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Geriatric nursing is a subspecialty for nurses trained to understand the unique needs of elderly patients. Registered nurses (RNs) and nurse practitioners (NPs) who specialize in caring for older adults have always been in demand. As the aging population continues to grow, the demand for geriatric nursing staff could outpace supply, and you may find your career opportunities expanding even quicker than before.
Although it’s not difficult to find geriatric NP jobs and other RN roles in this specialty, you should possess specific skills to ensure you provide the highest quality of care to this vulnerable patient population. We talked to some experienced geriatric nurses to get their take on must-have skills you should master to prepare for this career path.
9 Skills to Master in Geriatric Nursing
1. Communication Skills
Communication is essential in building strong relationships with any patient group, but communication challenges are often the norm for older adults. Hearing loss, cognitive decline and other issues related to the aging process can make it more challenging to effectively communicate with elderly patients.
“Effective communication is key when working with older patients. You should be able to explain things in a way they can understand and be able to listen to their concerns,” said Yasmine Seidu, BSN, RN, and founder of Nursepective. She has been caring for the geriatric population for nearly 10 years.
“Many older patients experience some form of hearing or vision loss,” Seidu continued. “As a nurse, it’s crucial to be able to assess and intervene. For instance, if a patient has difficulty hearing, you might need to speak louder or use hand gestures when communicating with them. If a patient has difficulty seeing, you might need to provide large print materials or use brighter lighting when providing care.”
2. Non-Verbal Communication Skills
It’s not just verbal communication skills you must master. Non-verbal skills also gain importance, especially for those patients with hearing or cognitive difficulties. Nancy Mitchell, a registered geriatric nurse and contributing writer at AssistedLivingCenter.com, has over 37 years of experience as a director of nursing care on geriatric wards. She stressed the importance of body language.
“Be mindful of your patient’s body language,” said Mitchell. “Elderly patients aren’t always vocal about their concerns. This often happens when they’ve switched nurses and aren’t accustomed to your care yet. It’s also common among patients with cognitive decline, as dementia and related diseases tend to affect thought processing and verbal communication. As a result, geriatric nurses need to have an eye for spotting non-verbal cues in their patients. It may be the only way to identify if a senior is ill or uncomfortable in a potential health crisis.”
3. Understand the Aging Process
One of the first things many nurses in geriatric nursing tell those new to the field is to make sure they fully understand the aging process. Aging not only potentially impacts a geriatric patient’s abilities to hear, see and communicate, but it can also affect many other aspects of their lives. By developing a better understanding of the aging process, nurses also develop the skills to handle the inevitable changes that occur.
Christi Crawford, LPN, BC-DEd, CDP, BCPA, has worked in healthcare for more than 30 years, including over 11 years as a nurse. She specializes in geriatric care in hospitals, nursing homes, assisted living, memory care, home health, private duty and hospice care. Currently, she works as an on-call hospice nurse and is the founder and president of Dementia360 Consulting, LLC.
Crawford pointed out the importance of understanding the multiple health issues that geriatric patients might face.
“Aging adults often have multiple chronic conditions, and a large percentage of them are living with Alzheimer’s disease or another type of dementia along with other chronic conditions,” she said. “Becoming knowledgeable and specialized in the geriatric population and more specifically dementias help nurses improve quality of life and patient outcomes through this knowledge.”
Seidu said her combined years in healthcare have equipped her with the knowledge to care for the unique needs of her older patients.
“It’s important for nurses to be aware of changes like hearing loss, vision changes and changes in skin integrity that happen as people age,” she said. “Understanding these issues allows you to tailor your care to meet each patient’s specific needs.”
4. Adaptability and Flexibility
To assist you with tackling all the fluctuations that occur during the aging process, you must hone your adaptability and flexibility skills. As your elderly patients’ needs change, these skills help you roll with these changes and continue to provide appropriate care.
“As patients age, their needs will change. It’s important for nurses to be able to adapt their care accordingly,” said Seidu. “Working with older patients can also be unpredictable. They might have good days and bad days. Having a flexible approach to caring for their wants and needs is a crucial skill to care for them successfully.”
5. Lots of Patience
Patience is a vital soft skill when dealing with aging patients whose movements often become slower, so everything they do takes a bit more time than it used to. Getting slower can be extremely frustrating to older adults. It becomes even more so if they feel everyone, including their nurse, is trying to rush them. Having patience and empathy as you allow them the additional time they need to finish tasks helps build better relationships with your elderly patients.
Seidu warned that older patients might also resist changes or adapt slowly to new situations, so you need patience and tolerance to help them through these changes successfully. Crawford added that always having patience is also essential for better patient outcomes.
“Move at their speed, match your pace with their pace, and give them time to do things independently so that they’re able to maintain their abilities much longer,” she said.
6. Mobility Management
An aging patient who has become slower may have underlying issues besides just getting older. In geriatric nursing, you must be skilled at investigating whether their diminished pace stems from a mobility issue. If so, you must also have the mobility management skills to help them retain their ability to move about independently.
“Many older patients experience some form of mobility issues,” said Seidu. “It’s important for nurses to be able to assess and manage these issues. For instance, knowing they might not be as fast while walking will let you know that you might have to give them more time to get from place to place or help them with a wheelchair.”
A mobility issue that requires transitioning to a walker or wheelchair is one of those changes an elderly patient might resist and requires patience to resolve. Continued mobility is essential to minimize physical complications and improve an elderly patient’s emotional and social well-being.
7. Ability to Recognize Signs of Dementia
The natural aging process may cause some people to misplace things or forget instructions, but symptoms of dementia can mask themselves as normal age-related behaviors and be overlooked. Recognizing early signs of dementia in older patients is crucial to help slow the progression and improve outcomes. Developing the knowledge and skills necessary to care for patients with dementia allows you to help them maintain their independence longer.
“Dementia is characterized by a decline in cognitive function,” Seidu explained. “This can be highly challenging for both patients and their families. As a nurse, providing support and resources to the patient and their family is essential. This includes being patient when they sundown or say things that might not make sense. Knowing this helps you devise strategies to keep them safe and preserve their dignity.”
8. Empathy and Compassion
Empathy and compassion are two soft skills most geriatric nurses can’t emphasize enough. They’re essential components when working with elderly patients and vital to their health and happiness.
“Caring for older patients can be physically and emotionally challenging,” said Seidu, “but it’s important to be able to empathize with their situation and have compassion for their challenges.”
Empathy isn’t the same as sympathy. It requires you to put yourself in your patient’s shoes to see, hear and feel everything they do. Compassionate care helps make your elderly patients more comfortable when they feel unwell, suffer from mental or emotional stress or are in pain. By demonstrating empathy and compassion, you provide older patients with the support and confidence they need to face the inherent downsides intertwined with the aging process.
9. Ability to Connect and Engage
“Connect and engage with your senior patients or residents,” stressed Crawford. “They have amazing stories and lives to share. Their legacy deserves to live on. Connection and engagement make their quality of life so much better, and it will do the same for you as a nurse. Help them to thrive, not just survive in their environment. Get to know who they are, what they have experienced and what lessons they can teach and pass on, and respect them by connecting with them and treating them like the human beings they are.”
Don’t Forget the Human Touch
In the end, Seidu said her best advice for anyone going into geriatric nursing is to be prepared for anything, have strong clinical skills and knowledge and remember the importance of the human touch.
“A lot of times, just being there for our patients and providing them with companionship can make all the difference in the world,” she said. “Imagine yourself sitting or lying where they are. How will you want to be treated? How will you want to be talked to? What kind of information will you want to know? How would you like the staff to communicate with your family? Once you’ve answered these questions, you’ll have a good foundation for providing excellent care to your older patients.”
“Caring for our older patients, like any other patient population, can be very challenging. They might be grumpy, resistant to change or have mood swings. But remember that they’re going through many life changes and challenges. They might be dealing with losing a spouse, declining health or loneliness. Treating them with compassion and dignity is of utmost importance. Always be patient and understanding with them.”
Equipping yourself with the right combination of hard and soft skills maximizes your effectiveness in caring for older adults and helps you quickly adapt to their changing needs. Despite any challenges you might face in geriatric nursing, working with elderly patients offers many intangible rewards, including the knowledge that you’re genuinely making a difference in their lives and overall well-being.
Learn how these skills may become vital in our related article, The Nurse as Patient Advocate, which explores how nurses can often serve as the voice of their patients.
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