bluuebunny/crossref_metadata_2025 huggingface dataset:
DEATH AND DYING EDUCATION IN US MEDICAL SCHOOLS: A SCOPING REVIEW
Authors: Patterson Logan , Decker Autumn , Weaver Raven , Bolkan Cory , King Angelique , Roman Anna
Published: December 2023

With an aging population, knowledge about death, dying, loss, grief, and end-of-life (EOL) care is an essential skill for most physicians. However, EOL education has been minimally incorporated into medical school curricula in the United States (U.S.); there is a significant need to better prepare medical students for the unique challenges of improving patient wellbeing at end-of-life. To understand how death and dying topics have been incorporated into U.S. medical school education, we conducted a systematic scoping review, using PRISMA guidelines, of published research on death education for medical students between 2010 through 2022. An initial search in EMBASE and PubMed yielded 3,443 citations; 265 articles met the initial inclusion criteria (e.g., research-based, EOL education specific), with 97 articles selected for full-text review. Overall, we found significant variation in the type and content of EOL training in U.S. medical schools. Using a competency-based medical education framework that reflects tangible knowledge, skills, and attitudes as a guide to ensure proper EOL training, a deductive coding approach yielded several themes including: reliance on brief, skills-based workshop interventions and limited longitudinal integration into curricula; general research on student attitudes and wellbeing; and an emphasis on needs assessments highlighting gaps in evidence-based EOL training interventions. Using these findings, we offer applied considerations for teaching EOL related skills in U.S. medical schools. In turn, this work contributes to the enhancement of health across the lifespan and might ultimately lead to a society where a “good death” is not an exception, but a reality.
DIGITAL AGEISM AND ITS IMPLICATIONS FOR OLDER ADULT INCLUSION
Authors: Chu Charlene
Published: December 2023

“Digital ageism” is a new form of ageism that is embedded into technology and AI systems. Building on the World Health Organization’s recently published policy brief entitled “Ageism in AI for Health”, our work draws attention to digital ageism referring to the nexus of ageism (discrimination or bias related to age) that is mediated and perpetuated by artificial intelligent (AI) systems and technologies. This paper presents a conceptual framework for identifying various cycles of injustice that perpetuate ageism into our digital spheres. This framework also identifies key contributors that need to be addressed in order to break these cycles. We present the results of a scoping literature review, informed by Arksey and O’Malley, to identify the mechanisms in which digital ageism can be introduced as demonstrated in the literature. This work contributes to foundational knowledge about age-related biases in AI and how they might be encoded or amplified in AI systems. This work sheds light on the need for ethical thinking and other approaches to better include older people, and ensure technology benefits the aging population.
LEVERAGING AN “ETHICAL BY DESIGN” APPROACH TO CREATE MORE INHERENTLY RESPONSIBLE TECHNOLOGY TO SUPPORT AGING
Authors: Boger Jennifer
Published: December 2023

Responsible technologies are technologies that appropriately support the needs, abilities, and values of the people using them. While many aspects of responsible technology are ubiquitous, there are a multitude of considerations that are specific to older adults. These age-related aspects must be properly understood and incorporated into the technology development and selection process if technology is to be inclusive of and useful to older adults. However, as many of these aspects are subjective, qualitative, and/or dynamic, developers often consider them to be too abstract, undefined, or difficult to address, resulting in their omission from the technology creation process. In this presentation we will discuss how we can leverage the concept of ‘Ethical by Design’ to drive the change in thinking and doing that is required to enable developers to engage with age-related concepts in technology design, development, and evaluation. Concepts such as user-centered design, values-based engineering, brave spaces, and co-creation will be presented as some of the ways we can directly access lived experiences and translate them into the creation of technologies that are more inclusive of older adults.
STRONGER TOGETHER: GLOBAL COMPARISONS OF THE USE OF CITIZEN SCIENCE TO CREATE AGE- AND DEMENTIA-FRIENDLY COMMUNITIES
Authors: Robitaille Annie , Campbell Kimberly , Garcia Linda
Published: December 2023

The active involvement of older people in the development of age-friendly environments has been strongly recommended. However, participatory methods with older adults remain underutilised even though older people may be more qualified to recommend what makes an age-friendly space. Using a citizen science approach in research involving older adults presents a key opportunity to have them be active participants and for researchers to obtain meaningful insight. Using this approach, older adults are viewed as co-designers. They are involved in the research process from beginning to end - research design, development of tools, data collection, analysis and knowledge dissemination. This symposium will highlight some of the work done in Canada, Australia and the United Kingdom to make communities more age-friendly using a citizen science approach. Special attention will be given to how the approach might be adapted to citizen scientists who live with dementia. After an introductory overview of the citizen science approach, the use of this method in studies including persons living with dementia and their care partners will be discussed, both in general terms and as an application to air travel. One of the presentations will also address the use of citizen science in examining population ageing and urbanization. Our symposium will conclude with a discussion of future policy, practice, and research direction.
ORGANIZATIONAL READINESS FOR A VIRTUAL REALITY TRAINING PROGRAM CALLED BE EPIC-VR
Authors: Savundranayagam Marie , Schumann Annette , Sagrak Adriana , Norris Grace , Chen Allison , Campos Jennifer , Orange Joseph
Published: December 2023

An essential first step to implementing virtual reality programming in home care and long-term care settings is to assess organizational readiness by determining factors that enhance the likelihood of its successful implementation. Be EPIC-VR is one such virtual reality program that supports dementia-specific, person-centered communication training for frontline healthcare workers. Guided by the Consolidated Framework for Implementation Research (CFIR), the current study aimed to identify factors influencing Be EPIC-VR’s implementation in home care and long-term care settings. Semi-structured interviews were conducted with nine managers from home care and long-term care settings in Canada. Transcripts from these interviews were analyzed using the Framework Analysis’ five-step ongoing, iterative process: familiarization, identifying a thematic framework, indexing, charting, and mapping/interpretation. Textual data were open-coded and organized deductively (using CFIR’s pre-set codes) and inductively (for emergent codes) into themes and subthemes. Four themes emerged as factors contributing to organizational readiness including 1) openness to virtual reality as a training tool, 2) staffing and training logistics, 3) organizational culture supporting staff development, and 4) external pressures for organizational sustainability. These findings will guide how the Be EPIC-VR implementation team collaborates with organizational decision makers to ensure that Be EPIC-VR is a good fit for those organizations, to prepare for its implementation, and to optimize the likelihood of success. The study findings offer valuable insights for researchers and practitioners working to implement new virtual reality interventions in home care and long-term care settings.
PRESIDENTIAL SYMPOSIUM: HIGHLIGHTING EMERGING PROFESSIONALS WHO BUILD BRIDGES, CATALYZE RESEARCH, AND EMPOWER ALL AGES
Authors: Morgan Brianna , Hu Rita , Smith Jacqui
Published: December 2023

There are many ways to carve a path forward in aging research, policy, and practice. Sometimes the career possibilities are overwhelming, leaving us unsure of how best to proceed. As aging professionals, we know that there is much to learn from those who have gone before us. Therefore, in the ESPO Presidential Symposium we highlight four emerging professionals who are trailblazing diverse and fulfilling career paths in aging by building bridges, catalyzing research, and empowering all ages. Speakers include Drs. Cal Halvorsen, Lindsay Kobayashi, Jamie Justice, and Glenna Brewster Glasgow. Dr. Jacqui Smith will serve as the discussant, synthesizing main findings, emphasizing positive outcomes, and exploring challenges. Starting with identifying the “So What?” of his career, Dr. Cal Halvorsen will explore how his practice roots in policy and advocacy led to his current approach of merging scholarly pursuits and public communication to make an impact beyond the walls of academia. Next, moving to cross-national aging research, Dr. Lindsay Kobayashi will discuss the opportunities and challenges of combining diverse cross-national cohorts to identify policy-relevant and context-specific modifiers of health risks for older adults. Next, Dr. Jamie Justice will focus on her career in translational geroscience and share a translational framework for aging outcomes trials. Finally, from an interdisciplinary approach to conducting research with families living with cognitive impairment in the US and the Caribbean, Dr. Glenna Brewster Glasgow will reflect on practical strategies to develop and maintain collaborative relationships with researchers and stakeholders locally, nationally, and internationally.
SKILLSETS FOR FUTURE-READY OLDER WORKERS: SKILLS GAPS AND LEARNING BARRIERS IN SINGAPORE
Authors: Seidmann Vered , Cao Yuanyuan , Liu Yuezhong , Ho Ringo , Khong W. H. Andy , Goh Dion , Theng Yin-Leng
Published: December 2023

Population ageing in Singapore is on a rapid rise as approximately 25% of Singaporeans will be aged 65 or over by 2030. The employment rate of older workers aged 55 and above rose from 24.3% in 2014 to 26.4% in 2021 (MOM , 2022). Older workers are at greater risk of skills mismatch. To enhance employability, governments, and international organizations explore appropriate responses to shifting skills, employability and training. This paper presents results of the qualitative phase in a two-year project that aimed to identify emerging skills, skills gaps, and training barriers among older persons in the Singaporean workforce and provide recommendations to policy makers to better support upskilling and reskilling among employees aged 55 and over. The project included 132 participants (29 age 45-54, 53 age < 55, 35 managers and 15 training providers) from three sectors: Retail, Food Services, and Precision Engineering. The qualitative data revealed skills mismatch resulting from the implementation of technological innovation in daily tasks. Learning barriers among older workers included accessibility to training, mindset and attitudes towards reskilling, fear of technology and training applicability. Recommendations to policy makers included practical solutions to enhance accessibility to course lists and career coaches; identify opinion leaders among older workers and company managers; closer collaboration between employers (inhouse training) and training providers for better follow-up and needs assessments; and utilize Andragogy theory for training design.
PILOT TESTING OF NEWLY DEVELOPED OPEN EDUCATIONAL RESOURCES FOR AN AGING AND MENTAL HEALTH COURSE
Authors: McGee Jocelyn , Ambrose Madison , Wood Sinai , Zakrzewski Chris
Published: December 2023

The cost of secondary-level education is higher than ever in the United States. With the costs of tuition, housing, meal plans, and other necessary expenses, economically vulnerable students have difficulty locating affordable textbook options for their courses. In addition to finding affordable options, it is challenging to locate low-cost and credible up-to-date resources that best prepare students for the fields they wish to pursue after graduation. Furthermore, within these resources, the perspectives of diverse and underrepresented scholars are often overlooked. With an ever-increasing and diversifying United States, these areas need to be addressed within gerontological education to provide the best care for older populations. In this presentation, we detail our process of developing open education resources (OER) for an Aging and Mental Health course from a positive psychology framework integrating diverse perspectives and state of the art research, results from our first pilot test of the materials with a group of 25 students, and how we are going about adapting this course into an interactive Pressbook which will be available in the future at no-cost to the field.
PUBLIC HEALTH CURRICULUM: DEMENTIA CAREGIVING AS A PUBLIC HEALTH CHALLENGE AND OPPORTUNITY
Authors: Jackson Eva , Redd Tara , Johnson Elma , Bailey Dionne , Koffski Maya , Roberts Shelby , Gaugler Joseph
Published: December 2023

A new, free, one-hour, interactive, online module, Dementia Caregiving as a Public Health Challenge and Opportunity, is designed for public health students, educators and professionals. This course approaches caregiving for people with Alzheimer’s disease and other dementias from a population-based perspective , while remembering that these are the individual stories and lives of millions of people today. Dementia caregiving is a public health priority because of its prevalence; its profound influence on individuals, families, communities, and healthcare systems; and its disproportionate effects on subgroups of individuals. A number of public health actions can help to address the population effects of dementia caregiving. There remains a gap in public health curricula that features dementia and dementia caregiving, and this module represents an educational innovation to introduce key concepts in dementia caregiving for students and others. This module defines dementia caregiving, specifies why dementia caregiving is a public health issue, and reviews evidence-based programs for assisting dementia caregivers. Public health examples and case studies are used to support and assess learner understanding. This module was developed for the Alzheimer’s Association by the Emory Centers for Public Health Training and Technical Assistance with support from the Building our Largest Dementia Infrastructure (BOLD) Public Health Center of Excellence on Dementia Caregiving, and represents a novel strategy to elevate dementia caregiving as a matter of public health concern.
PUSHING BACK AGAINST AI: USING UNGRADING TO PROMOTE CRITICAL THINKING AND INTRINSIC MOTIVATION
Authors: Inker Jenny , MacDonald Catherine , Forder Michael , Arnette Shannon , Waters Leland
Published: December 2023

Ungrading is an innovative pedagogical practice in which instructors give frequent, detailed feedback on students’ work and/or encourage self-evaluation rather than assigning them points or letter grades. Ungrading has been shown to increase students’ intrinsic motivation to learn, their willingness to take intellectual risks, and the quality of their thinking. Prior to the introduction of advanced artificial intelligence (AI) writing in academia, grades were shown to be a motivating factor for cheating. Ungrading removes the pressure of grades, thus making the use of AI and other services including paper writing and test answer sharing less enticing. Ungrading could be key to pushing back against the potential for the advent of artificial intelligence tools, which have many universities “alarmed.” Educators at Virginia Commonwealth University College of Health Professions, supported by their Director of e-Learning, planned and piloted ungrading in one undergraduate and two graduate gerontology courses. Twenty-five students completed pre and post-surveys asking for their reactions to ungrading, if their views had changed as a result of the ungrading pilot, as well as their perceptions of traditional grading schemes. They also completed scaffolded assignments with multiple opportunities for receiving in-depth instructor feedback, rather than grades, at various points during the semester. Faculty journaled their ungrading experience in order to recognize how it can be a disruptive, and at times, uncomfortable practice and as a result, educators can better guide themselves and students through the transition. This presentation will include an Implementation Guide for gerontology faculty who wish to implement ungrading.
GERO-EDUCATION IN JAPAN: COMMUNITY RE-DESIGNING TO ACHIEVE HEALTHY AGING AND WELL-BEING
Authors: Iijima Katsuya
Published: December 2023

Japan has achieved the world’s highest level of life expectancy and is currently experiencing a super-aging society. Because of this, we have to take steps towards achieving a healthy aging society with evidence-based policies and longevity with happiness (well-being). In addition, it is necessary to integrate digitalization with information and communications technology through more than just the conventional healthcare measures such as going into the local community to increase opportunities for people from all generations to connect and interact. We also have to realize a true “population approach” with the aim of building a community where residents can easily engage in community-based activities centered on self-help and mutual aid. It is an urgent task to create a place for activities such as lifelong education and multi-generational exchanges as well as to build a comprehensively integrated community care system that allows people to live with peace of mind when they need long-term care. Thinking about planning the 100-year life, the super-aging society has had consequences for the healthcare and social care of older people in Japan, leading to societal innovations that promote health in older people. To extend the healthy life expectancy and achieve a bottom-up sense of community resilience and activity, an interdisciplinary gerontological collaboration with multi-stakeholders is indispensable, with collaborators such as municipal governments, industries, professional staffs, academic researchers (including universities, young career researchers, and students), and citizens. This session will introduce our efforts to promote gerontology education through redesigning the community with comprehensive knowledge.
INTERGENERATIONAL LEARNING TO ADDRESSING AGEISM IN HIGHER EDUCATION: SCOPING REVIEW FINDINGS
Authors: Hand Michelle , Tompkins Catherine , Ihara Emily , Inoue Megumi , Kang Hyun , Harvey Kaitlyn
Published: December 2023

Intergenerational learning strategies can increase wellness, both among students and older community members, while challenging ageism on college and university campuses. Still, existing studies on the mutual benefits and effectiveness of intergenerational learning strategies for addressing biases among college and university students are limited and as such, are continuing to emerge. Thus, a scoping review was conducted to explore current research on intergenerational learning in higher education, the potential relevance of such strategies to reduce ageism and better prepare future service providers, and to explore current implications for education, practice, policy, and research. Included in this scoping review were peer-reviewed and grey sources based on primary research on what is known about intergenerational learning strategies in higher education and their potential impacts on ageism. Excluded were sources not based on primary research or without clear implications for relevant education, practice, policy or research. In total, 313 articles were identified; 67 of these were screened in for full text reading, and 37 were initially screened in for analysis, after which another 8 were excluded, resulting in 29 cases for thematic analysis. Key themes surround intergenerational service learning and creative expression, attitudes toward older adults, perceptions on aging, mutual benefits of intergenerational learning (e.g., cultural learning and integration), and remaining needs for research and education, through integrating service learning opportunities into existing programs and courses in higher education. The results of this scoping review will be further discussed, along with future implications for research, practice, policy and education focused on reducing ageism.
ASSISTED LIVING DIRECT CARE WORKFORCE TRAINING REQUIREMENTS BY LICENSE TYPE
Authors: Smith Lindsey , Dys Sarah , Hua Cassandra , Weems Jacy , Thomas Kali
Published: December 2023

Assisted living (AL) residents and families often assume that care staff have clinical certifications or specialized training. We analyzed direct care worker training requirements for each AL license type across all 50 states and DC, using health services regulatory and content analyses. Across all licenses, we found the most common required training topics specific to care provision were resident rights, providing assistance with daily living, identifying and alleviating safety risks for residents with cognitive impairment, medication management and non-pharmacological interventions, nutrition and hydration, preservation of resident dignity, recognizing and reporting changes in a resident’s condition, understanding resident actions and behavior as communication, and coping with difficult behaviors. We found the most common approach—accounting for the regulations governing 22% of licensed AL communities in the U.S.—was licenses that require between 1 and 10 hours of initial and annual training, but do not have a detailed list of training topics. Only three states (Arizona, Michigan, and New Hampshire) have no training requirements for any unlicensed direct care workers, while 20 states have at least one license without requirements regarding training hours or topics that must be covered. We found that 10 states have a license that requires more than 10 hours of initial and annual training and specifies a detailed list of training requirements. Interestingly, four of these states (New Mexico, Pennsylvania, Virginia, and Washington) have these requirements for all license types, but three of these states (North Carolina, Illinois, and DC) also have a license with no training requirements.
STAFFING LEVELS AND INJURY-RELATED EMERGENCY DEPARTMENT VISITS IN OHIO
Authors: Hua Cassandra , Nelson Matt , Cornell Portia , White Elizabeth , Thomas Kali
Published: December 2023

Assisted living (AL) residents with dementia are at increased risk of injuries compared to residents without dementia. Nursing home research indicates that changes in staffing levels are related to quality, including rate of injuries among residents. We leveraged novel data from a survey administered to AL communities in Ohio from 2007-2015 linked to administrative claims of Medicare beneficiaries with dementia to explore the relationship between staffing levels and injuries among AL residents with dementia. We examined the relationship between changes in each type of staffing level (RN, LPN, and aide hours per resident day [HPRD]) and injury-related emergency department use among AL residents with dementia. We adjusted for demographic characteristics, AL characteristics, and fixed effects for year and AL. Our sample included 13,929 fee-for-service Medicare beneficiaries with dementia (141,749 person-months) from 472 AL communities. Staffing levels increased slightly over time; median aide HPRD were 0.93 in 2007 and 1.10 in 2015. Median RN HPRD were 0.00 in 2007 and 0.04 in 2015. Median LPN HPRD increased from 0.29 to 0.41. Using linear regression modeling, we did not detect a statistically significant relationship between staffing levels (RN, LPN, or aide) and injury-related emergency department visits among AL residents with dementia. Within-AL changes in staffing levels may have no effect on rates of ED visits. However, it is possible that we did not observe enough within-AL variation to detect an association, or that unobserved differences in resident acuity associated with staffing levels biased our finding toward the null.
THE ASSOCIATION BETWEEN RESIDENT ENGAGEMENT AND QUALITY OF CARE INTERACTION AMONG ACUTE CARE PATIENTS WITH DEMENTIA
Authors: McPherson Rachel
Published: December 2023

Care interactions are essential to patients with dementia. The purpose of the study was to describe the quality of staff-patient care interactions among acute care (AC) patients with dementia and to test whether the quality of staff-patient care interactions varied by resident level of engagement in the interaction. Specifically, it was hypothesized that controlling for age, cognition, pain, behavior, and function, actively engaged patients would have more positive care interactions with staff compared with passively engaged patients. This secondary data analysis used baseline data from the Function Focused Care for Acute Care (FFC-AC- EIT), an ongoing intervention study. The sample included 286 patients. Descriptive statistics and a multiple linear regression were conducted. The majority of interactions that occurred were positive care (n = 225, 79%). Actively engaged patients had significantly more positive interactions compared to passively engaged patients (b = 1.49, p < .001). Patients with more pain (b = -0.26, p < .001) and behavioral symptoms (b = -0.12, p < .05) had significantly poorer care interactions. Passively engaged patients or patients with pain and behavioral symptoms may be at risk to receive poor quality care interactions. Findings from this study will inform future interventions and training for AC staff to promote positive care interactions among patients with dementia. Managing pain, managing behavior, and supporting resident engagement in care will likely help increase the frequency of positive care interactions in future work.
INCREASING ACTIVITY-STIMULATING BEHAVIOR IN DUTCH HOME CARE: FEASIBILITY OF THE SELF-PROGRAM
Authors: Metzelthin Silke , Hermens Lotte , De Waal Getty Huisman - , Vluggen Stan , van Ginkel Janneke Man - , Zwakhalen Sandra
Published: December 2023

The concept of aging-in-place has become increasingly popular worldwide, including the Netherlands. However, as individuals age, their ability to perform activities of daily living often declines leading towards a need for homecare. Unfortunately, staff often unnecessarily take over care tasks and thereby potentially accelerate older adults’ functional decline. SELF is an interactive, tailored, holistic and theory-grounded training program consisting of 7 sessions spread over a period of 14 weeks, which aims to change staffs’ behavior towards more activity stimulating behavior. The program was evaluated in a cluster-randomized trial in Dutch nursing homes. However, its feasibility in the homecare setting was not yet known. Therefore, a feasibility study in one Dutch homecare team was conducted using a mixed-methods approach combining quantitative (i.e. checklist, logbooks, attendance forms and questionnaires) and qualitative data (i.e. focus group interviews) among program participants, team manager, coaches and trainers. Data was collected based on the three main pillars of the MRC framework: implementation, mechanisms of impact and contextual factors. In total, 24 staff members participated in the study, who delivered care to 145 clients. The SELF-program was largely implemented as intended, resulting in positive changes in staff knowledge, self-efficacy, and skills. However, contextual factors influenced the implementation of activity stimulating behaviour in practice. While reporting in electronic patient records and manager support were identified as facilitators, resistance from clients, bad expectation management by hospitals and GPs and time constraints acted as barriers. Overall, the SELF-program was feasible in Dutch homecare and only small program modifications are needed.
THE NIH STAGE MODEL AND STUDY EXAMPLES OF EARLY STAGES IN DEMENTIA CARE INTERVENTION DEVELOPMENT RESEARCH
Authors: Dobbs Debra , Meng Hongdao
Published: December 2023

The NIH’s Stage Model provides a common language to facilitate discussion of intervention development research. According to NIH Stage Model (2022), “an examination of the mechanisms of behavior change or the principles underlying an intervention is encouraged by the NIH Stage Model in every Stage of behavioral intervention development.” The five papers in this symposium focus on early-stage intervention development by refinement, adaptation and pilot testing (Stage 1) related to dementia and palliative care (PC) clinical trials. The first paper is a cluster trial of a PC education program for nurses (N=23) in 10 assisted living communities that tested the mechanism of staff self-efficacy in increases in advance care planning discussions with family members of residents living with dementia. The second paper is a clinical trial that tested the feasibility of Companion Robots in live-alone Korean-American older adults (N=30) to determine which features help improve health behaviors (e.g. medication adherence, daily exercises). The third paper is a single-site clinical trial pilot study developed with stakeholders which tested the feasibility of a palliative care community health worker support program for hospitalized minoritized persons living with dementia and their caregivers. The fourth paper adapts an evidence-based e-PainSupport intervention for use with dementia caregivers to report patient pain and administration of analgesics. The fifth paper is a protocol to test the feasibility and acceptability of a culturally sensitive caregiver peer support program (Pair2Care) in current (n=15) and trained former (n=15) African-American dementia caregivers. The discussant will highlight ways to improve clinical trial mechanisms.
CO-DESIGNING A STAGE 1B FEASIBILITY STUDY OF INPATIENT PALLIATIVE COMMUNITY HEALTH WORKER SUPPORT
Authors: Kwak Jung , Kvale Elizabeth , Mills Sarah , Patel Snehal
Published: December 2023

Persons living with dementia (PLWD) are 2-3 times more likely than their non-dementia peers to be hospitalized annually and experience burdensome care transitions and treatments at the late stage of dementia. Minoritized PLWDs are significantly more likely to be hospitalized and experience frequent transitions between care settings, and also less likely to access palliative care. There is a pressing need to develop better models of care transition support for PLWDs and their family caregivers. Proactive palliative care can reduce unnecessary hospitalization and improve outcomes for PLWDs and family caregivers. Community health workers (CHW) can effectively bridge cultural gaps between vulnerable patients/families and formal care systems, and provide care navigation and coaching support. We are currently conducting a single-site randomized controlled pilot trial study to co-design with key stakeholders (Stage 1a), implement and assess (Stage 1b) the acceptability and feasibility of a palliative CHW support for hospitalized PLWDs and caregivers. To date, we have conducted a needs assessment with 34 PLWD/caregiver dyads, key informant interviews with 4 palliative care providers and 2 CHW and social care experts, and multiple stakeholder meetings with hospital frontline providers and CHW groups to develop intervention components and research implementation plans that address language and cultural barriers and healthcare provider and system level barriers experienced by PLWD and caregivers from minoritized and financially vulnerable backgrounds. In this presentation, we will describe stakeholder engagement and co-design process outcomes and preliminary findings on intervention fidelity, participant recruitment and retention, and PLWD/caregiver outcomes.
EMPOWERING PEOPLE OF ALL AGES BY PROMOTING POSITIVE VIEWS OF AGING AMONG PK-12 STUDENTS
Authors: Newsham Tina , Borrero Lisa
Published: December 2023

Beliefs about aging and older adults form early in life and persist. People who hold positive views of aging rather than internalized ageism live, on average, 7.5 years longer. Communities where older adults retain meaningful engagement and are respected experience greater longevity and better social and physical well-being among people of all ages. Having positive interactions with older adults increases likelihood of pursuing careers working with older people. Promoting positive, accurate views of aging benefits individuals (of all ages) but is most effective when implemented early in life. Children, however, are rarely intentionally taught about aging and learn primarily negative stereotypes through media such as cartoons, books, and fairy tales. In this symposium, presenters will share projects aimed at disrupting the perpetuation of ageist stereotypes through intentional work with young children to promote positive views of aging. Laura Donorfio will present an aging education project developed for the Connecticut school system via an Administration on Aging grant. Next, Elizabeth Bergman will present two intergenerational case study projects involving elementary school-aged children, college students, and elders. Edward Miller will then the describe and sharing findings from an ongoing intergenerational tutoring intervention, begun during the early stages of the COVID-19 pandemic, wherein older adults provide free, online evidence-based tutoring to bi-lingual kindergartners. Finally, Tina Newsham and Cynthia Hancock will share research on a toolkit developed for preschool-2nd grade teachers to introduce information about aging and centenarians as a way to celebrate the 100th day of school. Lisa Borrero will serve as discussant. This is an Intergenerational Learning, Research, and Community Engagement Interest Group Sponsored Symposium.
EXPLORING NEW WAYS TO IMAGINE OUR FUTURE THROUGH INTERGENERATIONAL CASE STUDY PROJECTS IN ELEMENTARY SCHOOL
Authors: Bergman Elizabeth
Published: December 2023

Aging education is largely absent from the PK-12 curriculum. When students do encounter messages about aging and older adults it is generally through such activities as dressing “like a 100-year-old” to celebrate the 100th day of school which promotes the internalization of ageist stereotypes starting at a young age. Motivated by a desire to push back against these ageist messages in school, the presenter partnered with elementary school educators and school administrators to develop and deliver two intergenerational case study projects involving elementary school-aged children, undergraduate students, and older adults. The presenter will highlight objectives, activities, and outcomes of the Let’s Dream Together and Ages & Stages in Our Community projects and provide suggestions for aging educators interested in similar initiatives.
“I DON’T KNOW WHO GETS MORE OUT OF IT”: OLDER ADULTS’ EXPERIENCES WITH THE ONLINE INTERGENERATIONAL TUTORING PROGRAM
Authors: Miller Edward , Hoffman Jessica , Hermelbracht James , Burr Jeffrey , Mutchler Jan
Published: December 2023

Due to pandemic-related academic and social stressors experienced by children and social isolation and loneliness experienced by older adults, a team of school psychologists and gerontologists collaborated with older adults to develop the Online Intergenerational Tutoring Program. Conceived in fall 2020, the program is now in its third year of implementation. The program addresses a service delivery gap in schools because older adult volunteers expand schools’ capacity to implement reading instruction with students in need of support. Older adults share their time and talents with young children and children benefit from the care, attention, and instruction from older adults. Tutors meet with students after school 3-4 times per week over a 6–8-week period over Zoom; each of the 24 sessions last 30 minutes. Evaluation data show the program is socially valid, tutors deliver instruction with accuracy, students have high engagement, and there are literacy gains among students.
PROMISES AND CHALLENGES OF IMPLEMENTING TELEHEALTH IN LTC FACILITIES: LESSONS FROM A MULTISITE PILOT PROJECT
Authors: Yan Mengzhao , Zhu Yujun , Wilber Kathleen
Published: December 2023

In response to the COVID-19 pandemic, the demand for telehealth implementation has expanded in long-term care (LTC) facilities. To better understand the promises and challenges of implementing telehealth, we evaluated a pilot project in which five LTC facilities in California implemented telehealth from September 2021 to May 2022. Employing a mix-method approach, we used a diverse set of evaluation tools (i.e., documenting 37 telehealth visits, holding 8 monthly learning sessions, conducting 36 check-in interviews, and tracking monthly COVID-19 cases) to examine how telehealth was adopted, used, and perceived among residents, administrators, and health practitioners. From a descriptive analysis of quantitative data and a thematic analysis of qualitative data, we found that telehealth demonstrated the capability to treat a variety of conditions; prevented nearly 20% of transfers to emergency departments; residents indicated a high degree of comfort with telehealth; and healthcare practitioners perceived that telehealth could improve care delivery. In addition to benefits, several barriers were identified including initial concerns about the quality of visits, required upfront costs, time constraints, difficulties in coordinating different platforms in the healthcare system, uncertainty about payment parity with in-person care, and reduced staffing related to COVID-19. Based on our evaluation, we propose six strategies to help implement telehealth in LTC facilities: recognize sources of resistance to change; recognize the need for initial investment; understand and address contextual issues; prepare and pave the way for staff buy-in; identify a champion; and ensure sufficient and ongoing training and support.
THE LANDSCAPE AND OUTLOOK FOR CONTINUED WORK LATER IN LIFE IN THE 2020S
Authors: Cahill Kevin , Shaw Benjamin , Beach Brian
Published: December 2023

For the first time in more than three decades, older workers’ labor force participation rates are no longer increasing. Even more remarkable is that this trend contrasts with changes among younger workers, who have experienced increases in labor force participation in the wake of the Covid-19 pandemic. A narrative that has existed for more than two decades—that older workers have been the exception to reductions in labor force participation generally—may be coming to an end. A question then is, in the 2020s, will older workers who exited the labor force during the pandemic return? This symposium explores the new landscape that older workers face. The first paper addresses work-related trade-offs and the extent to which older workers assess the benefits and costs of continued work later in life. The second paper explores how pension eligibility triggers a new stage of the life course, in which older workers can leverage their newfound financial gains to improve work conditions or, alternatively, to exit the labor force. The third paper explores, specifically, how the Covid pandemic changed the workplace for older workers. The fourth paper rounds out the symposium by exploring the relationship between income and health in recent years in both the United States and in China. The flexibility of the U.S. labor force enables fairly abrupt shifts in workforce dynamics in response to macroeconomic changes and other events. The Covid-19 pandemic was one such shift. This symposium provides insight into the post-pandemic labor market for older workers. This is an Economics of Aging Interest Group Sponsored Symposium.
EFFECTS OF COVID-19 PANDEMIC ON OLDER WORKERS’ LABOR MARKET AND RETIREMENT DECISIONS
Authors: Radpour Siavash
Published: December 2023

Several studies have documented the increase in retirement since the onset of the Covid-19 pandemic. I contribute to this literature by answering two key questions that show the pandemic excess retirement is caused primarily by demand-side factors: first, using the monthly Current Population Survey (CPS) data on employment and retirement of older workers and CPS’s panel structure, I explore if older workers left their jobs and the labor force voluntarily as a part of “the great resignation”. I find that very few workers quit their jobs voluntarily, and most retirements were preceded by involuntary job loss and unemployment. Second, using the Health and Retirement Study (HRS) with its rich data on wealth, employment, and the special Covid-19 related questions included in 2020 HRS (Wave 15), I examine if older workers who experienced job loss during the pandemic retired because they were financially prepared for retirement. I find that among the small group of older workers who quit their jobs because of the pandemic, the majority did not have adequate retirement assets and their decision is more likely to be based on their health status and vulnerability during the pandemic.
THE EFFECTIVENESS OF A VIRTUAL INTERGENERATIONAL ACTIVITY FOR REDUCING YOUNGER AND OLDER ADULTS’ AGEISM
Authors: Fassi Janelle
Published: December 2023

This presentation will discuss results from a study that examined whether a virtual intergenerational activity was feasible and effective for reducing ageism among older (OA) and younger adults (YA) during the COVID-19 pandemic. OA (n = 16) and YA (n = 15) completed a virtual intergenerational activity, and analysis was conducted for a subsample (n = 5 OA, n = 10 YA) who completed pretest-posttest ageism surveys. Paired samples t-tests showed no significant ageism change in attitudes toward OA. OAs’ ageist attitudes toward YA (p = .012) were significantly reduced. Open-ended responses revealed several themes (e.g., challenging ageist stereotypes), which contrasted with statistical findings among the YA sample. Preliminary evidence demonstrated the feasibility of this activity. Further, OA and YA gained greater respect and understanding for each other as indicated by the open-ended responses. However, a larger sample size is needed to better determine efficacy. Nonetheless, the key takeaways from this presentation will help educators and program organizers alike explore when and how a virtual intergenerational activity can bridge gaps between older and younger adults.
TECHNOLOGY AND OLDER ADULTS: BEST PRACTICES FOR ENHANCING USABILITY, ENGAGEMENT, AND COMMUNICATION
Authors: Falzarano Francesca
Published: December 2023

The massive growth in population aging has coincided with a time of continued fast-paced innovations in technology. Technology can be leveraged to support health, well-being, and quality of life in older adults with health, mobility, and cognitive issues and is a means of maintaining social engagement in later life. However, for technology to achieve its intended purpose, older adults must have access to and recognize the value of such products. Despite the sheer size of the older adult population, the field of Information Communications Technology (ICT), has long overlooked the perspectives of older adults with regard the design of ICT applications. ICT systems that fail to consider the diverse capabilities and attitudes of older adult users are likely to alienate a significant, growing segment of the population and will likely be underutilized. This presentation will review best practices to enhance older adults’ usability and engagement with technology, with an emphasis on user-centered design principles as well as innovative tools facilitating virtual ICT support and training (e.g., TeamViewer software) to provide older adults who have limited to no technology proficiency with the skills needed to navigate its use. Key takeaways from this presentation will include a greater understanding of the importance of design principles to enhance usability and adoption of ICT systems among older adults; means of increasing access and adoption of ICT applications; and how user feedback can be leveraged to inform adaptions to enhance the efficacy and acceptability of technology applications, and ultimately foster psychosocial well-being in older adults.
PHYSICAL ACTIVITY AND DEMENTIA IN THE NATIONAL HEALTH AND AGING TRENDS STUDY (NHATS)
Authors: Davoudi Anis , Donahue Patrick , Carlson Michelle , Dougherty Ryan , Wanigatunga Amal , Freedman Vicki , Schrack Jennifer
Published: December 2023

Individuals living with dementia exhibit disrupted sleep/wake rhythms; however, whether daily physical activity volume and patterns are worse among those living with dementia is not well established. We examined the cross-sectional association between dementia classification and accelerometry-derived patterns of daily physical activity in NHATS. Wrist-worn accelerometry was collected using the Actigraph Centrepoint Insight Watch in a subset of Round 11 (2021) participants. Dementia status, including possible and probable dementia, was determined using the NHATS dementia algorithm. We characterized daily physical activity patterns using: most active 10-hours/day (M10), time of M10, least active 5-hours/day (L5), time of L5, relative amplitude (RA), intra-daily variability (IV), inter-daily stability (IS), and activity fragmentation using the active-to-sedentary transition probability (ASTP). We used separate linear regression models to study the association between dementia and each actigraphy feature, adjusting for relevant demographic features including age, gender, race, BMI, and education. 721 participants had ≥3 days of valid accelerometry data, dementia status, and complete covariate data (40% aged ≥80 years, 54% women). Compared to cognitively normal participants, those living with dementia averaged fewer activity counts/day (beta: -382K counts/day p<0.0001), lower M10 (beta: -261K counts, p<0.0001), lower IS (beta: -0.04; p= 0.0066), and higher ASTP (beta: 7.1%; p<0.0001). Participants with and without dementia did not differ in terms of IV, L5, or RA (p>0.05 for all). These results suggest important differences in volume and patterns of daily movement by dementia status. Future studies should investigate whether similar differences exist in earlier stages of cognitive impairment to enhance preventative efforts.
LINKING SELF-REPORTED FATIGUE TO OBJECTIVELY MEASURED PHYSICAL ACTIVITY IN MEN WITH AND WITHOUT HIV
Authors: Wanigatunga Amal , Kwon Sohyeon , Palella Frank , Koletar Susan , Gange Stephen , Brown Todd , Margolick Joseph , Schrack Jennifer
Published: December 2023

Fatigue, a symptom commonly associated with reduced physical activity, is difficult to measure among people living with HIV (PLWH), a population with the potential for comorbidity. We examined the association between self-reported fatigue and objectively measured physical activity by HIV serostatus across three commonly used fatigue measures. Self-reported fatigue and accelerometry data were collected cross-sectionally from 699 men (mean age 59 years; 57% PLWH) enrolled in the Multicenter AIDS Cohort Study. Linear regression was used to estimate differences in total daily physical activity (min/day) by self-reported fatigue measured by three separate assessments: 1) “unable to get going”; 2) “felt everything was an effort”; and 3) “work/activity difficulty due to physical health”. Models adjusted for age, BMI (kg/m2), and HIV serostatus, and interactions between HIV serostatus and each fatigue assessment were tested. Fatigue prevalence, defined as “unable to get going” (43%), “felt everything was an effort” (39%), or “work/activity difficulty” (20%) and total daily physical activity (7.4 hours active/d) appeared similar by HIV status. Men reporting “unable to get going” and “work/activity difficulty” were estimated to have an adjusted average of 21 (SE=8) fewer active min/day (p=0.01) and 35 (SE=10) fewer active min/day (p=0.001) than those without not reporting either, respectively. There was an interaction between HIV+ serostatus and “work/activity difficulty” (interaction beta: -54 active minutes/day, p=0.003). No association was detected with “felt everything was an effort” (p=0.16). Among the three questions assessed, “work/activity difficulty” was identified as a potentially useful measure of physical activity limitation in men living with HIV.