Aging Matters Through the Years: A Retrospective.

The goal of the Aging Matters column is to address important issues related to geropsychiatry and the well-being of older adults. This article offers reflections on columns from the past 15 years and how the aging process has changed in issues related to aging and technology, aging healthfully, end-of-life issues, caregivers for older adults, and growing old in American society. To promote successful aging, we need to hear stories of what it is like to grow old in America.

The Aging Brain: Can Cognitive Decline Be Reversed?

Little research has focused on aging changes in the normal brain, despite its significance as a public health problem. Recent research on neural mechanisms that underlie cognitive decline in the aging brain suggests that neuro-genesis, the creation of new brain cells, is possible throughout one's life. Research findings offer nurses and other health professionals new opportunities to encourage behavior changes for older adults that may eventually slow or reverse detrimental changes in the aging brain.

Losing a Generation: The Impact of COVID-19 on Older Americans.

As COVID-19 is killing untold numbers of older adults around the world, it is important to reflect on the loss of this generation. Approximately eight in 10 deaths were in people aged ≥65 years. This is a devastating loss to our society-losses that will last long after the pandemic has run its course.

Tidying Up: Good for the Aging Brain.

As older adults experience physical and mental changes, they may have difficulty keeping up with tasks that were once routine and may be faced with a growing accumulation of once important possessions that are no longer needed. Problems with clutter have been associated with stress and life dissatisfaction. Helping older adults realize the benefits of decluttering their living environment and providing them with advice on how to do this can help them feel accomplished and in control.

Music as a Healing Art in Dementia Care.

Music is an easily accessible and stimulating medium that can be enjoyed alone or with others, even in the context of severe dementia. The power of music to improve the lives of individuals with dementia, as well as their caregivers, is becoming increasingly recognized as more research is focused on underlying neural relationships and evidence-based music interventions. Nurses and other health professionals can be instrumental in designing and implementing music-based interventions and expanding needed research to promote music as a healing art in dementia care.

Using Docudrama in a New Graduate Nurse Residency Program: Stepping Into the Lives of Families Experiencing Dementia.

Hospitals are increasingly implementing residencies to help ensure that new graduate nurses are prepared to provide safe and effective care. At the Cleveland Clinic, a docudrama focused on ethical concerns in living with dementia was implemented into a 6-month pilot new graduate nurse residency program. Outcomes suggest that the docudrama helped nurse residents gain empathy and understanding through stepping into the lives of families experiencing dementia.

End-of-Life Conversations as a Legacy.

Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so.

Promoting Human Flourishing in Aging.

Human flourishing represents a state of mental health in which an individual is actively striving to live well rather than merely feeling good. This concept provides an important context for nurses working with older adults. Flourishing older adults exhibit a sense of personal growth in that they are still evolving and changing.

Living with Parkinson's Disease: Staying Determined.

Parkinson's disease is one of the most common chronically disabling disorders of the nervous system. The disorder affects predominately older adults; only 4% of individuals are diagnosed before age 50. Receiving a diagnosis of Parkinson's disease can be overwhelming for someone who is active and feels healthy, but new research shows that patients who take charge of their illness by adopting healthful habits of mind and body can slow the development of the disease and have a better quality of life.

Substance Use Disorders in Long-Term Care Settings: A Crisis of Care for Older Adults.

Many older adults struggle with lifelong addictions or become addicted to prescription drugs that they take for coping with physical or psychological pain. There has been little attention, however, focused on this problem in nursing homes, where powerful pain medications are administered routinely. The nursing home setting provides complex challenges for staff and administrators attempting to provide safe and high-quality care for older adults with substance use disorders.

Community-Based Older Adults With Mental Illness: We Can Do Better.

One third of older adults in the community have significant mental health problems, but many do not receive needed treatment for problems such as depression, anxiety, and psychotic disorders. Without effective community-based mental health services, older adults may give up and withdraw from treatment. New collaborative and integrative models of mental health services are being implemented that offer innovative roles for nurses.

Aging on the Street: Homeless Older Adults in America.

Older adults are at greater risk for homelessness today than at any time in recent history. Approximately one half of homeless individuals in America are older than 50, which has created serious challenges for how cities, governments, and health care providers care for homeless populations. Systems established in the 1980s to help care for homeless individuals were not designed to address problems of aging.

Critical Care Nurses' Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients.

Background: The term spirituality is highly subjective. No common or universally accepted definition for the term exists. Without a clear definition, each nurse must reconcile his or her own beliefs within a framework mutually suitable for both nurse and patient.

The Pain Experience of Patients Hospitalized With Inflammatory Bowel Disease: A Phenomenological Study.

Pain is personal, subjective, and best treated when the patient's experience is fully understood. Hospitalization contributes to the physical and psychological complications of acute and chronic pain experienced by patients with inflammatory bowel disease (IBD). The purpose of this qualitative phenomenological study was to develop an understanding of the unique experience of pain in hospitalized patients with an admitting diagnosis of IBD and related care or surgery.

Using Docudrama in a New Graduate Nurse Residency Program: Stepping Into the Lives of Families Experiencing Dementia.

Hospitals are increasingly implementing residencies to help ensure that new graduate nurses are prepared to provide safe and effective care. At the Cleveland Clinic, a docudrama focused on ethical concerns in living with dementia was implemented into a 6-month pilot new graduate nurse residency program. Outcomes suggest that the docudrama helped nurse residents gain empathy and understanding through stepping into the lives of families experiencing dementia.

Meditation for older adults: a new look at an ancient intervention for mental health.

New research is providing health care professionals with evidence for the effectiveness of mindfulness meditation as an intervention for older adults. Recent studies have provided evidence that meditation results in observable changes in brain structure related to memory, sense of self, empathy, and stress. Health care professionals should consider mindfulness training as a helpful intervention for older adults with problems such as depression, anxiety, chronic pain, loneliness, and caregiver burden.

Enhancing care of older adults in the emergency department: old problems and new solutions.

The dramatic increase in the number of older adults in our society is creating greater demand for age-appropriate health care services. Because older adults use proportionally more emergency services than any other age group, it is important to address problems and find solutions to emergency care for this vulnerable population. Older adults often need specialized care to meet complex physical and psychological needs in an emergency department (ED).

Postoperative cognitive dysfunction in older adults: a call for nursing involvement.

As the population continues to age and new medical developments make surgery at advanced ages increasingly possible, it is important to consider how older adults tolerate surgery and anesthesia. Considerable evidence shows that older adults have a higher risk of developing postoperative cognitive dysfunction (POCD), which leads to transient and sometimes long-term cognitive changes that may affect quality of life. Because little is known about how to prevent or treat POCD, it is important that nurses identify ways in which they can intervene to help patients who experience this disorder.

Understanding physical activity and exercise behaviors in patients with heart failure.

Objective: Explore perceptions of physical activity/exercise in patients with chronic heart failure (HF).

Background: Although activity/exercise are HF self-care expectations, perceptions of patients are not well understood.

Methods: Ambulatory adults with HF were interviewed.

Use of technology to enhance mental health for older adults.

Recent research suggests that older adults may gain significant mental health benefits from health resources made available through emerging modern technologies, especially because this population is becoming more Internet savvy. Technology-enhanced interventions for older adults have been shown to be helpful not only for general wellness activities (i.e.

Deciding for others: surrogates struggling with health care decisions.

As the number of older adults in our society increases, surrogate decision makers are increasingly likely to be called on to make complex, and often agonizing, health care decisions for loved ones. Recent studies of surrogate decision making have described the decision-making process as overwhelming and stressful. Nurses play an important role in helping family members to make meaningful decisions with less stress.

Nurses Managing Patients' Pain May Experience Moral Distress.

Bedside nurses care for patients with pain every day but the task is often challenging. A previous qualitative study that investigated nurses' experiences as they treated patients with pain suggested that nurses may suffer from moral distress if they are unsuccessful in providing adequate pain relief. As 20 of the original 48 nurses interviewed described frustration and distress when constrained from doing the right thing to provide pain relief for their patients, the purpose of this secondary qualitative analysis was to answer new research questions on nurse moral distress related to managing pain.

Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden.