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Part 2: Responsible Parties and Guardianships The Legal Issues Section Editor and an expert panel speak out about the protection of rights for older adults with diminished ability to make appropriate decisions on their own behalf.

The Elder Justice Act ( a part of the Patient Protection and Affordable Care Act of 2010 ) focuses on the development of a comprehensive mechanism to “prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation.” Elements of the Act that offer opportunities for nurses to demonstrate their advocacy role on behalf of older adults include (a) participating in the training of ombudsmen and/or becoming an ombudsman; (b) serving on the Elder Justice Act’s Advisory Board on Elder Abuse, Neglect, and Exploitation; (c) working in either a stationary or mobile forensic center dedicated to addressing elder abuse; (d) having an active role in the curriculum design and implementation of degree and certificate programs to build competency in gerontology and gerontological nursing; and (e) providing consultation to long-term care facilities in the areas of staff recruitment and quality of care.

The Legal Issues section editor and an expert panel speak out about abuse, neglect, and legal obligations nurses face.

This is the fourth and final presentation in the series of articles on legal issues in gerontological nursing by the Section Editor and a panel of experts. One goal of the series was to help stimulate nurses working with older adults to write about their research and practice from a legal issues standpoint. EXCERPT This series of articles was written by the Section Editor and an Expert Panel to help nurses get away from the myth that law and regulation equals lawsuits. As nurses and as citizens, our very being is governed by law and regulation. As nurses, we are responsible for knowing the statutes, rules, and regulations that affect our practice as we care for older adults. To be a reasonable, prudent nurse means we adhere to the standards of gerontological nursing. We also have the responsibility to be aware of emerging legal trends and risks and to voice our opinions about these trends and risks when needed.

This article is the third in a series of articles written by the Legal Issues Section Editor and a panel of experts related to current legal issues of concern to gerontological nurses intended to encourage potential authors to write about the legal issues they face in caring for older adults. The final article in this series will appear in an upcoming issue of the Journal. In Part 4, the panel discusses other significant legal issues and ideas for research and change in gerontological nursing practice. EXCERPT This installment of the series on legal issues affecting the practice of gerontological nursing focuses on standards of care. The expert panel speaks out on their perceptions of why nurses are not following accepted evidence-based standards of gerontological nursing care, and they make suggestions to nurses to help them to adhere to these standards.

Nurses have a crucial role in ensuring adequate food and fluid intake in the elderly. Nurses can improve the nutritional intake of their elderly patients by obtaining proper nutritional assessments, addressing risk factors for malnutrition and fluid deficit, providing enough staff and volunteers to help feed impaired patients, honoring each older person's meal pattern, scheduling drug regimens that do not interfere with food and fluid intake, not scheduling food-related activities and visits too near mealtime, serving food that is palatable and attractively served, ensuring adequate fluid intake, and being creative in finding ways to keep the restless, wandering patient well-nourished and hydrated. Monitoring food and fluid intake requires precise recording of what foods and fluids the older person is ingesting, keeping accurate intake and output records, determining periodic weights, informing the physician of patients' weight loss in a timely manner, and instituting corrective measures at once.

Providing a range of health-related services may be necessary for some elderly to remain in independent living environments. Wellness Centers can identify those at risk for disease, promote self-care techniques, and assess the need for other health services. Entrepreneural nurses have the opportunity to seek out congregate housing sites with large aging populations to create ways of promoting healthy lifestyles and a higher quality of life for older persons. A holistic approach to health care helps the elderly to manage chronic disease, maintain high levels of functioning, and promote self-responsibility.

Nursing should be a selfgoverning professional body with the power to administer care under its jurisdictions.