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As I write this editorial, the campaign season is in full swing and candidate advertisements are omnipresent. In a television ad, a candidate is reading to a group of preschoolers. "How old do you think I am?" he inquires of the eager faces. "Seven," someone volunteers the answer. He is seeking the office of governor, so obviously he is not 7, but when you're 3 years old, 7 is more than twice your age so surely it is old. Age is a perception-in the eye of the beholder. Recently, nursing students also realized that age is a perception when they decided to find representations of older persons in advertisements in popular press. The students were in a bachelor's completion program and were older than traditional college entry students. They discovered that there were few ads depicting older persons in magazines intended to have broad public appeal. Among the ads they found, the majority were for medications. Students noted that persons depicted in the ads were, in the students' judgment, in their 50s and 60s and therefore not really old. Age is in the eye of the beholder, and it has a moving reference point.


Many perceptions surround aging in America. An individual's perceptions are based in experiences and meanings; however, scholarly information and open dialogue can help shape perceptions. In nursing, our professional obligation is to be aware of our personal and collective perceptions about aging and appreciate how thoughts and feelings influence our care of the older adult. Clinical nurse specialists (CNSs) are in a great position to raise awareness about perceptions of aging and influence the standard of nursing care for older adults.


This issue of the journal brings you highlights of the National Association of Clinical Nurse Specialists (NACNS) Preconference on Gerontological Nursing. The preconference was possible because NACNS received a Nurse Competence in Aging Grant, funded by the Atlanta Philanthropies (USA) Inc, awarded to the American Nurses Association (ANA) through the American Nurses Foundation (ANF). The grant represented a strategic alliance between ANA, the American Nurses Credentialing Center (ANCC), and the John A. Hartford Foundation Institute for Geriatric Nursing at New York University in the Steinhardt School of Education, Division of Nursing. NACNS thanks the grant funding sources.


Angela P. Clark, PhD, RN, CNS, FAAN, FAHA, and Kathleen Baldwin, PhD, RN, ANP, GNP, were the principal and coprincipal investigators for the grant and they also deserve thanks. In addition to lending their considerable talent and skill to the development of the preconference, they also assisted the presenters with developing the presentations into manuscripts. Collectively, the preconference proceedings offer a broad overview of aging-related topics of interest to CNSs and an opportunity for CNSs of any specialty to advance their knowledge about best practices and evidence-based care of older adults.


In a separate but related effort, The American Association of Colleges of Nursing and The John A. Hartford Foundation recently released a new publication, Nurse Practitioner and Clinical Nurse Specialist Competencies for Older Adult Care ( The document offers guidance to nurse educators for integrating content about health and nursing care of older adults into curricula that prepare students whose practice includes older adults but whose focus specialty is not gerontology. I was pleased to serve as a member of the expert panel that developed the document along with several other members of the NACNS. Integrating content about aging into nursing curricula is yet another opportunity to shape the perceptions of nurses and influence care of older adults.


These recent initiatives, the preconference and the curricula guidelines, are a reflection of growing interest in thinking anew about the health needs of older adults. Colleagues in pediatrics like to say that children are not little adults; there are many differences to consider. Likewise, older persons are not just, well, old. Older adults, in contrast to younger adults, have many unique differences to consider. Older adults are a part of most CNSs practices and in some specialties older adults are the dominant age group. Nursing curricula vary in specific content on aging and students may leave basic or advanced programs not having been presented with fundamental content such as psychosocial development landmarks and physiologic age-related changes. With our perceptions not necessarily colored by scholarly information from our school days, and facing increasing numbers of older adults in our practices, it is timely and necessary that we turn attention to the differences that define the unique health needs of older persons. Take a minute to consider your perceptions of older adults as you read the preconference proceedings. May we all live long enough to experience old age as something less than twice our age!! As CNSs, may we provide and build programs of care that contribute to the unique needs of the older adult.