PURPOSE: The current meta-analysis aimed to evaluate the effectiveness of nonpharmacological interventions in preventing delirium among older adult surgical patients. METHOD: Randomized controlled trials (RCTs) examining...PURPOSE: The current meta-analysis aimed to evaluate the effectiveness of nonpharmacological interventions in preventing delirium among older adult surgical patients. METHOD: Randomized controlled trials (RCTs) examining nonpharmacological approaches were selected. A meta-analysis was performed using random-effect models to calculate standard mean differences and 95% confidence intervals (CI). FINDINGS: Twelve RCTs ( = 3,829) met inclusion criteria. Nonpharmacological interventions significantly reduced delirium incidence (OR [odds ratio] = 0.57, 95% CI [0.49, 0.66]). Multicomponent (OR = 0.6, 95% CI [0.49, 0.75]) and single-component (OR = 0.53, 95% CI [0.42, 0.66]) interventions were effective. Network meta-analysis revealed that the multicomponent intervention "Family HELP" demonstrated significant superiority over four other interventions (OR = 0.11, 95% CI [0.04, 0.33]; p-score = 0.911). CONCLUSION: Nonpharmacological interventions were found to effectively prevent delirium among older adult surgical patients, with the Family HELP intervention being the most effective. These interventions should be integrated into nursing care guidelines to enhance patient-centered care and experience.
PURPOSE: Challenging behaviors of residents with dementia represent a major concern in nursing homes (NHs). Although various studies have investigated the effects of staff training in challenging behavior management, few...PURPOSE: Challenging behaviors of residents with dementia represent a major concern in nursing homes (NHs). Although various studies have investigated the effects of staff training in challenging behavior management, few have explored their impact on laypeople's perceptions. However, NH professionals routinely interact with laypeople, such as current and prospective residents and their families, volunteers, and community partners. The current study examined the effect of person-centered staff training on naïve individuals' perceptions of staff competence. METHOD: Twenty-two NH professionals completed person-centered care training in challenging behavior management and responded to a clinical vignette before and after training. Their responses were evaluated by 59 naïve assessors for relevance, confidence, and competence. In addition, two trained assessors were recruited to explore whether their informed evaluations corroborated naïve assessors' impressions. RESULTS: Relevance, confidence, and competence improved significantly according to naïve and trained assessors. NH professionals also reported feeling more competent. CONCLUSION: Multiple measures indicate improved staff performance following training. Future studies should examine how laypeople's perceptions of staff competence influence their experiences in NHs and impact NH attractiveness.
J Gerontol Nurs
· 2025 Sep · PMID 40608423
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PURPOSE: Chronic dysregulated sleep is associated with increased fall risk in older adults, especially in low-income communities. However, little is known about the effects of acute dysregulated sleep. METHOD: In the cur...PURPOSE: Chronic dysregulated sleep is associated with increased fall risk in older adults, especially in low-income communities. However, little is known about the effects of acute dysregulated sleep. METHOD: In the current study, we report sleep characteristics the night (Nightx), week, and month prior to a reported fall in two low-income African American older women from Orlando, Florida. RESULTS: Light, deep, rapid eye movement, wake, and total sleep duration between the 7 and 30 days preceding a reported fall were similar for both participants. However, participants had notable differences in all sleep stages, wake time after sleep, and total sleep duration when comparing Nightx to their average sleep 7 and 30 days prior. Participant A had relatively consistent sleep times, whereas Participant B did not, whose lowest total sleep time was Nightx. CONCLUSION: An acute bout of atypical sleep may increase fall risk among low-income older women, but more research is needed to support this theory.
PURPOSE: Digital technologies and artificial intelligence (AI) offer valuable opportunities to improve patient care, but older adults face unique challenges in adopting these innovations. The current study sought to expl...PURPOSE: Digital technologies and artificial intelligence (AI) offer valuable opportunities to improve patient care, but older adults face unique challenges in adopting these innovations. The current study sought to explore the experiences of older adults with digital health technologies to inform more inclusive, accessible solutions. METHOD: Ten semi-structured interviews were conducted with participants aged ≥65 years from Family Health Centers affiliated with Dokuz Eylül University, Izmir, Turkey. Data were analyzed using phenomenological thematic analysis. RESULTS: Five themes emerged: (1) ; (2) ; (3) ; (4) ; and (5) . Participants were open to adopting digital health tools but faced barriers, such as cognitive limitations, lack of tailored education, and trust issues. Family support was key in facilitating adoption. Privacy and ethical concerns about AI influenced engagement. CONCLUSION: Addressing usability, trust, and ethical issues is essential to making technology accessible and beneficial for older adults.
J Gerontol Nurs
· 2025 Sep · PMID 40608421
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PURPOSE: To explore the transitional experiences of internationally educated nurses (IENs) in U.S. long-term care (LTC) settings, focusing on their preparedness to provide care for older adults and the perceived quality...PURPOSE: To explore the transitional experiences of internationally educated nurses (IENs) in U.S. long-term care (LTC) settings, focusing on their preparedness to provide care for older adults and the perceived quality of professional development opportunities. METHOD: A qualitative descriptive methodology was used with 22 IENs from eight countries participating in semi-structured interviews. Braun and Clarke's thematic analysis framework integrated inductive and deductive approaches. RESULTS: Two key themes emerged from the analysis- and . IENs with prior gerontological care experience felt more prepared for LTC roles. Professional development opportunities varied significantly, with many participants citing inadequate ongoing training. Findings suggest that a comprehensive clinical orientation program and ongoing professional development opportunities are essential for IENs to succeed in LTC facilities. CONCLUSION: Findings underscore the importance of comprehensive orientation and structured, continuous professional development tailored to IENs' needs. Enhanced support systems could improve IEN integration, care quality, and workforce retention in U.S. LTC settings.
PURPOSE: Social isolation poses significant risks to older adults' well-being, yet the mechanisms driving their demographic differences remain unclear. The current study investigated whether social participation mediates...PURPOSE: Social isolation poses significant risks to older adults' well-being, yet the mechanisms driving their demographic differences remain unclear. The current study investigated whether social participation mediates the relationship among social isolation, gender, and marital status among retirees. METHOD: A secondary analysis of AARP survey data ( = 6,664) was conducted. Mediation analyses examined the indirect effects of gender and marital status on social isolation through social participation. Participants were predominantly adults aged ≥50 years with low to moderate income. RESULTS: Women and married individuals showed higher social participation and lower social isolation. There was a significant direct effect of being female and being married on social isolation, and also a significant indirect effect through social participation. CONCLUSION: Interventions should consider diverse vulnerable groups. Although unmarried men may benefit from tailored social programs, broader strategies, inclusive of gender and marital status dynamics, are essential. Tailored programs targeting unmarried men could foster social participation, thereby reducing social isolation and promoting healthy aging.
PURPOSE: eHealth literacy is crucial for immigrant Korean American older adults to effectively access online mental health information and manage their mental health within the health care system. The current study aimed...PURPOSE: eHealth literacy is crucial for immigrant Korean American older adults to effectively access online mental health information and manage their mental health within the health care system. The current study aimed to investigate mental health issues, levels of eHealth literacy, and the impact of eHealth literacy on mental health among Korean American older adults. METHOD: Data were collected from Korean American adults aged ≥50 years through a survey that included the eHealth Literacy Scale and Depression, Anxiety and Stress Scale. Collected data were analyzed using descriptive statistics and regression analysis. RESULTS: Korean American older adults demonstrated lack of skills in assessing the quality of online health resources. Higher levels of eHealth literacy were significantly associated with lower levels of stress, anxiety, and depression. CONCLUSION: Findings indicate that strategies should be developed to address the specific needs and challenges of Korean American older adults, particularly for those with limited skills in using online mental health information when making health-related decisions.
PURPOSE: To examine associations between internet use behaviors, network information literacy, and trust in doctors across age groups, and to test the mediating role of subjective well-being (SWB). METHOD: Multiple linea...PURPOSE: To examine associations between internet use behaviors, network information literacy, and trust in doctors across age groups, and to test the mediating role of subjective well-being (SWB). METHOD: Multiple linear regression was used to test associations between internet use behaviors, network information literacy, and trust in doctors. The mediation effect of SWB was tested with the Karlson-Holm-Breen method. RESULTS: Internet use, particularly via mobile devices, decreased trust in doctors among older adults (coef. = -0.272, = 0.003) and increased trust among young adults (coef. = 0.122, = 0.011). However, among mobile device users, improved network information literacy significantly enhanced trust in doctors for both age groups. CONCLUSION: Findings highlight age-specific mechanisms linking internet use to trust in doctors, emphasizing the mediating role of SWB and protective effect of network information literacy.
PURPOSE: Xanomeline/trospium, a combination of a mixed muscarinic agonist/peripheral antagonist, is a novel treatment for schizophrenia that does not antagonize dopamine receptors. Given its unique pharmacology on the ch...PURPOSE: Xanomeline/trospium, a combination of a mixed muscarinic agonist/peripheral antagonist, is a novel treatment for schizophrenia that does not antagonize dopamine receptors. Given its unique pharmacology on the cholinergic system, special considerations may apply for older adults. METHOD: The current article reviews the evidence of xanomeline/trospium in older adults as well as implications and considerations for use in practice. RESULTS: The evidence of using xanomeline/trospium is largely derived from the phase-3 EMERGENT clinical trial program, which investigated safety and efficacy in adults aged 18 to 65 years with schizophrenia. Significant reduction in psychosis was demonstrated; however, gastrointestinal effects were common. CONCLUSION: Xanomeline/trospium is a novel treatment for schizophrenia that lacks many of the adverse effects associated with dopamine receptor blockers. Although the package insert provides guidance for use in older adults, patients aged >65 years were excluded from EMERGENT trials. Continued research is necessary to define the safety and place in therapy for older adults. [(6), 7-12.].
PURPOSE: Sleep quality is crucial for older adults, yet many experience poor sleep due to physical, mental, and social factors. The current study addresses the research gap on sleep quality among Korean American older ad...PURPOSE: Sleep quality is crucial for older adults, yet many experience poor sleep due to physical, mental, and social factors. The current study addresses the research gap on sleep quality among Korean American older adults in senior housing by examining relevant factors. METHOD: Using data from 314 Korean American residents in Los Angeles senior housing, we conducted descriptive analysis and logistic regression models. RESULTS: Poor sleep was significantly associated with poor physical health (odds ratio [OR] = 4.89), low energy (OR = 7.92), severe pain (OR = 14.92), multiple chronic conditions (OR = 2.71), and poor mental health (OR = 5.82), including moderate to severe anxiety (OR = 4.71) and depression (OR = 5.11). CONCLUSION: Findings emphasize the unique sleep needs of Korean American older adults in senior housing and provide insights to improve their well-being. The study also highlights the need for further research using longitudinal designs, broader samples, and comprehensive sleep measures.
PURPOSE: To develop clinical guidelines on managing wandering in hospitalized persons with dementia (PwD). METHOD: The PICO framework and a scoping literature review were used for guideline development. Expert consensus...PURPOSE: To develop clinical guidelines on managing wandering in hospitalized persons with dementia (PwD). METHOD: The PICO framework and a scoping literature review were used for guideline development. Expert consensus was established using the Delphi method, followed by external and methodological reviews. The guideline was tested for clinical applicability in hospital wards. RESULTS: The guideline encompasses two topics and 33 recommendations, which were positively rated by external and methodological experts. Among 30 nurses who evaluated its clinical applicability, most recommendations were deemed easy to implement. CONCLUSION: The guideline has the potential to enhance care quality for hospitalized PwD.
PURPOSE: To determine if implementation of a dementia-specific advance care planning (ACP) tool increased knowledge of dementia and decision maker confidence and decreased inappropriate health care utilization rates. MET...PURPOSE: To determine if implementation of a dementia-specific advance care planning (ACP) tool increased knowledge of dementia and decision maker confidence and decreased inappropriate health care utilization rates. METHOD: At a Program for All-Inclusive Care for the Elderly, individuals with a cognitive deficit (CD) and their surrogate decision makers (SDMs) were recruited as dyads in an ACP pilot program using a dementia-specific ACP tool. Knowledge was assessed for both dyad members and confidence regarding their role was assessed for SDMs, repeated at 3 months. RESULTS: Individuals with CD showed no increase in dementia knowledge scores; however, SDMs showed improvement in knowledge and confidence. Health care utilization rates decreased by five visits. CONCLUSION: Findings suggest that the terminality of dementia may be misunderstood. Timely implementation of a dementia-specific ACP may resolve ambiguity, allowing for discussion regarding care preferences. [(7), 43-48.].
PURPOSE: To identify distinct longitudinal trajectories of RNs' intention to stay in nursing homes (NHs) and examine key determinants to inform targeted workforce strategies. METHOD: A total of 163 RNs from 38 Korean NHs...PURPOSE: To identify distinct longitudinal trajectories of RNs' intention to stay in nursing homes (NHs) and examine key determinants to inform targeted workforce strategies. METHOD: A total of 163 RNs from 38 Korean NHs participated in a three-wave longitudinal survey (T1: August 2022; T2: May 2023; T3: February 2024). Latent class growth analysis identified three distinct trajectories: high-high (HH; consistently strong intention), high-low (HL; declining intention), and low-high (LH; improving intention). Individual- and organizational-level variables were measured. RESULTS: Distinct intention-to-stay trajectories revealed significant differences in resilience and retention rates. The LH group exhibited the greatest improvement in resilience and intention to stay, whereas the HL group showed a decline in these variables. Organizational factors, such as higher RN retention rates, were positively associated with stronger intention to stay. CONCLUSION: The current study underscores the importance of individual and organizational factors in shaping RNs' intention to stay in NHs. Strategies to enhance resilience and address systemic staffing challenges are essential for improving workforce stability and care quality. Findings provide actionable insights for policymakers and health care administrators in under-resourced NH environments, particularly in rapidly aging societies, such as South Korea.
PURPOSE: Getting Connected: Experiential Dementia Skills Training, based on the Positive Approach to Care model, was implemented to bridge the gap between knowledge and skills to determine whether nursing students feel m...PURPOSE: Getting Connected: Experiential Dementia Skills Training, based on the Positive Approach to Care model, was implemented to bridge the gap between knowledge and skills to determine whether nursing students feel more comfortable and prepared to care for persons living with dementia (PLWD). METHOD: The study examined the impact of experiential dementia skills training on nursing students' knowledge, comfort, and confidence when interacting with PLWD. The training was conducted at a 4-year pre-licensure, Bachelor of Science Nursing program in rural Southeast United States, where 62 sophomore students completed a 6-hour dementia skills training. Participation in the study was voluntary. Students were given pre- and posttests, with the dementia skills training serving as the intervention. Thirty-two students completed pre- and posttests, measuring knowledge, comfort, and confidence. RESULTS: Findings showed the training enhanced students' knowledge of dementia and communication approaches; however, they did not feel more confident or comfortable interacting with PLWD immediately following the training. CONCLUSION: The Getting Connected: Experiential Dementia Skills Training using the Positive Approach to Care model can be a useful approach for teaching nursing students about the lived experience of dementia and beneficial in helping them acquire knowledge and communication strategies for caring for PLWD. [(7), 21-24.].
PURPOSE: Promotion and maintenance of healthy aging is of utmost importance given the growing number of older adults worldwide. Fluctuation in intrinsic capacity (IC), defined as mental and physical functions, can be ass...PURPOSE: Promotion and maintenance of healthy aging is of utmost importance given the growing number of older adults worldwide. Fluctuation in intrinsic capacity (IC), defined as mental and physical functions, can be assessed objectively with an assigned score to predict health outcomes. The goal of the current review was to identify common measurement tools for IC assessment and evaluate IC scoring approaches. METHOD: Seventeen studies met inclusion criteria for assessing five domains: vitality, locomotion, cognitive, psychological, and sensory. RESULTS: Reviewed studies used diverse instruments with inconsistent scoring approaches. Scoring ranged from simple additive scores to complex item response theory models. CONCLUSION: Establishing consistency in assessment and scoring for IC will ensure usability of scores in clinical practice to promote healthy aging and identify older adults at risk for disability or care dependence. Additional research is needed to establish consensus in standardized scoring, assessment, and measurement of IC. [(7), 25-33.].