CGNA and NGNA websites.
NICE Interprofessional Core Competencies. Developed by the NICE Curriculum Committee and published with the Geriatric Education and Recruitment Initiative. Download from NICE website.
Gerontological Nursing Competencies and Standards of Practice created by the Canadian Gerontological Nursing Association. Available for download from the CGNA website.
Gerontological Nursing Education Initiatives in the News. The Toronto Star Nursing Week 2010 special feature includes an article featuring Kathy McGilton and her work with NICE to improve nursing education.
 Older Adults are the Core Business of Health Care
Evidence that Older Adults are the Core Business of Health Care. Use this data in teaching, to engage colleagues, to demonstrate the urgent need to prepare all nurses to provide care with older adults, their families, and communities.
The John A. Hartford Foundation website in the U.S. provides U.S. statistics that support their conclusion that "older adults are the core business of health care".
- Seniors (age 65+) are three times as likely as younger Canadians to be admitted to hospital 
- Repeat admissions are more common among seniors than younger people
- Once seniors are in hospital, they typically spend more time there than do younger people
- Delirium occurs in up to 50% of older persons admitted to hospital, with the highest rates among those having surgery, admitted to the ICU, or with pre-existing dementia
- Hospitalized patients who are delirious have a worse prognosis
- Delirium is often not recognized
Canadian demographics are available from the Statistics Canada website. For example, in 2008, there were 4,563,100 Canadians aged 65 and older. You can search by geographic region go obtain statistics for your area.
Dorothy Pringle's editorial "Scared to need nursing" in the Canadian Journal of Nursing Leadership, Volume 22, Issue 3, is a resource for lobbying colleagues for curricular changes.
Quotes related to aging on the Bandwith online.org website of the John A. Hartford Foundation.
 Help and tips for contributing to this Wiki
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