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Further validation of screening tools and developing the training of health care professionals, specific to detecting delirium, is required. [Journal of Gerontological Nursing, 46(6), 43-52.].The current quality improvement study aimed to determine hearing loss (HL) prevalence in older adult patients in a large urban hospital, and the success of current processes to identify its presence during routine admission procedures. Predictors of HL were also evaluated, with the goal of identifying risk factors that might help staff anticipate patient communication challenges. A sample of 162 newly admitted patients, age 70 and older, participated in a hearing/communication assessment that included audiometry and an informal self-report measure about hearing difficulty. Chart review was conducted to assess whether patients with confirmed hearing/communication deficits had been identified as such during the admission or nursing assessments. Results revealed a high prevalence of HL (72.8%) and relatively low sensitivity of routine admission procedures in identifying this communication deficit (14.4% to 43.2%). Age and male gender were found to be predictors of HL. The invisibility of HL poses a challenge to nurses in recognizing when older adult patients are at risk for communication breakdowns. Communication breakdowns associated with HL can potentially impact patients' adherence to treatment plans. [Journal of Gerontological Nursing, 46(6), 34-42.].Caregivers of individuals with heart failure are at high risk for diminished quality of life because of the energy involved in providing necessary care. Ceralasertib Caring for someone with chronic heart failure can affect caregivers' physical, psychological, and social health, collectively referred to as the burden of care, and may also affect family functioning. The current cross-sectional study aimed to investigate the relationship between caregiver burden and family functioning in caregivers of older adults with heart failure in southeastern Iran using the Zarit Burden Inventory and the Family Assessment Device based on the McMaster Model of Family Functioning. The Pearson correlation coefficient, independent t test, and analysis of variance were used to determine relationships among variables. Results showed a significant correlation between burden of care and total score of family functioning. Therefore, it is necessary to take measures to reduce burden of care for caregivers through education and support programs and to improve their family functioning and quality of life. [Journal of Gerontological Nursing, 46(6), 25-33.].This article reviews recent federal and state policy changes in response to the COVID-19 pandemic that affect health care and quality of life for older adults. Specific regulations and guidelines issued at the state and federal level have increased access and provided additional funding for essential services and supports. Many of these changes are temporary and have the potential to improve care beyond the immediate crisis. This period of greater flexibility offers the opportunity to accrue evidence on quality and access to influence sustained change. [Journal of Gerontological Nursing, 46(6), 19-23.].The complexity of health care systems requires coordination among multiple health care providers to adopt strategies that are congruent with patients' levels of health literacy. In the current study, 12 interdisciplinary members of a Program of All-Inclusive Care of the Elderly (PACE) completed the Assessment Questionnaire from the Agency for Healthcare Research and Quality (AHRQ) Health Literacy Universal Precautions Toolkit. Once the questionnaire was complete, organizational priorities were identified and the AHRQ Toolkit was used to develop next steps. Of the five subsets included in the Toolkit, the organization identified three as priorities (a) development of a health literacy team; (b) improving spoken communication with patients and caregivers; and (c) improving written information given via letters and home instructions. Organizations, nurses, and quality care leaders may find these results useful as they seek to assess organizational literacy and develop improvement plans. [Journal of Gerontological Nursing, 46(6), 12-18.].More and more states are addressing the long-term services and supports needs of Medicaid only and dually eligible persons by developing Managed Long-Term Services and Supports (MLTSS) programs. States are moving away from fee-for-service plans and coordinating care through these capitated programs. The goals of these programs include greater efficiency while maintaining quality and better coordination of care. For dually eligible persons, the expansion of MLTSS has been made possible through the creation of the Medicare-Medicaid Coordination Office at the Centers for Medicare & Medicaid Services by the Affordable Care Act to improve communication and coordination between state and federal programs. MLTSS invest heavily into home and community-based services and care coordination to increase the efficiency of their organizations and improve person-centered care. Nurses who engage with this vulnerable population are in a prime position to further innovate this model to improve person and family outcomes. [Journal of Gerontological Nursing, 46(6), 7-11.].Obtaining phase information remains a formidable challenge for nucleic acid structure determination. The introduction of an X-ray synchrotron beamline designed to be tunable to long wavelengths at Diamond Light Source has opened the possibility to native de novo structure determinations by the use of intrinsic scattering elements. This provides opportunities to overcome the limitations of introducing modifying nucleotides, often required to derive phasing information. In this paper, we build on established methods to generate new tools for nucleic acid structure determinations. We report on the use of (i) native intrinsic potassium single-wavelength anomalous dispersion methods (K-SAD), (ii) use of anomalous scattering elements integral to the crystallization buffer (extrinsic cobalt and intrinsic potassium ions), (iii) extrinsic bromine and intrinsic phosphorus SAD to solve complex nucleic acid structures. Using the reported methods we solved the structures of (i) Pseudorabies virus (PRV) RNA G-quadruplex and ligand complex, (ii) PRV DNA G-quadruplex, and (iii) an i-motif of human telomeric sequence.