bluuebunny/crossref_metadata_2025 huggingface dataset:
SUCCESSES IN THE TRANSLATION OF CAREGIVER INTERVENTIONS IN COMMUNITY-BASED ORGANIZATIONS AND HEALTH CARE SYSTEMS
Authors: Cho Jinmyoung , Stevens Alan B
Published: November 2019

Family caregiving of an older adult has become an essential element of the U.S. health care system, with 83 percent of long-term care provided to older adults coming from family members or other unpaid helpers. With the amount and type of care provided by families expected to increase, caregiving demands should be coupled with community and health care systems-based supports. While scientific research has demonstrated the value of providing education, skills training and support to family caregivers, health care and social service providers do not systematically include these interventions in their services. Thus, for the vast majority of family caregivers, caregiving support services remain extremely fragmented, if not elusive. This symposium provides four examples of how health care systems that frequently see patients with dementia and community-based organizations who provide ongoing supportive services to family caregivers, have adapted evidence-based caregiver interventions into branded service programs. Dr. Jinmyoung Cho will present racial/ethnic comparisons on the impact of community-based implementation of a caregiver education program, REACH-TX. Dr. Leah Hanson will introduce the implementation of Mindfulness-Based Dementia-Care (MBDC) within a health care system. Dr. Christine Jensen will address how caregivers can benefit from evidence-driven programs in health care settings. Lastly, Dr. David Coon will present two different approaches to translation of evidence-based programs through community-based organizations, with CarePRO embedded after completion of a clinical trial and EPIC embedded from the program’s initial pilot phase. The discussant, Dr. Alan Stevens, will highlight the needs of caregivers and support services recognized by all key stakeholders.
COMMUNITY-BASED IMPLEMENTATION OF A CAREGIVER EDUCATION PROGRAM, REACH-TX: RACIAL-ETHNIC GROUP COMPARISON
Authors: Cho Jinmyoung , Smith Donald R , Stevens Alan B
Published: November 2019

We present the effect of racial/ethnic group difference on the impact of REACH TX on measures of quality of life as implemented by the Alzheimer’s Association North Central Texas Chapter. Five dimensions of quality of life (burden, depression, social support, self-care, and problem behaviors) were assessed at baseline and 6-month follow-up among three racial/ethnic groups of caregivers (White: 1,050; African American: 269; Hispanic: 176). Generalized estimating equations (GEEs) were used to assess racial/ethnic differences in the changes of quality of life after adjusting covariates. Significant interaction effects between racial/ethnic group and time (from baseline to follow-up) were found in burden, depression, and social support. White and Hispanic caregivers showed significant improvements, while the improvement among African American Caregivers was not statistically significant. The disparity in outcomes among diverse racial/ethnic groups in the program suggests the REACH TX intervention would benefit from tailoring interventions for African American caregivers.
HOW STATES CHANGED REGULATORY REQUIREMENTS FOR ASSISTED LIVING STAFF SINCE 2003
Authors: Carder Paula , Dys Sarah
Published: November 2019

In 2003, the Assisted Living Workgroup (ALW) published quality improvement recommendations for states’ regulations, including 26 regarding staffing/workforce. We reviewed states’ 2003 and current regulations to identify the presence of ALW standards. Over half of states’ regulations reflect 7 of the 26 staffing/workforce recommendations. Those most often added after 2003 concern criminal background checks, with a 58.8 percent increase in states that added federal background checks and use of criminal background checks to inform hiring. At least 40 states’ regulations reflect the ALW recommendations for administrator and direct care staff training. Very few states require staff performance evaluations (n=13), human resource policies to improve retention (n=1), or management practices to improve retention (0). The 10 ALW recommendations concerning staff who administer medications have been adopted by fewer than 23 states. These findings can inform future policy analysis and research on staffing/workforce in assisted living communities.
DIGITAL INDEPENDENCE: HEALTH-RELATED DIFFICULTY IN INTERNET USE AND HOW IT AFFECTS OLDER ADULTS’ QUALITY OF LIFE
Authors: Ang Shannon , Lim Emily , Malhotra Rahul
Published: November 2019

Using the internet is increasingly a necessity. However, older adults may not do so due to either non-health reasons (e.g., lack of digital literacy or internet access) or health-related reasons. While researchers have studied internet use among older adults, most do not discriminate whether non-use is due to health reasons or otherwise. Recent studies also reveal that older adults use the internet to keep in touch with family and friends, highlighting that limitations in internet use may be detrimental for their well-being. We therefore, examine the key correlates of health-related difficulty in internet use, and how it may affect quality of life by reducing the size of their social support networks. Data were from a national survey of older Singaporeans (n=3966) conducted in 2016-17. Multinomial logistic regression and mediation analysis were used to identify older adult subgroups more likely to experience health-related difficulty in internet use, and whether such difficulty affected older adults’ quality of life through their social support networks. Results showed that males, those of Malay ethnicity, those with less education, and those with more instrumental activity of daily living (IADL) limitations were more likely to experience health-related difficulty in internet use. Social support networks mediated the relationship between health-related difficulty in internet use and quality of life. These findings suggest that other than managing the health conditions of older adults who face health-related difficulty in internet use, offline modes of keeping them socially connected may promote their quality of life.
INTERVENTION DEVELOPMENT: PARTICIPANT EXPERIENCES WITH NOVEL TECHNOLOGICAL DEPRESSION TREATMENTS
Authors: Shah Avani A , Morthland Martin , Scogin Forrest , Presnell Andrew
Published: November 2019

The purpose of this presentation is to discuss the development process of two novel technology-based interventions for depression in older adults while comparing older adults’ preferences for audio-based and computer-based cognitive behavioral therapy for depressive symptoms. The audio program consisted of eight compact discs and a workbook while the computer program consisted of 11 modules of similar duration provided on a tablet PC. Fifty-one older adults were recruited from medical settings and rural communities and randomly assigned to an immediate treatment group (computer or audio) with minimal contact or a four-week minimal contact delayed treatment control condition. Participants rated computer-based and audio-based cognitive behavioral therapy fairly equally, with 75% of those who received audio treatment and 85% of those who received computer-based treatment indicating benefits to their mood. Qualitative experiences will be presented by themes: challenges, benefits, recommended improvements, and technological issues. The goal of the presentation is to share information that may help clinicians and researchers develop other mental health technological interventions tailored for older adults needs.
DEVELOPING A DEMENTIA-FRIENDLY COMMUNITY GLOBAL TOOLKIT: INSIGHTS FROM STAKEHOLDERS IN WHO MEMBER COUNTRIES
Authors: Sun Fei , Chima Emmanuel , Seeher Katrin , Dua Tarun , Kestal Devora
Published: November 2019

Drawing on perspectives from stakeholders involved in dementia friendly initiatives (DFIs) in WHO member countries, this paper describes the characteristics of DFIs around the world and summarizes success factors and barriers to implementation. Data were collected through an online consultation survey of 129 stakeholders from 46 countries in all six regions of WHO. Most DFIs present three essential features of WHO’s definition for DFI, that is, centering on the needs of persons living with dementia (PWD), multi-sector collaboration, and physical and social environmental changes. Over 70% participants reported their DFIs targeted PWD and included PWD as important partners. High-income countries tend to focus on enhancing professional capacity and environmental adaptation, while low-middle income countries prioritize dementia awareness campaigns. This corresponds to the reported disparities in levels of inclusion of PWD in societies, support to PWD, and service access for PWD found between low-middle income countries and high-income countries.
AGE-FRIENDLY CARE AND MOBILITY IN HOSPITALIZED OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Vickers Jasmine K , Kennedy Richard E , Biswal Shari , James David , Booth Katrina , Simmons Emily , Flood Kellie
Published: November 2019

Hospitalization of older adults with cognitive impairment (CI) has been associated with higher risk for adverse outcomes. Acute Care for Elders (ACE) Units were developed to meet the unique hospital care needs of older adults and have been associated with reductions in functional decline and readmissions. The Virtual ACE intervention was developed to disseminate ACE principles across hospital units. Virtual ACE included training interprofessional providers to utilize screens and care protocols to optimize care for older adults on eight units at a large academic medical center. We conducted a preliminary analysis of mobility and patient outcomes before and after Virtual ACE among 192 older adults with CI on hospital admission. Chi-Square tests were used to examine the associations between Virtual ACE and patient outcomes. There were statistically significant pre vs. post improvements in patients’ mobility from bed to chair (30% vs. 51%, p=0.011) and on the unit hallway (12% vs. 27%, p=0.046). Although not statistically significant, there were also improvements in hospital room mobility (39% vs. 50%, p=0.214) and documentation of activities of daily living (ADL) screens (70% vs. 80%, p=0.196). There were non-significant reductions in pressure ulcer prevalence (26% vs. 22%) and restraint use (5% vs. 0%) during the hospital stay. Pain was similar before and after Virtual ACE. Virtual ACE was associated with increased mobility and slight reductions in adverse outcomes. As increased hospital mobility improves patient functioning post-discharge, Virtual ACE has the potential to maintain function and enhance outcomes in hospitalized older adults with CI.
MULTISENSORY STIMULATION FOR HOSPITALIZED PATIENTS WITH DEMENTIA: A PILOT STUDY
Authors: Molony Sheila L , Waszynski Christine
Published: November 2019

Introduction: Delirium occurs in up to 50% of hospitalized patients and the risk is higher in persons with dementia. Multi-sensory stimulation environments (MSSE), including trademarked “Snoezelen” rooms, have been effective in achieving positive outcomes in persons with dementia, but there have been no studies in the acute-care setting. Purpose: This pilot study tested the effect of a therapeutic Multi-sensory Stimulation Environment known as “the Hub” in an acute-care hospital. Methods: A sample of 56 patients were randomized to receive usual care or the Therapeutic Hub intervention during hospital days 2-4. Hub activities were multi-sensory and tailored based on preferences and abilities. We will describe techniques to address methodological challenges in the study with acutely ill, cognitively vulnerable participants. We will also present qualitative data describing the experience of participants receiving the Hub intervention, and will present preliminary findings regarding between group-differences in function (Functional Independence Measure), mobility, falls, wellbeing (Warwick-Edinburgh Mental Wellbeing Scale)– and person-environment relationship conceptualized as situational at-homeness (S-EOH). Conclusion: The results of this study will inform future trials on the effects of unique therapeutic environments for hospitalized persons at highest risk for delirium.
VISIBILITY OF PROGRAMS AND SERVICES ON HOSPITAL WEBSITES: GERIATRICS COMPARED WITH OBSTETRICS
Authors: Johnson Brenda P , Kim MyoungJin , McMahon Emily E , Mojadam Ali
Published: November 2019

Hospitals increasingly use a digital platform to market their services as well as reflect the values and mission of the organization. As payment incentives and national initiatives grow for making hospitals more “age friendly” in both the quality and extent of specialized services for older adults, the visibility of these services on a digital platform is of interest. This exploratory, descriptive analysis of hospital websites was to illuminate the ease with which a consumer could identify that a hospital has specialized services in geriatrics as compared with obstetrics. A proportionate stratified random sampling based on the five geographical regions of the country was used to select 220 hospitals with 5% margin of error, 95% confidence interval and 50% sample proportion with no prior information from a population of over 600 hospitals known to have implemented at least one quality initiative specific to older adults (NICHE). A binary matrix was developed for collecting data related to the visibility of services in three main areas of hospital websites: 1) images and terms on the homepage 2) identification of programs in the “Services” function and 3) availability of the specialty in the “Search for Doctor” function. Data show that the frequency of all key words used to identify obstetrical services was greater than those used to describe geriatric services across all functional areas explored in this study. Implications are that hospital websites may be an underutilized resource for marketing services as well as accurately reflecting specialized services for the older adult population.
PROLONGED MECHANICAL VENTILATION: CHARACTERISTICS OF PATIENTS TREATED AT HOME COMPARED TO HOSPITAL LONG-TERM CARE
Authors: Jacobs Jeremy M , Marcus Esther-Lee , Stessman Jochanan
Published: November 2019

Rising numbers of patients receiving Prolonged Mechanical Ventilation (PMV) pose a challenge, and advancing technology supports ventilators appropriate for either Home or Hospital Long Term Care (HLTC).Data guiding decisions concerning place of care are lacking. This study describes the characteristics of the majority (120/123) of all PMV patients aged ≥18 (and their caregivers) in Jerusalem, covered by the Clalit Health Service, treated either with Home Hospital or HLTC. Patients were more alert and communicative at Home vs. HLTC (40/46 vs. 22/74), younger (54 vs.73 years, p12 years (36% vs.21%, p=0.1), and without legal guardian (59% vs. 12%, p<0.01). Primary reason for PMV at home was degenerative neuromuscular disease (59% vs. 28%), compared to post resuscitation/sepsis/CVA in HLTC patients (17% vs. 62%), who suffered more comorbidity, functional decline post-PMV, and pressure sores (0% vs. 42%). Ventilation was more likely to be planned at home vs HLTC (33% vs. 8%), and yet 119/120 were without Advanced Directives prior to PMV. Caregivers at home tended to be spouses (48% vs. 31%) and offspring at HLTC (17% vs. 47%), with reduced Modified Caregiver Strain Index at home (10.5 vs. 12.9, p=0.12). Mortality during follow-up was lower at home (15.2% vs. 27%). Costs to the health fund for home versus HLTC were approximately 1:3. Our findings suggest that with appropriate targeting of eligible PMV patients, Home Hospital may be the preferred model of care for patients, caregivers and healthcare providers.
INNOVATIONS IN EMERGENCY MEDICAL CARE: EARLY ADOPTERS OF GERIATRIC EMERGENCY DEPARTMENTS
Authors: Schumacher John G
Published: November 2019

Hospital emergency departments (EDs) treat more than 20 million older adults each year making it a remarkably significant site of healthcare delivery. To date, the nation’s nearly 5,000 EDs have been slow to modify their staffing, ED training, procedures, or physical environment to better serve the unique needs our heterogeneous older adult population. Nonetheless, nationwide a small set of innovative EDs have redesigned their care and now promote themselves as Geriatric Emergency Departments (GEDs) which specifically tailor care to older adults and their families. Using a systematic, nationwide search process of U.S. hospitals, this research identified n=83 EDs which clearly self-identified as GEDs. All eligible GEDs were contacted with n=54 (65%) responding to our self-administered survey regarding their organization, delivery of care, and adherence to national guidelines on the emergency medical care of older adults. Results document a wide variety of care models, staffing patterns, screening procedures, clinical care modifications, quality improvement efforts, physical environment enhancements, referral patterns, and tracking of older patient outcomes. Analysis of open-ended responses demonstrated widely divergent interpretations of the national guidelines on emergency care for older adults including the definition of a GED. Based on the findings, research recommendations are made to researchers regarding the conceptualization and specific wording of future survey items in order to increase the reliability and validity of research into GEDs.
PREDICTORS OF PRESSURE ULCER DEVELOPMENT AMONG SENIORS DURING EMERGENCY TRANSFERS TO HOSPITAL EMERGENCY DEPARTMENT
Authors: Reid Colin , Jiwani Hannah , Tate Kaitlyn C , Cummings Greta G
Published: November 2019

Emergency transfers of seniors in long-term care facilities (LTCF) aged >65 to hospital emergency departments (ED) are common and carry with them risks that can lead to less-than-optimal quality of care and quality of life. Pressure ulcers are one such risk. We used data from the Older Persons Transitions in Care (OPTIC; N=637) study, conducted in two Canadian provinces in 2011 and 2012, to assess potential predictors of pressure ulcer development between the time that a resident is transported to the ED until the time they return to their original nursing home. Step-wise binary logistic regression was employed to identify predictors of pressure ulcer development during the transition. Potential predictors included length of transition, inpatient status, demographic, health variables (including incontinence). Among the 335 residents for whom we were able to gather new pressure ulcer data, 56 (16.7%) were identified as having developed new skin wounds upon return to the LTCF. Transitions from ED admission to return to LTCF averaged 106.7 hours (sd=143.6) with a median of 50.0 hours. Length of transition and whether the resident spent time as an inpatient emerged as the only predictors: longer transition times and spending time as an inpatient predict development of bed sores. These results speak to the need for improved monitoring and treatment of skin wounds during emergency transitions of older adults from LTCF.
IMPROVEMENTS NEEDED FOR JAPANESE ELDER ABUSE PREVENTION LAW: COMPARISONS WITH OTHER ABUSE PREVENTION LAWS
Authors: Katsumata Asako , Tsukada Noriko
Published: November 2019

Japan has four stand alone abuse prevention laws, including child abuse (enforced in 2000), domestic abuse (2001), elder abuse (2006) and abuse for people with disabilities (2011). These laws are distinctive in that they aim to prevent abuse, not merely to address abuse after it occurs. This paper compares components of these four abuse prevention laws, delineating major strengths and weaknesses of the elder abuse prevention law in comparison to the other three. The analysis considers both institutional and domestic settings and suggests possible improvements of elder abuse prevention law that need to be made. Evidence for this analysis is supplied through examination of trends abuse using longitudinal data (2012-2017) collected by Japan’s Ministry of Health, Labour and Welfare. The analysis shows commonalities in trends in the four abuse categories. For example, the number of abuse cases has risen over time despite the dissemination and implementation of abuse prevention training, program implementation, and public outreach. Differences include reporting – police more often report abuse cases of children and people with disabilities, while elder abuse cases are more often reported by professional staff members responsible for dealing with elder abuse cases. Although some amendments have been made to the child abuse and domestic abuse prevention laws, no amendments have been made to the elder abuse prevention law despite the requirement to review its success. Needed revisions include provisions of protection orders and temporary shelters to protect elder victims from abusers as soon as possible.
ELDER ABUSE BY FAMILY CAREGIVER: DOES COGNITIVE IMPAIRMENT REALLY MATTER?
Authors: Yan Elsie
Published: November 2019

Previous research suggested that cognitive impairment is a risk factor for elder abuse. Persons with dementia experience elevated risk of abuse as compared to the general aging population. The present study compared rates of abuse reported by family caregivers of older persons with and without dementia. A total of 693 family caregivers participated, among which 592 were providing care older persons with dementia and 101 were providing care to older persons without. Participants provided information on their demographic characteristics, care recipient physical functioning (Instrumental Activities of Daily Living), behavioral problems (Cohen Mansfield Agitation Inventory), caregiver stress (Zarit Burden Interview), emotional and instrumental social support, and abusive behaviors directed at the care recipients (Conflict Tactics Scale and Potentially Harmful Behaviors). Abuse is common in this sample: 46.8% reported potentially harmful behaviors, 52.7% reported psychological aggression, 11% physical assault, and 1.3% injury. No significant difference was observed between caregivers providing care to older persons with or without dementia (p>.05). A series of logistic regression was conducted to determine factors associated with abuse. Care recipient behavioral problems and caregiver burden were two prominent factors associated with potentially harmful behaviors and all forms of abuse. Behavioral problems are common in persons with cognitive impairment and many caregivers feel stressful managing them. It is plausible that cognitive impairments per sec do not increases risk of abuse, but the associated characteristics do. Helping family caregivers manage the caregiving situation and their expectation, positive appraisal and cognitive restructuring may help prevent elder abuse.
CRIME-RELATED PHYSICAL INJURIES AMONG OLDER ADULTS IN THE UNITED STATES: FINDINGS FROM 2015 NIBRS DATA
Authors: Galdamez Gerson , Gassoumis Zach
Published: November 2019

Approaches to addressing crimes within the justice system typically do not differentiate between younger and older adults. However, approaches to addressing elder abuse cases—which involve older adult victims exclusively—often rely on the preconception that abuse can only occur if a visible physical injury exists. This preconception is driven in part by perceptions of frailty and ease-of-injury in older, vulnerable victims. We aimed to quantify the prevalence of physical injuries among older victims of violent crimes. We used data reported by the U.S. National Incidence-Based Reporting System (NIBRS) in 2015 to quantify the frequency of reported crimes which resulted in visible, physical injuries to victims aged 60+. Logistic regression was used to determine effects of age, race/ethnicity, type of crime, relationship to offender, and victim locality on physical injury from crime. Among 1,373,417 crime victims, 80.63% of older adults (60+) sustained an injury, as opposed to 65.17% of younger adults (<60). The proportion of individuals who showed physical injuries consistently increased with age until age 90. Knowing the offender was associated with higher odds of sustaining a visible injury (OR 1.47, 95% CI 1.38-1.58). Although older adults show higher risk of visible physical injuries from violent crimes than younger adults, it is possible for a crime against an older adult to have occurred without a visible injury. Medical and criminal justice practitioners should utilize this evidence on elder crime victimization to aid in expert witness testimony and other activities related to justice in crimes against older adults.
LONGITUDINAL CHARACTERISTICS OF INFORMAL CAREGIVERS OF COMMUNITY-DWELLING PERSONS WITH DEMENTIA
Authors: Jutkowitz Eric , Gaugler Joseph E , Trivedi Amal , Mitchell Lauren L , Gozalo Pedro L
Published: November 2019

Alzheimer’s disease and related dementias (ADRD) affect >5 million Americans. Persons with ADRD experience functional limitations and often require support from informal caregivers (e.g., help with feeding). Little is known about how caregiving evolves over the full course of the disease. We used data from the Health and Retirement Study to identify incident predicted community-dwelling persons with ADRD (n=565), their informal caregivers, and the total hours of care they received in a month from predicted incidence up to 8-years post incidence. We estimated linear mixed-effects models to determine the characteristics of the person with ADRD that are associated with trajectories of caregiving hours. At predicted incidence, persons with ADRD received 120 hours of care in a month of which spouses provided 30% of care hours, adult children provided 32% of care hours, other relatives provided 12% of care hours, and non-relatives (including paid support) provided 25% of care hours. By 8-years post incidence, persons with ADRD still in the community (n=23) received 303 hours of care in a month of which spouses provided 28% of care hours, adult children provided 41% of care hours, other relatives provided 3% of care hours, and non-relatives provided 28% of care hours. Having great grandchildren and more functional limitations were associated with receiving more hours of informal care. Attrition (mortality and residing in a nursing home) was influenced by hours of care received in the previous interview and resulted in those that remained in the community being persons that required less care.
THE ROLE OF DEMENTIA FRIENDS IN CREATING STRONGER NETWORKS WITHIN FAITH-BASED COMMUNITIES
Authors: Nishita Christy M , Chun Heather
Published: November 2019

Faith-based communities are uniquely positioned to support members of their congregation with dementia and their caregivers. Aligned with their ministry and service work, congregations can identify individuals who need help and provide needed instrumental and emotional support. This poster will present preliminary findings from a pilot study with a Chinese, Mandarin-speaking church and a Samoan church in Honolulu, Hawaii. Using the Dementia Friends USA curriculum, which was translated into Mandarin and Samoan, the pilot study examined the potential for the Dementia Friends approach to mobilize a congregation and support caregivers. Findings indicate that there was great interest and need for information and dementia within the church community. In addition, a strong ministry and high proportions of older congregation members were keys to the success of the pilot. Finally, misperceptions of dementia within the Chinese and Mandarin communities were common and needed to be addressed in order for church members to fully embrace Dementia Friends principles (i.e., it is possible to have a good quality of life with dementia.) Future work will further explore faith-based community characteristics and other program components that lead to improved support for persons with dementia and their caregivers, as well as stronger dementia-friendly, faith based communities.
IMPACT OF DUAL SENSORY IMPAIRMENT ON HEALTH CARE INTERACTION
Authors: Swenor Bonnielin , Swenor Bonnielin , Alshabasy Yasmeen , Pedersen Emily , Deal Jennifer , Willink Amber , Reed Nicholas
Published: November 2019

Using data from 46,029,364 Medicare beneficiaries included in the 2015 Current Beneficiary Survey (MCBS), we examined the relationship between dual sensory impairment (DSI) – concurrent vision impairment (VI) and hearing impairment (HI) – and accompaniment to physician visits. Analyses examined reasons for accompaniment and self-reported sensory impairment was categorized as: no sensory impairment (89%), hearing impairment (HI) only (5%), vision impairment only (4%), and DSI (1%). There was no difference in odds of accompaniment among HI compared to those without sensory impairment (odds ratio [OR] = 1.04; 95% Confidence Interval [CI]: 0.84,1.29); however, VI and DSI were associated with accompaniment: (OR=2.14; [CI]:1.6,2.8 and [OR]= 2.70; [CI]:1.55,4.72, respectively). Our study further demonstrates that older adults with sensory impairment are accompanied to physician visits more often than those without sensory impairment, and transportation is the most frequently reported reason for accompaniment among adults with VI and communication for those with HI.
STRENGTHENING DEMENTIA CAREGIVING NETWORKS WITH TECHNOLOGIES: INTERSECTIONS OF POLICY, RESEARCH, AND PRACTICE
Authors: Ruggiano Nicole , Bangerter Lauren R , Gruber Melinda , Luetke-Stahlman Hannah , Malley Kelly A O , Wolff Jennifer L
Published: November 2019

Both family caregivers and providers report numerous challenges to providing care for of adults with Alzheimer’s disease and related dementias (AD/RD). Many of these challenges stem from ineffective communication and coordination within the health and support service networks, including: (1) communication challenges posed by AD/RD patients; (2) communication barriers between caregivers and providers; and (3) communication barriers among providers across institutions. Caregivers increasingly rely on technology to fill gaps in their knowledge, identify social support, and learn how to execute more complex care demands. While technology has been suggested as an effective strategy for improving the quality of AD/RD care and support caregivers, the role that public policy and research can and should play in advancing the goal of such tech-based solutions is still emerging. This is especially true in respect to how technology can strengthen care networks for patients and caregivers who are racial/ethnic minorities and/or living in rural communities. This presentation will identify the role that past legislation (e.g. the Affordable Care Act, HITECH, Medicaid) has played, as well as the role that recent and proposed legislation (e.g. RAISE Caregiver Act, CARE Act, 21st Century Cures Act, BOLD Infrastructure for Alzheimer’s Act, Older American’s Act reauthorization) should play in strengthening the health, support networks that caregivers interact with to provide ongoing care. This presentation will also summarize the current state of research on caregiver technologies and discusses how future research and policy initiatives can promote the translation of tech-based interventions into everyday care settings.
DEFINING DEMENTIA-FRIENDLY COMMUNITIES FROM THE PERSPECTIVE OF THOSE AFFECTED: A QUALITATIVE APPROACH
Authors: Wernher Iris A
Published: November 2019

Cities and communities across the globe are pledging to become more “dementia friendly,” yet many communities lack direction as to what this pledge might entail. This poster describes findings from a qualitative study conducted in and around Portland, Oregon. The goal was to better understand how communities can become more dementia friendly – from the perspective of those directly affected by the disease. The study further aimed to clarify how a city or community’s age- and dementia-friendly efforts can be integrated. Fifty community-dwelling participants – 25 individuals living with dementia and their 25 informal care partners – were interviewed separately. The questions centered on the participants’ daily lives, barriers to and opportunities for realizing desired activities, and the participants’ thoughts on how communities can become better and more inclusive places for people living with dementia. The analysis of the interviews yielded common themes, such as social inclusion, public awareness, and transportation, which served to develop a framework of dementia friendliness. This framework was compared to the World Health Organization’s framework of age friendliness to identify areas of overlap and divergence, providing the foundation for a synergistic integration of dementia-friendly initiatives into the greater context of age friendliness. Finally, the answers of individuals living with dementia and those of their care partners were compared to identify similarities and differences in their perspectives. The study was funded, in part, by Oregon citizens through the Alzheimer’s Disease Research Fund of the Oregon Charitable Checkoff Program, administered by the Oregon Partnership for Alzheimer’s Research.
DISENTANGLING KNOWLEDGE AND BIAS: COMBATING AGEISM WITH THE REVISED FACTS ON AGING QUIZ
Authors: Davis Jensen , Breytspraak Linda , Marszalek Jacob , McDowd Joan
Published: November 2019

The Facts on Aging Quiz (FoAQ) was developed in 1977 as a 25-item True/False test of knowledge about older adults. Since that time, it has been utilized in hundreds of studies involving clarifying misconceptions, measuring factual knowledge across different groups, and assessing bias toward older adults. The current study examines the psychometric properties of a revision to the FoAQ created in 2015 that modified the original items and added 25 more to better reflect contemporary aging research. Participants were sampled using Qualtrics and MTurk platforms and targeted to equally represent the following four age groups: 18-34, 35-49, 50-64, and 65 and older. Exploratory factor analysis (n=956) did not support a multi-factor structure, contrary to previous theories of it having cognitive, physical, societal, and psychological health factors. A single factor model was forced which contained 28 items that only accounted for 26% of the variance in scores. The reliability reached satisfactory levels in the younger three age groups with the 28-item version but remained inadequate among those 65 and older. Small associations with the Expectations Regarding Aging-12 and Aging Semantic Differential scales were observed. In its present format, the FoAQ is not sufficient for research use but remains a useful tool in provoking discussion about age bias and areas in which people of all ages lack factual information. Researchers suggest an expansion in response options and further clarifying the use of this instrument as a measure of knowledge or bias.
VIEWS ON AGING ALTER THE IMPACT OF DEATH FEARS ON GENERALIZED ANXIETY
Authors: Rainville G , Mehegan Laura
Published: November 2019

This study looks at the relationship between fear of death, views on aging, and generalized anxiety. We theorize that positive views on aging (such as disagreeing that old age is a time of loss and decline) will buffer anxieties related to the unavoidable event of death. To test an implication of this theory, we ran a model looking at whether scores from a five-item views of aging scale altered the relationship between a fear of death measure (i.e., Collet-Lester’s “Your death” subscale) and generalized anxiety as measured on the GAD-7. Covariates related to religious beliefs, history with depression and anxiety, stress, social desirability reporting, and routine behaviors were included. An online probability sample of American adults age 18 and older (fielded January 2019) yielded results consistent with a “views-on-aging-as-an-anxiety-buffer” theory. Specifically, visualizations indicate that in a high fear of death condition, those with positive views of aging have significantly lower anxiety levels than those who do not. As such, this research suggests that positive views on aging may console those harboring fears about death.
PLANNING FOR FUTURE CARE NEEDS: THE IMPORTANCE OF PERCEIVED NEED
Authors: Gorenko Julie A , Speirs Calandra , Konnert Candace , McGuinness Claire , Mori Camille
Published: November 2019

Despite the demonstrated need to plan for future care needs, many individuals fail to engage in planning, often with negative consequences for their future health and well-being (Lee, Mason, & Cotlear, 2010). Theoretically, the propensity to utilize planning resources may be related to the perceived need for care in the future, a demonstrated predictor of the utilization of health and mental health services (Andersen, 1995; Karlin, Duffy, & Greaves, 2008). The purpose of this study was to examine perceptions of need for future care in combination with predisposing (age, financial security, attitudes towards planning) and enabling (anticipated support, satisfaction with family discussions about future care needs) variables in predicting planning behavior. The sample was comprised of 385 adults, aged 50 years and older (M=66.5, SD=9.3, range=50-92). Hierarchical regression analyses entered two well-established predictors, age and financial security in step 1, and attitudes towards planning, anticipated support, satisfaction with family discussions, and perception of need in step 2. Age and financial security explained 17% of the variance in planning; the addition of step 2 variables explained 33% of the variance and R-squared was significant (p<.001). All predictors were significant at p<.001, with the exception of anticipatory support (p<.05). These results support both the individual (i.e. positive attitudes, perceived need) and contextual nature of planning, in particular the belief that support will be available when you need it and the benefits of family discussions in facilitating planning. Recommendations for enhancing successful planning among individuals and their families will be presented.
DIMINISHED COMPLEXITY OF RELIGIOUS BELIEF AMONG DROPOUTS FROM A LONGITUDINAL STUDY OF COPING
Authors: Anderson Jordan A , Harris Shaelyn M , Nelson Erica L , Teuber Ingrid , Futterman Andrew
Published: November 2019

Selective attrition is a common problem in longitudinal studies of older adults. Dropout is due to many factors, but frequently health concerns figure prominently as a reason for attrition. In light of previous work that suggests health problems reduce complexity of religious and other social involvements, the current study examines complexity of religiousness among dropouts and continuers in a longitudinal study of religion and health in later life. A random sample of 287 older adults living in Worcester, MA was assessed at two times of measurement 12 months apart using interview-based measures of religious orientation (Batson, Schoenrade, and Ventis, 1993) and health (OARS). Of the 287 who began the study, 72 dropped out and were not available to be assessed at 12 month assessment. Using Mplus, a three-factor model of Ends, Means, and Quest orientations demonstrated a good fit to the data in both dropout and continuer subsamples (e.g., CFI’s equaled .959 and .966, respectively). Diminished correlations between Ends, Means, and Quest orientations in the dropout vs. continuer subsample suggests diminished complexity of religious orientation among dropouts. Dropouts were more seriously ill, had higher levels of functional impairment, and demonstrated lower SES, suggesting increased vulnerability and fewer resources may have been the reason for dropping from the study as well as one possible cause of their diminished religious complexity.
AGING BODIES IN PARADISE? AN ETHNOGRAPHIC STUDY OF FANTASY FEST IN KEY WEST, FLORIDA
Authors: Douglas Rachel A , Barrett Anne
Published: November 2019

Dominant cultural constructions of aging bodies, particularly those of women, as unattractive and asexual may be challenged within politically and socially progressive leisure environments, like Key West, Florida, that promote out-group acceptance, collectivity, and cultural diversity. However, this possibility receives limited scholarly attention. Addressing this gap, our study employs observational and interview data (n=60) collected in 2017 and 2018 at Key West’s Fantasy Fest – an annual event marketed as a “10-day party in paradise for grown-ups.” The festival, drawing as many as 100,000 people, cultivates a relaxed atmosphere permissive of nudity and theatrical body adornment, including body paint and costume. This feature makes it an ideal site for examining the effect of inequalities, including age and gender, on body displays and social reactions to them. Data analysis revealed four themes centering on aging bodies – Judging Bodies, Limiting Body Displays, Displaying Bodily Difference, and Liberating Bodies. Age and gender inequality strongly influenced judgments of attractiveness and sexual appeal, contributing to older participants’ more limited body displays. Nevertheless, both young and old participants collectively contributed to creating a liberating environment that celebrates bodily difference and encourages cross-age interaction. While limited to one site with a unique political and social climate, our study suggests the potential of progressive leisure environments to broaden notions of aging bodies and encourage cross-age connections.
DYADIC PREDICTORS OF AGING SATISFACTION: RELATIONSHIP QUALITY MODULATES THE IMPACT OF HEALTH RESTRICTIONS
Authors: Jopp Daniela , Lampraki Charikleia , Meystre Claudia , Kim Kyungmin , Kim Yijung K , Boerner Kathrin
Published: November 2019

How individuals develop perceptions of their own aging process is receiving increasing attention. While own age-related experiences are important, the aging of close others, such as parents, has been also found to play a role. Of particular interest may be parental health, yet relationship quality aspects may influence the extent to which health restrictions affect the children’s aging perceptions. Dyadic data from the Swiss “Aging Together” study were analyzed (dyad N = 98, Parent Mage = 83.85; Child Mage = 56.43). For parents, actor-partner interdependence models indicated a negative relationship between health restrictions and aging satisfaction; the more health restrictions they experienced, the less happy they were with their aging process. Parental health restrictions also played a role for children’s aging satisfaction, but the effect was dependent on how the relationship with the parent was perceived by the child; parents’ health restrictions were negatively associated with aging satisfaction of children who reported better relationship quality (i.e., less conflictual), but not with aging satisfaction of children who reported worse relationship quality (i.e., more conflictual). In addition, when the parent was more restricted, children who perceived the parent as more supportive showed lower levels of aging satisfaction, compared to children who perceived the parent as less supportive. Lastly, children’s own health restrictions had no negative impact on their aging satisfaction when they perceived the parent as more supportive. In sum, health restrictions may influence both dyadic partners’ aging satisfaction, but relationship quality modulates their impact.
ATTITUDES OF OLDER ADULTS TOWARD PHARMACEUTICAL DIRECT-TO-CONSUMER ADVERTISING
Authors: O’Hanlon Ann M , McLin and Carlen L
Published: November 2019

According to national data, older adults view more television than any other age group. However, further research is needed about how older adults respond to programming. In particular, this study focused on the attitudes of older viewers toward pharmaceutical direct-to-consumer advertising (DTCA). Prior research has shown DTCA increases consumers’ demand for drugs, but less research has addressed how older consumers perceive such advertising. Researchers surveyed 293 older adults who attended Senior Centers throughout New Orleans about their television viewing and response to direct-to-consumer drug advertising. The sample was predominantly female (96%) and African American (87%) with a mean age of 76 years. The primary motivations selected for viewing television were to watch a favorite show, to be entertained, or learn information; older adults did not often endorse reasons of boredom, escapism, or relaxation. A majority of the sample (62%) perceived commercials as an interruption or annoying, and indicated they were uninfluenced by advertising (74%). When asked about direct-to-consumer advertising, 54 percent disapproved of such advertising, but 50% reported attending to such commercials when aired. Some older adults reported that advertisements on medicines could provide valuable information (46%), but also perceived the ads as confusing (57%) or alarming (61%). After viewing DTCA, older adults most often reported speaking to a doctor (46%) or seeking information (27%) about a drug, but some reported that they decreased (11%), increased (3%) or stopped (3%) taking medicine. The results provide additional information about how direct-to-consumer advertising is perceived by older adults and affects compliance behavior.
ASSESSING RISK FOR ENDOMETRIAL CANCER AMONG HISPANIC FEMALES AGE 50 YEARS AND OLDER
Authors: Rodriguez Ana , Kuo Yong-Fang , Hsu Enshuo
Published: November 2019

Endometrial cancer is the most common gynecological cancer in the US, with most women diagnosed between 55 and 64 years old. Seventy-five percent of women with endometrial cancer are postmenopausal, and the most common symptom is postmenopausal bleeding. Only a few studies have addressed the lack of knowledge and awareness of risk factors and/or health care utilization for early signs and symptoms of endometrial cancer. The objective of this study was to evaluate health care utilization among Hispanic women aged ≥50 years who are at risk for endometrial cancer. This retrospective cohort study used a combination of diagnosis and procedure codes from UTMB’s electronic health records to identify Texas Hispanic females who had a health encounter at ≥50 years of age between 2012 and 2016. Risk factors included conditions/treatments affecting hormone levels, age, body mass index, diabetes, gravidity, parity, family history of endometrial or colorectal cancer, previous diagnosis of breast or ovarian cancer or endometrial hyperplasia, smoking or alcohol use, and treatment with radiation therapy in the pelvis area. Multivariate logistic regression models evaluated for predictors of endometrial cancer. The study included 11,563 Hispanic females aged ≥50 years (median age=57). Most women were overweight. Currently, we identified 705 Hispanic females (6.1%) with possible endometrial cancer with validation underway. Females who have a history of vaginal spotting/bleeding, pelvic bleeding, and pelvic pain are at higher risk for endometrial cancer. It is important for physicians to educate patients on recognizing the signs and symptoms of endometrial cancer.