Gerontological Nursing Certification (GERO-BC) key terms

Prejudice or discrimination based on a person's age, often expressed through stereotypes of decline, dependency, or cognitive loss. In health care it can cause dismissed symptoms, exclusion from treatment decisions, and reduced rehabilitation effort.

Tornstam's theory that aging can bring a shift from material and self-focused concerns toward introspection, connection with past and future generations, and greater acceptance of death. It describes a possible developmental path, not a required outcome.

The concept that prevention and healthy behavior can postpone the onset of chronic illness and disability so those years occupy a shorter portion of life near its end, rather than adding years lived with disease.

An aging theory proposing that remaining socially engaged, maintaining familiar roles, and replacing lost activities supports well-being and life satisfaction in later life. It contrasts with disengagement theory, which framed withdrawal as normal aging.

The principle that older adults have the right to make their own choices about care, including refusing recommended treatment, when they have decision-making capacity. Nurses honor it through informed consent, honest information, and shared planning.

Intentional or negligent acts by a trusted person that harm an older adult, including physical, emotional, sexual, and financial abuse, neglect, and abandonment. Nurses in most jurisdictions must report suspected cases to adult protective services.

A clinical judgment that a person can understand relevant information, appreciate consequences, reason about options, and communicate a consistent choice. It is task-specific and assessed by clinicians, while competence is a legal determination made by courts.

A multidimensional, team-based evaluation of medical, functional, cognitive, psychological, social, and environmental status that produces an individualized care plan. It improves outcomes for hospitalized and frail older adults compared with usual care.

Tasks requiring higher-level planning and organization, such as managing money, shopping, cooking, using transportation, and handling medications. Losing IADLs often signals early cognitive or physical decline before basic self-care fails.

A mobility test in which the person rises from a chair, walks 3 meters, turns, and returns to sit. A time of roughly 12 seconds or more suggests increased fall risk and prompts further gait and balance evaluation.

A state of reduced physiologic reserve that raises vulnerability to stressors such as infection, surgery, or a new medication. Phenotype models use unintentional weight loss, exhaustion, weak grip, slow gait, and low activity.

An acute disturbance of attention and awareness that develops over hours to days and fluctuates, usually triggered by illness, medications, pain, sensory deprivation, or environmental change. It is a medical emergency, not a normal part of aging.

A structured tool that identifies delirium from four features: acute onset with fluctuation, inattention, disorganized thinking, and altered level of consciousness. Acute onset plus inattention plus either of the last two indicates delirium.

A yes-or-no screening questionnaire built for older adults that omits somatic symptoms such as weight loss and insomnia, which may be caused by medical illness. The 15-item short form is quick to administer at the bedside.

A 30-point screening test sampling memory, executive function, attention, language, visuospatial skill, and orientation. It is more sensitive than the MMSE for mild cognitive impairment, and scores are adjusted for educational level.

A screening tool for older adults combining appetite, weight loss, mobility, acute illness, body mass index, and dietary intake. It classifies nutritional status as adequate, at risk, or malnourished and guides referral and intervention.

Use of multiple medications, commonly defined as five or more, especially when some have no current indication. It increases the risk of adverse drug events, falls, and hospitalization, making periodic full medication review essential.

An expert consensus list of potentially inappropriate medications for adults 65 and older, organized by drug class and clinical concern. It is a decision aid rather than a prohibition, so prescribers weigh risks against remaining benefit.

A planned, supervised process of reducing or stopping medications whose harms now outweigh their benefits, tapering when withdrawal risk exists. It is done with the patient and family, never to the patient.

The cumulative effect of drugs that block acetylcholine, which can cause confusion, constipation, urinary retention, dry mouth, and falls. Burden scores sum individual drug potencies; lowering the total load often improves cognition and continence.

Team-based care that relieves symptoms and supports quality of life for serious illness at any stage, delivered alongside curative or life-prolonging treatment. It is appropriate from the time of diagnosis, not only near death.

A Medicare-covered model of comfort-focused care for people with a prognosis of about six months or less who forgo curative treatment of the terminal condition. It includes interdisciplinary support and bereavement care for the family.

A legal document stating a person's preferences for future medical care, or naming a surrogate decision-maker, used when the person can no longer speak for themselves. It takes effect only after decision-making capacity is lost.

An observational scale for pain in advanced dementia scoring breathing, negative vocalization, facial expression, body language, and consolability. A score of 4 or more suggests moderate to severe pain and prompts a comfort intervention with reassessment.

A formal process of comparing a patient's complete medication list across care transitions and resolving discrepancies, including over-the-counter drugs and supplements. It reduces errors at admission, unit transfer, and discharge.

The capacity to obtain, understand, and act on health information when making decisions. Older adults are at higher risk because of vision, hearing, and cognitive changes, so plain language, large print, and pictures are essential.

A technique in which the patient explains in their own words how to take a medication or perform a task, letting the clinician confirm understanding and correct errors without shaming the person.

A person's confidence in their ability to carry out a specific health behavior, such as managing medications or exercising regularly. Higher self-efficacy predicts better self-management, so coaching builds small, mastered steps.

A conversation in which the clinician explains options, benefits, and harms while the patient contributes values and goals, arriving at a choice together. It goes beyond informed consent because the patient's preferences shape the recommendation.

A yearly preventive visit for Medicare beneficiaries that produces a personalized prevention plan, screens for cognitive impairment and fall risk, and updates the problem list. It is not a head-to-toe physical examination.

A structured handoff format of Situation, Background, Assessment, and Recommendation that gives the receiver a concise, predictable picture and a clear request. It reduces omissions and speeds escalation to physicians and rapid response teams.

Plan-Do-Study-Act, a rapid quality improvement method in which a small change is tested, results are observed, and the change is refined before wider spread. It builds local evidence rather than waiting for a perfect large program.

A structured team review after a serious safety event that maps contributing factors in systems, processes, equipment, and communication, then produces an action plan. It targets system failures rather than blaming one individual.

Teamwork in which nurses, physicians, pharmacists, social workers, therapists, and others share goals, communicate openly, and coordinate care with the patient and family as team members. It improves outcomes and reduces duplicated effort.

An organizational approach to error that separates human error, at-risk behavior, and reckless conduct, responding with support, coaching, or discipline accordingly. It encourages staff to report near misses and unsafe conditions.

Measures of care quality influenced by nursing practice, such as falls with injury, hospital-acquired pressure injuries, catheter-associated urinary tract infections, and restraint use. They are tracked for benchmarking and improvement work.