America’s population is aging, with senior citizens representing an increasingly large segment of the overall populace. According to data from the 2020 U.S. Census, about one in six Americans is over the age of 65. In 1920, that number was closer to one in 20. As the older adult population continues to grow, an increasingly large number of citizens will require assistance in managing chronic health concerns, particularly those associated with aging.
To help meet these needs, more nursing professionals are becoming certified as Adult-Gerontology Primary Care Nurse Practitioners (AGPCNPs). These advanced practice nurses play a significant role in managing the care needs of an aging demographic. Nurses who are interested in this important work should consider earning a postgraduate nursing degree and certifications focused on adult gerontology needs.
What Is the Role of an AGPCNP?
Nurses in this specialty work with adults of all ages in a variety of environments, including long-term care settings, community-based clinics and private practices. They manage acute and chronic illnesses and are also focused on health promotion and disease prevention. Like other types of nurse practitioners, an AGPCNP performs as part of an interdisciplinary healthcare team.
While specific duties can vary, the AGPCNP role usually entails:
- Assessing, diagnosing and planning for patients’ health needs
- Examining medical histories, performing physical examinations, ordering screening tests, interpreting diagnostic tests and administering pharmacological and nonpharmacological therapies
- Providing patient and caregiver education and assessment
- Considering the impacts of environmental, occupational, social and economic factors on patients’ health and corresponding treatment plans
AGPCNP Salary and Career Outlook
Considering healthcare needs in the U.S. and the current job market, nurses who want to become AGPCNPs can expect a bright career outlook.
From more work-life balance to higher salaries, there are many benefits to advancing your nursing career and pursuing the path of adult gerontology primary care.
The median annual wage for NPs overall was $121,610 as of 2022, according to the U.S. Bureau of Labor Statistics (BLS). A number of factors can affect salary range, including level of education, years of experience and geographic location.
The BLS forecasts positions for NPs will increase by 45% between 2022 and 2032. That figure is significantly higher than the average for the U.S. job market as a whole, which is close to 3%.
Just around 9% of NPs work in adult-gerontology primary care, compared to more than 70% of NPs who work as FNPs (Family Nurse Practitioners). As a result, there is a considerable need for AGPCNPs in the U.S., especially with the country’s aging population.
Individuals experience specific challenges related to aging throughout their lifetimes. AGPCNPs treat chronic conditions and illnesses as they arise and educate patients on steps they can take to improve their health. In this way, AGPCNPs play a vital role in taking care of the aging population.
In the U.S., nurses must complete the following qualifications to practice as AGPCNPs.
- Obtain a baccalaureate degree (BSN) or higher in nursing
- Complete and pass the NCLEX-RN exam
- Obtain an RN license
- Earn an MSN or DNP degree specializing in adult-gerontology primary care
- Earn a board certification in adult-gerontology primary care through the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners Certification Board (AANPCB)
- Obtain AGPCNP licensure in the intended state of practice
AGPCNP vs. FNP: What’s the Difference?
To better understand what makes the AGPCNP advanced practice nursing specialty unique, it may be helpful to compare it with other roles. One common role is the family nurse practitioner (FNP).
FNPs focus on delivering primary care to individuals and families across the lifespan. They manage common acute and chronic illnesses and promote health and well-being through disease prevention, patient-centered treatment and education.
FNPs seek to meet the healthcare needs of diverse populations ranging from infants to older adults. Since they treat patients of all ages, they work in numerous settings, including private practices, community-based clinics, retail clinics and schools.
In comparison, AGPCNPs work exclusively with patients ages 18 and over. They have acquired specialized nursing knowledge and clinical competence so they can screen patients for common health concerns and deliver individually tailored treatment to patients throughout their adulthood.
Some AGPCNPs provide a wide range of services, including palliative and end-of-life care. They also help patients manage chronic conditions such as heart disease, HIV/AIDS, diabetes and arthritis.
Like FNPs, AGPCNPs can work in various practice settings, like hospital outpatient clinics and private group practice.
What Are the Differences between Acute Care and Primary Care AGNP Practice?
Adult-gerontology nurse practitioners are certified in primary care (AGPCNP) or acute care (AGACNP). Their scope of practice is based on the patient population and not their practice setting. This means that both specialties remain focused on the care of adult and geriatric patients. However, the AGPCNP is focused on this population's primary care needs and alternatively the AGACNP is focused on their acute care needs. This results in them working in different environments.
Acute Care vs. Primary Care
AGACNPs provide care to adults and geriatric patients experiencing complex and acute conditions. Acute conditions are often caused by an infection or virus, but can also be caused by an injury due to an accident or misuse of drugs or medications. Acute conditions may also occur as chronic conditions become more complex and cause rapid instability in the patient's overall health.
Many AGACNPs can be found in intensive care, an emergency department or acute care units — some may also work in specialty clinics and long-term care facilities. AGACNPs focus on stabilizing patients and improving their health conditions while preventing future complications.
Some common acute illnesses the AGACNP may treat include:
- Asthma COPD exacerbation
- Falls with Broken bones
- Cardiac failure or Heart attack
- Acute respiratory illness
The AGACNP-patient relationship is more short-term. That’s because AGACNPs deliver restorative care characterized by rapidly evolving conditions. These include acute, critical and complex chronic conditions that require frequent monitoring and intervention.
In contrast, chronic conditions treated by the AGPCNP in the primary care setting are typically caused by normal deterioration associated with advanced age, unhealthy behaviors that increase the risk of disease, such as poor nutrition, lack of physical activity, drug or alcohol abuse, etc.
Some common chronic illnesses the AGPCNP may treat include:
- High or low blood pressure
- Headaches or migraines
- High cholesterol and cardiac risk factors
- Urinary tract infections
- Mobility and gait conditions
This is where patient education allows AGPCNPs to make a difference as they provide ongoing care for stable patients, many of whom return for additional healthcare services. As a result, AGPCNPs often enjoy long-term patient-provider relationships. They focus on health maintenance and managing chronic conditions. AGPCNPs also coordinate care with specialized providers beyond their scope of practice.
3 Geriatric Nursing Challenges for AGPCNPs
Caring for older adults can present a few common challenges for AGPCNPs.
1. Struggling with Self-Care and Loss of Independence
Geriatric patients may struggle with a loss of independence. Some geriatric patients maintain a high level of independence, but others find themselves increasingly needing to rely on help to manage activities of daily living such as bathing, eating and dressing. With less independence, negative feelings like anger, shame and sadness can arise in geriatric patients as they cope.
Nursing professionals working in geriatrics can help by ensuring patients are allowed the time and assistance to complete tasks within their appropriate level of functioning. For instance, some geriatric patients have mobility issues and may need assistance with bathing, but can still perform other tasks like brushing their hair. These tasks that are within reach should be encouraged to promote feelings of independence.
Regular assessment of patients’ functional abilities will also help practitioners understand their patients’ needs. The Katz Index of Independence is a great tool to help healthcare providers assess patients’ functioning levels. Assessing capabilities and performance issues is essential to developing and implementing an effective treatment plan.
2. Dementia and Memory Loss
Dementia is another common issue in geriatric care. With the loss of memory and functional ability, coping can be difficult for patients, families and caregivers. Individuals with dementia may become easily frustrated as they realize they have difficulty remembering and must accept the help they didn’t need previously. Those with dementia may also struggle with communication. Understanding their needs requires patience, good communication skills and careful observation.
Nurse practitioners can help manage the progress of certain types of dementia by prescribing medications such as cholinesterase inhibitors. AGPCNPs may also try to regulate other conditions that may worsen dementia, such as diabetes and high blood pressure. Providers working in geriatrics can also support patients with dementia by helping them receive physical therapy to help prevent falls, and occupational therapy to help them maintain some independence with activities of daily living.
3. Abuse and Neglect
Nurse practitioners who work in geriatrics are serving a vulnerable population, and geriatric mistreatment must be identified early on for prevention. This requires keen vigilance and attention to detail. Not all signs of abuse are identified easily. Geriatric abuse may include physical, emotional, sexual abuse and financial exploitation, as well as neglect or abandonment.
Some cases of geriatric neglect are unintentional. They may result from increased care needs becoming greater than what can be provided by medically educated caregivers. These instances may involve family members who become responsible for an older adult relative but do not realize an issue the patient displays is a symptom of neglect.
By diligently recognizing the signs of geriatric mistreatment and supporting those coping with the effects of abuse and neglect, nurse practitioners can have a positive impact on a major issue in geriatric care.
What Healthcare Trends Will Affect the AGPCNP Role?
Current trends in healthcare are expanding the AGPCNP role to meet the needs of our country’s diverse patient population. Here are a few examples.
Rising Rate of Chronic Disease
According to the Centers for Disease Control and Prevention (CDC), chronic diseases are the leading causes of death and disability. Currently, six in 10 U.S. adults have one chronic disease, and four in 10 have multiple.
The good news is that many chronic diseases can be prevented through healthier lifestyle choices. The primary causes of chronic diseases are smoking, poor nutrition, alcohol consumption and a lack of physical activity.
Nurse practitioners maximize the ability of the healthcare workforce to address the challenges of chronic disease. AGPCNPs play an especially vital role. That’s because they can care for patients ages 18 and over; the population most affected by chronic disease. In particular, AGPCNPs are educated to not only manage and treat chronic disease but also to prevent it.
Increased Use of Telehealth
Telehealth adoption and satisfaction are growing. This is one of the ramifications of the COVID-19 pandemic.
A July 2021 report from McKinsey & Company showed telehealth usage “has stabilized at levels 38 times higher than before the pandemic.” In June 2021, the American Psychiatric Association released survey results showing that 2 in 5 respondents wanted to continue using telehealth after the pandemic.
What does this trend mean for the AGPCNP role? AGPCNPs must be prepared to use telehealth platforms and educate patients on how to do the same. Before implementing telehealth, AGPCNPs should also be aware of federal and state legal requirements, best practices to ensure patient safety, as well as the need for additional professional liability insurance.
Shortage of Primary Care Doctors
The nation needs more primary care providers to meet the rapidly expanding demand for healthcare.
By 2034, the American Association of Medical Colleges estimates the U.S. will have a shortage of between 17,800 and 48,000 primary care physicians. Multiple factors are contributing to this deficit, including a growing aging population that needs more care and many doctors nearing retirement age.
Fortunately, AGPCNPs are prepared to help fill the gap. Evidence shows NP care is cost-effective and equal to or better than comparable services offered by other highly credentialed providers.
Make a Difference as an AGPCNP
AGPCNPs can play a critical role in providing continuous, ongoing care to one of America’s largest demographics. Spring Arbor University’s online Master of Science in Nursing – AGPCNP helps students:
- Gain knowledge of gerontology concepts and how they address the biological, psychosocial, mental and spiritual needs of older adults
- Understand what goes into the management of chronic disease and the complex care needs of older adults
- Learn how to arrange and evaluate care for health-compromised clients through case management and interdisciplinary collaboration
- Develop essential competencies and master methodologies to deliver comprehensive primary care to adolescents, adults and older adults
With online MSN tracks available to BSN and ADN/ASN degree holders, students can benefit from a streamlined educational path as they work to promote adult health in their community.
Discover more about the Spring Arbor University online Master of Science in Nursing – AGPCNP today.
- Safety in Nursing Tips: Challenges and Opportunities
- Why Become a Nurse Practitioner?
- 4 Problems Nurses Face in the Hospital
- American Association of Nurse Practitioners, “Are You Considering a Career as an Adult-Gerontology Primary Care Nurse Practitioner?”
- American Association of Nurse Practitioners, NP Fact Sheet
- Association of American Medical Colleges, “AAMC Report Reinforces Mounting Physician Shortage”
- Centers for Disease Control and Prevention, Chronic Diseases in America
- McKinsey & Company, “Telehealth: A Quarter-trillion-dollar Post-COVID-19 Reality?”
- U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
- United States Census Bureau, 2020 Census: 1 in 6 People in the United States Were 65 and Over