National League of NursingNational League of Nursing

The Voice of Nursing Education

Complexity of Care


Complexity of Care

The care of older adults requires specialized knowledge in the art and science of both nursing and geriatrics to manage the interplay of factors that influence quality of care.

Older adults represent nurses’ most complex clients. But this has not always been evident in how we teach or in the experiences faculty create for students. Clinical experiences need to recognize, respect, and respond to numerous interconnected factors that affect care and the multiple variables that impact the quality of care for older adults.

Management of multiple co-existing acute and chronic conditions may generate tension between immediate and long term needs. Older adults’ immediate and long-term needs converge in complex ways as older adults experience changes, both temporary and permanent, in environment and levels of independence and functioning. Nurses’ use judgment to observe, interpret, respond, and reflect, based on their knowledge and the older adults’ or caregivers’ expectations.

Unfolding cases, simulations, and teaching strategies using ACES Essential Knowledge Domains and Nursing Actions facilitate the ability of nurses to care for older adults and their caregivers in a way that is competent, individualized, and humanistic.