This issue of the Journal of Gerontological Nursing is part of a series of articles exploring the independent nurse role in community care gerontological nursing. The first article, published ', in the April issue, described a nurse-managed membership plan for home and community-based ', elderly individuals (Schoenfelder, ; Maas, & Specht, 2005). This issue ; continues the series by describing the practice role of seven nurses developing independent practices serving rural elderly individu- i als. The third article of the series, which will appear in an upcoming issue, explores the process and challenges of becoming an entrepreneur. The fourth article will present strategies for guiding other nurses in developing the role of the rural community care gerontologi- : cal nurse entrepreneur. This series of articles addresses a sampling of the possibilities for autonomous and innovative roles in commu- ; nity-based gerontological nursing. ;
All of these articles address the desire of elderly individuals to remain at home or in home-based care settings as safely and independently as possible. Visits by nurses ; at appropriate intervals to monitor ; chronically ill elderly individuals in home care settings can prevent costly and unnecessary physician, emergency department, and hospital visits, as well as unnecessary nursing home placement decisions. Additionally, these nurses can provide emotional support to elderly individuals, their caregivers, and their families by ensuring them that their loved ones* needs are being addressed.
Rural elderly individuals face additional problems in accessing care that will help them maintain independence while enjoying an optimum quality of life. Although the role and activities of these independent community care nurses are applicable in urban settings, the special problems rural elderly individuals face make this role an especially critical one.
In the past, public health nurses regularly visited older clients with chronic illnesses as a part of their ongoing caseload. Many changes have occurred in health care financing since then, but the need for nurses to be the primary provider of home-based nursing care for a population of clients with chronic health problems is increasing as the numbers of elderly individuals and life expectancy increases. Nurses know their clients, their health care needs, health status, and support systems, as well as the appropriate resources available in the community. Nurses already living in rural communities are ideal for actualizing this role.
I challenge those of you living in rural community settings, thinking about a career change and wanting to make a difference in the lives of elderly individuals in the community, to consider taking on this role. Based on the experiences of nurses already engaged as independent entrepreneurs caring for home-based elderly individuals, your professional life will be enriched in ways you never imagined.
- Schoenfelder, D.P., Maas, M. L., 8c Specht, J.K. (2005). HomeSafe: Supportive assistance for elderly individuals through a nurse-managed plan. Journal of Gerontological Nursing, 31(4), 5-11.