Geriatric Nursing Commons^™

Implementation Of A Provider-Focused Multimodal Educational Initiative To Address Polypharmacy And High-Risk Medication Use In A Home And Community Medicare Advantage Setting, Jennifer Butler-Rickard, Kellie Olsen, Eileen Stuart-Shor, Craig Drew

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Community-dwelling adults are at risk for adverse drug events such as falls, hospitalizations, cognitive decline, drug-to-drug interactions, and mortality related to high-risk medication use and polypharmacy, often defined as concurrent use of five or more different medications. Lack of provider knowledge of polypharmacy and high-risk medication use as well as suboptimal communication with primary care providers can lead to gaps in medication management in this vulnerable population.

LOCAL PROBLEM: Patients seen by the Comprehensive Annual Health Assessment Program advanced practice clinicians (APCs) at the project Medicare Advantage insurer organization often experience polypharmacy. Given the lack of provider knowledge of …

Two-Year Retrospective Evaluation Of Frailty To Optimize Postoperative Spinal Fusion Outcomes In Adults Aged 65 And Older, Sheri Loo

Doctoral Projects

Many older adults over the age of 65 have both spinal stenosis requiring spinal fusion surgery and frailty. As life expectancy has increased, many older individuals will undergo elective spinal fusion surgery to decrease their chronic pain in pursuit of improved quality of life. There is currently an underutilization of frailty screening for risk stratification of postoperative complications. A retrospective chart review over a two-year period from July 2023 to June 2025of adults aged 65 and older who underwent posterior spinal fusion surgery, involving 126 participants, was completed. We assessed the correlation between frailty and postoperative outcomes, discharge disposition, and …

Early Pressure Injury Identification And Intervention In Emergency Department Older Adults Who Are Admitted Into A Community Hospital Intensive Care Unit, Lisa M. Britt

Doctor of Nursing Practice (DNP) Scholarly Projects

A clinical gap was identified when reviewing a hospital acquired pressure injury (HAPI) dashboard from a 369- bed, acute care community hospital located in North Texas. Fifty percent of HAPIs acquired occurred in older adults, aged 60 or higher, who were admitted into the intensive care unit (ICU) from the emergency department (ED). A retrospective review of the electronic health records (EHR) demonstrated that none of the patients had received HAPI prevention interventions while they were in the ED and the inconsistent document of skin assessments resulted in identification of few HAPIs present on admission (POA). The purpose of this …

From Fear To Familiar: Decreasing Technology Anxiety Among Older Adults In A Senior Community, Regina Rayz

Master's Projects and Capstones

Objective: Older adults (defined by the WHO as those 65 and older in developed countries) are more susceptible to technophobia than younger adults (Song et al., 2025). The fear and anxiety occurs with use of smartphones, tablets, social media, and telehealth and is associated with higher rates of social isolation and reduced autonomy. Technology-use anxiety is a preventative obstacle that inhibits both technology acceptance as well as overall health (Kim et al., 2023). Aim: To reduce technology-related anxiety among older low-income adults living in a senior residential facility in Richmond, CA by at least 25% using a brief, individualized technology …

Bridging Gaps In Safety: A Team-Based Approach To Reducing Falls Among Older Adults, Enzali Min

Master's Projects and Capstones

A skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility's fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving the …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Associations Between Older Hispanics’ Diabetes Control And Their Caregiver’S Health Literacy, Jorge Rico

Nursing Dissertations - Archive

Background: Older Spanish-speaking Hispanics are a rapidly growing population in the United States that face disproportionally high rates of diabetes and inadequate health literacy. Familism is valued among Hispanics and caregivers may play an important role in overcoming the social determinants of health facing this vulnerable population. Methods: This descriptive correlation study sought to explore correlations between the caregiver’s health literacy and the patient’s control of diabetes. Findings: Mixed effects model found a significant correlation between the caregiver’s print literacy and the patient’s hemoglobin A1c. Conclusion: The findings are encouraging for future research to explore interventions that target the caregivers …

The Lived Experiences Of Older Adults With Cancer Who Are Non-Adherent To Prescribed Oral Chemotherapy: A Descriptive Phenomenological Study, Ludmila Kosmari

Nursing Dissertations - Archive

Background: Despite the ease of receiving OCT, patients’ OCT adherence is low. With this low prevalence rate, patients are not likely obtaining the full life-promoting effects of OCT. Since medication adherence is often related to lived experiences and standardized medication adherence instruments may not capture these experiences completely, the purpose of this study was to explore how the lived experiences of older adults with cancer influence their adherence to OCT.

Methods: the researcher used a descriptive phenomenological design and conducted individual interviews with 20 older adults with cancer. All participants were prescribed OCT and reported missing at least one dose. …

Guideline On The Education And Use Of The Cognitive Assessment And Care Planning Services Visit For Patients 65 And Older With Cognitive Impairment, Katherine J. Koonce

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: The lack of education and use of the Cognitive Assessment and Care Planning Services (CACPS) visit creates a gap in care for Medicare patients over the age of 65 with cognitive impairment.

Methods: Recommendations were created from a robust collection of graded, evidence-based literature. The recommendations were presented to a set of stakeholders who rated each recommendation on a Likert scale from 1 (poor) to 4 (excellent).

Results: The twelve stakeholders agreed with the recommendations to support the education and use of the CACPS visit for Medicare patients 65 and older.

Conclusion: This guideline promotes provider education to investigate …

The Impact Of Health Promotion Home Visits On Loneliness In An Older Adult Population, Jean M. Herb

West Chester University Doctoral Projects

Loneliness among older adults is a significant public health concern associated with adverse physical, emotional, and cognitive outcomes. Despite widespread recognition of the issue, effective interventions remain limited in clinical practice. This Doctor of Nursing Practice (DNP) project implemented and evaluated a Health Promotion Home Visit (HPHV) intervention designed to reduce loneliness in community-dwelling adults aged 65 and older. A quality improvement initiative using a pre-post design was conducted at a community outreach division of a home health agency. Patients received HPHV every other week over an eight-week period. The UCLA Loneliness Scale (Version 3) was used to assess loneliness …

Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

The Effects Of Nurse-Led Physical Activity On The Aging Population, Kaitlyn P. Carruba

Honors Undergraduate Theses

The aging population in the United States is increasing in proportion, yet older adults' physical activity levels have not increased much. The lack of physical activity leads to numerous health complications, such as an increased risk for cardiovascular disease, increased risk for falls and fractures, as well as lead to obesity and diabetes. Unfortunately, few healthcare facilities monitor or audit physical activity. Older adults are frequently placed on fall risk precautions, which heavily encourages a sedentary hospital stay. This commonly leads to older adults with declining abilities to accomplish their activities of daily living (ADLs) after hospitalization. Nurses, spending the …

Older Adult's Fall Prevention Program, Myles Butler, Rebecca King

Fall 2024 OTD Capstone Symposium

The decline in bodily functions with aging increases older adults' vulnerability to falls, which is a leading cause of death within this population. The poster presents an educational based fall prevention program focused on safety awareness and risk management for older adults. In conclusion, implementing a fall prevention program leads to increased awareness regarding risk factors that are detrimental to the safety and well-being of the older adult community

Implementing The Brief Confusion Assessment Method (Bcam) Delirium Screening Tool In An Emergency Department, Carolina Van Dalen

Master's Projects and Capstones

Problem: Persons with delirium have an elevated risk of falls. Thus, falls and delirium are inextricably linked. Both should be routinely screened for older adults.

Context: A 40-bed Emergency Department (ED) in the East San Francisco Bay area of Northern California and the first site among all acute care hospitals in the organization to implement the Brief Confusion Assessment Method (bCAM) delirium scoring tool within the Electronic Health Record (EHR).

Interventions: An EHR toolkit for delirium screening using bCAM was developed, tested, and implemented in the ED.

Measures: The outcome measure was the percentage of patients with a reported fall …

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

A Contextual Analysis Of Life Stories From Older Adults Participating In A Telephone Reminiscence Program, Eliana Likorama

Honors Scholar Theses

Life satisfaction, loneliness, and mental health & well-being are important factors to consider when working with the older adult population. This population is predisposed to many risk factors for mental health problems such as coping with a serious illness, losing a loved one, living alone, cognitive deficits, and more. Reminiscence is one simple, flexible, and cost-effective intervention that can be utilized to promote the mental health and well-being of older adults. Reminiscence is defined as the cognitive process of recalling the past. Numerous studies have shown beneficial effects of reminiscence in older adults: increased self-esteem, enhanced quality of life, increased …

The Effectiveness Of Dexmedetomidine In The Reduction Of Postoperative Delirium In Patients Over 65: A Scoping Review, Jacqueline Renee Breuer, Michael G. Callonas, Kathleen Chmelicek, Laura Elizabeth Denman, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Postoperative delirium impacts as many as 51% of surgical patients, resulting in increased mortality and morbidity, longer hospital stays, and increased healthcare costs. Adults ≥ 65 have a high risk for developing delirium. This scoping review examines the use of dexmedetomidine in the perioperative period in adults ≥ 65 years old to prevent and treat postoperative delirium.

Methods

Using relevant inclusion criteria, an extensive review of the literature was performed from September through November 2022, utilizing the Cochrane, CINAHL, ClinicalKey, PubMed, and Embase databases. Search phrases included: dexmedetomidine infusion, dexmedetomidine, intraoperative dexmedetomidine, postoperative delirium, older adults, and elderly delirium. …

Maggot Debridement Therapy Vs. Negative Pressure Wound Therapy And Their Effectiveness On Tissue Healing On Older Adults, Angelica L. Funes

Soaring: A Journal of Undergraduate Research

Chronic ulcers, particularly prevalent in older adults, significantly impact patients' quality of life, leading to prolonged hospital stays and increased healthcare costs. This study explores the efficacy of two common therapies, Negative Pressure Wound Therapy (NPWT) and Maggot Debridement Therapy (MDT), in promoting tissue healing for chronic ulcers in adults aged 60 and older. A methodical search was conducted using databases such as CINAHL, PubMed, EBSCO, and ProQuest, employing specific search strategies and inclusion/exclusion criteria. Four high-quality Level 1 randomized controlled trials were selected for analysis, comparing NPWT and MDT in various settings. The results indicate that MDT exhibits superior …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Attitudes Toward Caring For Older Adults Among Undergraduate Nursing Students At A Public University In Kuala Lumpur, Malaysia, Azera Hasra Ismail, Siti Zuhaida Hussein, Aslina Mohamed Yasi, Nurul Izzati Ishak, Nurul Nazira Mohd Yazar, Nur Syafiqah Sabri

Makara Journal of Health Research

Background: The growing number of elderly members of the population is expected to increase the demand for more dedicated nursing students committed to providing excellent care. This study aims to determine prevailing attitudes toward the care of older adults among undergraduate nursing students at a public university in Kuala Lumpur, Malaysia.

Methods: This is a quantitative cross-sectional survey of 107 undergraduate nursing students enrolled at a public university in Kuala Lumpur, Malaysia. The students were recruited using stratified random sampling. The respondents’ attitudes toward caring for older adults were measured using 14 items from the Geriatrics Attitudes Scale …

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …

Investigating The Perspectives Of Older Adults In Residential Aged Care On Oral Health-Related Quality Of Life, Parisa Malekpour, Amanda Devine, Julie Dare, Leesa Costello

Research outputs 2022 to 2026

Objective

The objective of the study was to explore how older people living in a residential aged care facility perceived that their oral health influenced their food preferences and attitudes towards food, their social interactions and their self-esteem.

Background

Poor oral health can have biological, behavioural and social impacts on quality of life among older adults (aged 65+ years). In terms of biological impacts, oral health impairments may cause older adults to avoid many types of foods. This shift in dietary pattern can lead to malnutrition among older people, undermine general health and negatively impact quality of life (QOL).

Materials …

Efficacy, Acceptance, And Feasibility Of Virtual Reality For Chronic Pain Relief In Older Adult Veterans Residing In Long Term Care, Valicia Philibert

Dissertations, Theses, and Capstone Projects

Older adults residing in Long-Term Care (LTC) have a high prevalence of chronic pain. Pain management strategies have primarily focused on pharmacological approaches, but with physiological changes associated with aging, this population is at an increased risk for adverse effects from prescribed medications. More research is needed on innovative non-pharmacological interventions in the LTC setting. This study examined the feasibility, acceptance, and preliminary efficacy of Virtual Reality (VR) for chronic pain among older adult veterans in LTC. In this quasi-experimental, 12 older adult participants living with chronic pain in a long-term care facility received two sessions of VR. Pain intensity …

Evaluating Mindfulness On Loneliness In An Older Adult Population, Jessica Tieskoetter

Dissertations

Problem: Loneliness is a widespread public health concern and has negatively impacted mortality and health outcomes among older adults. This quality improvement project’s purpose was to evaluate mindfulness on loneliness and quality of life among adults aged 65 years and older, participating in a weekly befriending socialization program.

Methods: A descriptive cohort design was utilized to assess loneliness pre-and post-implementation of a mindfulness telephone line over three months. A convenience sample of 22 older adults enrolled in a befriending socialization program was used. The Iowa Model of Evidence-Based Practice framework was applied to guide the implementation of a practice change …

Fall Risk Assessment And Intervention To Reduce Fall-Related Injuries And Hospitalization In Older Adults, Pittawat Emerson

Doctor of Nursing Practice Final Manuscripts

Falls among older adults is a major issue that has become a leading cause of injuries and deaths. This study is an evaluation of fall-risk assessment using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) tool and physical activity intervention in older adults aged 65 and above during their annual wellness visits to reduce fall-related injuries and hospitalizations. The results showed a reduction of fall-related injuries by up to 11.8% after the 12-week intervention. Patients with moderate-to-high fall risk saw a decrease in injury by 12.9%. Patients with moderate-to-high fall risk scores saw a decrease by 12.9%, from 25.9% to …

Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles

DNP Projects

Introduction

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.

Purpose

The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …

Factors Affecting Quality Of Life And Asthma Control In Older Adults With Asthma., Karen Schuckmann

Electronic Theses and Dissertations

Introduction: Approximately 7.7 percent of adults over the age of 65 have asthma in the United States (U.S), further, the population of older adults in the U.S. will increase to 20% by 2030. Health Related Quality of Life is low for this age group and asthma is often misdiagnosed and undertreated creating a need for research to improve factors that influence Asthma Quality of Life. Aims: This study explored two aims. The first aim evaluates the relationship between medication numeracy and asthma self-management knowledge with asthma self-efficacy. The second aim evaluates medication numeracy, asthma self-management knowledge, asthma self-efficacy, and asthma …

A Physical Therapy Mobility Checkup For Older Adults: Feasibility And Participant Preferences From A Discrete Choice Experiment, Dalerie Lieberz, Hannah Borgeson, Steven Dobson, Lindsey Ewings, Karen Johnson, Kori Klaysmat, Abby Schultz, Rachel Tasson, Alexandra L. Borstad

Journal of Patient-Centered Research and Reviews

Purpose: Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

Methods: Adults over 55 years of age were recruited from the community. In the study’s first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the …

Nurses Leading Volunteer Support For Older Adults In Hospital: A Discussion Paper, Rosemary Saunders, Kate Crookes, Karen Gullick, Olivia Gallagher, Karla L. Seaman, Debra Scaini, Seng G.M. Ang, Caroline Bulsara, Beverley Ewens, Jeff Hughes, Beverly O'Connell, Christopher Etherton-Beer

IHR Papers and Journal Articles

Background

The ageing population has led to growing numbers of older adults in hospital. Given the increased care needs of older adult patients, hospitals are facing resource challenges to ensure patient safety and quality of care. Support from trained volunteers focussed on older adults needs, such as eating, drinking, ambulation and cognitive stimulation have been found to improve patient outcomes.

Aim

This discussion paper describes a novel nurse-led model of volunteer support providing individualised supportive care for hospitalised older adults.

Methods

Discussion paper.

Findings

Nurses’ clinical expertise, 24 hour care and leadership skills makes them ideally placed to guide support …