Gerontological Nursing Certification Examination key terms

A structured, multidisciplinary evaluation of an older adult's medical, functional, cognitive, psychological, and social status, used to build an individualized care plan. It typically involves a team and focuses on preserving independence rather than treating a single disease.

Common clinical conditions in older adults that are multifactorial in origin and not attributable to a single disease, such as falls, delirium, incontinence, frailty, and functional decline. They often overlap and require broad assessment rather than a single-organ approach.

A state of reduced physiological reserve that leaves an older adult more vulnerable to stressors such as illness, surgery, or hospitalization. It is often identified by unintentional weight loss, exhaustion, weakness, slow gait, and low activity.

Age-related loss of skeletal muscle mass and strength that impairs mobility and raises fall and disability risk. It is distinct from weight loss alone and is addressed through resistance exercise and adequate protein intake.

Basic self-care tasks a person performs daily, including bathing, dressing, toileting, transferring, continence, and feeding. Difficulty with ADLs signals significant functional dependence and higher care needs.

More complex tasks needed to live independently, such as managing finances, shopping, cooking, housekeeping, using transportation, and handling medications. IADL loss often precedes ADL loss and can signal early cognitive change.

A measurable loss of ability to perform self-care or independent living tasks, often triggered or accelerated by hospitalization, illness, or immobility. Early mobilization and function-focused care can prevent or reverse part of the loss.

A structured evaluation to identify older adults likely to fall, using history of falls, gait and balance testing, medication review, vision and foot checks, and environmental review. Positive screening leads to multifactorial intervention rather than advice alone.

Testing of walking pattern, speed, steadiness, and postural control, commonly with a timed walk or sit-to-stand test. Abnormal findings predict falls and functional loss and guide exercise-based interventions.

Persistent worry about falling that leads an older adult to restrict activity and social participation, which paradoxically worsens strength, balance, and fall risk. It is assessed separately from actual fall history and responds to confidence-building exercise programs.

A drop in blood pressure on standing, often defined as at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of rising. It causes dizziness and falls and is frequently linked to dehydration or blood pressure medications.

An acute, fluctuating disturbance of attention and awareness, usually caused by an underlying medical problem, medication, or environmental trigger. It is a medical emergency that is often mistaken for dementia and is preventable with non-drug measures.

A chronic, progressive decline in two or more cognitive domains that interferes with independence in daily life. It is distinguished from delirium by its gradual onset and stable or slowly worsening course rather than acute fluctuation.

Use of validated tools such as the Geriatric Depression Scale to detect mood disorders, since older adults may present with somatic complaints, withdrawal, or cognitive slowing rather than classic sadness. Untreated depression worsens function, adherence, and mortality.

Use of multiple medications at once, often defined as five or more, which raises the risk of interactions, adverse effects, and hospitalization in older adults. It warrants periodic review to confirm each drug still has a clear indication.

An evidence-based list of medications considered potentially inappropriate for older adults because of high risk of harm relative to benefit. It is a decision-support tool, not a prohibition, and should prompt review rather than automatic discontinuation.

The cumulative effect of medications with anticholinergic properties, which can cause confusion, constipation, urinary retention, dry mouth, and falls. It is a common and reversible contributor to cognitive and functional decline.

A planned, supervised process of reducing or stopping medications when harms outweigh benefits, such as in frailty, limited life expectancy, or after a goals-of-care change. It involves tapering, monitoring, and communication with the prescribing clinician.

An injury or harmful effect resulting from a medication, including falls, bleeding, confusion, or kidney injury. In older adults these are often nonspecific and mistaken for new illness or aging.

A formal process of comparing a patient's full medication list across care settings and resolving discrepancies at admission, transfer, and discharge. It prevents omissions, duplications, and dangerous interactions during transitions.

Coordinated actions designed to ensure continuity and safety as a patient moves between settings such as hospital, home, and skilled nursing facility. It includes timely communication, medication reconciliation, and follow-up planning.

The likelihood that an older adult will require rehospitalization soon after discharge, driven by factors such as polypharmacy, functional decline, poor social support, and unclear follow-up plans. It is a key target of transitional care interventions.

Deliberate organization of patient care activities among multiple providers and settings to avoid gaps, duplication, and error. It is especially important for older adults with multimorbidity and multiple specialists.

The coexistence of two or more chronic conditions in one person, common in older adults and often complicated by interacting treatments and competing priorities. Care focuses on function and goals rather than single-disease targets.

Structured support that helps older adults build skills to manage long-term conditions, such as symptom monitoring, action planning, and problem solving. It improves confidence and reduces avoidable acute care use.

Activities that maintain or improve well-being and independence, including physical activity, nutrition, immunizations, sensory screening, and social engagement. It is appropriate at every age, including for those with chronic illness.

Administration of recommended vaccines, such as influenza, pneumococcal, shingles, and COVID-19, based on age and health status. Immunization reduces severe illness and is a core preventive service in geriatric care.

A person's ability to obtain, understand, and act on health information to make decisions. Low health literacy is common in older adults and requires plain language, teach-back, and simplified instructions.

A communication technique in which the clinician asks the patient to explain information in their own words to confirm understanding. It reveals gaps and corrects misunderstandings without blaming the patient.

An ongoing conversation and documentation process in which a person clarifies values, goals, and preferences for future medical care. It may include naming a health care agent and completing advance directives before a crisis occurs.

A legal document that records a person's wishes about medical treatment or names someone to decide if the person cannot speak for themselves. It takes effect only when decision-making capacity is lost.

A person appointed in writing to make medical decisions on behalf of someone who can no longer do so. The proxy should follow the patient's known values and wishes rather than personal preference.

Making health care decisions for an adult who lacks capacity, using the standard of substituted judgment or, when wishes are unknown, best interest. Surrogates should be supported with clear information and documentation.

A clinical determination that a person can understand relevant information, appreciate consequences, reason about options, and communicate a choice. It is task-specific and does not equal a diagnosis of dementia.

The outcomes a patient values most, such as comfort, independence, or longevity, which guide treatment choices. Clarifying them aligns care with patient priorities and reduces unwanted interventions.

A collaborative process in which clinician and patient discuss options, benefits, harms, and patient values before choosing a plan. It is central to person-centered care for older adults with complex conditions.

A comfort-focused model of care for people with a serious illness and a limited prognosis, typically defined by a prognosis of six months or less. It addresses physical, emotional, and spiritual needs and includes family support.

Interdisciplinary care that relieves symptoms and improves quality of life for people with serious illness at any stage, alongside curative or disease-directed treatment. It is not limited to end-of-life care.

Use of observation-based tools and caregiver reports to detect pain in people who cannot reliably self-report, looking for facial grimacing, guarding, restlessness, and behavior change. Untreated pain often presents as agitation.

The physical, emotional, financial, and social strain experienced by family or friends providing care. It predicts caregiver illness, nursing home placement, and elder mistreatment, so it should be screened and supported.

Temporary relief for family caregivers, provided in the home, an adult day program, or a facility. It supports caregiver health and helps sustain home-based care.

Intentional harm or neglect of an older adult, including physical, emotional, sexual, financial abuse, neglect, and self-neglect. It requires screening, documentation, and reporting under state law.

An older adult's failure to meet their own basic needs, such as food, hygiene, medication, or safety, often linked to cognitive impairment, depression, or isolation. It is the most common reported form of elder mistreatment.

Nonmedical conditions that shape health, including income, housing, transportation, food security, and social connection. In older adults they strongly influence medication adherence, safety, and access to care.

New or worsening loss of function during a hospital stay, often from immobility, sleep disruption, and poor nutrition. It is preventable through early mobilization and minimizing tethers such as catheters and restraints.