Treating frail and elderly patients.

September 25, 2001

ANN ARBOR---U.S. Census estimates predict the number of Americans age 65 and over will grow from 34.6 million in 1999 to 82.0 million in 2050---a 137 percent increase, with a significant portion of that growth coming in the group 85 and older. As a result, the health care community should focus more of its attention on that population's needs, says a University of Michigan faculty member.

This school year, the U-M School of Nursing is introducing a new concentration in care for the frail and elderly, under the direction of Donna Algase, professor of nursing and a faculty associate at the U-M Institute of Gerontology.

"The complexity of dealing with their special kind of vulnerability is beyond what's addressed in preparation for general advanced practice nursing," Algase said.

Nurses need to understand not just what these patients need physically, but also to be prepared to address their overall quality of life including the difficult questions of quality vs. longevity, she said. Frailty affects patients physically, psychologically and socially and students will look at those holistic effects.

Of about 175 graduate students enrolled at the School of Nursing, Algase expects about six each year to participate in the three-course concentration.

In addition, she hopes to offer the series to existing graduate nurses as a continuing education certificate program, as well as to develop a network of nursing schools interested in collaborating to offer the concentration via a distance learning setup.

The first offering in the series is a class titled "Frailty in Aging," which will address such things as the complex interactions of multiple health problems, quality of life, end-of-life decision-making and palliative care are included. Needs of families and care-givers and strategies for meeting these needs also are part of the course.

Later, students in the concentration will study specialized nursing interventions for working with frail elders. The series is capped off by a course in which students apply concepts and interventions to actual frail and elderly patients.
Algase noted that the U-M School of Nursing already offers a master's-level program for gerontological advanced-practice nursing ( and the frail elderly concentration is focused on nursing students who perhaps have an interest in treating the elderly but do not want to specialize in it exclusively.

The concentration is funded in part by a three-year, $500,000 grant from the Bureau of Health Professions, part of the U.S. Department of Health and Human Services.

EDITORS: For more information on the elderly, visit the following Web sites:

--National Institute on Aging at the National Institutes of Health report on growth in centenarians:

--National Institute on Aging:

--U.S. Census Bureau: Sixty-five plus in the United States

--Administration on Aging's synopsis of data on senior citizens:

--American Association of Retired Persons Health and Long-Term Care information:

University of Michigan

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