PURPOSE: To evaluate the effectiveness of a 6-week holistic sexuality education program in enhancing sexual knowledge, positive attitudes, and self-efficacy among older adults. METHOD: The current study used a mixed meth...PURPOSE: To evaluate the effectiveness of a 6-week holistic sexuality education program in enhancing sexual knowledge, positive attitudes, and self-efficacy among older adults. METHOD: The current study used a mixed methods, pre-/postintervention design (quantitative) supplemented with postintervention focus groups (qualitative). Twenty-three participants aged ≥50 years attended one of three sexuality education courses. Participants completed the Aging Sexual Knowledge and Attitudes Scale and Sexual Self-Perception and Adjustment Questionnaire before and after the interventions. RESULTS: Post-course results revealed improved sexual knowledge, and positively reinforced sexual self-efficacy. Holistic sexuality education also demonstrated post-course results of significantly decreased anxiety related to sexual communication, issues, and overall sexual health. CONCLUSION: Findings support the value of structured, age-inclusive sexual health education in promoting confidence, communication, and overall well-being in later life.
PURPOSE: Alzheimer's disease and related dementias often remain undiagnosed in home health care, where early symptoms are rarely documented in electronic health records (EHRs). The current study aimed to develop and eval...PURPOSE: Alzheimer's disease and related dementias often remain undiagnosed in home health care, where early symptoms are rarely documented in electronic health records (EHRs). The current study aimed to develop and evaluate a speech-based screening algorithm for detecting mild cognitive impairment (MCI) using routine follow-up calls. METHOD: Speech data were collected from brief, semi-structured follow-up calls between nurse assistants and patients, Clinical Dementia Rating (CDR) interviews, and structured EHR data (Outcome and Assessment Information Set [OASIS]). Machine learning models were trained on these modalities individually and in combination. Model performance was evaluated using the area under the curve (AUC) of the receiver operating characteristic and secondary metrics. RESULTS: Among 114 participants, the multimodal model combining follow-up call speech and OASIS variables achieved the best performance (AUC = 91.03), outperforming models based on CDR interviews (AUC = 80.67), follow-up calls alone (AUC = 81.09), and OASIS alone (AUC = 78.53). Patients with MCI showed greater comorbidity burden, higher rates of dual eligibility, and lower health literacy compared with cognitively healthy participants. CONCLUSION: Speech collected from routine follow-up calls, when combined with structured clinical data, can enhance early detection of MCI in home health care. This multimodal, low-burden approach leverages existing care coordination workflows and holds promise for scalable cognitive screening in diverse, aging populations.
PURPOSE: The Institute for Healthcare Improvement developed the 4Ms Framework-What Matters, Medication, Mentation, and Mobility-to enhance age-friendly, person-centered care. At one medical center, nurses ask inpatients...PURPOSE: The Institute for Healthcare Improvement developed the 4Ms Framework-What Matters, Medication, Mentation, and Mobility-to enhance age-friendly, person-centered care. At one medical center, nurses ask inpatients daily, "What is most important to you?" to align care with patient priorities and the "What Matters" component of the 4Ms. Thus, the current study aimed to identify patterns and recurring themes across age groups and departments. METHOD: The current study analyzed >11,000 responses from geriatric inpatients using unsupervised clustering and topological data analysis. RESULTS: Four key themes emerged: , , , and of . CONCLUSION: Understanding these priorities can help provide more responsive and tailored care. Integrating these themes into system-level pathways and consult triggers may strengthen alignment with the 4Ms.
PURPOSE: To evaluate the effects of a 6-week cognitive-behavioral therapy for insomnia (CBT-I) intervention delivered via a WeChat Mini Program on sleep quality and cognitive function among older adults with mild cogniti...PURPOSE: To evaluate the effects of a 6-week cognitive-behavioral therapy for insomnia (CBT-I) intervention delivered via a WeChat Mini Program on sleep quality and cognitive function among older adults with mild cognitive impairment (MCI) and insomnia. METHOD: Sixty older adults were recruited from February 2023 to June 2023, 30 older adults in the experimental group received a 6-week intervention based on the WeChat Mini Program, whereas those in the control group received 6 weeks of online sleep health education. Primary outcomes included sleep quality and cognitive function, and secondary outcomes were sleep hygiene, anxiety, and self-efficacy. RESULTS: Significant improvements were observed in sleep quality, cognitive function, sleep hygiene, anxiety, and self-efficacy in the experimental group compared to the control group ( < .05). In addition, findings showed significant enhancements in these areas before and after the intervention within the experimental group ( < .05). CONCLUSION: Results indicate that the WeChat Mini Program-based CBT-I intervention effectively improved sleep quality and cognitive function, enhanced knowledge and habits related to sleep hygiene, increased self-efficacy, and reduced anxiety in older adults with MCI and insomnia.
PURPOSE: To evaluate the feasibility and preliminary outcomes of Age-Friendly Integrative Mobile Services (AIMS), a community-based model guided by the 4Ms Framework to address complex needs of underserved older adults a...PURPOSE: To evaluate the feasibility and preliminary outcomes of Age-Friendly Integrative Mobile Services (AIMS), a community-based model guided by the 4Ms Framework to address complex needs of underserved older adults aging in place. METHOD: This longitudinal pilot enrolled adults aged ≥65 years who received in-home assessments, a mobile health unit visit, and follow-up encounters at 1 and 3 months. Nurse practitioner-pharmacist collaboration supported medication reviews and personalized care planning. RESULTS: Seven participants enrolled (mean age = 70 years). Frequent needs included transportation, home modifications, food insecurity, and legal aid. Three participants showed possible cognitive impairment and four were at risk for falls. All received social prescriptions aligned with goals. Interprofessional collaboration resulted in deprescribing and tailored education to improve adherence. Follow up showed increased engagement with services. CONCLUSION: The AIMS pilot demonstrated feasibility and acceptability of a nurse-led, person-centered model. Community-based, age-friendly care may address disparities and promote safe aging in place.
PURPOSE: To describe a systematic process for developing an art making intervention, guided by a previously developed theoretical framework outlining its proposed mechanism of action as a potential pain management strate...PURPOSE: To describe a systematic process for developing an art making intervention, guided by a previously developed theoretical framework outlining its proposed mechanism of action as a potential pain management strategy for older adults. METHOD: A multi-method approach that combined a descriptive qualitative study and survey methodology was used. Initially, a qualitative study with 11 older adults experiencing various chronic pain conditions provided insights into their perspectives on the preliminary intervention. Participants described the intervention, which included drawing, painting, and craft activities, as generally appropriate but in need of revisions to instructional details and difficulty levels. Based on this feedback, we created six independent intervention books featuring activities at three levels of difficulty. A quantitative survey was conducted with five content experts and three experiential experts to collect formative evaluations of the revised intervention. RESULTS: The eight experts rated the revised intervention highly overall but recommended improving the organization of the written and visual instructions and ensuring the use of age-appropriate language. The final intervention offers 20 art making activities delivered in a home-based, individual format using an art making activity book and YouTube channel. CONCLUSION: By using a multi-method design, we tailored the intervention to the unique needs of older adults while grounding it in our theoretical framework describing its proposed mechanism of action for chronic pain management. Future studies are needed to rigorously test our hypotheses and evaluate the intervention's efficacy in reducing pain intensity among older adults.
PURPOSE: Private duty nurses and professional caregivers providing nonmedical home care play an important role in supporting older adults, yet they are often underrecognized in Age-Friendly Health System strategies. As t...PURPOSE: Private duty nurses and professional caregivers providing nonmedical home care play an important role in supporting older adults, yet they are often underrecognized in Age-Friendly Health System strategies. As the age-friendly care movement grows, there is an opportunity to better integrate these professionals as partners in supporting safe transitions, reducing hospitalizations, and delivering person-centered care aligned with the 4Ms Framework. METHOD: Data were drawn from structured assessments completed in 2024 and client/family narratives collected with informed consent. All analyses were descriptive; data were aggregated and de-identified in compliance with HIPAA. RESULTS: Older adults receiving nonmedical home care demonstrated improvements in management of chronic medical conditions, daily activities, mobility, nutrition, and participation in meaningful routines. CONCLUSION: Nonmedical home care extends the 4Ms Framework into the home, enhancing independence and safety. Although findings are preliminary, they suggest consistent in-home support may reduce risks for decline and better align care with what matters most to older adults.
PURPOSE: To describe older adults' lived experience with a chronic wound in a long-term care (LTC) facility, with the ultimate goal of enhancing well-being and overall quality of life (QoL). METHOD: A descriptive phenome...PURPOSE: To describe older adults' lived experience with a chronic wound in a long-term care (LTC) facility, with the ultimate goal of enhancing well-being and overall quality of life (QoL). METHOD: A descriptive phenomenological design guided by Colaizzi's method was used. Seven cognitively intact LTC residents with chronic wounds were interviewed using a semi-structured guide. Interviews were analyzed inductively through multiple coding cycles, consensus-building, and member checking. RESULTS: Four interrelated themes were constructed: , , , and . Participants described physical and emotional burdens, a reliance on staff, and disruptions to routines and relationships. Despite challenges, most expressed appreciation for the wound care received in the facility. CONCLUSION: Chronic wounds deeply affect quality of life and identity. Clinicians should recognize the emotional and social dimensions of wound care. Results can help guide clinicians in LTC facilities to improve residents' wound healing and promote overall QoL.
PURPOSE: To explore family care partners' (FCPs) experiences with delirium superimposed on dementia (DSD) and identify their needs and preferences for education, support, and resources. METHOD: A qualitative descriptive...PURPOSE: To explore family care partners' (FCPs) experiences with delirium superimposed on dementia (DSD) and identify their needs and preferences for education, support, and resources. METHOD: A qualitative descriptive design was used. Data from 16 FCPs were collected using demographic surveys and semi-structured interviews, which were conducted via telephone and/or Zoom video conference. Thematic analysis identified key patterns and themes. RESULTS: Five key themes were identified: (1) ; (2) ; (3) ; (4) ; and (5) . CONCLUSION: Findings emphasize the need to educate and support FCPs through clinician-led training and community resources to improve caregiving confidence, effectiveness, and dyadic well-being.
PURPOSE: To map existing literature to understand the impact of mobile health (mHealth) interventions on older adult patients' self-efficacy in adhering to prescribed treatment plans for heart failure (HF). METHOD: The c...PURPOSE: To map existing literature to understand the impact of mobile health (mHealth) interventions on older adult patients' self-efficacy in adhering to prescribed treatment plans for heart failure (HF). METHOD: The current scoping review examined peer-reviewed studies identified in PubMed, CINAHL, and SCOPUS, with data screening and extraction conducted independently by two reviewers to ensure accuracy and minimize bias. RESULTS: The search yielded 731 articles, of which 16 were included in the final review. After examining all studies, three key themes were examined in detail: , , and . CONCLUSION: mHealth apps have shown promising effects on medication and treatment adherence in patients with HF. However, modifications addressing the specific needs of older populations are necessary to effectively implement these tools. Comprehensive feasibility trials on a larger scale are essential for fully understanding the potential effectiveness and implementation requirements of these interventions.
PURPOSE: Iron deficiency (ID) is common in older adults and is associated with adverse clinical outcomes. Oral iron is often limited by poor absorption and gastrointestinal intolerance. The current article reviews consid...PURPOSE: Iron deficiency (ID) is common in older adults and is associated with adverse clinical outcomes. Oral iron is often limited by poor absorption and gastrointestinal intolerance. The current article reviews considerations for intravenous (IV) iron therapy in older adults with ID. METHOD: To review IV iron efficacy, safety, and practical use in older adults. RESULTS: IV iron effectively restores iron stores; improves hemoglobin, functional status, and quality of life; and reduces transfusion requirements. Comorbidities, such as chronic kidney disease, heart failure, and gastrointestinal disorders, frequently necessitate IV iron therapy. Risks include allergic reactions, infusion reactions, hypophosphatemia, and transient hypotension, although serious adverse events are rare. Therapy should be individualized based on comorbidities and practical considerations. CONCLUSION: IV iron is a safe and effective option for older adults, offering reliable and rapid repletion when oral iron is ineffective or contraindicated. Clinicians must weigh benefits and risks to optimize outcomes.
J Gerontol Nurs
· 2026 Feb · PMID 41252730
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Full text
Older adults hospitalized in an intensive care unit (ICU) frequently experience adverse outcomes, including delirium, functional decline, medication-related harm, and goal-discordant care. Despite the availability of evi...Older adults hospitalized in an intensive care unit (ICU) frequently experience adverse outcomes, including delirium, functional decline, medication-related harm, and goal-discordant care. Despite the availability of evidence-based interventions to address these risks, adoption and sustained implementation remain limited. The Age-Friendly Health Systems 4Ms Framework offers a policy-aligned structure for advancing adoption and sustainability of gerontological nursing interventions in the ICU. The Centers for Medicare & Medicaid Services announcement of the 2025 Age-Friendly Hospital Measure marks a turning point: hospitals will be incentivized to deliver care integrated with the 4Ms (What Matters, Medication, Mentation, and Mobility) to older adults. The introduction of this new measure presents a timely opportunity to align innovative gerontological nursing interventions with institutional quality goals. Grounding interventions in the 4Ms will facilitate engagement with key stakeholders, including frontline health care providers and hospital leadership, who are essential to the adoption and sustainability of age-friendly critical care for older adult patients in the ICU.
PURPOSE: To examine whether psychotropic medications (antipsychotics, sedatives, antiseizures, antidepressants, and anxiolytics) and opioids were associated with physical function in hospitalized older adults with dement...PURPOSE: To examine whether psychotropic medications (antipsychotics, sedatives, antiseizures, antidepressants, and anxiolytics) and opioids were associated with physical function in hospitalized older adults with dementia. METHOD: A secondary analysis was conducted using baseline data from the Function Focused Care for Acute Care Using the Evidence Integration Triangle randomized controlled trial ( = 368). It was hypothesized that when controlling for age, sex, race, comorbidities, cognitive function, and pain, use of psychotropic medications and opioids would be negatively associated with physical function. RESULTS: Overall, 72.5% ( = 230) of participants used psychotropic medications and 18.8% ( = 69) used opioids. Neither was associated with physical function. However, comorbidities, cognition, and pain significantly influenced function, with fewer comorbidities, better cognition, and less pain linked to greater independence. CONCLUSION: Findings support prior research showing lack of association between psychotropic medication and opioid use with physical function in hospitalized older adults with dementia; however, additional research may be necessary to investigate the importance of pain control in optimizing function in older adults with dementia.
PURPOSE: Social support networks are essential for maintaining quality of life among older adults, particularly in nursing homes where loneliness and isolation are common. The current study analyzed the perceived impact...PURPOSE: Social support networks are essential for maintaining quality of life among older adults, particularly in nursing homes where loneliness and isolation are common. The current study analyzed the perceived impact of formal and informal social support networks on emotional well-being and evaluated recreational activities as factors promoting social connections among older adult residents in Spain. METHOD: A qualitative study was conducted using semi-structured interviews with seven nursing home residents. Data were analyzed thematically to identify key aspects of social support and well-being. RESULTS: Participants highlighted the importance of family visits, peer relationships, and nursing staff support in enhancing emotional well-being. Although many reported satisfaction with their social environment, some expressed a need for more diverse recreational activities to foster social interaction. Maintaining external connections was also deemed essential. CONCLUSION: Strengthening social support networks and increasing opportunities for meaningful social engagement can significantly improve the emotional well-being of older adults residing in long-term care facilities.
PURPOSE: To evaluate the effectiveness of an information-motivation-behavioral skills (IMB) model-based sarcopenia prevention program. METHOD: A quasi-experimental study was conducted with 50 older adults from senior cen...PURPOSE: To evaluate the effectiveness of an information-motivation-behavioral skills (IMB) model-based sarcopenia prevention program. METHOD: A quasi-experimental study was conducted with 50 older adults from senior centers in South Korea, divided into experimental ( = 25) and control ( = 25) groups. The 12-session intervention program spanned 6 weeks, comprising structured physical activity exercises, nutritional education focusing on protein and vitamin D intake, and motivational strategies aimed at sustaining behavior change. Data were analyzed, applying logistic regression, tests, and Mann-Whitney U tests for group comparisons. RESULTS: The experimental group showed significant improvements in physical performance (odds ratio [OR] = 2.37, 95% confidence interval [1.42, 107.74], = .002) and sarcopenia-related quality of life ( = 8.02, < .001). However, no significant changes in muscle mass (OR = 3.12, = 1.000) or muscle strength (OR = 2.00, = .153) were observed. CONCLUSION: The IMB model-based program improved physical performance and quality of life in older adults, making it a viable nursing intervention for sarcopenia prevention. Further studies should explore long-term adherence and intervention effectiveness over extended periods.
PURPOSE: To implement an Age-Friendly Health System (AFHS) in a Veterans Health Administration nursing home using shared decision-making and goal-concordant care, achieve Institute for Healthcare Improvement recognition,...PURPOSE: To implement an Age-Friendly Health System (AFHS) in a Veterans Health Administration nursing home using shared decision-making and goal-concordant care, achieve Institute for Healthcare Improvement recognition, and assess patient perceptions of care. METHOD: This pilot study took place over 3 months and included 35 patients aged ≥65 years. Pre- and post-implementation chart reviews assessed documentation of the 4Ms (What Matters, Medication, Mentation, Mobility). After implementation, 12 patients completed the collaboRATE survey to evaluate shared decision-making and goal-concordant care. RESULTS: Documentation of all 4Ms improved. The collaboRATE top score was 83%, with a mean score of 3.94 of 4, indicating high levels of perceived shared decision-making. CONCLUSION: Implementing the AFHS 4Ms Framework in a nursing home setting is feasible and supports high-quality, person-centered care. Results suggest strong alignment with the 4Ms and what matters most to older adults.
PURPOSE: To describe how a Mobility Dashboard was created to aggregate patient mobility metrics monthly by unit to empower bedside teams to implement and measure mobility-related quality improvement (QI) activities as pa...PURPOSE: To describe how a Mobility Dashboard was created to aggregate patient mobility metrics monthly by unit to empower bedside teams to implement and measure mobility-related quality improvement (QI) activities as part of an Age-Friendly Health System (AFHS). METHOD: A multidisciplinary team improved existing electronic health record documentation to facilitate count of mobility events and created a framework for mobility measurement. Through partnering with IT Analytics, the dashboard was built and made accessible to interdisciplinary teams to facilitate future QI efforts. RESULTS: Implementation of the dashboard yielded quantifiable mobility data for all system hospitals to achieve AFHS recognition. The dashboard facilitates nursing QI initiatives. Two projects are described yielding increased mobility, reduction in length of stay, falls, and discharges to inpatient rehabilitation facilities with hospital-wide dissemination. CONCLUSION: Focus on mobility in an AFHS and enhanced access to accurate mobility data encourages nursing QI efforts and leads to measurable and improved patient outcomes.