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.

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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.

Several predictors of suicidal ideation found in older adults and adults with HIV are the same; synergistically, those aging with HIV may be at risk for suicidal ideation. Focusing on the concept of hardiness provides insight into mitigating suicidal ideation and accentuating successful aging with HIV. Some individuals may have hardy characteristics that counteract the detrimental effects of aging with HIV; others may require greater guidance to cope with the effects that lead to suicidal ideation. As these connections are examined, the concept of hardiness is examined in relation to aging with HIV. Implications for nursing are posited.

As the number of older adults with HIV/AIDS increases, new challenges are emerging that threaten their ability to age with this disease. Threats of particular concern are depression and suicidal ideation. Studies show that those aging with HIV/AIDS have a number of stressors that tax their coping mechanisms, increasing vulnerability to depression and suicidal ideation. These stressors can be categorized into three areas. First, there are psychosocial stressors that can contribute to depression. Second, there are health and biochemical stressors that can contribute to depression, as well as compromise cognitive abilities needed to adapt to such stressors. Third, cognitive stressors may create predispositions to depression. In particular, certain cognitive abilities needed to cope with depression and suicidal ideation may be compromised by aging with HIV/AIDS. A model of these stressors is provided for didactic purposes, as well as to suggest implications for social work practice and research.