bluuebunny/crossref_metadata_2025 huggingface dataset:
Advocacy Through Partnerships: Data, Demographics, and Decisions
Authors: Sisofo Briana , Asman Anne
Published: December 2020

The Summit County Aging Alliance (SCAA) in Park City, Utah is representative of state government, county and city government(s), private citizens, land developers, Senior Center attendees, national and local associations, non-profit support organizations, home health agencies, colleges and universities, recreation centers, hospital administrators and area associations on aging. The focus of the Alliance has been to provide a forum for critical listening and discussion. Data from a survey to determine the ‘real’ needs and vision of the older adult community provided perspective from more than 100 older adults representing diverse ethnic and socio-economic backgrounds. This work is now providing a benchmark from which both the city and county governments in Summit County are creating their strategic plans, and the Alliance has become the official voice of the community’s older adults.
Ethnographic Methods, Music, and Aging
Authors: Couve Amanda , Kotarba Joseph
Published: December 2020

Qualitative methods are proving to be important tools for studying the multi-faceted experience of living with aging, with a focus on the arts. Ethnographic methods are productive ways to discover and examine music in everyday life. Systematically studying the normal and often taken-for-granted ways aging adults experience music, in the full range of settings where they can be found, can abide by the first rule of translational science research: to design and conduct research in order to facilitate the efficient and timely development and application of clinical and caring interventions. This presentation will review a series of ethnographic studies of music experiences in residential facilities, dementia respite groups, family, and hospice. We will suggest ways to apply findings from these studies to enlighten volunteer hospice workers’ protocols for care.
Arts-Based Interventions for Dementia Care: East Meets West Symposium
Authors: Sun Fei , Duncan Angel , Hooyman Nancy
Published: December 2020

This East Meets West symposium presents evidence of arts-based interventions in dementia care in different societal settings, focusing on the U.S.A. and China, where live about one-third of the world’s total estimated 49 million dementia population. The first study from Kansas in the U.S. outlined the varieties of arts being applied in dementia care and recommended dementia care, inter-professional teams, to involve those professionals in arts and humanities. The second paper, based upon secondary national representative data, examined the association with arts-related hobbies and cognition status among Chinese older adults. The authors called for more research to shed light on the underlying mechanisms between arts and cognition. The third paper discussed two arts-based clinical trials on persons with dementia (PWD) at different stages living in Hong Kong. It found that dancing body movement therapy improved behavioral and emotional outcomes among those at the mild dementia stage. In contrast, music and movement worked better for those at the moderate dementia stage. The fourth study reviewed the effectiveness of body movement therapies for PWD, using an example of the Wheelchair-bound Senior Elastic Band for older adults with disability and dementia. The last study examined the effectiveness of a program that used museum tours to empower, educate, and inspire PWD. One discussant will share lessons learned across studies, and the other discussant from AARP Global Council on Brain Health will speak to the effects of music relating to the AARP 2020 consensus report on music and the brain health.
Why Arts Matter to People and Families Living With Dementia: Interprofessional Health Humanities Collaboration
Authors: Kennedy Teri
Published: December 2020

This presentation will share examples of arts-based and creative interventions serving people and their families living with dementia representing evidence-based and promising practices in the United States. Such interventions offer effective non-pharmacological approaches to dementia care including use of the visual arts (e.g., drawings, paintings, sculpture) and performing arts (e.g., music, theatre); literature and writing including reminiscence, biographical approaches, and life story work; photography and Photovoice; and dance and movement as intervention modalities. Current evidence will be presented that demonstrates the effectiveness of arts-based interventions as a form of psycho-social and self-care to alleviate the effects of dementia and enhance the quality of life. Recommendations for future research will be discussed. Strategies will be proposed to develop interprofessional health humanities networks between universities, healthcare systems, libraries, museums, and the arts community to collaborate on the creation of arts-based programs in communities currently without the benefit of such programs.
The Relation Between Cognition and Interests in Arts Among Chinese Older Adults
Authors: Li Xia , Fang Yuan , Qiu Qi , Qian Shixing
Published: December 2020

This study aims to examine the association between arts related interests and cognition among older Chinese. Data were drawn from 3,243 participants (Mage=71.1, SD=7.8) in the China Longitudinal Aging Study collected in 2011. About 54.4% were female, the average education was eighth grade, 560 interested in music, 86 interested in drawing, and 69 interested in both. Those interested in music or drawing were more likely to enjoy tea and exercise like Taichi, and less likely to smoke or drink (p < 0.01). Those interested in both reported best cognitive function, and those interested in music or drawing had better cognitive function than those without these interests (p< 0.01). However, the difference in cognition between those interested in music and those without diminished after education was controlled. The effect of arts hobbies in cognition among older Chinese remains to be further examined within the context of education and associated lifestyle factors.
Longitudinal Engagement in Modifiable Lifestyle Behaviors and Dementia Risk
Authors: Wong Roger
Published: December 2020

Dementia is a major public health threat as there are currently no definitive methods to prevent, treat, and cure the disorder. Recent efforts have focused on modifiable lifestyle behaviors to reduce dementia risk. Yet, the majority of these studies have utilized cross-sectional data or are limited to specific geographic areas. The purpose of this study was to explore how longitudinal engagement in modifiable lifestyle behaviors (physical activity, smoking, and social contacts) influence dementia risk. This study analyzed eight annual waves (2011-2018) of prospective data from the National Health and Aging Trends Study, a large nationally representative U.S. sample of older adults. Each wave, physical activity was measured as engagement in vigorous physical activities; smoking was measured as current engagement in cigarette smoking; and social contacts was measured as visiting friends/family outside of their home. The dependent variable was number of years to a new dementia diagnosis. Multivariate analyses were conducted using the Cox proportional hazards model with survey sampling weights applied for a national sample of 6,800 community-dwelling older adults dementia-free at baseline. After controlling for sociodemographics (age, sex, race, etc.) and health (physical health, chronic disease, etc.), longitudinal engagement in physical activity significantly decreased dementia risk (Hazard Ratio [HR]=0.60, p<.05), however, there was no significant relationship with smoking (HR=1.12, p=.58) and social contacts (1.06, p=.83). Our findings indicate physical activity is a promising modifiable lifestyle behavior for prevention. Future research should explore physical activity interventions that are most effective in reducing dementia risk, such as strength-based or aerobic-based activities.
Caregiver-Centered Communication: A New Tool for Assessment of the Quality of Communication With Family Caregivers
Authors: Demiris George
Published: December 2020

Improved communication with caregivers can lead to reduced caregiver anxiety and burden, improved quality of life, and better coping during a stressful time. Even though caregiver communication with the health care team is essential in gerontology, we are lacking standardized instruments to assess quality of communication. We describe the initial development and testing of the Caregiver Centered Communication Questionnaire (CCCQ). The questionnaire has 30 items with 5 subscales: exchange of information, fostering health relationships with team/provider, recognizing and responding to emotions, managing care and decision making. We conducted a cross-sectional survey of 115 family caregivers of older adults in home care and hospice. Cronbach’s α for the scale was 0.97. Internal consistencies of subscales were high, ranging from 0.82 to 0.93. Preliminary testing indicates the potential of CCCQ in assessing engagement and quality of communication; further testing is required.
Caregiving Together: The Relationship Between Paid and Family Caregivers in the Home
Authors: Reckrey Jennifer , Stone Robyn
Published: December 2020

Family caregivers provide the lion’s share of care that allows older adults with functional impairment to remain living at home. Yet as care needs grow, many older adults and their families turn to paid caregivers (e.g. home health aides, personal care attendants, and other direct care workers) to provide additional support. While evidence suggests that paid and family caregivers work together to provide increasingly complex care at home, research that describes this important collaboration is limited. In this symposium, we present innovative and interdisciplinary research that highlights the overlap between family caregiving and long-term care workforce research. We begin by presenting two studies that focus on populations where paid caregivers may have outsized impact on family caregivers: Reckrey et al report that receipt of 20+ hours of paid caregiving per week was associated with less caregiver strain among family caregivers of those with advanced dementia and Falzarano et al report that home care hours mediated the association between caregiver stressors and negative effects of caregiving among long-distance family caregivers. Franzosa et al then describe home health aides’ perceptions of relationship dynamics as aides and family members negotiate care tasks in the home. Finally, Gallopyn et al explore scenarios where paid and family caregiver roles blur (e.g., family caregivers receiving payment for providing care, paid caregivers with extensive experience as family caregivers). Taken together, these studies describe critical ways paid and family caregiver experiences are intertwined and highlight the importance of ongoing research about this collaboration.
Mechanisms of Cardiometabolic Disparities: Stressor Characteristics Linked to HPA-Axis Dysregulation
Authors: Allen Julie Ober , Mezuk Briana , Ko Tomohiro , Rafferty Jane , Abelson Jamie , Kalesnikava Viktoryia , Jackson James
Published: December 2020

Diurnal cortisol slopes are stress-sensitive HPA-axis biomarkers implicated in cardiometabolic health outcomes and disparities. This study used two longitudinal cohort studies (CREATE and TRIAD) with harmonized variables to comprehensively examine what types of exposure to stressors are most salient for cortisol dysregulation in later life, and whether the characteristics of stressor exposure accounts for Black-White disparities in cortisol dysregulation (merged sample N=209, 65% male, mean age 61, 17% Black). Black participants reported greater stressor exposure than Whites along some dimensions (e.g., # recent major stressors, appraised severity of lifetime stressors, all p<.02) but comparable exposure in others (e.g., # of lifetime stressors and life domains). Stressor exposure measures that captured psychological components (i.e., appraised severity, psychological distress) and pervasiveness (i.e., # life domains with major stressors) were more closely related to cortisol dysregulation than more objective measures (e.g., # of recent /lifetime stressors). Everyday discrimination was associated with racial disparities.
Contextual and Social Characteristics Relevant to Health and Well-Being in African American and White Adult Populations
Authors: Sardina Angela , Aiken-Morgan Adrienne , Gamaldo Alyssa
Published: December 2020

With the burgeoning older adult population, there will be an increased demand for neighborhood and housing developments conducive to the interests and needs of older adults from diverse backgrounds of varying health and functional status. Several initiatives have sought to develop age-friendly neighborhoods, which focused on improving access and affordability of community resources. However, limited effort has focused on physical and social attributes of immediate housing environments, particularly amongst lower-income older adults. The need for affordable and usable housing developments for older adults that provide greater opportunities for social engagement, social services, and convenience to neighborhood resources (e.g., grocery stores, healthcare) will continue to rise. The objectives of the proposed symposium are the following: (1) to explore the physical and social attributes of older and low-income residents’ housing and their surrounding community; and (2) discuss how older and low-income residents’ housing and community resources relates to their health and well-being. This symposium will include presentations from three pilot investigations that highlight relevant subjective and objective contextual metrics related to health and well-being in underserved older populations. Tan and colleagues explored the role of well-being (i.e., purpose in life) in the relationships among sociodemographics, health, housing and community resources. Sardina and colleagues explored perceived leisure barriers and their relationship to sociodemographic, health, and psychosocial characteristics. Aiken-Morgan and colleagues examined associations between neighborhood socioeconomic disadvantage and health status among low-income African American older adults. Wright and colleagues explored associations between neighborhood disadvantage, brain health, and neurocognitive function in cognitively normal older adults.
Discrimination and Social Isolation Among African Americans Across the Lifespan
Authors: Nguyen Ann , Taylor Harry
Published: December 2020

Social isolation is associated with a wide range of health problems, including early mortality. However, little is known about the risk factors for social isolation specifically among African Americans. This study examined 1) the associations between discrimination and objective and subjective social isolation and 2) how these associations vary by age in a nationally representative sample of African American adults from the National Survey of American Life (N=3570). Multinomial logistic regression analyses indicated that discrimination was positively associated with being subjectively isolated from friends only and family only. Discrimination did not predict objective isolation. A significant interaction revealed that the association between discrimination and subjective isolation from friends only varied by age, with older adults being most vulnerable to the effects of discrimination. These findings argue for a more nuanced and systematic investigation of the detrimental effects of discrimination on older African Americans’ social relationships, especially perceptions of relationships.
Older Couples Coping With Adverse Life Events: The Importance of Dyadic Personality Profiles
Authors: Wang Shuangshuang , Kim Kyungmin , Burr Jeffrey
Published: December 2020

Personality can be an important resource as older couples cope with adverse life events. Analyzing 4,893 older couples from the Health and Retirement Study, this study examined how one’s own and spouse’s adverse life events (health decline, job exit, loss of wealth, family member’s death) occurring in the past two years are associated with changes in depressive symptoms. We further examined the moderating effects for this association of six dyadic personality profiles (combinations of spouses’ positive and negative personality characteristics). We found significant actor and partner effects of health decline for increases in both spouses’ depressive symptoms, and significant actor effects of a family death for husbands’ increased depressive symptoms. For wives, having positive personality profiles buffered negative effects of one’s own health decline and spouses’ family death, whereas having negative profiles intensified negative effects of husbands’ job exit and loss of wealth on the depressive symptoms for both spouses.
Screening for Cognitive Function in Primary Care
Authors: Cortes Tara , Seidel Liz
Published: December 2020

A comprehensive program for early detection and treatment of Alzheimer’s and related dementias requires a systematic process for provider education, assessment of cognitive function and referral to appropriate resources when indicated. This discussion will focus on the implementation of cognitive screening into primary care. Over 200 staff across 11 primary care sites were trained on screening for dementia in the annual wellness visit. In the following 6 months nearly 2000 annual wellness visits were conducted. The annual wellness visit was designed to include a cognitive screen. 83% of the patients were asked the cognitive screen questions and 13% responded “yes” to the question. Further testing was offered to that group and 71% of those who had responded “yes” agreed to be tested with a picture memory screen. 32% scored less than 5 on that screen and were referred to gero-psychiatry, geriatricians and community based organizations for caregiver support services.
Expanding Housing With Services in the United States: The Case of the Right Care, Right Place, Right Time Program
Authors: Miller Edward , Nadash Pamela , Simpson Elizabeth , Cohen Marc
Published: December 2020

Older people living in congregate environments are obvious beneficiaries of supportive services. The potential for prevention is clear, particularly among low-income elders living in subsidized housing; it is this group that is at high risk for significant healthcare and other costs, and it is this group that suffers considerably from a fragmented healthcare system. The purpose of this presentation is to illustrate the potential of housing with services, drawing from evaluation of The Right Care, Right Place, Right Time (R3) initiative (R3) located in the Greater Boston area. The R3 program consists of two on-site wellness teams, including a wellness nurse and wellness coordinator. Each team is responsible for about 200 participants across two housing sites. Evaluation findings highlight the potential of housing with services for improving the health, quality of life, and access to health-related services and supports among seniors living independently in affordable housing, while reducing healthcare costs.
The Voices of Persons Living With Dementia: Exploring Their Information Needs to Live Well
Authors: Kimzey Michelle , Baucham Ramona , Martin Chelsea , Howe Carol
Published: December 2020

There are unique challenges and considerations when receiving the diagnosis of dementia. There are interventions, services, and supports for people with dementia and their care partners, yet they are often unknown, disconnected, and may not be widely available or easily accessible. Health literacy was defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Using a descriptive qualitative design, the purpose of this study was to describe how persons living with dementia and their care partners obtain, understand, and use information to make health decisions to live well with dementia. The convenience sample consisted of 28 care partners and 15 people living with dementia participating in 6 separate focus groups. To illuminate findings, data was analyzed using a hybrid approach (deductive followed by inductive). Four themes emerged deductively as persons gain health literacy in dementia (access, understand, appraise, and understand). The notable finding is the trend at diagnosis where they first are “seeking the expert” ,and as they move from dependence and gain understanding they are “becoming the expert”, and finally as they apply information they are “acting as the expert” for themselves and others. Engaging them in research not only gave them a voice but more importantly it influenced the health information that will be developed and implemented by them. These findings suggest there is a wealth of knowledge to be gained by persons living with dementia and their care partners.
Racism and Cumulative Dis/Advantage in Healthcare Access: Implications for the Life Course
Authors: Dannefer Dale
Published: December 2020

Despite its origins in the study of race in America in Gunnar Myrdal’s American Dilemma, research on cumulative dis/advantage (CDA) and the life course has paid little attention to the significance of racism in the overall production and patterning of CDA. Building on recent work that has reviewed the life-course implications of the inscribing of racist interests in social policy, this paper explores the life-course implications of race bias in another domain, specifically the domain of medical diagnosis, where algorithm formulas have been shown to disadvantage black patients based on economic and other parameters. Even with training, experimental evidence comparing human and AI diagnostics have demonstrated that despite improvements, residual racism is evident in differential diagnoses. We consider the life-course implications of this and similar race-based differentials in organizational decision-making as a component in systems of cumulating dis/advantage.
Wealth, Health, and Disability Gaps at Midlife: Implications for Disparate Retirement Outcome
Authors: Crystal Stephen
Published: December 2020

Late-life economic outcomes in coming years will be strongly shaped by the impact of economic and health experience for cohorts now at midlife. These cohorts have experienced lagging and increasingly disparate wealth accumulation, along with challenges to health and earning potential that augur highly disparate retirement futures. For example, analyses of Survey of Consumer Finances data indicate that in 2016, members of Generation X had mean assets that were only 39% those of the boomers in that year. Increasing risk of “deaths of despair” among individuals in midlife have been accompanied by increases in disability that threaten the ability of those members of these cohorts who are not in the educationally advantaged minority to achieve secure retirement futures, particularly in the context of increasing employment precarity. This presentation will review recent findings on midlife wealth and health inequality, implications for retirement futures, and policy choices facing a new Presidential administration.
ESPO/ Behavioral and Social Sciences Section Symposium: Promoting Behaviors That Support Healthy Aging
Authors: Irani Elliane , Sprague Briana , Stoeckel Luke
Published: December 2020

Maintaining healthy behaviors has been linked to positive emotional and physical health outcomes. Older adults are at a greater risk for functional decline and can benefit from the protective effects of health behaviors. The purpose of this symposium is to present and highlight: (1) innovative research linking health behaviors and health outcomes among older adults, and (2) work of emerging scholars in the Behavioral and Social Sciences (BSS) section. The papers highlight findings from descriptive studies and randomized trials testing behavioral health interventions. O’Brien and Hess describe patterns of engagement in health-promoting activities and highlight mediating and moderator factors. Fausto and colleagues report on physical activity and cognitive health benefits of a multi-level intervention focused on heart and brain health for older African American residents of public and subsidized housing. Still and colleagues assess the efficacy of a multi-component technology-based intervention on hypertension self-management in African American older adults. Nehrkorn-Bailey and colleagues report on the pilot testing of AgingPLUS, an intervention targeting attitudinal and motivational barriers to physical activity and highlight improvements in grip strength and blood pressure. Lastly, Wierenga and colleagues test an emotion regulation intervention following a cardiac event and highlight the intervention’s potential efficacy in improving mental health and physical activity. These papers underscore the importance of promoting healthy behaviors in older adults and the need for large-scale interventions that support healthy aging. As discussant, Atienza will assess the strengths and limitations of these papers, and consider how emerging scholars can contribute to the field.
The Role of Self-Perceptions of Aging for Recovery of Older Adults After a Hospital Stay
Authors: Blawert Anne , Freiberger Ellen , Wurm Susanne
Published: December 2020

For older adults, a hospital stay can lead to loss of physical function and frailty. It is therefore important to investigate factors for recovery after hospitalization. Recent studies suggest negative self-perceptions of aging (SPA) as a potential risk factor in the context of serious health events. This ongoing longitudinal study investigates how negative SPA might contribute to worse physical recovery (assessed with the Short Physical Performance Battery) after hospital stay in a sample of 244 German adults aged 75 to 96. Preliminary mediation analysis based on available data of the first 50 participants indicate that negative SPA is related to increased fear of falling after 6 months, which predicts worse physical function one year after hospitalization (indirect effect: B = -0.70, SE = 0.41, p = .09). The results stress the importance of SPA for health recovery in old age and introduce fear of falling as a psychological pathway.
A Cross-Lagged Panel Analysis of the Relationship Between Loneliness and Depression
Authors: Minahan Jillian , Siedlecki Karen
Published: December 2020

Loneliness and depression have similar psychological features but are theoretically and statistically distinct (Hawkley et al., 2008). Most research has examined a unidirectional relationship between loneliness and depression (Cacioppo et al., 2006). Cacioppo et al. (2010), however, found that loneliness predicted subsequent depression, but depression did not predict subsequent loneliness. We extended this work by examining the reciprocal relationship between loneliness and depression in 1,560 healthy adults (ages ranging from 18-95 years at baseline) from the Virginia Cognitive Aging Project using cross-lagged panel analysis across three time points. Depression more strongly predicted subsequent loneliness (βs= 0.16 and 0.23, p < .05) than vice versa. These findings are consistent with the cognitive discrepancy theory, suggesting that affective processing, like depression, can negatively impact one’s perception of their social environment (Burholt & Scharf, 2014). Our findings highlight the need for increased longitudinal research examining the relationships among indices of well-being across adulthood.
Forgotten Variables in Gerontological Evaluation of Religiosity and Spirituality
Authors: Bishop Alex , Blieszner Rosemary
Published: December 2020

Despite the fact that religiosity and spirituality are commonly cited as essential elements of physical and mental health functioning in old and very old age, the conceptualization of religiosity and spirituality continues to present a quandary in contemporary gerontological inquiry and assessment. Identification of variables that best capture and truly define religious and spiritual constructs has remained relatively inconclusive over the past few decades. Recently, there has been a renewed interest among gerontologists to identify underlying religious and spiritual variables using alternative qualitative and quantitative methods of evaluation. Such methods have been used to further disentangle and understand the uniqueness of religion and spirituality as variables for studying human aging. This symposium will be used to communicate empirical results, methodological procedures, and conceptual insights concerning the identification of understudied and under-represented variables often absent within modern gerontological inquiry of religion and spirituality. Four presentations representing qualitative and quantitative studies will be used to report key religious and spiritual variables stemming from the context of personal narrative, oral storytelling, self-improvement behavior, and the disposition to seek forgiveness. Recommendations pertaining to future gerontological inquiry in the science of religion and spirituality, as well as applications within geriatric and gerontological practice will be highlighted and discussed.
Identifying Activity Support Needs for individuals Aging With Disability: Subject Matter Expert Interviews
Authors: Koon Lyndsie , Bayles Megan , Remillard Elena , Rogers Wendy
Published: December 2020

Technology designed to support aging-in-place for people with long-term disabilities begins with understanding the specific tasks that need support, and individual abilities, preferences, cultural practices, and privacy concerns. Such understanding is best achieved through a multi-method approach that includes direct, detailed assessments of representative users as well as individuals who work with or care for them. Our target users are people who identify as having a sensory or mobility impairment prior to the age of 50, including individuals aging with multiple sclerosis, late-onset hearing loss, and late-onset vision loss. In the present study, we are interviewing Subject Matter Experts (SMEs) to identify the scope of the challenges that should be explored in more depth. The SMEs include caregivers and medical professionals to identify challenges that the target populations experience in their everyday activities, advice about research adaptations, and recruitment ideas.
Issues Related to Late-Life Sexuality: Sex in Long-Term Care
Authors: Spalding Rachael , Lichtenberg Peter
Published: December 2020

Despite surrounding social stigma and stereotypes of the “asexual older adult,” older adults, including those residing in long-term care facilities, indicate that expressing their sexuality continues to be important to them (Doll, 2013). This presentation will feature presentations regarding recent research and perspectives relevant to late-life sexuality with a focus on how issues of sexual expression may particularly emerge in long-term care settings. Dr. Maggie Syme will present findings from mixed-methods, consumer-based approaches that elucidate how current and future long-term care residents view late-life sexuality, with a focus on the practical applications of these findings to inform facility administration and policies. Ethical and legal issues surrounding sexuality in long-term care will be discussed by Dr. Pamela Teaster, who will present ethical models that can translate into potential best-practice recommendations and strategies. Rachael Spalding will discuss the paucity of psychometrically sound assessment tools for measuring attitudes towards late-life sexuality and discuss their development of such a measure. Finally, Dr. Lilanta Bradley and Dr. Pamela Payne-Foster will present a framework for sexual agency in late-life and identify relevant gaps in the literature regarding gender, ethnicity/race, and geographical differences. Ultimately, this presentation will offer a forum for lively discussion among attendees regarding these pertinent topics.
A Resident-Centered View of Sexual Expression in Long-Term Care
Authors: Syme Maggie , Cohn Tracy , Graf Allyson
Published: December 2020

Contrary to societal beliefs, older adults residing in nursing homes continue to have sexual interests. However, the right and need to engage in intimate relationships are often ignored in nursing homes, erring on the side of safety and prohibiting intimacy. This is due to ageist sexual stigma, under-educated providers, complexities of care, and fear of retaliation. Nursing homes are not attending to resident preference/choice when it comes to sexuality and intimacy, which ignores the consumer of services and is wholly inconsistent with person-centered care. However, in order to craft resident-centered/informed policies and practices, we must understand the needs and preferences of the resident/consumer. The following presentation will highlight findings from three separate mixed-methods studies that address the consumer, or how now and future residents understand and evaluate intimacy and sexuality in long-term care. We will address potential challenges, areas for intervention, and a unique consumer-oriented solution— sexual advance directives.
An Exploration of Sexual Agency in the Aging Population
Authors: Bradley Lilanta
Published: December 2020

There are some unique social and environmental challenges to geriatric sexual well-being. This presentation explores sexual agency in the aging population with a special emphasis on barriers and facilitators of sexual agency in long-term care settings. We will situate late-life sexuality literature with Cense’s (2019) theory of sexual agency. Her four components of moral agency, embodied agency, narrative agency, and bonded agency will be used to examine the older person’s perceptions, beliefs, and behaviors associated with sexual autonomy from a macro and micro lens. This framework uses assertions that agency is built on self-concepts from the individual and relational level; reflects power dynamics and social inequalities; and requires strategic negotiation of social norms, policies, and relationships to shape one’s autonomy and sexual self perceptions. We will also discuss gaps in the literature regarding gender, race/ethnicity, and geographical differences that can impact an older person’s sexual agency and overall sexual well-being.
Kinlessness at the End of Life in the United States: Implications for Place of Death, and Quality of Life Among Older Adults
Authors: Ornstein Katherine , Plick Natalie , Ankuda Claire
Published: December 2020

We used the Health and Retirement Study, a large nationally representative study of U.S. older adults from 2002-2015, to identify decedents and assess quality of EOL care by availability of kin. 7.9% of participants were kinless at EOL (no adult children or spouses), reflecting national estimates of 1,027,600 older adults. Those who were kinless at EOL were more likely to be female (61.2% vs 51.5%), from the lowest wealth quartile (53.6% vs 35.6%), and less likely to be white and non-Hispanic (75.6% vs 81.8%). Among the community-dwelling population, individuals with kin received 2.4 times as much hours of help from informal caregivers per month, compared to those without kin. We did not observe differences in rates of hospital death by kin status in adjusted models. More work is needed to assess any unmet needs in the EOL period for kinless older adults, especially as healthcare moves towards increased in-home supports.
Autobiographical Memory and End-of-Life Treatment Preferences in China
Authors: Fu Yao , Idler Ellen
Published: December 2020

In this mixed-methods study of religious/cultural beliefs and end-of-life treatment preferences in China, we surveyed 1,085 mainland Chinese people aged 18 or above online. We assessed the effects of past experience with dying people they have known and their own end-of-life treatment preferences in two hypothetical terminal illness vignettes. We found that respondents who knew or visited someone at the end of their lives were somewhat less likely to choose aggressive treatment for themselves in a lung cancer scenario (25% compared to 33%, p=.013). However, there was less difference in an Alzheimer’s disease scenario, with a choice to use a gastric feeding tube or not (39% compared to 42%, p=.262). Open-ended responses indicate that people refer to these past experiences as a reference in making end-of-life decisions for themselves. This study provides empirical evidence that autobiographical memory has a directive function that individuals call on to inform future behaviors.
Memories of a Grandparent’s Death: Preparation for Future Losses
Authors: Bolkan Cory , Weaver Raven
Published: December 2020

Experiences of death in early life may result in identity-defining memories that last a lifetime. Autobiographical memories serve psychosocial functions, acting as guides for future behavior. Understanding early death experiences may thus inform lifelong personal views about death, dying, and bereavement. We queried 50 adults (ages 19 – 67 years) using a structured set of questions to recall and write about their earliest and most significant losses. The narratives were qualitatively analyzed using the constant comparative method associated with grounded theory. Results indicated a grandparent’s death was the most frequently reported significant loss, reflecting the value of intergenerational relationships and the long-lasting impact of grandparent death. Themes also emerged concerning participants’ reports of the benefits of actively remembering and reflecting on loss, as well as learning from others’ losses, which further deepened their views of death. These findings highlight how early memories of death, including one's grandparents, can have lifelong impact.
Needs of and Services for Grandparents Raising Grandchildren: Regional, National, and International Perspectives
Authors: Lee Youjung , Whitley Deborah
Published: December 2020

Grandparents raising grandchildren build strong foundations for their grandchildren. Despite grandparents’ significant contributions to their grandchildren’s future and society in general, there is a limited understanding of the unique needs and service utilization of grandparents raising grandchildren in various contexts. This symposium is focused on the needs of and services for the grandparent population at the regional, national, and international levels. Stucki will present findings from an examination of types and locally available services for grandparents raising grandchildren in Appalachia by sub-region. Musil and colleagues will discuss the service need utilization and unmet service needs of a nationwide sample of 284 grandmothers living with/ raising grandchildren and the relationships between service use/need and resilience, resourcefulness, perceived stress, reward, and appraisals of their current living environment for themselves and their grandchildren. Lastly, Lee will describe research findings from her comparative transnational research on needs and experiences of grandparents raising grandchildren in Malawi (n=29), South Korea (n=23), and the U.S. (n=23). Unique needs and cultural interpretation of intergenerational caregiving in each country will be presented. The symposium discussion will address diverse needs of grandparents raising grandchildren and strategies to meet those needs at regional, national, and international levels. Grandparents as Caregivers Interest Group Sponsored Symposium.
Service Need Utilization and Unmet Service Needs of Grandmothers Living With or Raising Grandchildren
Authors: Musil Carol , Wallace McKenzie , Jeanblanc Alexandra
Published: December 2020

This study explores the service need utilization and unmet service needs of a nationwide sample of 284 grandmothers living with/raising grandchildren, and the relationships with service use/need, perceived stress, reward, and appraisals of their current living environment for themselves and their grandchildren. Participants were asked whether they currently used, had unmet need for, or did not need 25 different support services, including babysitting, financial assistance, legal assistance, family therapy/communication, among others. Overall, 89.5% (N=255) were receiving at least 1 service (mean = 3.4, range 0-18), and 89.1% (N=253) reported having at least 1 unmet service need (7.4, range 0-23). Receiving services was positively correlated with psychosocial resources, but not with appraisals of stress, reward, or living situation. Unmet service needs were inversely correlated with psychosocial resources, reward, and appraisals of living situation. Implications of these varying patterns will be discussed. Part of a symposium sponsored by the Grandparents as Caregivers Interest Group.
New Perspectives on Loneliness: From Micro Qualitative to Macro Quantitative Cross-National Comparisons
Authors: Aartsen Marja
Published: December 2020

Longitudinal research revealed a number of micro-level drivers of loneliness, such as widowhood, exclusion from the wider society, ill health and migrant status, but a number of questions are still unanswered. For example, the prevalence of loneliness varies substantially across countries, but we do not know precisely what causes these differences. It may be due to differences in the composition of the populations, it may also be caused by macro-level drivers, or by variations in the impact of risk factors between countries. For example, losing a spouse may be loneliness provoking in countries where living with a partner is the norm, but less so in countries where living alone is more valued. Also how early childhood and events over the life course affect the level of loneliness in later life is still under-researched. The aim of our symposium is to address this gap by presenting different perspectives on loneliness and social isolation. The first presenter interprets five-year follow-up information from qualitative interviews with a life course perspective. The second investigates the role of trust as factor producing social integration, which leads to variations in loneliness. The third compares and discusses loneliness in three different continents, based on an ecological model of contexts. The forth presenter critically discusses ways to measure loneliness in societies that are culturally distinct from western cultures. The last presenter discusses the dynamics between loneliness and material deprivation in Europe. The findings provide a new lens through which we can understand loneliness and inform about effective prevention.
How Area Agencies on Aging Contribute to Social Connection for Older Adults in Rural America
Authors: Pendergrast Claire
Published: December 2020

Social ecological models of health identify intrapersonal, interpersonal, institutional, community, and policy-level contexts as social factors influencing individual and population health outcomes. However how institutions such as Area Agencies on Aging (AAA) shape rural older adults’ social networks and influence health is little explored. This research examines institutional influences of social networks for rural older adults, particularly the social connections resulting from their AAA services and programs. AAAs are local social service organizations that coordinate home- and community-based supports. Our 2020 case study of a rural AAA in upstate New York involved in-depth semi-structured interviews with AAA staff, volunteers and participants included key themes related to older adults’ social networks, social wellbeing, and physical and mental health. Our findings have both theoretical implications for rural community social structure as experienced by older adults, and practical implications to build AAA’s capacity to address social isolation for rural older adults. Part of a symposium sponsored by the Rural Aging Interest Group.
Sensory Impairment and Social Isolation: Implications for the Hispanic Population
Authors: Richardson Stephanie , Tanner Corinna , Yorgason Jeremy
Published: December 2020

Although the likelihood of developing a disability increases with age among all demographics, older adults of hispanic origin are more likely to experience vision and hearing impairment than both their white and black non-hispanic counterparts. Both hearing impairment and vision impairment are known risk factors for social isolation, yet little research has examined this association in Hispanic populations. Using data from 472 Hispanic and 5,186 White participants of the NHATS study, we examined 8-year trajectories of social isolation, along with how sensory impairment was associated with initial levels and change over time. Findings suggest that sensory impairments are linked with steeper increases over time among White participants. Among Hispanics vision and hearing impairments were linked with higher initial levels of social isolation, yet no associations were found across time. It may be that Hispanic older adults maintain social connections across time despite potentially isolating sensory impairments.
Evidence for the Need to Standardize Data Collection on Patient Outcomes Across Adult Day Centers in the United States
Authors: Sadarangani Tina , Zagorski William , Missaelides Lydia
Published: December 2020

Researchers’ ability to measure the impact of adult day centers (ADCs) on participants’ health has been hampered by a lack of large-scale data. We examined categories of data ADCs across the United States are collecting related to patients’ health and health outcomes with the idea of developing a future national cohort of centers. We distributed an electronic survey to ADCs in 50-states on current data collection efforts. Forty states were represented (N=250). Only 32% of ADCs collect patient level data for research and analysis. Vital signs, nutritional risk, falls, and activities of daily living data were most commonly collected. However, validated assessment tools were used in less than 50% of cases. Researchers’ ability to pool data on clinical outcomes among ADC users is limited by lack of data collection and use of uniform outcome measures across ADCs. Standardizing data collection is critical to strengthening ADC programs and demonstrating their effectiveness.
Social Contexts of Subjective Aging Perceptions
Authors: Cohn-Schwartz Ella , Ayalon Liat
Published: December 2020

The way adults perceive their aging process is an important predictor of later life outcomes, including mental and physical health. Despite the importance of living a socially active life in old age, the inter-connections of individuals’ perceptions of aging with their social lives and behaviors are not well-understood. This symposium addresses questions of how the social environment and social behaviors are related to subjective aging perceptions, including subjective age and self-perceptions of aging. Two papers examine self-perceptions of aging in the context of couple relations. Mejía and colleagues focus on married older adults’ shared beliefs about aging, showing that within older couples, beliefs about aging are shaped in part through partners’ co-experience of each other’s biological aging. Kim and colleagues also examine couples, finding evidence that changes across time, as well as average differences in individual characteristics, may affect self-perceptions of married/partnered men and women differently. The final two papers examine the interplay between chronological age and perceptions of aging. Weiss and Weiss examine the social conditions and consequences of subjective age across the life span in the work domain, demonstrating that feeling relatively older among young adults and younger among older adults predicts proactive behaviors such as speaking up. Cohn-Schwartz and colleagues investigate the bi-directional temporal associations of adults’ self-perceptions of aging and the age composition of their social networks. The symposium concludes with summarizing remarks from the discussant who will suggest possible directions for future research on the social contexts of the perceived experience of aging.