This paper examines the skills and knowledge critical to healthcare leaders serving the aging population, with a focus on nurse leadership in gerontological care. Drawing on three peer-reviewed studies, it surveys current research on lifestyle factors affecting cognitive aging, the relationship between Vitamin D deficiency and cognitive decline, and the state of nursing leadership in residential aged care. The paper identifies key gaps — including unresolved questions about Vitamin D and cognition, the absence of a systematic review of nursing leadership skills, and a lack of structured leadership training in geriatric nursing — and discusses how continued research can strengthen nurse leaders and support healthcare reform for older adults.
Gerontology is the science of aging and the problems associated with aging. This paper focuses on identifying the skills and knowledge most critical to leaders of healthcare organizations — such as accountable care organizations, healthcare homes, medical homes, and clinics — that specifically serve the aging population. In particular, it examines teamwork among nurse leaders, nurses, and other healthcare professionals; the current status of relevant research; the barriers to collaboration; inadequacies in care delivery; and proposed solutions to those inadequacies, all with the aim of increasing healthcare professionals' ability to serve aging clients more productively.
Studies now focus on the effects of lifestyle factors — including physical and mental activity, social interactions, and nutrition — on cognitive function in aging adults (Williams & Kemper, 2010). These studies provide initial evidence that physical and mental activity, satisfying social support, and a balanced diet support cognitive function in the aging population. However, the specific factors that positively influence cognitive changes in aging have not yet been clearly identified and isolated. The synergistic effects of combined approaches — including cognitive and physical therapy, social interaction, and balanced nutrition — deserve further investigation (Williams & Kemper, 2010).
A growing body of research has linked inadequate Vitamin D to cognitive decline (Annweiler et al., 2015). The condition known as hypovitaminosis D is common among adults aged 65 and older and is associated with brain changes and dementia. An international task force of experts was convened to address this health issue. Drawing on existing reports and their collective expertise, the members developed key questions about the role of Vitamin D in Alzheimer's disease and related conditions. They then discussed and voted on these questions through a Delphi-like process, ultimately agreeing on five principles connecting Vitamin D and cognition in older persons. Nevertheless, many issues remain unresolved. The task force's recommendations may need to be revised as new evidence emerges (Annweiler et al., 2015).
Population aging has become a global phenomenon that continues unchecked (Dwyer, 2011). One critical response is the provision and improvement of residential care and services for older persons. The nurse's role is especially critical in the clinical supervision and provision of care for this sector. Yet no systematic review has investigated nurses' level of leadership and management competency in this context (Dwyer, 2011).
Nurse leaders and staff nurses draw on available knowledge derived from research findings as standards of care — particularly for older adults — in healthcare facilities and organizations, and as the basis for healthcare decisions and reforms. However, they need to identify the specific factors that affect cognition in elderly patients in order to provide precise, targeted care. As yet, these factors have not been isolated. Regarding the link between Vitamin D and cognition, the outstanding issues identified by the international task force should be promptly addressed, and their recommendations adjusted as new evidence becomes available. Nurse leaders must continue to update their knowledge and upgrade their care decisions accordingly, relying on the most recent and authoritative standards that follow from new findings. The connection between insufficient Vitamin D intake and cognitive deficits in older adults is of particular interest in this regard.
The absence of a systematic review of nurses' leadership and management capabilities is a serious gap that must also be addressed. The lack of specific education or training in clinical leadership and management represents a significant barrier — and more specifically, there is no structured pathway for leadership training in nursing careers focused on geriatric care. These are areas in which nurse leaders should be challenged to take action.
"Explains why findings matter for aged care practice"
"Outlines potential gains from continued gerontology research"
"Summarizes highlights from each reviewed article"
"Projects how new research benefits nursing leadership"
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