HIV and normal aging can each negatively affect executive functioning, attention, memory, and, ultimately, metacognitive abilities, which are important for internally monitoring neuropsychological performance. Some individuals who are aging with HIV may experience severe changes in their metacognitive abilities. They may be unaware of their neuropsychological functioning and may not be accurately monitoring their cognitive abilities. Nurses who rely on patients' self-reports of cognitive status should exercise caution regarding the accuracy of these reports and consider confirming and validating such responses when impairments are suspected. A flowchart for monitoring patients with suspected metacognitive impairments is provided.

Many older adults experience memory problems due to normal or pathological aging, which impairs daily functioning. Spaced Retrieval is a technique that can be used to augment memory function as it relates to a specific, everyday task. This technique requires individuals to recall a single piece of information over progressively longer periods until the information is consolidated into long-term memory. It works effectively in various settings and for individuals with memory problems. Given their direct contact with older adult patients, nurses are in a position to notice memory declines and guide their patients in the use of this technique.

The number of older adults with HIV continues to grow primarily because of the effectiveness of highly active antiretroviral therapy. Despite this welcomed benefit from pharmaceutical advances, aging with this disease presents an entirely new set of problems. The combination of aging and HIV can create a variety of stressors that may weaken one's resolve and further debilitate already compromised cognitive systems, which may increase rates of depression, suicidal ideation, and suicide. Studies indicate that older adults with HIV experience higher levels of depression and suicidal ideation than other older adults do or than younger adults with HIV do. Cognitive declines associated with both HIV and aging may provide insight into this phenomenon. A model of cognitive decline and suicidal ideation in adults aging with HIV is provided. Implications for nursing practice and research are discussed.

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Social workers frequently work with clients who have cognitive deficits that impair their ability to perform instrumental activities of daily living and reduce their quality of life. Borrowing from the cognitive aging literature, the Spaced Retrieval Technique can be used by social workers to help their clients retain information needed for more autonomous functioning. This technique consists of recalling information over progressively longer periods of time until the information is successfully consolidated into long-term memory. The retained information may include adhering to medication regimens, keeping doctor's appointments, and remembering to pay bills. This technique is established and employed in early Alzheimer's disease, traumatic brain injury, and HIV. Implications for social work practice are posited.