The number of aged people is rising rapidly. Ageing is a normal biological process, associated with physical and social changes that may lead to debilitating effects of multiple acute and chronic diseases.

In view of this, preparing a large number of nurses trained in gerontological nursing is vital to address the needs of the elderly. Notwithstanding the ever-increasing population of older adults in this country, the number of nurses holding recognised certification in gerontological nursing is low.

Since 1997, there has been serious discrepancy between the number of older Malaysians who need specialised care and the number of trained general practitioners who provide that care. Alarmingly, this has led to a dire need for the healthcare industry to produce more care providers who specialise in geriatric practices

Geriatric nursing is unpopular among students

Several studies were conducted among nursing students to determine their work preferences. Many felt that working with older patients was the least preferable as compared to other areas of clinical practice.

This is unsurprising as providing patient care to the elderly may lead one to experience fear related to dying and suffering. Geriatric wards may be another barrier for students opting to work with the elderly. This is because they view long term care as too slow-paced and yet, physically demanding.

Hence, the limited nursing manpower in geriatric settings causes students to work in other settings. Some have suggested that increasing the number of geriatric nurses would make working in geriatrics more favourable. 

Stigma surrounding care for elderly patients

Preconceived views should be diminished by changing the way students are exposed to gerontological education. This can be done through clinical placements and incorporating gerontological content as a stand-alone course.

To begin, it is necessary for the faculties to introduce gerontological nursing course as a preliminary subject during the first year of their nursing programme. By doing so, students gain exposure on working in geriatric care settings, which improves their perception.

The early introduction of gerontology courses are important for dispelling myths of what it is like to care for older adults. The course will also be helpful in increasing understanding on caring for the elderly, which can be extremely complex. This may increase their interest to working with those of older age.

Nursing students may feel unprepared

Nursing homes are the most familiar aged care settings for elderly to receive continuum of care and supervision. However, students feel that it is an unfavourable workplace, citing reasons such as poor care quality, lack of resources to provide quality care, complex environment, and overwhelming for new graduates.

Despite this, the care management of older patients is completely different from other age groups. Thus, it can be very challenging to be the sole person making decisions regarding patient care.

In many nursing faculties, the importance of clinical internship in nursing homes was not emphasised. Consequently, this caused them to feel unprepared to take on this role right after graduation. Students reported that if they had the opportunity to have clinical exposure in nursing home settings, they may have considered the setting as a possible place of employment after graduation.

Ultimately, it is imperative to prepare nurses as gerontological specialists. With adequate exposure and training in geriatric practice, nurses will be more able to provide high quality healthcare for both the relatively older patients and the elderly. MIMS

Read more:
The future of geriatric care in Malaysia depends on what you do now
Malaysia's MOH to set up agency offering "free advice" to help adapt to Aged Healthcare Act
Can elderly Malaysians afford to retire with the increasing costs of healthcare?

Fagerberg, I., Winblad, B., & Ekman, S. (2000). Influencing aspects in nursing education on Swedish nursing students’ choices of first work area as graduated nurses. The Journal of nursing education. 39(5):211
Happell, B. (2002). Nursing home employment for nursing students: valuable experience or a harsh deterrent? Journal of Advanced Nursing. 39(6):529–536
Henderson, J., Xiao, L., Siegloff, L., Kelton, M., & Paterson, J. (2008). ‘Older people have lived their lives’: First year nursing students’ attitudes towards older people. Contemporary Nurse. 30(1):32–45