DNP Dissertation Topics in Geriatric Care

DNP Dissertation Topics in Geriatric Care: An In-Depth Analysis for Doctoral Students

The Doctor of Nursing Practice (DNP) degree represents the terminal practice degree for nurses, emphasizing evidence-based practice, quality improvement, and systems leadership. In the rapidly evolving landscape of geriatric healthcare, DNP-prepared nurses are uniquely positioned to address the complex challenges facing older adult populations through innovative research and practice improvement initiatives. This comprehensive guide provides detailed exploration of dissertation topics, methodological approaches, and practical considerations for DNP students focusing on geriatric care.

The urgency of this focus cannot be overstated. The U.S. Census Bureau projects that by 2060, nearly 95 million Americans will be 65 and older, representing 23% of the total population. This demographic shift, often referred to as the “silver tsunami,” brings unprecedented challenges to healthcare systems worldwide. The complexity of caring for older adults—who often present with multiple chronic conditions, cognitive changes, functional limitations, and intricate psychosocial needs—requires sophisticated, evidence-based approaches that DNP research can help develop and refine.

The DNP Approach to Geriatric Care Research

Distinguishing DNP from PhD Research

DNP dissertation research differs fundamentally from PhD research in its focus on practice improvement rather than theory generation. While PhD research seeks to create new knowledge through rigorous scientific inquiry, DNP research applies existing knowledge to solve real-world practice problems. In geriatric care, this translates to projects that directly impact patient outcomes, improve care processes, enhance quality of life, or address systems-level challenges in caring for older adults.

DNP projects typically employ quality improvement methodologies, implementation science frameworks, and evidence-based practice models. They often involve stakeholder engagement, interprofessional collaboration, and sustainability planning—all crucial elements in geriatric care where successful interventions require buy-in from multiple disciplines and care settings.

Theoretical Frameworks for Geriatric Care Research

Several theoretical frameworks are particularly applicable to DNP research in geriatric care:

1. The Iowa Model of Evidence-Based Practice: This framework guides the systematic application of research evidence to clinical practice, making it ideal for implementing geriatric care improvements.

2. The Chronic Care Model (CCM): Developed by Wagner and colleagues, this model provides a framework for improving chronic disease management—a critical need in geriatric populations.

3. Age-Friendly Health Systems Framework: The Institute for Healthcare Improvement’s framework focusing on the 4Ms (What Matters, Medication, Mentation, and Mobility) provides a comprehensive approach to geriatric care improvement.

4. Transitional Care Model (TCM): Particularly relevant for addressing care coordination challenges that frequently impact older adults moving between care settings.

Detailed Exploration of Research Areas

1. Chronic Disease Management and Care Coordination

Background and Significance

Approximately 85% of older adults have at least one chronic condition, and 60% have two or more. The complexity of managing multiple chronic conditions in older adults requires sophisticated care coordination approaches that account for physiological changes of aging, medication interactions, and patient preferences.

Specific Research Topics

A. Diabetes Management in Older Adults

• Developing age-appropriate glycemic targets and monitoring protocols
• Implementing technology-assisted glucose monitoring in community-dwelling older adults
• Creating interprofessional care teams for complex diabetes management
• Examining the effectiveness of peer support programs for older adults with diabetes
• Developing hypoglycemia prevention protocols for older adults in various care settings

B. Heart Failure Management

• Implementing telemonitoring programs for older adults with heart failure
• Developing self-management education programs tailored to cognitive abilities
• Creating protocols for managing heart failure in the presence of multiple comorbidities
• Examining the role of family caregivers in heart failure management
• Developing decision-making tools for advanced directives in end-stage heart failure

C. Chronic Kidney Disease (CKD) Care

• Creating shared decision-making tools for dialysis initiation in older adults
• Developing conservative management protocols for advanced CKD in frail older adults
• Implementing CKD education programs in primary care settings
• Examining outcomes of geriatrician-nephrologist collaborative care models

Research Methodologies:

• Quasi-experimental designs comparing pre/post implementation outcomes
• Randomized controlled trials of specific interventions
• Mixed-methods studies incorporating patient and caregiver perspectives
• Quality improvement projects using Plan-Do-Study-Act (PDSA) cycles
• Implementation science studies examining barriers and facilitators to program adoption

2. Medication Safety and Polypharmacy Management

Background and Significance

Older adults are at significantly higher risk for adverse drug events due to age-related physiological changes, polypharmacy, and increased sensitivity to medications. Approximately 40% of older adults take five or more prescription medications, with medication-related problems contributing to over 125,000 deaths annually in the United States.

Specific Research Topics

A. Deprescribing Initiatives

• Implementing systematic deprescribing protocols in primary care settings
• Developing decision-support tools for potentially inappropriate medications (PIMs)
• Training healthcare providers in shared decision-making for medication discontinuation
• Examining patient and provider attitudes toward deprescribing
• Creating protocols for deprescribing in patients with limited life expectancy

B. Medication Reconciliation and Safety

• Developing technology-enhanced medication reconciliation processes
• Implementing pharmacy-led medication reviews in primary care
• Creating patient-centered medication management programs
• Examining the effectiveness of medication synchronization programs
• Developing protocols for managing medication adherence in cognitively impaired older adults

C. Anticholinergic Burden Reduction

• Implementing anticholinergic burden assessment tools in clinical practice
• Developing educational programs for providers about anticholinergic risks
• Creating protocols for reducing anticholinergic medication use
• Examining outcomes of anticholinergic burden reduction interventions

Research Methodologies:

• Retrospective chart reviews examining medication-related outcomes
• Prospective cohort studies following patients through deprescribing interventions
• Cluster randomized trials comparing different approaches to medication management
• Economic evaluations of medication safety interventions
• Qualitative studies exploring patient and provider experiences with deprescribing

3. Cognitive Health, Dementia Care, and Delirium Prevention

Background and Significance

Cognitive impairment affects approximately 22% of adults aged 71 and older, with Alzheimer’s disease and related dementias representing a growing public health crisis. Additionally, delirium affects up to 50% of hospitalized older adults, yet remains underrecognized and undertreated.

Specific Research Topics

A. Early Detection and Cognitive Screening

• Implementing cognitive screening protocols in primary care settings
• Developing technology-based cognitive assessment tools
• Training healthcare providers in early dementia recognition
• Creating pathways for post-diagnosis support and care planning
• Examining the effectiveness of different cognitive screening instruments in diverse populations

B. Delirium Prevention and Management

• Implementing multi-component delirium prevention programs (e.g., HELP protocol)
• Developing nursing-led delirium screening and intervention protocols
• Creating family-centered delirium prevention strategies
• Examining the effectiveness of non-pharmacological delirium interventions
• Developing protocols for managing delirium in emergency departments

C. Dementia Care Innovations

• Implementing person-centered care models in long-term care facilities
• Developing behavioral intervention protocols for dementia-related symptoms
• Creating caregiver support and education programs
• Examining the effectiveness of music, art, or pet therapy interventions
• Developing protocols for managing advanced directives in dementia care

D. Mild Cognitive Impairment (MCI) Management

• Creating lifestyle intervention programs for MCI
• Developing cognitive stimulation protocols
• Examining the role of physical exercise in cognitive preservation
• Creating support programs for individuals newly diagnosed with MCI

Research Methodologies:

• Randomized controlled trials of specific interventions
• Pre-post implementation studies of screening programs
• Mixed-methods studies incorporating patient and family perspectives
• Economic evaluations of dementia care interventions
• Longitudinal studies examining cognitive trajectories

4. Fall Prevention and Mobility Enhancement

Background and Significance

Falls are the leading cause of fatal and non-fatal injuries among older adults, with one in four adults aged 65 and older falling each year. Falls result in more than 3 million emergency department visits annually and cost the U.S. healthcare system over $50 billion per year.

Specific Research Topics

A. Multi-factorial Fall Prevention Programs

• Implementing comprehensive fall risk assessments in primary care
• Developing interprofessional fall prevention teams
• Creating community-based fall prevention programs
• Examining the effectiveness of tai chi, yoga, or other exercise interventions
• Developing home safety evaluation and modification protocols

B. Technology-Enhanced Fall Prevention

• Implementing wearable device monitoring for fall risk assessment
• Developing smart home technologies for fall detection and prevention
• Creating mobile applications for fall prevention education and exercise
• Examining the effectiveness of virtual reality balance training

C. Post-Fall Care and Management

• Developing protocols for post-fall assessment and intervention
• Creating fear of falling intervention programs
• Implementing post-fall care coordination protocols
• Examining the effectiveness of different approaches to fall-related injury recovery

D. Environmental Modifications

• Developing evidence-based home modification protocols
• Creating institutional environmental safety assessments
• Examining the effectiveness of lighting improvements on fall prevention
• Developing protocols for optimizing footwear and assistive device use

Research Methodologies:

• Cluster randomized controlled trials of fall prevention programs
• Prospective cohort studies examining fall risk factors
• Economic evaluations of fall prevention interventions
• Mixed-methods studies exploring patient and provider experiences
• Implementation science studies examining program sustainability

5. Mental Health and Psychosocial Well-being

Background and Significance

Mental health conditions are common among older adults but often underrecognized and undertreated. Depression affects approximately 15-20% of older adults, while anxiety disorders affect 10-20%. Social isolation and loneliness have become increasingly recognized as significant health risks, particularly highlighted during the COVID-19 pandemic.

Specific Research Topics

A. Depression Screening and Treatment

• Implementing systematic depression screening in primary care settings
• Developing collaborative care models for late-life depression
• Creating peer support programs for older adults with depression
• Examining the effectiveness of different psychotherapeutic interventions
• Developing protocols for managing depression in the presence of chronic illness

B. Anxiety Management

• Implementing anxiety screening protocols in geriatric care settings
• Developing non-pharmacological anxiety interventions
• Creating protocols for managing anxiety in dementia care
• Examining the effectiveness of mindfulness-based interventions

C. Social Isolation and Loneliness Interventions

• Developing community-based social connection programs
• Implementing technology-based social interaction interventions
• Creating volunteer visitor programs for homebound older adults
• Examining the effectiveness of intergenerational programming
• Developing protocols for identifying and addressing social isolation in clinical settings

D. Grief and Bereavement Support

• Creating bereavement support programs for older adults
• Developing protocols for supporting complicated grief
• Examining the effectiveness of peer support groups
• Creating resources for healthcare providers caring for grieving older adults

Research Methodologies:

• Randomized controlled trials of specific interventions
• Community-based participatory research approaches
• Mixed-methods studies incorporating qualitative experiences
• Implementation science studies examining program adoption
• Economic evaluations of mental health interventions

6. Transitional Care and Care Coordination

Background and Significance

Older adults frequently experience transitions between care settings, with inadequate care coordination contributing to medication errors, duplicated services, and preventable readmissions. Approximately 20% of older adults are readmitted to hospitals within 30 days of discharge.

Specific Research Topics

A. Hospital-to-Home Transitions

• Implementing comprehensive discharge planning protocols
• Developing nurse-led transitional care programs
• Creating patient and family education resources for discharge
• Examining the effectiveness of post-discharge follow-up calls
• Developing protocols for medication reconciliation during transitions

B. Care Coordination Models

• Implementing care coordination programs for high-risk older adults
• Developing interprofessional care team models
• Creating communication protocols between care settings
• Examining the role of care coordinators in improving outcomes
• Developing technology-enhanced care coordination tools

C. Emergency Department to Primary Care Transitions

• Developing protocols for emergency department follow-up
• Creating decision-support tools for disposition planning
• Implementing geriatric emergency department programs
• Examining the effectiveness of observation unit alternatives

D. Long-term Care Transitions

• Developing protocols for hospital-to-nursing home transitions
• Creating communication tools between acute and long-term care settings
• Examining factors influencing successful nursing home placement
• Developing support programs for families navigating long-term care decisions

7. Technology Integration and Digital Health

Background and Significance

Technology integration in geriatric care presents unique opportunities and challenges. While older adults may have lower technology adoption rates, thoughtfully designed digital health interventions can significantly improve care access, monitoring, and outcomes.

Specific Research Topics

A. Telehealth and Remote Monitoring

• Implementing telehealth programs for rural older adults
• Developing remote monitoring protocols for chronic disease management
• Creating technology training programs for older adults and caregivers
• Examining the effectiveness of virtual visits for geriatric care
• Developing protocols for technology-assisted medication management

B. Electronic Health Record Optimization

• Developing geriatric-specific clinical decision support tools
• Implementing age-friendly EHR modifications
• Creating protocols for documenting geriatric syndromes
• Examining the impact of EHR modifications on care quality

C. Mobile Health Applications

• Developing and testing mobile applications for older adult health management
• Creating user-friendly interfaces for older adults
• Examining the effectiveness of medication reminder applications
• Developing applications for fall prevention and mobility enhancement

8. End-of-Life and Palliative Care

Background and Significance

Quality end-of-life care remains a significant challenge in geriatric healthcare, with many older adults receiving aggressive, unwanted interventions at the end of life. Palliative care integration throughout the illness trajectory can significantly improve quality of life and reduce healthcare costs.

Specific Research Topics

A. Advance Care Planning

• Implementing systematic advance care planning protocols
• Developing conversation tools for discussing end-of-life preferences
• Training healthcare providers in advance care planning skills
• Examining factors influencing advance directive completion
• Creating culturally appropriate advance care planning materials

B. Palliative Care Integration

• Implementing palliative care screening protocols
• Developing primary palliative care training programs
• Creating protocols for symptom management in serious illness
• Examining the effectiveness of community-based palliative care programs
• Developing family-centered palliative care interventions

C. Comfort Care and Symptom Management

• Developing protocols for managing pain in older adults
• Creating non-pharmacological symptom management interventions
• Examining the effectiveness of comfort care protocols in long-term care
• Developing protocols for managing breathlessness, nausea, and other common symptoms

Advanced Methodological Considerations

Implementation Science in Geriatric Care

Implementation science provides crucial frameworks for translating research evidence into practice. Key implementation science models relevant to geriatric care research include:

1. Consolidated Framework for Implementation Research (CFIR): Useful for examining factors that influence implementation success across different care settings.

2. RE-AIM Framework: Particularly valuable for evaluating the reach, effectiveness, adoption, implementation, and maintenance of geriatric care interventions.

3. Proctor Implementation Outcomes Framework: Helpful for measuring implementation success through acceptability, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability.

Mixed-Methods Approaches

Given the complexity of geriatric care, mixed-methods research designs are often particularly valuable, allowing researchers to:

• Quantify intervention effects while capturing rich qualitative experiences
• Understand both individual and systems-level factors influencing outcomes
• Examine intervention processes alongside outcomes
• Capture diverse stakeholder perspectives (patients, families, providers, administrators)

Quality Improvement Methodologies

Quality improvement approaches are central to DNP research and particularly relevant to geriatric care:

1. Plan-Do-Study-Act (PDSA) Cycles: Ideal for testing small-scale changes before full implementation.

2. Lean Methodology: Useful for eliminating waste and improving efficiency in geriatric care processes.

3. Six Sigma: Applicable for reducing variation and defects in care delivery.

4. Model for Improvement: Provides a framework for testing changes that lead to improvement.

Ethical Considerations in Geriatric Research

Research with older adult populations requires special attention to ethical considerations:

1. Capacity and Consent: Ensuring participants have the capacity to consent and developing appropriate processes for those with cognitive impairment.

2. Vulnerability: Recognizing that older adults may be vulnerable due to illness, dependency, or institutional residence.

3. Risk-Benefit Assessment: Carefully weighing potential risks and benefits, particularly for frail older adults.

4. Cultural Sensitivity: Considering cultural factors that may influence participation and intervention acceptance.

5. Family Involvement: Navigating complex dynamics when family members are involved in care decisions.

Practical Implementation Strategies

Stakeholder Engagement

Successful geriatric care research requires engagement of multiple stakeholders:

1. Older Adults and Families: Incorporating patient and family perspectives from project conception through dissemination.

2. Healthcare Providers: Engaging physicians, nurses, pharmacists, social workers, and other team members.

3. Healthcare Administrators: Securing organizational support and resources for implementation.

4. Community Organizations: Partnering with aging services organizations, senior centers, and advocacy groups.

5. Policymakers: Engaging with local, state, and federal policymakers who influence geriatric care.

Sustainability Planning

DNP projects must consider long-term sustainability:

1. Financial Sustainability: Examining costs and potential cost savings of interventions.

2. Organizational Sustainability: Ensuring interventions can be maintained within existing organizational structures.

3. Clinical Sustainability: Developing interventions that can be realistically implemented in routine clinical practice.

4. Policy Sustainability: Considering how policy changes might support or hinder intervention continuation.

Measurement and Evaluation

Comprehensive evaluation is essential for DNP projects:

1. Process Measures: Examining intervention implementation, reach, and fidelity.

2. Outcome Measures: Assessing clinical outcomes, quality of life, functional status, and patient satisfaction.

3. Balancing Measures: Monitoring for unintended consequences of interventions.

4. Cost Measures: Examining intervention costs and potential cost savings.

Emerging Trends and Future Directions

Artificial Intelligence and Machine Learning

AI and ML present exciting opportunities for geriatric care:

• Predictive modeling for fall risk, delirium, or readmission risk
• Natural language processing for identifying geriatric syndromes in clinical documentation
• Machine learning algorithms for medication optimization
• AI-powered cognitive assessment tools

Social Determinants of Health

Growing recognition of social determinants’ impact on aging:

• Housing stability and modification programs
• Food security interventions for older adults
• Transportation assistance programs
• Income support and benefits optimization

Climate Change and Aging

Climate change disproportionately affects older adults:

• Heat illness prevention programs
• Disaster preparedness for older adults
• Air quality interventions
• Climate-resilient aging communities

Diversity, Equity, Inclusion, and Justice (DEIJ)

Addressing health disparities in aging:

• Culturally appropriate interventions for diverse older adult populations
• Language accessibility in geriatric care
• Addressing structural racism in aging services
• LGBTQ+ affirming care for older adults

Global Aging

International perspectives on aging:

• Comparing geriatric care models across countries
• Examining cultural factors in aging experiences
• Developing interventions for aging immigrant populations
• Learning from countries with advanced aging populations

Funding Opportunities

Federal Funding Sources

• National Institute on Aging (NIA)
• Agency for Healthcare Research and Quality (AHRQ)
• Patient-Centered Outcomes Research Institute (PCORI)
• Health Resources and Services Administration (HRSA)

Foundation and Private Funding

• John A. Hartford Foundation
• Robert Wood Johnson Foundation
• Commonwealth Fund
• Fan Fox and Leslie R. Samuels Foundation

Professional Organization Funding

• American Nurses Association
• Gerontological Society of America
• American Geriatrics Society
• Sigma Theta Tau International

Dissemination and Impact

Publication Strategies

• Peer-reviewed journals (Journal of the American Geriatrics Society, Gerontologist, etc.)
• Practice-focused publications
• Policy briefs and white papers
• Professional organization communications

Conference Presentations

• American Geriatrics Society Annual Meeting
• Gerontological Society of America Annual Meeting
• American Nurses Association conferences
• Quality improvement and patient safety conferences

Policy Impact

• Testimony at legislative hearings
• Participation in professional organization policy committees
• Collaboration with advocacy organizations
• Development of practice guidelines and standards

Media Engagement

• Popular press articles
• Social media engagement
• Podcast appearances
• Community presentations

The field of geriatric care offers DNP students unprecedented opportunities to conduct meaningful research that directly impacts the lives of older adults. The complexity and urgency of challenges facing aging populations require innovative, evidence-based solutions that DNP-prepared nurses are uniquely qualified to develop and implement.

Success in geriatric care research requires careful attention to methodological rigor, stakeholder engagement, ethical considerations, and sustainability planning. The multifaceted nature of aging necessitates interdisciplinary collaboration and systems-thinking approaches that address not only clinical care but also social, environmental, and policy factors that influence aging experiences.

As the population continues to age and healthcare systems adapt to serve growing numbers of older adults, the research conducted by DNP students today will shape the future of geriatric care. By focusing on practice-relevant questions and implementing evidence-based solutions, these future healthcare leaders have the opportunity to significantly improve the quality of life for older adults while contributing to the development of age-friendly healthcare systems.

The topics outlined in this guide represent just a fraction of the research opportunities available in geriatric care. DNP students should consider their own clinical interests, community needs, and available resources when selecting specific research focuses. Regardless of the specific topic chosen, geriatric care research offers the potential for meaningful impact on one of healthcare’s most vulnerable and rapidly growing populations.

Through rigorous research, thoughtful implementation, and sustained commitment to improvement, DNP graduates can play a crucial role in creating healthcare systems that not only serve older adults effectively but help them thrive throughout the aging process. The future of geriatric care depends on the innovative research and practice improvements that today’s DNP students will develop and implement.