In ambulatory care: geriatric nurses care for older adults in primary care practices, in assisted living facilities, in retirement communities developed for older people or in high rise buildings where many older people cluster called NORCS (naturally occurring retirement communities), and in home hospice. Often these nurses work as part of a geriatric team made up of physicians, social workers, pharmacists etc. Geriatric nurses also serve as case managers helping patients and families maximize their opportunities to remain functionally independent and living in the community.
In these settings, geriatric nurses are expert in functional and cognitive assessment, disease prevention and management especially around chronic illnesses, prevention, early recognition and management of geriatric syndromes (falls, urinary incontinence, sleep disturbances), medication management, and the resources that can help older people remain in the community.
In hospitals: geriatric nurses care for older adults through out the hospital but are especially prominent on same-day surgery units, for example those focused on care of patients with cataracts, on specialized ACE (Acute Care of the Elderly) units, on units that specialize in rehabilitation, care of patients with dementia and on gero-psychiatric care. Geriatric nurses in hospitals are often the wound and skin specialist, the nurse called in to assess and manage common geriatric syndromes such as delirium, dementia, wandering or combative behavior, pressure ulcers, and staff concerns about the use of physical restraints.
In nursing homes: geriatric nurses manage the full care of residents, including assessment, diagnosis, management of physical, functional and cognitive impairments, and the development of programs that promote early recognition of change in the resident's status, the prevention of unnecessary hospital admissions, and the attainment of a peaceful death.
In administration, leadership and public policy: geriatric nurses become directors of nursing and vice presidents for nursing. They work in managed care companies to conduct utilization review and establish programs and protocols for disease management. The work with companies establishing automated medical records to assure appropriate assessment of older patients across the continuum of care. They work with state and federal organizations to establish regulations for care and for reimbursement.
In schools of nursing: geriatric nurse faculty teach across the curriculum, staff specialty courses in geriatrics, link with numerous clinical agencies for student experiences, write textbooks and journal articles and conduct research.
In nursing research: geriatric nurse researchers have been at the forefront of research addressing some of the most profound concerns of older adults, including devising strategies to markedly reduce the use of physical restraints in hospitals and nursing homes, improving the care of older adults with urinary incontinence, reducing hospitalizations for people with chronic illness such as congestive heart failure, improving the management of the disruptive behaviors of people with severe dementia, helping families gain confidence in providing care, and devising systems of care that improve quality and decrease the cost of care.