PURPOSE: Certified nursing assistants (CNAs) provide indispensable, direct care to residents in long-term care (LTC). When a traumatic event occurs, CNAs may be negatively affected. The purpose of the current qualitative...PURPOSE: Certified nursing assistants (CNAs) provide indispensable, direct care to residents in long-term care (LTC). When a traumatic event occurs, CNAs may be negatively affected. The purpose of the current qualitative pilot study was to explore the experiences of LTC CNAs who have experienced a traumatic event at work. METHOD: Two CNAs participated in semi-structured interviews via Zoom. An exemplar case was developed to describe one participant's story. RESULTS: The exemplar case demonstrated the CNA's genuine concern for LTC residents, lack of support from management, and traumatic events' effects on the CNA. CONCLUSION: This study adds to the body of literature regarding LTC CNAs and provides a foundation for additional research of this population. It is essential that further research be conducted to better understand CNAs' experiences with traumatic events. [(7), 15-20.].
Most people living with dementia (PLWD) live at home with assistance provided by an unpaid family caregiver. Many PLWD require toileting assistance, thus leaving the home is stressful due to lack of public toilets that a...Most people living with dementia (PLWD) live at home with assistance provided by an unpaid family caregiver. Many PLWD require toileting assistance, thus leaving the home is stressful due to lack of public toilets that are accessible by PLWD and their caregivers. Many choose to stay home instead of seeking needed social interaction or schedule their activities around usable public toilet locations, which can leave PLWD and their caregivers feeling isolated, depressed, and excluded. Dementia-friendly toilets, which are unisex, large enough to accommodate assistive devices and a caregiver, and contain simple fixtures/signage, are needed. PLWD and their caregivers deserve to have the same accessibility as others, including enjoyment of leisure activities, which has been shown to improve quality of life and confidence.
PURPOSE: To evaluate whether participation in the Cycling Without Age program is associated with improvements in life satisfaction and mood. METHOD: A 16- to 20-week quasi-experimental single-arm study, using a pre/post...PURPOSE: To evaluate whether participation in the Cycling Without Age program is associated with improvements in life satisfaction and mood. METHOD: A 16- to 20-week quasi-experimental single-arm study, using a pre/post evaluation with a total of 52 participants (median age = 79.5 years) from eight Danish nursing homes, was conducted. Data were obtained prior to and immediately following rides through interview-based questionnaires assessing life satisfaction using the 10-point Cantril Ladder at baseline and follow up, and mood assessments using a 5-point smiley scale. RESULTS: Life satisfaction improved significantly (+0.94, = 0.04) over the study period, especially in men, and those with zero to five trishaw rides. Mood also improved significantly (+1.01, < 0.001) immediately after rides. CONCLUSION: Participation in Cycling Without Age significantly improved mood and enhanced life satisfaction among nursing homes residents. Findings underscore the potential of volunteer-driven trishaw activities for community-based health promotion in nursing homes. [(7), 35-42.].
As the Administration for Community Living (ACL) reaches its 13th year as an organization within the U.S. Department of Health and Human Services, current plans for restructuring will result in its closing. The current a...As the Administration for Community Living (ACL) reaches its 13th year as an organization within the U.S. Department of Health and Human Services, current plans for restructuring will result in its closing. The current article reflects on the policies and programs led by the ACL for more than a decade, promoting the health and independence of older adults and people living with disabilities, including their families and caregivers. A brief overview of exemplars focused on family caregivers, fall prevention, and home- and community-based services highlight the potential impact of the closing of the ACL on vulnerable communities. As a result, a list of growing organizations and advocates, including health care and scientific professional groups, have voiced their concerns for the future without the ACL and limited details regarding the continuation of services and resources. The historic nature of these changes calls for gerontological nurse leaders, clinicians, and researchers to stay informed and engaged in support of the population and communities we serve. [(5), 7-11.].
PURPOSE: To evaluate the effectiveness of self-hydration management interventions for middle-aged and older adults without cognitive impairment. METHOD: A systematic review and meta-analysis was conducted. Studies publis...PURPOSE: To evaluate the effectiveness of self-hydration management interventions for middle-aged and older adults without cognitive impairment. METHOD: A systematic review and meta-analysis was conducted. Studies published from January 2010 to May 2024 were included. A total of 1,065 articles were reviewed, leading to the selection of 20 eligible articles; of these, five were considered suitable for inclusion. RESULTS: The analysis showed a significant increase in total daily fluid intake and urine volume in intervention groups compared to control groups. This improvement demonstrates the effectiveness of various self-hydration management interventions. CONCLUSION: Nurse-led self-hydration management interventions are effective and provide valuable guidance for middle-aged and older adults. [(5), 17-25.].
Scharp D, Song J, Palmer MH
… +2 more, Barcelona V, Topaz M
J Gerontol Nurs
· 2025 Jun · PMID 40273366
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PURPOSE: To determine factors associated with emergency department (ED) visits or hospitalizations among older adults with urinary incontinence (UI) in home health care (HHC). METHOD: We analyzed HHC episode data for adu...PURPOSE: To determine factors associated with emergency department (ED) visits or hospitalizations among older adults with urinary incontinence (UI) in home health care (HHC). METHOD: We analyzed HHC episode data for adults aged ≥65 years with UI. Five clusters were identified a priori using hierarchical clustering of symptoms extracted from clinical notes using natural language processing. Chi-square tests and backward stepwise logistic regression identified cluster, sociodemographic, and clinical variables associated with outcomes. RESULTS: A total of 39,179 HHC episodes reflecting 29,981 patients were included. Episodes in the anxiety, all symptoms, dizziness-anxiety, and constipation-anxiety-dizziness clusters were more likely to result in ED visits/hospitalizations versus the no symptoms cluster. Episodes for Black and Hispanic patients had higher odds of these outcomes than White patients. Episodes for patients with skin ulcers and prior urinary tract infections had higher odds of these outcomes than those without these characteristics. CONCLUSION: Older adults with UI require comprehensive care addressing complex factors contributing to ED visits/hospitalizations. [(6), 38-47.].
Miller ES, Wills CE, Wilson-Lawson KS
… +4 more, Happ MB, Tan A, Monroe TB, Moss KO
J Gerontol Nurs
· 2025 Jun · PMID 40273365
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PURPOSE: To describe the perspectives of lower socioeconomic status (SES) former family caregivers of Black persons living with dementia (PLWD) on advance care planning needs and preferences for their care recipients. ME...PURPOSE: To describe the perspectives of lower socioeconomic status (SES) former family caregivers of Black persons living with dementia (PLWD) on advance care planning needs and preferences for their care recipients. METHOD: Semi-structured interviews were completed with 17 lower SES former family caregivers of Black PLWD. Basic qualitative description was used for these analyses. RESULTS: Four major themes were identified: (1) , (2) , (3) , and (4) . Former family caregivers also expressed a desire to support current caregivers. CONCLUSION: Findings fill a critical gap in the literature by highlighting challenges faced during and after caregiving. Future research should leverage perspectives of former caregivers to assist with improving outcomes for Black caregivers, thereby promoting health equity. [(6), 30-37.].
PURPOSE: To determine the prevalence of frailty among individuals aged ≥65 years with heart failure and/or chronic obstructive pulmonary disease, and if there was a difference in length of stay (LOS) and/or discharge dis...PURPOSE: To determine the prevalence of frailty among individuals aged ≥65 years with heart failure and/or chronic obstructive pulmonary disease, and if there was a difference in length of stay (LOS) and/or discharge disposition in individuals who mobilized daily versus those who did not. METHOD: Thirty-five individuals were screened using the FRAIL Scale. A retrospective chart review was performed for participants with frailty, assessing residential location on admission and discharge, LOS, and daily mobilization during hospitalization. RESULTS: Participants were categorized as robust ( = 1, 2.9%), pre-frail ( = 15, 42.9%), and frail ( = 19, 54.3%). Mean LOS for those who mobilized daily ( = 12) was 2.33 and 4.71 for those who did not mobilize daily ( = 0.028). A lower percentage of participants who mobilized (16.7%) required higher levels of care at discharge versus those who did not mobilize (42.9%, = 0.067). CONCLUSION: Early recognition of frailty may provide opportunities to implement mobility programs to decrease LOS and ensure these individuals remain at functional baseline. [(6), 13-16.].
PURPOSE: To summarize current evidence on the effectiveness of digital health interventions in improving the mental health of people with dementia (PWD) and their caregivers. METHOD: Four databases were searched for peer...PURPOSE: To summarize current evidence on the effectiveness of digital health interventions in improving the mental health of people with dementia (PWD) and their caregivers. METHOD: Four databases were searched for peer-reviewed articles from January 2013 to September 2023. Two reviewers screened titles and abstracts, and a third settled disagreements. At least two reviewers completed full-text reviews and reached consensus through discussion. Three reviewers abstracted the data. At least two reviewers conducted quality appraisals, with discrepancies resolved by a third reviewer. RESULTS: Nineteen articles met inclusion criteria. Evidence suggests digital health interventions improve caregivers' burden, depression, stress, quality of life, anxiety, coping, and well-being. No significant changes were found in caregivers' mood or mental health outcomes for PWD. CONCLUSION: Digital mental health interventions supporting PWD and caregivers are evolving. Further research should use more diverse and larger samples. Enhancing nurse participation in digital mental health design, implementation, and evaluation is crucial. [(4), 19-28.].
Alexander GL, Livingstone A, Han S
… +10 more, Chapman W, Comans T, Demiris G, Fisk M, Fossum M, Fung C, Kennedy R, O'Malley TA, Skubic M, IS-ITCOP Participants
J Gerontol Nurs
· 2025 Apr · PMID 40163614
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PURPOSE: As the global population ages, long-term/post-acute care (LTPAC) systems face challenges in ensuring quality care for older adults with complex medical needs. Using health information technology (IT) is a promis...PURPOSE: As the global population ages, long-term/post-acute care (LTPAC) systems face challenges in ensuring quality care for older adults with complex medical needs. Using health information technology (IT) is a promising strategy to address these challenges. However, evidence gaps remain regarding barriers and facilitators to technology integration in LTPAC. Thus, the current study explored barriers and facilitators to technology adoption in emerging models of care for older adults through the International Summit on Innovation and Technology for the Care of Older People (IS-ITCOP). METHOD: The IS-ITCOP Summit, held in June 2024, brought together 47 interdisciplinary experts from eight countries. Qualitative data were collected via facilitated discussion groups and analyzed using two approaches: human-coded thematic analysis and ChatGPT 4.0-driven analysis. RESULTS: Shared themes included technology barriers, ethical considerations, workforce challenges, and patient-centered care. Human analysis emphasized abstract themes, whereas ChatGPT provided granular insights on emerging technologies. CONCLUSION: Combining human and artificial intelligence-driven analyses enriched understanding, highlighting opportunities and challenges for integrating IT into LTPAC systems. [(4), 6-11.].
J Gerontol Nurs
· 2025 Jun · PMID 40152458
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PURPOSE: To explore the association between adverse childhood experiences (ACEs) and care-related strain among spouses of persons living with dementia (PLWD). METHOD: Data from spouses ( = 30) of PLWD were included in a...PURPOSE: To explore the association between adverse childhood experiences (ACEs) and care-related strain among spouses of persons living with dementia (PLWD). METHOD: Data from spouses ( = 30) of PLWD were included in a cross-sectional analysis examining whether childhood adversity, as measured by the Adverse Childhood Experiences Questionnaire (ACE-10), was associated with reports of care-related strain, as measured by the Zarit Burden Interview (ZBI-12). RESULTS: Care-related strain was moderate (mean = 17), and there was a significant difference between ZBI-12 scores of spouses with no ACEs ( = 10, mean = 11.3) versus those with ≥1 ACE ( = 18, mean = 20.17) ( = 0.01, 95% confidence interval [-15.37, -2.36]). Multiple linear regression analysis indicated there was a significant association between ACE-10 and ZBI-12 scores ( = 0.006), even when controlling for role captivity ( < 0.001). CONCLUSION: ACEs may influence the degree of care-related strain experienced by spouses of PLWD based on these preliminary results. Future research is needed to understand mechanisms and potential interventions for heightened appraisal of strain among spousal caregivers with ACEs. [(6), 17-21.].
PURPOSE: To assess geriatric care competencies of nurses in home health care (HHC) settings in Saudi Arabia and explore the factors influencing these competencies. METHOD: A cross-sectional design was used. Data were col...PURPOSE: To assess geriatric care competencies of nurses in home health care (HHC) settings in Saudi Arabia and explore the factors influencing these competencies. METHOD: A cross-sectional design was used. Data were collected using the Gerontological Nursing Competence Scale among 393 RNs working in HHC units in the Riyadh and Qassim regions. RESULTS: Nurses demonstrated high competence in ensuring safe living environments and addressing nutritional needs. However, weaker competencies were noted in supporting older adults' sexuality and managing ethical challenges. Specialized training and shorter work hours were significantly associated with higher self-perceived competency levels. This finding may suggest that reduced working hours allows nurses to engage in continuing education, skill development, and quality-focused care, rather than indicating lack of clinical experience. CONCLUSION: Findings highlight strengths and gaps in geriatric care competencies among HHC nurses, emphasizing the need for targeted training to address weaknesses in sensitive areas, including sexual health, ethical dilemmas, and communication challenges in end-of-life care. [(5), 35-45.].
PURPOSE: The current study examined the mediating effect of the meaning of work in the relationship between quality of life and experiences with ageism and social exclusion among working older adults. METHOD: A cross-sec...PURPOSE: The current study examined the mediating effect of the meaning of work in the relationship between quality of life and experiences with ageism and social exclusion among working older adults. METHOD: A cross-sectional correlational design was used. Data were collected using self-administered questionnaires between October 1 and November 30, 2019, and were analyzed using Pearson correlation coefficients and multiple linear regression. RESULTS: Quality of life correlated positively with the meaning of work and inversely with experiencing ageism and social exclusion. Meaning of work partially affected ageism's and social exclusion's respective relationships with quality of life. CONCLUSION: Nursing interventions (to improve older adults' quality of life) could include strategies to reduce working older adults' ageism experiences and social exclusion and enhance the meaning of their work. Findings contribute to providing data for developing industrial nursing policies and guidelines to maximize the quality of life of working older adults. [(5), 46-54.].
J Gerontol Nurs
· 2025 May · PMID 40152455
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PURPOSE: To determine the mediating effects of the quality of family caregivers' relationships with their older adult care recipients on the association between care-giver burden and caregivers' mental health and perceiv...PURPOSE: To determine the mediating effects of the quality of family caregivers' relationships with their older adult care recipients on the association between care-giver burden and caregivers' mental health and perceived general health. METHOD: Participants included 2,431 family/informal caregivers from the 2022 National Study of Caregiving. Mediator path analysis models adjusting for caregivers' age, sex, and race/ethnicity were used to test the direct and indirect effects of caregiver burden on mental health and perceived general health via the caregiving relationship. RESULTS: Quality of the caregiving relationship partially mediated the association between caregiver burden and mental health, and also partially mediated the association between caregiver burden and perceived general health. CONCLUSION: Caregiver burden and quality of the caregiving relationship are influential factors in caregiver health. Strategies addressing caregiver burden and the caregiving relationship simultaneously could yield potential benefits. [(5), 27-34.].
PURPOSE: To explore the relationship between social isolation and psychological well-being among community-dwelling older adults and analyze the mediating role of physical activity and psychological resilience in the cha...PURPOSE: To explore the relationship between social isolation and psychological well-being among community-dwelling older adults and analyze the mediating role of physical activity and psychological resilience in the chain mediation effect between social isolation and psychological well-being. METHOD: Two hundred sixty-five older adults from six communities in Baoding City were selected using convenience sampling. Social isolation, physical activity, psychological resilience, and psychological well-being were measured. The SPSS PROCESS program was used to test the chain mediation effect. RESULTS: Pearson correlation analysis indicated significant relationships between psychological well-being and social isolation, psychological resilience, and physical activity (all < 0.001). Mediation analysis results showed that social isolation directly affects psychological well-being and influences psychological well-being through three mediation chains: physical activity, psychological resilience, and the chain mediation effect of physical activity and psychological resilience. Total mediation effect accounted for 60% of the total effect. CONCLUSION: Social isolation is a significant risk factor for decreased psychological well-being among older adults, and physical activity and psychological resilience serve as important explanatory mechanisms. Community health workers should prioritize the impact of social isolation on the psychological well-being of older adults and develop intervention strategies based on the pathways of physical activity and psychological resilience to enhance psychological well-being and promote healthy aging. [(6), 23-29.].
PURPOSE: Continuous glucose monitoring (CGM) devices are increasingly used by older adults. Although these devices offer several advantages over traditional techniques, such as fingerstick capillary blood glucose, the cu...PURPOSE: Continuous glucose monitoring (CGM) devices are increasingly used by older adults. Although these devices offer several advantages over traditional techniques, such as fingerstick capillary blood glucose, the current article discusses the impact and benefits of CGMs in the context of older adults in skilled nursing facilities (SNFs) and explores ways to improve and manage their use through the collaboration of an interprofessional team. METHOD: Current evidence and guidance on implementing CGM devices in SNFs is reviewed. RESULTS: Current strategies for the successful and safe use of CGM devices in SNFs include staff and patient education, close monitoring, operational workflow, and interprofessional collaboration. CONCLUSION: To manage patients with diabetes in SNFs, an interactive, multidisciplinary, and multifaceted approach is needed. Larger studies on the management of CGM devices in SNFs are required. [(3), 7-12.].