A Challenge for Change: The Role of Gerontological Nursing. By the American Nurses1 Association Division on Gerontological Nursing Practice. Kansas City, MO, the Association, 1982.
Convinced that the application of the medical model is inappropriate and does not work to meet the needs of today's more than 23,000,000 older Americans, the American Nurses' Association's Division on Gerontological Nursing Practice raises issues, offers new definitions, and proposes policy changes in a 24-page document, A Challenge for Change: The Role of Gerontological Nursing, Consumers, policy makers, and health care providers as welt as nurses would do well to read and consider the statements contained within this small document.
The document essentially "throws down the gauntlet" to challenge consumers, policy makers, and providers to make the commitment needed to provide services to older adults that meet their health and illness needs and to effect constructive changes in policies governing health care.
The first challenge conies in recommending that a more positive understanding of health is needed and that the health care system be reconceptualized to include these five essential components: health promotion, health maintenance, disease prevention, self-help, and self-care.
The second challenge comes with the call to nurses and older adults to be innovative in developing new delivery systems, with adequate financing mechanisms, that allow the consumers options in health care services, including direct access to the services of nurses. Further, nurses are encouraged to work to establish a health care financing system that provides ready access to their services by amending the reimbursement systems established by both public and private third-party payer systems.
Finally, members of the nursing profession themselves are challenged to face three issues in gerontological nursing: "manpower," education, and research.
This document does provide a factual overview of the development of gerontological nursing and many specific statistics related to older adults and their use of the health care system. It also provides listings of priority activities that the ANA currently is undertaking to deal with some of the issues identified. Obviously, the brevity of the document precludes an extensive unfolding of all the issues or potential solutions for meeting the health needs of older adults.
It is extremely clear throughout the document, though, that the authors believe that the current nursing profession and population of older adults can begin to reshape the health care system and thereby help both today's and tomorrow's older adults and maintain healthy and productive lives.