bluuebunny/crossref_metadata_2025 huggingface dataset:
NURSING HOME ADMINISTRATOR STRESS, SATISFACTION, AND INTENTIONS TO LEAVE
Authors: Nelson H Wayne , Yang Bo Kyum , Engineer Cyrus Y , Carter Mary W
Published: November 2019

Previous studies reported that high Nursing Home Administrator (NHA) turnover correlates with low staff morale and poorer care outcomes. The purpose of this study was to assess how NHA job satisfaction (JS) (in five subscales: job content, coworkers, work demands, work load, work skills, and rewards) interacts with role conflict and ambiguity, autonomy, work conflict, and influence and to estimate the odds of having NHA’s intent to quit by degree of job satisfaction. A total 208 responses were collected from the online survey in 2017 among NHAs currently working in nursing homes in 5 states. We analyzed the data using descriptive statistics and ordinal logistic regression models. The findings suggested that NHAs were generally satisfied in all JS subscales and expressed moderately high levels of autonomy, neutral levels of work conflict, role conflict and role ambiguity. NHAs with good coworker relations (adjusted odds ratio [AOR]=0.67), fair job demands (AOR=0.68) and rewards (A0R=0.8), were less likely to harbor quitting intents. Interestingly, NHAs reporting higher job skills were more likely to consider leaving nursing homes (AOR=1.46). Overall, study findings are consistent with previous JS research with the exception that higher perceived skill efficacy was found to be associated with greater likelihood of quitting in the near future. This suggests perhaps that more highly skilled NHAs may now have less tolerance for work discomfort. These findings are presented in the context of earlier studies on NHA turnover as well as likely implications of changing market conditions.
ARE TRACK-AND-TRIGGER SYSTEMS GOOD NEWS FOR RESIDENTS IN LONG-TERM CARE FACILITIES? A MULTI-METHOD EVALUATION
Authors: Barker Robert O , Russell Siân , Stocker Rachel , Liddle Jennifer , Adamson Joy , Hanratty Barbara
Published: November 2019

Changes in physiological measurements such as blood pressure or temperature may signal deteriorating health before it is apparent. Early warning (or track and trigger) systems provide a framework to use such measurements to identify acute illness and prompt a timely response. They are in widespread use in acute hospitals across North America and Europe, but few have been validated in community settings. Hospitals in the UK have adopted the National Early Warning Score (NEWS) which measures temperature, respiratory rate, pulse, blood pressure, oxygen saturation and conscious level. This presentation describes a multi-method evaluation of the introduction of NEWS into 47 long-term care facilities. Staff with little or no healthcare training were tasked with digital recording of the NEWS. This multi-method evaluation consisted of a survey to explore staff views (n=42), a quantitative analysis of approximately 17,000 NEWS readings, and 21 semi-structured qualitative interviews with stakeholders. Survey and interview findings suggested that use of the score increased staff confidence in communication and care. There were many challenges to implementation, including practical difficulties in measuring vital signs, competing priorities for staff and a persistent lack of shared understanding across professional boundaries. Quantitative analysis of recorded scores described an increase in use of the NEWS over time, but wide variation in uptake between different facilities. Early warning systems may enhance management of acute illness in long-term care facilities but implementation is not straightforward. This presentation will discuss will discuss findings in depth - what worked, lessons learned and implications for the future.
HEALTH-RELATED QUALITY OF LIFE AND CARDIOVASCULAR DISEASE IN ASIAN AMERICAN AND PACIFIC ISLANDER OLDER ADULTS
Authors: Doan Lan , Takata Yumie , Hooker Karen , Mendez-Luck Carolyn , Irvin and Veronica L
Published: November 2019

Cardiovascular disease (CVD) is the leading cause of death for Asian American (AA), Native Hawaiian, and Pacific Islander (NHPI) older adults, and AAs/NHPIs have not enjoyed decreases in CVD mortality rates, as have non-Hispanic whites (NHWs). Heterogeneity exists in the prevalence of traditional CVD risk factors for AAs/NHPIs. Health-related quality of life (HRQOL) reflect physical and mental burdens beyond clinical burdens, which may help explain discrepant CVD rates and risk factors in AAs/NHPIs. We examined HRQOL among NHW and AA/NHPI Medicare Advantage enrollees with and without a CVD (i.e., coronary artery disease, congestive heart failure, myocardial infarction, and stroke) using the Medicare Health Outcomes Survey. The sample included 655,914 older adults who were 65 years or older, self-reported as AA/NHPI or NHW, and were enrolled in Medicare Advantage plans in 2011-2015. HRQOL was measured using the Veterans RAND 12-item survey and is composed of a physical component score (PCS) and mental component score (MCS), where higher scores reflect better physical and mental health, respectively. Multivariable linear regression was used to explore HRQOL and CVD prevalence. Asian Indian, Filipino, Vietnamese, Other Asian, and NHPI subgroups had lower overall PCS, and all AA/NHPI subgroups had lower overall MCS, compared to NHWs. Among those reporting having any CVD, PCS varied by CVD outcomes and subgroups, whereas MCS was lower for all CVD outcomes and for all but one AA/NHPI subgroups (Japanese), compared to NHWs. Attention to mental health for AA/NHPI older adults could be important for the equitable realization of healthy aging.
FACTORS ASSOCIATED WITH MEANINGFUL ACTIVITIES AMONG ETHNICALLY DIVERSE OLDER ADULTS
Authors: Adeniji Dolapo O , Hong Michin
Published: November 2019

Objectives: With aging, there is an increased chance for older adults to experience negative health outcome and lose independence. Previous studies have shown the positive influence of engagement in physical, religious, recreational and social activities on healthy aging. This study aims to examine the factors contributing to the frequency of activity participation that helps older adults achieve the goal of staying healthy. Method: A sample (n=480) aged 60-90 with M=74.31, SD=7.65, and female 55.6 % from Well Elderly II were surveyed for the study. Hierarchical regression analysis was performed to examine factors associated with the frequency of activity participation. Age, ethnicity, education and gender controlling for meaning ascribed to activity were entered in model I. While the independent variables: social support, perceived mental and physical health and meaning ascribed for activity participation were in model II. Model II (R2=57.8%) significantly improved the prediction of the outcome variable greater than model I (R2=13.4%). Results: Results showed that age, education, ethnicity, perceived mental health, physical health, social support were significant. Of all variables the meaning attributed to activity participation (β =59.2%, <.001) is the most predictor of meaningful frequency of activity participation in older adults. This implies that the meaning individuals attribute to activity participation increases their frequency of activity participation. Also, age, education, and ethnicity play important role in understanding the importance of consistency in activity participation. Implications: Meaningful activity participation should be encouraged to enable older adults increase their participation in activities that promote healthy living.
ROLE OF RELIGIOUSNESS AND SPIRITUALITY AND SOCIAL NETWORKS IN DETERMINING DEPRESSION AMONG OLDER KOREAN AMERICANS
Authors: Roh Soonhee , Lee Yeon-Shim , Park So-Young
Published: November 2019

Korean Americans (KAs) are one of the fastest growing minority populations in the U.S. Depression is the most common psychological problem among older KAs. While the relationship between religiousness/spirituality (R/S) and well-being in later life is an important health concern, older KAs are often affiliated with a protestant church and have the highest church participation. This study assessed the role of R/S and social networks in determining depressive symptoms and identified the best predictors of depressive symptoms. Data were drawn from a cross-sectional survey with 200 older KAs residing in New York. Best-subsets regressions were used to evaluate the best predictors of depression. Findings indicated that nearly 30% of older KAs reported experiencing mild or severe depressive symptoms. The best model fit for depression involved physical health, R/S coping skills, social networks, and annual household income. Social networks and R/S coping skills were found to be a protective factor against depressive symptoms and may be an effective tool for health care strategies in the management of depression and health-promoting behaviors. Careful assessment of R/S and social networks among older KAs may provide a more comprehensive approach to traditional, biomedically derived clinical practices by focusing on the whole person in early identification of risk factors, prognosis, and intervention for depression. Health education and intervention could be framed in ways that strengthen such psychosocial coping resources for older KAs. Facilitating social participation and mobilizing R/S resources in a wide range of personally meaningful activities may mitigate psychological distress and enhance life satisfaction.
A PRESCRIPTION FOR WELLNESS: EXERCISE REFERRALS FOR PATIENTS AT A FEDERALLY QUALIFIED HEALTH CENTER
Authors: Benavidez Gabriel , Ylitalo Kelly
Published: November 2019

Physical activity improves quality of life and prevents or delays chronic disease, but most adults in the United States are inactive. Consultation and planning with a health care provider, specifically with an exercise “prescription,” may increase physical activity, but utilization patterns and success of such programs are not well understood. This study assessed the initial 6 months of an exercise prescription program at a large, federally-qualified health center during 2018 whereby adult patients were referred via prescription to personalized health coaching by a fitness advisor. A census of all adults (n=512) who received an exercise prescription was combined with attendance data from the on-site exercise facility to classify patients as never attended, 1 to 3 visits, and ≥4 visits. Ordinal logistic regression was used to examine patient characteristics from the electronic health record that influenced exercise facility attendance. Only 30.2% of adults (mean age 44.7 years (SD 14.4)) completed ≥1 visit and 21.7% completed ≥4 visits. We identified no significant utilization differences by sex, race/ethnicity, body mass index, diabetes, hypertension, or coronary artery disease, but adults aged ≥60 years had almost twice the odds of ≥4 visits (OR=1.97; 95% CI: 1.18, 3.33; p=0.01) compared to younger patients. Many adult patients did not participate in the exercise prescription program, but older adults were more likely to participate. Exercise prescription programs with personalized health coaching may be useful for older adult patients receiving care at a federally-qualified health center. Future work will examine if or how exercise prescriptions impact chronic disease self-management.
EXAMINING SEX DIFFERENCES WITHIN THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND EXECUTIVE FUNCTION IN OLDER ADULTS
Authors: Losinski Genna , Hicks Hilary J , Laffer Alex , Watts Amber
Published: November 2019

Research has demonstrated sex-associated differences in physical activity and its benefits on cognition in older adults. The present study explored differential associations between moderate-to-vigorous physical activity (MVPA) and executive function, which is known to decline with aging. N = 53 older adults without cognitive impairment (M = 73.19 years, SD = 6.53) wore accelerometers (Actigraph GT3X+) during 7 consecutive days. Activity intensity was categorized as light, moderate, or vigorous based on Freedson Adult Vector Magnitude cutpoints. Participants completed a battery of executive function tests: Digit Symbol Substitution Test, Verbal Fluency, Trail Making Test, and Stroop Color-Word Test. A cognitive composite score was created using confirmatory factor analysis. Women had a higher mean MVPA (4.57%) than men (2.64%, t (19.04) = -2.49, p = .022). However, executive function performance did not differ by sex (t (26.20) = 1.67, p =.107). The interaction between sex and time in MVPA did not predict performance on executive function, adjusting for age and education. Older age was the only significant predictor of poorer executive function (β = -0.038, p = .003). The current sample had limited engagement in MVPA (range 0.18-10.87%). These findings suggest that the amount of engagement in MVPA in a free-living environment may not be sufficient to demonstrate sex-associated differences in executive function performance. Future studies should explore executive function performance with other intensity levels and examine other areas of cognition.
ACTIVITIES OF DAILY LIVING DIFFICULTIES AND TOILETING AMONG OLDER GHANAIANS: AN APPLICATION OF WHO-ICF FRAMEWORK
Authors: Awuviry-Newton Kofi , Tavener Meredith , Wales Kylie , Kowal Paul , Byles Julie
Published: November 2019

The aim of the study was to analyze the prevalence of activities of daily living (ADL) difficulties among older Ghanaians and specifically how one ADL, toileting difficulty, predicts care and supports needs using the World Health Organization International Classification of Disability and Health framework (WHO-ICF). Toileting difficulty requiring upper extremity strength is among ADLs that can lead to functional loss of independence among older people globally. A sample of n=5,096 adults aged 50 years and older from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1 was used to analyze difficulties with ADLs and toileting. Level of difficulty was assessed against 22 other functioning items from the interview. Out of the 22 functioning items, climbing one flight of stairs without resting was the most difficult activity to be completed by older Ghanaians, and difficulty eating being the least endorsed item. Toileting was ranked the 16th in terms of reported difficulty and was related to other ADLs. Logistics multivariate regression was used to analyze data. Including significant variables from the univariate analysis in parsimonious model based on WHO-ICF framework, age, self-report health, memory, bodily pain, short distance vision, stroke, neighborhood trust, toilet facility type, and religious meeting attendance, were significantly independently associated with toileting difficulty. Gender was significant at the univariate level but became insignificant after adjusting for body function and structural variables. Toileting difficulty was associated with factors across different components in the WHO-ICF making the WHO-ICF an appropriate tool for understanding health and disability.
INCREASING PHYSICAL ACTIVITY POST-KIDNEY TRANSPLANT: A PILOT RANDOMIZED CONTROLLED TRIAL
Authors: O’Brien Tara , Russell Cynthia , Hathaway Donna
Published: November 2019

Older kidney transplant recipients are at risk for graft failure and death due to lack of physical activity. Physical activity after transplant is the most modifiable non-pharmacological factor for improving physical function. One personal system intervention called, SystemCHANGE™ in combination with activity trackers, holds promise for increasing physical activity among this population. The purpose of this pilot randomized controlled trial was to evaluate the efficacy of SystemCHANGE™ on increasing average daily steps in older (age 60 and over) kidney transplant recipients from baseline to 6 months. The intervention group met monthly to implement a successful personal system solution based on their daily routines and step-data collected from the activity tracker. The control group received monthly educational information on healthy living with a transplant. Participants were randomized 1:1 to the intervention or control group. The sample consisted of 31 participants (n = 15 intervention, and n = 16 control). No significant differences were found at baseline among the groups for demographics, self-efficacy and health outcomes (blood pressure, weight, waist circumference, 6 minute Walk Test). However, the intervention group had greater increase in the average daily steps from baseline to 6 months (mean ± SD: 1511 ± 2320) as compared to the control group (181 ± 2419). The between-group difference was of medium effect size (d = .56).The data suggests SystemCHANGE™ in combination with activity trackers may be feasible for older kidney transplant recipients to enhance daily steps.
RELATIONSHIP OF AGING EXPECTATIONS, GOAL CONGRUENCE, AND ACTIVITY TO MUSCLE FUNCTION IN OLDER ADULTS
Authors: Taani Murad H , Sima Christina , Apchemengich Immaculate , Kaplan Andrew , Fendrich Michael , Schiffman Rachel , Strath Scott
Published: November 2019

Poor muscle function is a major source of disability among older adults and leads to negative health outcomes including falls and fractures, exacerbating healthcare cost. This study was undertaken to understand: a) the characteristics of muscle function; and b) the relationship of self-management process variables (expectations regarding aging, goal congruence, and self-efficacy for physical activity) and physical activity self-management behavior to muscle function in a sample of older adults (N = 65) 75-93 years of age living in Continuing Care Retirement Communities. Using a descriptive correlational design, muscle function was measured with the Short Physical Performance Battery (SPPB) test and physical activity level with ActiGraph GT3X. Questionnaires included Expectations Regarding Aging and goal congruence scales and Physical Activity Assessment Inventory to assess self-efficacy. Pain was assessed by the PROMIS Pain Intensity 3a. Most participants (77%) performed poorly on the SPPB test. Controlling for pain, expectations regarding aging, goal congruence, self-efficacy and physical activity explained 46% of the variance in SPPB score. The model demonstrated that self-efficacy and light-intensity physical activity significantly explained 24.6 % of the variance in SPPB score; suggesting that low self-efficacy and decreased levels of light-intensity physical activity were significant predictors of low SPPB score. The findings demonstrate the need for more research documenting the underlying processes and risk factors for reduced muscle function. The potential benefits of this approach provide a basis for designing interventions to improve muscle function and delay the transfer to more restrictive living environments.
MOBILITY TRAJECTORIES, HEALTHCARE SATISFACTION, AND PERCEIVED DISABILITY DISCRIMINATION AMONG OLDER ADULTS
Authors: Mueller Collin , West Jessica S
Published: November 2019

Although functional mobility limitations are associated with increased healthcare needs in later life, little research explores how older adults with varying functional mobility trajectories experience healthcare quality. To this end, we explore the effects of functional mobility trajectories on differences in healthcare treatment satisfaction, perceived disability discrimination in healthcare settings, and perceived everyday disability discrimination. We analyzed 9 waves of the Health and Retirement Study (n=29,284, 1998-2014, ages 50-84). First, we estimate age-specific group-based trajectories of functional mobility across age using finite mixture models. Second, we use multinomial logistic regression to identify sociodemographic factors that place individuals at elevated risk of membership in each group. Third, we explore how membership in one disability trajectory group over another affects healthcare satisfaction, perceptions of everyday discrimination in the context of healthcare treatment settings, and perceived discrimination in everyday life. Regression models include clustered standard errors to account for heteroscedasticity across repeated observations of individuals over time. We identify six group-based trajectories of functional mobility limitation among aging Americans. Black, female, and less-educated Americans are at higher risk of membership in disadvantaged trajectories, characterized by more rapidly increasing counts of functional mobility limitations, than their counterparts. Disadvantaged functional limitation trajectories are associated with lower levels of healthcare satisfaction, higher levels of perceived physical disability discrimination in healthcare treatment settings, and higher levels of perceived physical discrimination in other contexts of everyday life. The present study advances our knowledge of how older adults experience healthcare settings and discrimination across functional mobility status trajectories.
EXAMINING GENDER DIFFERENCES IN RELIGIOUS INVOLVEMENT AND DEPRESSION IN LATER LIFE
Authors: Santiago Hailey J , Curtin Caitlin , Stengel Julia , Thompson Edward H , Futterman Andrew
Published: November 2019

This study examines gender differences in a causal model of religious motivation, religious participation and depression. Using a random sample of 287 community-dwelling older adults living in Worcester, MA, the model hypothesizes that motivations for religious involvement (intrinsic vs. extrinsic) differentially predict religious participation (organizational and non-organizational) as well as depression at both initial and 12-month assessments. In this model, participation also mediates direct relationships between religious motivation and depression. Religious motivation and participation are assessed using standard measures (e.g., Allport & Ross, 1967; Ainlay & Smith, 1982), and depression is assessed both by self-report (CESD and by interview (Hamilton Rating Scale for Depression derived from the Schedule for Affective Disorders and Schizophrenia, SADS). Using MPlus, confirmatory analyses of the model were conducted separately in male and female samples. The model which includes both direct effects of religious motivation and participation on depression and with religious participation as mediating variable demonstrated reasonably good fit to the data in both male and female samples (e.g., CFI=.956 and .943, respectively). Consistent with previous research (e.g., McFarland, 2009), gender differences in the models emerge. For example, men report higher levels of religious participation and less depression than women. In addition, older men demonstrate stronger positive associations between extrinsic religiousness and organizational participation and a more negative association between extrinsic religiousness and depression, than older women. Elucidating the structural relationships among religious orientation, religious participation, and depression in older adults benefits our understanding of vulnerability and treatment of depression in this population.
RELIGIOUS EXPERIENCE AS A KEY FACTOR IN THE DEVELOPMENT OF LATE-LIFE TRUE BELIEF
Authors: Prusak Austin , Iapalucci Margaret , Walsh Eoin , Wolfram Ann-Kathrin , Futterman Andrew
Published: November 2019

Hoffer (1951) argued that “true believers” are individuals who cannot tolerate questions about their views. In terms of “true” religious believers, such individuals would not be able to tolerate questions about religious doctrine. In this study, we examine potential causes of religious “true” belief in later life. Using a model of religious orientation developed by Allport (1950) and Batson (1991), we defined “true” religious believers as those individuals who describe deep and broad religious commitments (score high on measures of intrinsic religious orientation) but refuse to question or doubt their commitments (score low on quest religious orientations). Using logistic regression analyses, we examined predictors of religious true belief in a sample of 357 denominationally diverse older adults living in New England. Predictors in the model included denominational affiliation, religious knowledge, organizational and non-organizational religious participation, and religious experiences, as well as non-religious factors such as personality traits (NEO), severity of illness and self-rated health, overall life stress, and other background factors (SES, gender, age) Of these 14 predictors, one factor in particular stood out as a particularly robust predictor of membership in the “true” believer group (n=47) – high scores on self-reported religious experience. Religious life experiences may be influenced by cohort and personality, resulting in extremely high scores of the individual on the intrinsic orientation scale and extremely low scores on the quest scale; together these embody the “true believer”.
DETECTION OF DEPRESSION USING THE UCLA THREE-ITEM LONELINESS SCALE IN OLDER CHINESE
Authors: Liu Tianyin , Wong Gloria H Y , Tang Jennifer Y M , Lu Shiyu , Leung Dara , Sze Lesley , Sing Joyce , Lum Terry
Published: November 2019

Loneliness is a significant and independent risk factor for later life depression. This study aimed to validate the Chinese version of the UCLA 3-item Loneliness Scale and to ascertain the cut-off point in detecting depression in community-dwelling older adults. The English version of the UCLA was translated into Chinese by six experienced social workers, clinical psychologists and researchers, and content validity was established by consultation and revision with 10 older adults. 1,919 older adults aged 60 years and over (average age = 76.3±8.0) were recruited from local NGOs, they were interviewed for demographic information, and assessed using the 3-item loneliness scale and the Patient Health Questionnaire (PHQ-9). Cronbach’s α of the Chinese loneliness scale was 0.87; the average score was 4.0 ± 3.0 out of 9, and it significantly correlated with living alone (r = 0.18, p < 0.001), unmarried (r = 0.12, p < 0.001), no emotional support (r = 0.14, p < 0.001), and depression (r = 0.41, p < 0.001). Using PHQ-9 cut-off score of 5 for mild and above depression, the area under the curve (AUC) was 0.73 ± 0.1 (p < .001, 95% CI 0.71-0.76) with 77% sensitivity and 61% specificity. We determined a cut-off point of 3 for loneliness using the Youden index, which revealed better sensitivity over alternative definitions of loneliness. A cut-off point of 3 in the Chinese UCLA 3-item loneliness scale can reliably identify possible depression in community-dwelling older Chinese.
LONELINESS AND HYPOCHONDRIASIS AMONG OLDER ADULTS: THE MEDIATING ROLE OF INTOLERANCE OF UNCERTAINTY AND ANXIETY
Authors: Moore Jenna M , Archuleta William P , Helphrey Jessica H , Smith Leah N , Sawyer Jennifer , Rose III David W , Reed Christopher , Barnett Michael D
Published: November 2019

Loneliness is prevalent among older adults and is associated with adverse outcomes for health and mortality. Additionally, researchers have suggested that loneliness may cause a person to direct attention inward and become preoccupied with bodily symptoms which may subsequently lead to health anxiety. However, little extant research has examined the association among older adults. In this study, we proposed a loneliness model of hypochondriasis in which loneliness contributes to hypochondriasis through intolerance of uncertainty and anxiety. Healthy, community-dwelling older adults (N = 280; 64.4% female; age range: 65-95; M = 76.08, SD = 7.59) completed an interview survey. Loneliness was associated with higher hypochondriasis and had an indirect effect on hypochondriasis through intolerance of uncertainty and anxiety. Lonelier older adults may have an activated threat system which prompts greater intolerance of uncertainty and anxiety and thereby results in greater hypochondriasis.
GENDER DIFFERENCES IN CARE USE IN THE NETHERLANDS: CHANGES BETWEEN 1995 AND 2016
Authors: Aaltonen Mari , Deeg Dorly , van Groenou Marjolein Broese
Published: November 2019

In recent decades, care policy in the Netherlands reduced budgets for residential care and formal home care, which increased the demand for informal care. Women use formal care more often than men, but we lack information on the extent to which the gender gap in care use is explained by differences in individual chracteristics and changes in care policy. Data from the Longitudinal Aging Study Amsterdam (LASA) were employed to explore the gender gap in the use of informal, formal and private home care, community services, and residential care in the years 1996-2016, analyzed using Generalized Estimating Equations (GEE). The data consisted of 9,497 observations, gathered from 3,369 respondents aged 65-85. Women used all types of formal care more than men. The gender differences persisted even when individual characteristics were taken into account; however, only in residential care the differences diminished after care preferences were included in the analysis. During the study years, the gender gap increased in formal home care and in non-use of care, as women increasingly used formal home care and the proportion of men without care expanded. The gender gap in informal care use reversed, with men using more informal care during the earlier years and women using more in the later years. The persistent and even increasing gender differences in care use deserve further exploration of the role of gender in current care culture. The growing gender gab in non-use of care raises concern for older men and their possible increase in unmet care needs.
COASTAL RETIREMENT: IT’S ALL FUN AND GAMES UNTIL THE HURRICANE HITS
Authors: Glass Anne P , Blair Jenni , Nichols Judith
Published: November 2019

Many people dream of retiring to the beach. Twenty-four individuals who retired from out-of-state to a beach area in southern North Carolina had previously been interviewed regarding their retirement process and decision to move to this destination. Hurricane Florence brought major flooding and devastation to the area in September 2018. Shortly after, 10 participants agreed to complete a second interview and data collection about their hurricane-related experiences. This sample consisted of 8 women and 2 men, average age of 74.4 (range=68-88), and all were white. Nine evacuated, including one who went to a shelter. This project provided a unique opportunity to compare answers about stress levels and how they felt about their choice to move to the area, before and after the storm. Six and five rated their stress high/very high just prior to, and during Florence, respectively, but stress levels returned to low/very low for 90%. Two stated the storm caused them to rethink their decision to move; one now says she feels ambiguous about her move and would probably not choose it again. Stress caused by uncertainty was a thread across all interviews. Anxiety and concern were experienced, but no one reported fear. Neighbors played an important role pre-, during, and post-storm. No participants had significant damages, although one had a break-in; all expressed gratitude. They reported some lessons learned to apply the next time. These findings will be of interest to planners and others. They also demonstrate the resilience of older adults in dealing with natural disasters.
SOCIAL ISOLATION AND LONELINESS: A LATENT CLASS APPROACH TO COSTING HEALTH SERVICE ENGAGEMENT IN AGING POPULATIONS
Authors: Douglas Elaine , Bell David
Published: November 2019

Social isolation and loneliness are associated with poorer health status and poorer health outcomes. Little is known the impact on health service usage, and its inherent cost, although it is considered to be higher. Latent class analysis (LCA) was used to determine profiles (population groups) of loneliness and social isolation in older people (aged 50+, n=1,057) using model-fit criteria. Loneliness was measured using the UCLA Loneliness Scale and social isolation used a measure of social networks and social contact. We then analysed the socio-demographic, perceived health, and health behaviour of these profiles using descriptive statistics and logistic regression. The survey data (HAGIS, 2016/17) were linked to retrospective administrative health data to investigate patterns of repeat prescription use (from 2009) and health service usage (from 2005) and their associated costs. Our results highlight the distinction and inter-relation between social isolation and loneliness (including associations with socio-demographic and health characteristics), and the variation in health service usage and costs between the population groups. LCA profiles may help focussed targeting of these groups for health interventions. Further, the data-driven approach of LCA may overcome some of the limitations of indices of social isolation and loneliness. As such, this will extend the existing methodological approaches to quantitative analyses of social isolation and loneliness and demonstrate the benefits of using linked administrative health data. Significantly, this study incorporates the social and financial cost of social isolation and loneliness on health and its implications for health services.
CREATING THE CT GERONTOLOGY CONSORTIUM TO BRING FACULTY AND STUDENTS TOGETHER TO PROMOTE GERONTOLOGICAL EDUCATION
Authors: Barmon Christina , Oakes Claudia E , Fedus Donna , Michalowski Erica , June Andrea , Andreoletti Carrie
Published: November 2019

Although commonplace for faculty across universities to collaborate on research, it is less common to bring faculty and students from different institutions together for pedagogical purposes. In this poster, we describe the development of the Connecticut Gerontology Consortium, comprised of gerontology instructors at several academic institutions. We created this consortium in order to 1) develop a support network for faculty interested in teaching about aging, and 2) to support collaboration on efforts to promote creative, interdisciplinary student experiences that foster a passion for gerontology. In addition, we describe one endeavor, a student project, from the planning stages to post-project reflections. The intercollegiate and interdisciplinary “Careers in Aging” project brought together 62 students from four academic institutions with a broad range of experiences and interests. Students were assigned to groups from different schools to investigate careers in the aging network in Connecticut. Each student group interviewed a professional, delivered a presentation about their career path and day-to-day experiences, and created an informational brochure about the profession. Students indicated that they valued the experience of learning about the aging network and engaging with other students who shared an interest in gerontology. However, they cited challenges in communicating with students from other classes and at other institutions. This project has the potential to build networking opportunities for students as well as strengthening the community of gerontology professionals. The presentation will include lessons learned and how the consortium plans to move forward.
UTILIZING UNDERGRADUATE RESEARCH TO INFORM COMMUNITY RESOURCES FOR OLDER ADULTS: A SERVICE-LEARNING PROJECT
Authors: Barnett Amanda E , Olinger Sara
Published: November 2019

Engaging undergraduate students with aging-focused community resources is critical for preparing students to work with older adults and make positive contributions to aging societies. During the fall, 2018 semester, undergraduate students in a human development course on middle and late adulthood partnered with a county aging and disability resource center (ADRC) in Wisconsin to evaluate and update several of their existing programs and resources using empirical research. Upon completion of this project, students synthesized course material to meet all course learning objectives such as: (1) critically analyze physical, psychological, and sociological processes of aging across categories of difference (e.g. cultural, ethnic, class); (2) evaluate social policies and their multigenerational implications for midlife and older adults; and (3) construct a personal position on aging that integrates theory, research, and policy to demonstrate a sensitive and competent approach to working with midlife and older adults. Students researched, wrote reports, and presented to ADRC staff on the impact of social isolation on older adults, best practices for home visitor and transportation programs serving older adults, cognitive competency tools and best practices for utilizing memory assessments, grief supports and groups for family caregivers, and best practices for supporting veterans as they age. The outcome of these projects are research-based recommendations for any ADRC to consider when developing and implementing related programs. All stakeholders (students, professor, and ADRC staff) were satisfied with the process and outcomes of the project. Strengths and challenges of carrying out such a collaborative project will be reviewed.
TEACHING SEX AND AGING TO PRE-PROFESSIONALS: EXPERIENTIAL LEARNING OF A TABOO TOPIC
Authors: Naar Jill Juris , Weaver Raven H , Sonnier-Netto Libbie
Published: November 2019

Myths and stereotypes of sex in late life prevail (e.g., sex becomes unimportant or irrelevant; sex gets worse as individuals age; older adults are asexual). Unless the workforce is adequately prepared and knowledgeable to address the sexual health needs of older adults, it is difficult to disrupt ageism that contribute to discrimination against older adults. Methods: We evaluated a two-day experiential workshop designed for students to develop factual community resources and educational materials related to sex and aging. Results: Using content analysis, we examined open-ended responses from 41 students. We identified three themes that depicted the value of experiential learning, specifically for this taboo topic. Students (1) increased awareness of late life sexual health and behaviors, (2) demonstrated comfort and creative strategies to discuss sex, and (3) appreciated the opportunity for transferable pre-professional skill development. Discussion: Providing pre-professional training helped close the knowledge gap about basic gerontological issues and issues specific to sexual health and sexual behaviors in late life. Students perceived the flipped classroom and collaborative structure of this experiential workshop as beneficial and practical for their learning and professional preparation. They developed skills for translating knowledge into practical resources that likely will transcend professions. Emphasizing the potentially uncomfortable topic of sex and aging provided students an opportunity to increase their comfort when addressing issues they will experience in their various professions. It is critical for gerontology educators to identify strategies to deliver sex and aging education among professionals to enhance interactions with older adults.
2019 GSA FELLOWS SYMPOSIUM: STRENGTH IN AGE: HARNESSING THE POWER OF NETWORKS
Authors: Martin Peter
Published: November 2019

The 2019 GSA Fellows Symposium includes GSA members who were recently granted GSA Fellow status. They represent each of the GSA sections: Biological Sciences (BS), Health Sciences (HS), Behavioral & Social Sciences (BSS), Social Research, Policy & Practice (SRPP), and the Academy for Gerontology in Higher Education (AGHE). The theme of the 2019 GSA Fellows Symposium is focusing on the power of networks and will highlight the importance of neuroendocrine networks (Christian Sell), the role of social support for refugees in Canada (Esme Fuller-Thomson), the importance of professional partnerships to promote health (Heather Young), aging-friendly communities (Emily Greenfield), and the role of networks in teaching gerontology (Tina Kruger). The importance of networks across disciplinary boundaries will be discussed.
CONTEXTS SURROUNDING PSYCHOLOGICAL MISTREATMENT AND NEGLECT BY CAREGIVERS TO PEOPLE WITH DEMENTIA
Authors: Meyer Kylie , Lee Kyungmi , Yefimova Maria , Pickering Carolyn
Published: November 2019

This presentation examines the individual experiences of caregivers using psychological mistreatment and neglect. When a caregiver indicated psychological mistreatment (e.g., yelling) or neglect (e.g., skipping necessary care) occurred on their daily diary, they were asked what they were doing and how they felt when the event occurred. Text responses were analyzed using content analysis. When psychological mistreatment occurred, there was often a triggering event. For example, 43.8% of caregivers reported they were responding to a behavioral symptom, and 28% indicated something inconvenient occurred. Caregivers were mostly frustrated/angry (68.8%) and annoyed (21.9%) when they used psychological mistreatment. When the caregiver neglected the recipient, 43.5% of caregivers reported the recipient refused to receive care and 30% reported prioritizing other care activities. In cases of neglect, caregivers were frustrated/angry (39.1%) and worried/anxious (30.4%). Findings indicate psychological mistreatment and neglect occur in unique contexts; prevention of these behaviors likely will require distinct intervention strategies.
INTEREST GROUP SESSION—ASSISTED LIVING: DEMENTIA IN ASSISTED LIVING: STATE VARIABILITY IN REGULATIONS, OVERSIGHT, AND RESIDENT OUTCOMES
Authors: Thomas Kali S , Schwartz Lindsay
Published: November 2019

Approximately one million individuals, an estimated 40% with a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care provided in AL. Unlike other forms of long-term care (LTC), the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their regulatory approaches. The overall objective of this symposium is to examine states’ AL regulatory environments and understand if and how the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. Presenters will highlight the state variability in the regulation, oversight, resident composition, and outcomes of AL residents with ADRD. The first presentation will describe states’ different regulatory requirements for staffing and admission/discharge criteria as it relates to residents with ADRD and how those have changed over the last decade. The second presentation will report results from a national survey of state agents regarding their oversight and enforcement activities in AL. The third presentation will characterize differences in the resident composition and healthcare utilization among residents with ADRD across states. The fourth presenter will report on the effect of residing in an AL licensed to provide specialized dementia care versus a standard-licensed AL on ADRD residents’ outcomes. The discussant will contextualize findings as they relate to the current state of the AL industry. Results will ultimately inform policy-makers, organizational leaders, and clinicians as they seek the most effective ways to ensure optimal outcomes vulnerable residents with ADRD.
DOES MEMORY CARE MATTER? EXAMINING THE EFFECT OF DEMENTIA-LICENSED CARE ON RESIDENTS’ OUTCOMES
Authors: Cornell Portia Y , Rahman Momotazur , Zhang Wenhan , Thomas Kali
Published: November 2019

The objective of this study is to estimate the effect of receiving care in a dementia-care licensed (DCL) assisted living community, versus a standard AL, on outcomes of residents with ADRD. In four states that issue a license for specialized dementia care (AL, CO, MS, and NY), we identify a cohort of 5,720 Medicare fee-for-services beneficiaries with ADRD who moved to an AL in 2014. To control for unobserved factors that contribute to a patient’s selection of AL type, we use the difference in the log-distances from an individual’s home address to the nearest DCL and standard AL as an instrumental variable. We will report the effect of residence in a DCL AL on mortality, inpatient hospital days, emergency department utilization, and hospice use, showing how the use the distance instrument offers differing estimates from unadjusted or multiple-regression methods.
STATE VARIABILITY IN HEALTHCARE UTILIZATION AMONG ASSISTED LIVING RESIDENTS WITH DEMENTIA
Authors: Thomas Kali S , Cornell Portia , Zhang Wenhan , Rahman Momotazur , Dosa David , Kaskie Brian , Carder Paula
Published: November 2019

The objectives of this study are to describe the state variability in the prevalence of ADRD among AL residents and in this group’s healthcare utilization. Using 2014 Medicare enrollment data, Medicare claims, and the Minimum Data Set for a sample of 493,867 Medicare fee-for-service beneficiaries in AL (178,787 with ADRD), we present their rates of hospital and emergency department (ED) use, by state, adjusting for age, sex, race, and dual-eligibility status. States varied in their unadjusted percent of residents with ADRD from 25% in MN to 48% in WV. In 2014, 40% of AL residents with an ADRD diagnosis were hospitalized during the year, ranging from 30% in UT to 47% in FL. Forty-two percent of residents with ADRD used an ED in 2014, ranging from 36% in MD to 56% in NC. The potential influence of state regulations, enforcement, and market factors will be discussed.
INTEREST GROUP SESSION—CHINESE GERONTOLOGY STUDIES: DEVELOPING A BODY-MIND-SPIRIT CAREGIVER SELF-MANAGEMENT PROGRAM AND A MOBILE APPLICATION FOR CHINESE AMERICANS
Authors: Chi Iris , Boot Walter
Published: November 2019

Caregivers of older adults are at risk for poor physical and mental health outcomes. Chinese American caregivers, especially those who are recent immigrants, are at risks for developing health symptoms while less likely to seek outside help and utilize caregiver resources due to cultural barriers, low health literacy, and limited-English proficiency. This symposium will introduce the Caregiver Self-Management Program (CSMP), a training program based on the Body-Mind-Spirit model to equip Chinese immigrant caregivers with self-care knowledge, skills, and self-efficacy. We designed the in-person training to be four 3-hour sessions and pilot tested it among 11 Chinese caregivers. The training was well-received by participants; however, the caregivers’ duties and their working status, compounded with transportation barriers, leave them little time to participate in the intervention. To address these challenges, we further employed a user participatory approach to design, prototype, and pilot-test a CSMP mobile application (app) to meet the needs of Chinese immigrant caregivers. App functions included interactive multi-media lessons and practice, scheduling of coaching sessions for problem solving, extended readings, community resources, etc. We co-designed the app with seven caregiver co-designers, alpha-tested the app prototype with 12 caregivers, and beta-tested the app in real-life settings with 20 caregivers. Four presentations in the symposium will discuss the CSMP in-person training design and evaluation, influence of Chinese culture on caregiving and impacts of CSMP, user-participatory approach used in co-design and alpha-testing of the app prototype, and preliminary results from the beta-testing to assess external user acceptance and feasibility of the CSMP app.
A BODY-MIND-SPIRIT CAREGIVER SELF-MANAGEMENT PROGRAM FOR CHINESE AMERICANS: PROGRAM DESIGN
Authors: Liu Mandong , Wu Jinli , Zhang Geng , Chi Iris
Published: November 2019

The aging society presents a growing demand for formal and informal caregivers. Literature review reveals that cultural practices and immigration challenges compound the caregiving burden in Chinese American caregivers. The team designed a culturally sensitive and linguistically appropriate training program targeting the overall well-being of Chinese caregivers. The intervention pivots on the Body-Mind-Sprit model, a health model rooted in Chinese traditional philosophies and integrating three components into an inseparable unity. We designed the in-person training to be four 3-hour sessions and incorporated modalities, which include mini lectures, skill training, discussion, exercise videos, homework activities, and a website. We pilot tested the intervention among 11 Chinese caregivers, followed by two focus group discussions and formative evaluation. Participants provided positive feedback in program evaluation survey, while analysis of focus group revealed three major topics: program benefits, barriers to receiving training and applying its content, and suggestions.