Gerontological Nursing Foundations

Chronological age is context, not a diagnosis. Normal aging is commonly accompanied by a gradual reduction in physiologic reserve, yet the degree varies widely. Two adults of the same age may have very different strength, cognition, medication management, and ability to live safely. The clinically useful comparison is the person’s usual function with the current function. Begin by establishing baseline and present status: activities of daily living and instrumental activities, cognition and mood, gait and falls, intake and hydration, vision and hearing, continence, medication use, social supports, living environment, and goals. A decline in one domain can destabilize another; poor vision increases fall risk, while dehydration or medication effects can produce both weakness and confusion. A sudden or fluctuating change in attention, arousal, perception, or cognition over hours to days suggests delirium, not simply normal aging. Dementia may be present at baseline, but it does not explain away an acute change. The nurse’s task is to identify the change, look for reversible threats, reduce preventable harm, and compare response with baseline. LVN/LPN assessment, documentation, implementation, and reporting must remain within...