bluuebunny/crossref_metadata_2025 huggingface dataset:
OLDER ITALIANS’ VIEWS OF AND EXPERIENCES WITH IMMIGRANT CAREWORKERS
Authors: Vecchione Katia , Barrett Anne
Published: November 2019

Population aging has led, in many countries, to new care arrangements to meet the growing need. In Italy, with the second oldest population in the world, family members, especially women, provide the majority of care; however, paid immigrants are increasingly filling in where families cannot. Known as “badanti,” most of these careworkers are middle-aged women from Eastern Europe. Although some research examines this phenomenon, it focuses exclusively on careworkers – not those receiving their care. Addressing this gap, my paper examines older Italians’ attitudes toward and experiences with immigrant careworkers, using interviews with 20 nursing home residents and 20 senior center participants. Analyses reveal polarized views of “badanti, with more positive views found among those with personal experience receiving their care. I find that negative attitudes are shaped by three broader cultural discourses about aging, as well as immigration. Attitudes are influenced by views of independence and autonomy -- core values perceived to be threatened by badanti. Relatedly, attitudes are influenced by the centrality of space and home, which again are viewed as challenged by badanti’s presence. Negative views of badanti also are shaped by dominant discourses regarding immigrants, who are viewed as threats to security, particularly regarding one’s belongings. Such beliefs and values influence older adults’ willingness to accept help from careworkers and its effectiveness -- knowledge of which can help create better care scenarios.
EMERGING MODELS OF CARE: THE IMPACT OF PHARMACIST-LED MEDICATION MANAGEMENT IN A TRANSITIONAL CARE PROGRAM
Authors: Andrews Ebony , Brown-Hughes Travonia , Lyon Ronald , Parker Shanea D , Lazernick Brad
Published: November 2019

Transitional care programs have emerged as successful models of care in which to reduce cost and improve health outcomes. However, few transitional care models have directly incorporated the expertise of the pharmacist as an integral member of the care coordination team. Therein lies an inherent limitation of many community-based transitional care programs, the underutilization of pharmacist during all stages of the care transition process. In 2013, the Hampton Roads Care Transitions Project (HRCTP), a partnership between Senior Services of Southeastern Virginia Area Agency on Aging in Norfolk, VA and Hampton University School of Pharmacy, was established. The goal of the HRCTP is to provide medication management services to reduce preventable hospital readmissions for adults 60 years of age and older with targeted diagnoses. Pharmacists work in collaboration with social workers who act as HRCTP care transition coaches. Between May 2017- October 2018, 678 patients were enrolled in the HRCTP. The hospital readmission rate among patients with targeted diagnoses was reduced by 55.3% with an absolute percentage point reduction of 9.9% and estimated savings amount per avoided readmission of $14,400. Patients who participated in the HRCTP showed a 14% increase in the Patient Activation Assessment indicating an improvement in self-managing efficacy. 93% of patients/caregivers indicated they felt more confident in their ability to manage their health, and 91% expressed satisfaction with the program. The program has proven effective in assisting seniors to remain in their home, reducing hospitalizations, promoting health, increasing patient satisfaction, and reducing healthcare cost.
A SIMPLE INTERVENTION TO REDUCE ANTICHOLINERGIC DRUG USE WHILE ATTENDING A GERIATRIC DAY HOSPITAL
Authors: Apostolides Costa
Published: November 2019

Attendance at a Geriatric Day Hospital has previously been shown to reduce both the overall number of medications and the number of anticholinergic medications of patients. In the present study, patients enrolled in a Geriatric Day Hospital program from January to February 2019 were divided into a control and intervention group. Anticholinergic medications in the intervention group were flagged by highlighting them in the patient chart and alerting the attending clinician, whereas no alerts were provided in the control group. Anticholinergic load was calculated using the Anticholinergic Cognitive Burden (ACB) and Drug Burden Index (DBI) scores. In comparing admit versus discharge medications in the intervention group, both the mean number of overall medications (10 vs. 9.7) and anticholinergic medications (3.5 vs. 3.1) was reduced; this was not the case in the control group, where the mean number of overall medications remained the same (11.92) and the mean number of anticholinergic medications increased (3.83 vs. 3.92). More significantly, in comparing admit versus discharge scores, both the mean ACB and DBI scores were reduced in the intervention group, but in the control group both the ACB and DBI scores either remained the same or increased at the time of discharge. This clearly shows that a simple intervention (highlighting anticholinergic medications in the patient chart) can have a clinically beneficial outcome of reducing these harmful medications in patients. With approximately 50% of the older population taking at least one anticholinergic drug, the importance of reducing anticholinergic burden cannot be overemphasized.
CHALLENGES FACED BY OLDER PERSONS IN USING PRESCRIPTION MEDICATION LABELS: WHAT NEEDS TO CHANGE?
Authors: Malhotra Rahul , Suppiah Sumithra , Tan Yi Wen
Published: November 2019

In Singapore, while many older people cannot read English, prescription medication labels (PMLs) are predominantly dispensed in English. This qualitative study documented the challenges faced and solutions employed by users (i.e. older Singaporeans) and dispensers (i.e. pharmacy staff) of PMLs. In total, 30 in-depth interviews were conducted; 20 were equally divided between older Singaporeans (≥60 years) who could read English and those with limited/no English reading ability, and 10 were conducted with pharmacy staff across 6 polyclinics. The audio-taped interviews were transcribed verbatim and analysed thematically. The interviews with older Singaporeans and pharmacy staff revealed similar challenges in using PMLs. The first challenge related to reading and understanding PMLs by older people, mainly due to their limited English proficiency (LEP) or illiteracy. Consequently, older Singaporeans often relied on family members, domestic workers or pharmacy staff to help them interpret PMLs. Specifically, to address LEP, pharmacy staff reported translating PML instructions verbally and also handwriting them on PMLs. For illiterate patients, pharmacy staff reported drawing illustrations on PMLs to communicate key medication information. The second challenge related to PML readability, due to small font size. To address this, pharmacy staff routinely re-wrote medication information on PMLs in larger handwriting. Such improvised solutions by pharmacy staff to address the challenges faced by older Singaporeans in using PMLs indicate a pressing need for system-level improvements to PMLs. Improvements such as standardised and legible bilingual medication instructions and/or pictograms would appreciably facilitate medication counselling and allow for better understanding of PMLs by older Singaporeans.
WHAT IS THE EVIDENCE BASE FOR NONPHARMACEUTICAL INTERVENTIONS TO DECREASE USE OF PSYCHOTROPIC MEDICATIONS?
Authors: Garavito German Alarcon , Abrahamson Kathleen
Published: November 2019

Psychotropic medications (anti-depressants, anti-anxiolytics, anti-psychotics, others), have been targeted as a class of medications that can be reduced among residential long-term care (LTC) residents with proper environmental intervention. Reduction of psychotropic medications has the potential to increase resident health/well-being and decrease costs. However, residential LTC facilities face numerous challenges in reducing psychotropic medications, including but not limited to behavior and communication difficulties in advanced dementia, lack of staff training/awareness of needed environmental modifications, and use of medications to manage the cascade of side-effects that occur with polypharmacy and multi-morbidity in the LTC population. A developed literature exists surrounding non-pharmaceutical interventions to reduce psychotropic use in residential LTC. The goal of this current study was to synthesize that body of literature through a systematic review, and categorize findings in a way that is meaningful to direct-care nursing staff. The search of 13 databases identified 14 studies published since 2007 that focused specifically upon residential care and nurse-led non-pharmaceutical interventions. Identified study designs were experimental (5), observational (3), and systematic reviews/meta-analyses from within 8 countries. Findings were categorized based upon type of intervention (educational, environmental, sensorial, care-approach, physiological, and social), as well the target population. Successful interventions were most commonly targeted toward staff and residents, less commonly toward family. The most common approach was education and change in care-approach, with physiological interventions being the least common. We will discuss the implications for nursing staff surrounding the available evidence, and pro/cons of implementing interventions within different organizational settings based upon the study findings.
PROBING THE COMPLEX INTERACTIONS BETWEEN DIET, DISEASE, AND AGING
Authors: Anderson Rozalyn
Published: November 2019

Nutrient response pathways are conserved modifiers of longevity, and dietary restriction is the most studied intervention for slowing aging in laboratory animals. For many years it was believed that lifespan extension from dietary restriction was tightly linked to total caloric intake. Recent evidence suggests that the interaction between diet and aging is more complex than this, however, with nutrient sensing, dietary composition, and circadian components all playing a role. This symposium will delve into some of the complex biological interactions linking food intake, lifespan, and diseases of aging.
A TRIAL TO IMPROVE MEDICATION SAFETY IN OLDER ADULTS: RECRUITMENT CHALLENGES HAVE GENERALIZABILITY IMPLICATIONS
Authors: Anzuoni Kathryn , Field Terry , Mazor Kathleen , Zhou Yanhua , Konola Timothy , Kapoor Alok , Garber Lawrence , Gurwitz Jerry
Published: November 2019

For older adults, the transition from hospital to home is a high-risk period for adverse drug events, functional decline, and hospital readmission. Randomized trials of interventions to improve this transition must recruit potential subjects immediately after hospital discharge, when people are recovering and tired. Within a randomized trial assessing the impact of a pharmacist home visit to provide medication assistance immediately post-discharge, we determined whether individuals who enrolled were comparable to those who were invited but did not enroll, and described reasons for not enrolling. Individuals ≥50 years of age discharged from the hospital and prescribed a high-risk medication were eligible. We attempted to recruit individuals by phone within 3 days of discharge, and recorded reasons for not enrolling. Of 3,606 eligible individuals reached, 3,147 (87%) declined, 361 (10%) were enrolled, and 98 (3%) were initially recruited but did not complete a consent form. Individuals ≥80 years of age (odds ratio 0.45, CI 0.25, 0.78) and those with an assigned visiting nurse (odds ratio 0.64, CI 0.48, 0.85) were least likely to enroll. Among those who provided a reason for declining (2,473) the most common reason given was the belief they did not need medication assistance (22%). An additional 332 (13%) declined because they were receiving visiting nurse services. Recruiting older adults recently discharged from the hospital is difficult and may under-enroll the oldest individuals, limiting the ability to generalize findings across older patient populations. Researchers planning RCTs among newly discharged older adults may need creative approaches to overcome resistance.
RACE DIFFERENCES IN ALLOSTATIC LOAD AMONG BLACK AND WHITE MEN: DOES AGE MATTER?
Authors: Thorpe Roland J , Zare Hossein , Archibald Paul , Bruce Marino A , Norris Keith , Whitfield Keith E
Published: November 2019

Although Black-White disparities in health and mortality among men persist, there is a paucity of work focusing on race differences in physiological dysregulation of biological processes resulting from the cumulative impact of stressors among men. The purpose of this study was to assess potential race differences in Allostatic Load (AL) among adult men and if such differences vary by age. Data were drawn from the 1999-2010 NHANES, and the study population included 2700 non-Hispanic Black (NHB) and 19930 Non-Hispanic White (NHW) born in US. AL was derived by summing across cardiovascular, metabolic, and inflammatory biomarkers considered to be high risk, resulting in a count variable ranging from 0 to 9. Race was based on self-report. Age was categorized: 18-24, 25-44, 45-64, and 65 years and older. Negative binomial regression was used to examine the relationship between race and AL score. Models included education, marital status, family income, health insurance and self-reported health. Adjusting for potential confounders, NHB men had a higher AL score ((incidence rate ratio (IRR) = 1.06, 95% confidence interval (CI) 1.01, 1.11) than NHW men. NHB men 25-44 years old had a higher AL score than (IRR = 1.14, 95% CI;1.04, 1.24) than their NHW peers. No race differences with respect to AL score were observed among the other age groups. Race differences in AL vary by age categories. Efforts to improve longevity should focus on developing age-tailored health promoting strategies to reduce stress among Black men during early adulthood.
MIGRATION, MOBILITY, AND PURSUIT OF GOOD OLD AGES: NARRATIVES OF OLDER PUERTO RICAN ADULTS WHO MIGRATE
Authors: Jespersen Brooke V
Published: November 2019

Migration research has articulated “regimes of mobility,” or multi-scalar movements (within and across households, communities, and borders) that are interconnected and embedded in unequal power relations. Research on late-life migration has been limited by: (1) simplistic conceptualizations of mobility as adaptive or traumatic; and (2) a focus on transnationalism. The migration of older adults between Puerto Rico and US mainland presents a new frontier for examining mobility in aging. Puerto Rico’s population is rapidly aging and out-migrating. Moreover, as US citizens, Puerto Ricans experience no legal restrictions on migration typical of transnationalism. Yet little is known about their migration patterns and associated narrated meanings. I conducted semi-structured interviews and participant observation among older Puerto Ricans who migrated to the US mainland in late-life. Preliminary findings suggest that older Puerto Ricans negotiate competing definitions of “good” old ages based on residential context. They report migrating to the mainland to pursue “good” old ages defined in material terms, namely access to social and medical services. Post-migration, however, older Puerto Ricans report experiences of confinement and loneliness, due to language barriers and familial separation. In narrating hopes for the future, they describe an alternative “good” old age in Puerto Rico, emphasizing belonging and familial connection. As older Puerto Ricans negotiate multiple definitions of “good” old ages through circular mobility, the social and economic inequalities which first necessitated migration reproduce disadvantage in the new location. This study highlights the need to conceptualize multi-scalar mobilities that intersect with inequality to shape aging among migrant populations.
SOCIOCULTURAL DETERMINANTS IN PAIN PERCEPTION AND MANAGEMENT AMONG OLDER CHINESE AMERICANS
Authors: Kwon Simona , Wong Jazmine , Pan Janet , Rosenberg Andrew , Cuff Germaine , Aye Myint
Published: November 2019

Background: Chinese Americans make up the largest Asian American subgroup in the US. Data from a large health system indicate that older Chinese Americans experience lower satisfaction in pain management after surgery compared to all other racial/ethnic groups. Objective: To understand pain experience among older Chinese American patients to improve pain satisfaction strategies Methods: A mixed methods study was conducted, including: 1. A scoping review of the peer-reviewed published literature; 2) face-to-face survey; and 3) qualitative interviews. 14 Chinese American postsurgical patients >65 years of age were recruited for the survey and interview with a trained bilingual Community Health Worker. Questions from the Survey on Disparities in Quality of Healthcare and Kleinman’s Explanatory Model of Illness guided the data collection tools. Results: The 31 studies identified in the review were largely observational; none assessed pain control or management interventions for older Chinese Americans. Most participants reported experiencing a language barrier that hindered healthcare staff communication during hospital stay. Even with an interpreter, limited English proficient patients reported lower understanding of health information compared to those who did not need interpretation. Ideas of “pushing through” pain, perceiving physicians as “busy people,” and mismatch in pain assessment tools contributed to pain attendance delay. Facilitators to care included family support, culturally and linguistically-tailored tools, and availability of cultural remedies. Conclusions: This mixed-methods study identified key themes including socio-cultural barriers and facilitators to effective pain care and management. Findings will inform tools and resources to better capture and address pain management in Chinese Americans.
MIDDLE-AGED AND OLDER LATINOS’ SATISFACTION OF BAILAMOS LATIN DANCE PROGRAM
Authors: Balbim Guilherme M , Aguinaga Susan , Marques Isabela G , Guzman Jacqueline , Marquez David X , Vasquez Priscilla
Published: November 2019

Older Latinos engage in low levels of leisure-time physical activity (LTPA). Dance is a culturally appropriate activity which can be used to increase LTPA levels. We examined middle-aged and older Latinos’ satisfaction with the revised BAILAMOS Latin dance program. Healthy and low actives middle-aged and older Latinos (Mage = 64.89±7.08) were randomized to a 4-month dance program (n=167) or health education (n=166). The dance program consisted of four Latin dance styles (Merengue, Bachata, Cha Cha Cha, and Salsa). Classes were held twice a week for one hour. A total of 113 participants completed the program. Participants completed a program evaluation about the 4-months program regarding time, duration, settings, instructor, and overall satisfaction. Items were evaluated on a 1 (strongly disagree/very bad) to 4 (strongly agree/excellent) Likert agreement scale. A total of 73 participants evaluated the 4-month dance program. Participants evaluated the program adequacy agreeing or strongly agreeing as far: time, duration and setting (96-98%); instructor’s enthusiasm, quality of instructions, and eager to help (96-100%); dance program’s progression and enjoyment (93-96%); difficulty level (59%). Participants reported they intended to keep dancing by themselves (93%) and would recommend the program to friends and family (98%). Many participants (88%) reported feeling physically excellent or good as a result of the program, 95% found the program excellent or good, and 100% thought the program was worth their time. Overall, the BAILAMOS program evaluation demonstrated high participants’ acceptability and satisfaction. Those results can promote sustained LTPA and provide initial evidence to translation into community settings.
EXPERIENCES OF DISCRIMINATION ARE ASSOCIATED WITH DECREASED FUNCTIONAL ABILITY IN AFRICAN IMMIGRANT OLDER ADULTS
Authors: Nkimbeng Manka , Bandeen-Roche Karen , Han Hae Ra , Szanton Sarah L , Thorpe Roland
Published: November 2019

Discrimination impacts functional health outcomes of African Americans and other racial/ethnic minorities in the United States; yet this is understudied in African immigrants whose population has risen by 137% since 2000. We examined the relationship between discrimination and physical function with a convenience sample of first-generation African immigrants age 50+ recruited through community-based organizations (N=124). Discrimination was measured with the Everyday Discrimination scale with higher scores indicating more experiences of discrimination (range=0-23). High versus low levels of discrimination were categorized at the mean. Physical function was measured using the PROMIS Physical Function measure with high scores indicating greater functional ability (range=11-50). Raw function scores were converted to standardized T-scores with a population mean of 50 and standard deviation (SD) of 10. Linear regression was used for analyses. Mean age of the sample was 61.4(SD=7.9) years. About two-thirds (63%) were female, more than half (52.4%) immigrated in search of better opportunities and half of the sample had high levels of discrimination. The mean function score was 44.2(SD=8.3) indicating that this sample had functional ability 6 points less than the population average. After adjusting for demographic and migration factors, the mean physical function score was 2.5 points lower (b=-2.53, 95% CI= -5.04, -0.01) for participants with more experiences compared to those with fewer experiences of discrimination. In conclusion, discrimination was associated with poor physical function in African immigrant older adults after adjusting for covariates. Longitudinal studies of discrimination and physical functioning should be pursued in more diverse, larger samples of African immigrants.
THE UPSIDE OF GETTING OLD: TESTING A MODEL OF OLDER AGE AND BETTER EMOTIONAL WELL-BEING
Authors: Wilson Jenna , Strough JoNell , Shook Natalie
Published: November 2019

Older adults often report better emotional well-being than younger adults. Socioemotional Selectivity Theory posits that with age, reduced future time perspective motivates prioritizing emotional well-being in the present moment (Carstensen, 2006). Mindfulness, a receptive attention to experiences as they occur (Brown & Ryan, 2003), and savoring, the ability to regulate positive feelings in the moment (Bryant, 2003), are present-oriented processes associated with greater well-being. Recent evidence indicates that greater mindfulness in part accounts for age differences in positive affect (Shook et al., 2017). The current study investigated whether older age is associated with a greater present-oriented time perspective, which in turn is related to greater savoring and mindfulness, thus statistically accounting for older adults’ better well-being. Participants (N = 888, 20-88 years, Mage = 46.37, SD = 15.20) recruited via MTurk completed an online survey. Data were analyzed using structural equation modeling. The model provided an adequate fit to the data (CMIN/DF = 2.94, CFI = 0.985, RMSEA = 0.048). Older age was associated with greater present-oriented time perspective, and present-oriented time perspective was associated with greater savoring and mindfulness which, in turn, were associated with better emotional well-being. Alternative models were tested, but did not significantly improve model fit. Findings suggest that there may be benefits for younger adults’ well-being if they learned to be more present focused, savor the moment, and be more mindful like older adults. Thus, present-oriented time perspective may be an important factor for healthy aging.
DOES PERSONALITY PREDICT PATTERNS OF AGING? LONGITUDINAL FINDINGS FROM THE VA NORMATIVE AGING STUDY
Authors: Nath Ritwik , Aldwin Carolyn M , Choun Soyoung , Kurth Maria , III Avron Spiro
Published: November 2019

Previous research using the Veterans Affairs Normative Aging Study identified four patterns of aging using group-based multi-trajectory modelling to identify joint changes in life satisfaction (LS) and functional health (FH) (Nath et al., 2018a,b). The purpose of the present study was to examine whether personality traits predicted these four patterns: impaired (stable low LS and FH), normal (decreasing LS and FH), optimal (high LS, decreasing FH), and successful aging (high LS and FH). The sample consisted of 992 NAS men who provided 3,853 observations (M=2.81, SD=1.54, range 1–8) between 1987 and 2010 (Mage=62.31, SDage=7.50, range 44-86 in 1987). Multinomial logit regression analysis with robust estimation controlled for marital, employment, and self-rated health status, using optimal aging as the reference group. Compared to the optimal aging group, neuroticism predicted membership to the normal aging (RR=1.61, CI=1.16–2.22) and the successful aging groups (RR=.55, CI=.38–.79). Optimism predicted membership to all groups, with lower risk ratios to the impaired aging group (RR=.11, CI=.04–.33) and normal aging group (RR=.57, CI=.42–.79), and higher risk ratio to the optimal aging group (RR=1.96, CI=1.35–2.85). Extraversion only predicted membership in the impaired aging group (RR=.27, CI=.12–.63) indicating high levels of social isolation. Thus, personality may play an important role in determining the patterns of aging.
CROSS-SECTOR COLLABORATION TO BUILD DEMENTIA-FRIENDLY BUSINESSES: ENGAGING STUDENTS IN PUBLIC ISSUES IN AGING
Authors: Huber Lesa L , Mosier Amanda , Abramenaka-Lachheb Victoria
Published: November 2019

Despite a nationwide campaign to build dementia friendly communities, increasing awareness and engagement with programs like Dementia Friendly Businesses remains a challenge for local champions. To create welcoming environments for people living with dementia (PLWD), communities may benefit from cross-sector collaboration. Fundamental to collaborative efforts is the conviction that individuals, families, businesses, organizations, and institutions each play a role in reducing the stigma associated with dementia and facilitating welcoming environments. This exploratory study considers the outcomes of a cross-sector collaboration between a university, a hospital, individual community members, and students to build awareness of the need for new norms that reduce stigma for people living with dementia. We measured change at each ecological level. Through this collaboration, 61 local businesses and organizations are now DFB certified, 350 individuals have participated in training, and 150 students have joined 12 community trainers to advocate for dementia friendly spaces. Students’ survey responses show that 75% agree or strongly agree that the project engaged them in a meaningful real world experience and advocating for the need for dementia friendly spaces. PLWD provide qualitative data on feeling welcomed in the community. The university and hospital co-created an online open access dementia friendly training taken by 89 people in 6 months. 150 community members came together for a day-long workshop to build capacity and innovate solutions. Implications of the project suggest that changing cultural norms about dementia requires creative solutions that meaningfully engage individuals, organizations, institutions, and communities to collaborate across multiple sectors
EXPLORING DEATH AND DYING WITH HEALTHCARE STUDENTS
Authors: Foti Megan , Cassel Stacy
Published: November 2019

Although death is a universal experience, many avoid discussing or learning more about the topic (Mak, 2011). However, healthcare professionals are expected to be knowledgeable, resourceful, and professional within their scopes of practice, but oftentimes avoid end of life topics (Ramvi & Gripsrud, 2017). Students also report concerns when working with clients at the end of life expressing fear of how they will handle an encounter with a dying client (Ek et al., 2014). Therefore, professionals need didactic and personal preparation to be more comfortable with discussions related to end of life treatment and planning (Kumar et al, 2013). Evidence supports that students can benefit from self-reflective and narrative exercise with older adults that challenge their perspectives on end of life. Students who are able to openly discuss death, dying, illness and loss express a desire to learn more about working with the older adult population and increased sensitivity to the beliefs and attitudes of older adults (Butler & Baghi, 2008; Nelson et al., 2018). In order to provide students with an opportunity to explore end of life topics, professors designed an educational module which included activities such as writing a living will, discussing end of life topics with older adults, and critically reflecting on their experiences. This proposed poster will highlight current background literature relevant to end of life topics, methods for integrating end of life topics into academic curricula, and student perceptions related to end of life topics as shared in their reflections.
THE IMPACT OF DEMENTIA TRAINING ON HOSPITAL STAFF’S KNOWLEDGE AND ATTITUDES
Authors: Schneider Julia , Teichmann Birgit , Kruse Andreas
Published: November 2019

Older people with dementia are more frequently hospitalized and more strongly associated with negative outcomes. We examined the acceptance and the effect of a dementia training on attitudes and knowledge of the hospital staff. In the current study, we utilized a mixed-methods research design to examine a clinic group of six hospitals in Germany. Besides semi-structured interviews, we collected quantitative data with a questionnaire given before and three-months after the training. The questionnaire contained German translated versions of the Knowledge in Dementia (KIDE) Scale and the Dementia Attitudes Scale (DAS-D) to assess changes in attitudes. The participant population (N=60) consisted of nurses (n=35, 58%), medical assistants (n=13, 22%) and other medical professions. Satisfaction with the training was predominantly positive, 92% would recommend the training to their colleagues. At baseline, a small but significant correlation between the standardized questionnaires KIDE and DAS-D was evident (r(60)=.357, p=.005). The participants (n=32) showed a more positive attitude in the post-test (M=5.39, SD=0.64) than in the baseline-test (M=5.19, SD=0.66). This difference was significant (t(31)=-2.434, p=.021). However, we did not find any significant effects on the KIDE. The reason for this may be the use of a standardized questionnaire, which does not reflect the increase in knowledge, or there has been no increase in knowledge of dementia. The results are based on a small sample size. However, they have demonstrated that dementia training can positively influence attitudes toward people with dementia. A significant increase in knowledge was expected but could not be demonstrated.
SELF-MANAGEMENT INTERVENTIONS IN DIALYSIS FACILITIES
Authors: Washington Tiffany R , Mingo Chivon , Smith Matthew L
Published: November 2019

There have been few attempts to implement self-management interventions in dialysis facilities. This paper presentation describes four studies that constitute the formative work necessary to inform implementation. Studies one and two examined the relationship between psychosocial factors and kidney disease self-management, finding depression and cognitive decline to undermine self-management behaviors. Study three examined how dialysis patients define and think about self-management and their interest in participating in a self-management program. Among them, 78% affirmed they would participate in a self-management program if it were offered in their facility. Finally, when examining organizational readiness to implement a self-management intervention in dialysis facilities, staff perceived it to be consistent with facility values, and agreed they were well-positioned to implement the program. Taken together, these findings suggest a self-management intervention would be beneficial and supported, but would require thoughtful implementation considerations. These studies have implications for developmental self-management research with other chronic conditions.
MULTIPLE SOURCES OF SOCIAL STATUS IN OLD AGE: THE ROLE OF AGE GROUPS AND GENERATIONS
Authors: Weiss David , Zhang Xin
Published: November 2019

This cross-cultural study compared attitudes towards age and generational groups across the life span in China, Germany, and the US including N = 1302 participants between 18 and 86 years of age. We asked younger, middle-aged, and older respondents to rate either age (e.g., adolescents, young adults, middle-aged adults, and older, adults) or generational groups (e.g., Millennials, Generation X, Baby Boomer, and Silent Generation) on various characteristics. Results demonstrate that across all three cultures older age groups were perceived consistently less positive and more negative, whereas older generations were perceived as significantly more positive and less negative. Our results suggest that generations in contrast to age groups represent a source of high social status in later life providing a sense of respect, value, and admiration. Thus, social status can be derived from multiple sources and older adults can draw upon alternative social status domains (their generation) when confronted with loss.
PARADOXICAL ASSOCIATION BETWEEN AGING STEREOTYPES AND PROSOCIAL BEHAVIORS TOWARD OLDER ADULTS
Authors: Zhang Xin , Xing Cai , Liu Ming
Published: November 2019

According to stereotype content model, older adults were perceived as low in competence (but high in warmth). Studies have demonstrated that such negative stereotypes could affect older adults significantly. However, it remained unclear how younger adults could be influenced, especially during intergenerational interactions, i.e., would positive or negative aging stereotypes promote more prosocial behaviors toward older adults. 104 younger adults were randomly assigned to three aging stereotype conditions (i.e., negative, neutral vs. positive), and they were then introduced to play two prosocial tasks (i.e., social value orientation and ultimatum game), in which they were imagined to play with either a younger or an older adults. It was found that younger adults exhibited more prosocial tendencies toward older partners than that to younger partners in both tasks. Moreover, activation of a negative aging stereotype could make younger adults behave more prosocially to the older partners in the social value orientation task.
INCREASE IN HSP25 EXTENDS LIFESPAN AND IMPROVES RESPONSE TO TAU TOXICITY THROUGH A CELL, NON-AUTONOMOUS MECHANISM
Authors: Rodriguez Karl
Published: November 2019

The accrual of aggregation-prone cytotoxic proteins underlies neural pathologies seen in aging, Alzheimer’s disease and other dementias. Recent evidence indicates that heat shock protein 25kDa (HSP25) interacts with tau. To demonstrate a causal role for HSP25 in these pathologies, we overexpressed HSP25 protein in worms. This manipulation led to an increase in life span. Moreover, the longevity-effect was associated with increased expression of genes downstream of the SKN-1/Nrf2 stress-response transcription factor. HSP25 over-expression also reduces aggregate pathology and extends lifespan in a C. elegans neuronal-specific, aggregate-prone tau model . We propose that over-expression of HSP25 could provide protection from protein aggregation induced neurodegeneration. However, it is not yet clear whether this HSP25 effect could be efficaciously provided exogenously by other cell types. Thus, we will test whether increased peripheral HSP25 will reduce protein aggregation and stimulate a global Skn-1 stress-response pathway, reduce toxicity in neurons, and improve health outcomes.
A COMMUNITY AND TECH-BASED APPROACH FOR HYPERTENSION SELF-MANAGEMENT (COACHMAN)
Authors: Still Carolyn H , Moore Shirley M , Sattar Abdus , Wright Jr Jackson T
Published: November 2019

African American (AAs) are disproportionately affected by hypertension. Developing effective outreach programs with community partners is a major public health priority and ideal to educate, empower, and offer support to self-manage hypertension in AAs. The purpose of this pilot is to investigate the effectiveness of a community outreach program using a technology-based intervention for hypertension self-management (COACHMAN) to improve blood pressure (BP) control. Forty AAs with hypertension will be randomly assigned to COACHMAN or enhanced usual care (EUC). COACHMAN is comprised of four components: self-monitoring of BP; web-based education; nurse counseling; and training on a medication management application. The primary outcome is change in BP from baseline to 3-months. We hypothesize that participants in COACHMAN (compared to EUC) will have better BP control. Findings from this study, if confirmed, will provide knowledge to the scarce literature available on technology-based interventions appropriate to help AAs self-manage hypertension and improve BP control.
COMPREHENSIVE HEALTH ASSESSMENT AND MOTIVATION PROGRAM FOR PEOPLE AGING WITH DISABILITIES (CHAMP-D)
Authors: Heyn Patricia C , Carollo James J
Published: November 2019

We developed a Comprehensive Health Assessment and Motivation program (CHAMP-D) focused on self-health promotion and management for people aging with disabilities. The goal of the CHAMP-D is to enhance healthy lifestyle, self-health management and communications with the care team by a person-centered Health Passport tool. All study participants underwent comprehensive health, physical, and blood laboratory evaluation. CHAMP-D results were formatted into an easy to follow health passport. A follow-up survey evaluated the CHAMP-D on 59 respondents and 77% found the recommendations to be achievable and reported improved quality of life (QoL). Other improvements were noted in in self-care (54%), physical activity (49%), and diet (24%). 51% of the participants shared the Health Passport with their PCP. Overall, the CHAMP-D had a positive impact on participants’ self-reported health, self-care, and wellbeing. Empowering individuals with disabilities to take an active role in self-managing their health is feasible and can impact their QoL.
THE IMPACT OF FOOD INSECURITY ON THE HEALTH AND WELL-BEING OF OLDER ADULTS: THE GROUPS MOST AT RISK
Authors: Popham Lauren E , McGovern Erin
Published: November 2019

Older adults who experience food insecurity (4.6 million) often have worse health outcomes. Food insecure older adults consume less nutrients, which puts them at greater risk of developing chronic diseases. They are at increased risk of falls due the impact of poor nutrition on muscle mass, bone density, and balance. Low-income older adults are often forced to choose between buying groceries and paying other bills. The Supplemental Nutrition Assistance Program (SNAP) plays an important role in reducing food insecurity. SNAP enables older adults to buy the nutritious food they need, while freeing up resources to pay for everyday things to meet their health needs such as prescription drugs. Research shows that medication adherence increases when low-income older adults enroll in SNAP. Despite the beneficial impact of enrolling in SNAP, it’s estimated that 55% of eligible adults age 60 and older are not participating in this critical program. To understand which older adults are missing out on SNAP, the National Council on Aging engaged researchers at Leading Age LTSS Center at UMass Boston to analyze data from the 2014 Health and Retirement Study. The results show that some of the most vulnerable older adult populations are less likely to participate in SNAP even though they are eligible (i.e., Hispanic, age 75 and older, those who are not utilizing healthcare, etc.). The findings suggest that more targeted outreach to these groups is needed to ensure that the most vulnerable populations of older adults access this critical benefit.
IMPLEMENTING A GERIATRIC FRACTURE PROGRAM IN A PLURALISTIC ENVIRONMENT REDUCES LENGTH OF STAY AND TIME TO SURGERY
Authors: Rosen Sonja L , Breda Kathy , Lin Carol , Black Jeanne , Lee Jae , Chiang Aaron , Vrahas Mark , Rosen Brad
Published: November 2019

Geriatric-orthopaedic co-management models have been demonstrated to improve patient outcomes, but are typically implemented in closed, non-pluralistic medial systems. The Cedars-Sinai Geriatric Fracture Program (GFP) was developed through collaboration amongst a multi-disciplinary group. Cedars-Sinai is an academic medical center with a pluralistic medical staff that includes faculty, several hospitalist groups, and private practitioners. The GFP was introduced in July 2018 as a quality improvement pilot to provide standardized treatment for geriatric fracture patients. We hypothesized GFP enrollment would reduce time to surgery (TTS) and length of stay (LOS). Geriatric fracture patients were prospectively enrolled from July -December 2018. The Wilcoxon Rank- Sum test was used to compare TTS and LOS between the two patient groups. A p < 0.05 was considered significant. 190 operative fractures in patients over 65 years-old were prospectively followed.56 (30%) were enrolled in the GFP, 54 (28%) were admitted to other hospitalist groups (OH), and 80 (42%) were managed by their primary care physician (PCP). There were no demographic differences between groups. Patients enrolled in the GFP had a significantly shorter LOS compared to the OH and PCP groups (4 days v 5 days v 5 days, p = 0.039) as well as a significantly shorter TTS (19.7hrs v 22.4 hrs vs 23.3 hrs, p = 0.037). Our data shows that a multi-disciplinary geriatric fracture program can be successfully implemented in a complex pluralistic environment resulting in improved patient metrics. Adherence to evidence-based protocols and close multidisciplinary teamwork are critical to program success.
IN-HOSPITAL NURSE CARE CONTINUITY: DOES IT MATTER?
Authors: Tonkikh Orly , Zisberg Anna , Shadmi Efrat
Published: November 2019

In-hospital cognitive decline affects up to 40% of hospitalized older adults and is associated with post-hospitalization worsening of medical and functional status. Studies pointed to the substantial role of the interpersonal relationship between older adults with cognitive impairment and the nurses who care for them. We investigated the association between nursing interpersonal continuity and cognitive outcomes in a cohort of 646 older adults aged 70 or older admitted to internal units for non-disabling conditions. Cognitive decline was defined as at least one point decline in the Short Portable Mental Status Questionnaire from at admission to discharge assessments. Nursing interpersonal continuity was measured using continuity of care index (CoC). CoC assesses the extent of different nurses assigned to take care of each patient during the hospital stay (2 shifts per day) and ranges from 0 (none of the nurses is the same) to 0.4 (highest feasible score according to full time standard shift plan and length of stay (LOS)). Multivariate logistic regression showed that achieving 25% of the highest feasible in-hospital nursing CoC was associated with lower odds of cognitive decline (OR=0.67, 95% CI=0.47-0.97), controlling for age, sex, premorbid activities of daily living status, at admission cognitive status, comorbidities, severity of illness and LOS. This study shows that in-hospital nursing continuity is negatively associated with older adults’ cognitive decline, even in low-continuity levels. Future studies should investigate in-hospital continuity patterns and interventions maintaining continuity in larger and more heterogenic samples.
TELEVISION VIEWING AND HEALTH IN LATE LIFE
Authors: Fingerman Karen , Ng Yee To L , Huo Meng L
Published: November 2019

Television viewing is a risk factor for poor physical and cognitive health. Yet, we know little about associations between current health and frequency of television viewing throughout the day. This study examined associations between multiple assessments of physical and cognitive well-being and television viewing. Participants (N = 313) from the Daily Experiences and Well-being Study completed an initial interview assessing their health and well-being. They also wore an Electronically Activated Recorders (EAR) to capture sound in the environment and an Actical to measure physical activity for 5 days. Coders rated the audiofiles for television viewing. Multilevel models revealed that participants who spent a greater proportion of time tuned into television had: higher BMI, poorer health, expended less energy, were more sedentary, and reported drinking more alcohol and eating more junk food. We discuss findings with regard to potential reciprocal influences between television viewing and poor health.
OH, YOU JUST GOT ARTHRITIS: OLDER AFRICAN AMERICANS LACK FAMILIAL, SOCIAL, AND PROVIDER SUPPORT FOR PAIN MANAGEMENT
Authors: Booker Staja , Herr Keela , Tripp-Reimer Toni
Published: November 2019

Self-management support from family, friends, and providers is a crucial element in controlling osteoarthritis pain. 110 African-Americans (50-94 years) were surveyed regarding social and provider self-management support, and 18 of the African-American participants were also individually interviewed. This mixed-methods analysis unveiled that 77% were not receiving familial/social or provider support, and a conventional qualitative content analysis confirmed the lack of expected support for self-management with sentiments such as “I’m doin’ this all on my own.” Nonetheless, older African-Americans respected providers’ professional opinion, and 82% believed that treatment from a provider would be helpful. They desired more education and treatment options because they “need somebody to help with these joints and muscles”. However, participants were forced to learn how to care for osteoarthritis pain: “I was taking pain medication, but when I went to the doctor last time he told me to stop… Told me to deal with it [pain].”
LGBT OLDER ADULTS IN RURAL SOUTHERN APPALACHIA: PERCEPTIONS OF CURRENT AND FUTURE FORMAL SERVICE NEEDS
Authors: Williams Kelly A , Dakin Emily
Published: November 2019

Older sexual and gender minority adults in rural communities face challenges in accessing formal health, mental health, and long-term care services (Butler, 2017; Koch & Knutson, 2016; Stein et al., 2010). Formal service providers in rural Southern Appalachia are more likely to have conservative values that are closely linked to their religious beliefs (Keefe, 2005). Some may be opposed to gender non-conformity and same-sex relationships or marriage, making it wise for LGBT older adults in rural contexts to carefully select formal service providers and settings (Willging et al., 2006). Barriers to accessing formal services for LGBT older adults residing in rural contexts include few LGBT-inclusive service providers and facilities, transportation, cost, and health insurance (Butler, 2017). When faced with the prospect of long-term care, older LGBT adults are more likely to conceal their sexual or gender identity due to fears of being mistreated (Brotman et al., 2003). This session will present results of a qualitative study examining experiences, concerns, and recommendations regarding formal services among 11 LGBT older adults residing in rural southern Appalachia. Several of the participants described experiencing discrimination from local service providers. A number of participants were fearful about the perceived lack of LGBT-inclusive services in the area and expressed that they would consider leaving the area if their own or their partner’s health declined. Many participants expressed the need for local provider education about the needs of LGBT older adults. The presenters will discuss the implications for research and for health, social, and long-term care services.