bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial Literacy in the Family Context: The Role of Spousal Education and Gender Among Older Couples
Authors: Li Yang
Published: December 2020

Despite recent advances in the literature on the association between one’s own education and financial literacy, the role of the family context in financial literacy has received limited attention. I examine whether spousal education is associated with one’s own financial literacy among older couples and whether this association differs by gender. Using data from the 2016 Health and Retirement Study (n=1,220), I employ a multilevel actor-partner interdependence model to examine the cross-partner effect of spousal education on own financial literacy among older couples. I analyze a set of regression models on pairwise data to estimate the moderating effect of gender. I find that having a college-educated spouse was associated with a higher likelihood of being financially literate and that wives’ education attainment was associated with a higher likelihood of financial literacy for husbands. Understanding the role of spousal education in late-life financial literacy adds to our knowledge about the role of the family context as related to individual financial knowledge and skills. Older adults may acquire financial literacy within the family, such as learning from a spouse.
Lifestyle Challenges Among Older Female Cancer Survivors
Authors: Krok-Schoen Jessica , Pisegna Janell , Arthur Elizabeth , Ridgway Emily , Rosko Ashley
Published: December 2020

The American Cancer Society recommends that survivors maintain a healthy lifestyle including a normal weight, being physically active, and maintaining a healthy diet to improve prognosis and health-related quality of life (HRQoL). Unfortunately, the majority of cancer survivors do not engage in a healthy lifestyle. The largest proportion of cancer survivors are older adults (≥65 years), yet they are often understudied, particularly regarding healthy lifestyles. This study sought to examine the lifestyle behaviors (maintaining healthy weight, dietary intake, physical activity) of older female cancer survivors and to identify associations with HRQoL. Older female cancer survivors (n=170) completed surveys to assess HRQoL (RAND-36), diet quality (HEI-2015), physical activity, malnutrition, and BMI. Descriptive analyses, correlations, and stepwise linear regressions were utilized. The majority of the sample (mean age=74.67±8.43 years) were white (90%), married (54.4%), college-educated (63.9%), and breast cancer survivors (67.4%). Self-reported health was very good (42.6%) and good (39.6%) and general HRQoL was 59.48±15.34 out of 100. Self-reported physical activity was low; 75.3%, 54.2%, and 68.1% reported no strenuous, moderate, and mild physical activity, respectively. Mean BMI was 27.71±6.24 with 64% of the participants being overweight or obese. Mean HEI-2015 scores were 66.39±10.00, below the “good” diet quality score of 80. Risk of malnutrition was present in 27.4% of participants. Regressions found that being White (β=-0.528, p=0.001) and lower BMI (β =-0.405, p=0.024) were significant predictors of HRQoL. Results indicate the need for tailored health coaching for older cancer survivors regarding their lifestyle behaviors to improve prognosis and HRQoL.
Environmental Interventions to Promote Infection Control in Senior-Living Facilities: Cases in the USA and China
Authors: Wang Zhe , Li Bo
Published: December 2020

In the evolving situation of COVID-19, an outbreak of the contagious disease in a nursing home near Seattle prompted urgent calls for precautionary tactics in senior-living facilities. Worldwide, the USA and China are the countries with the largest and second largest populations of people aged 80+. More than two million older adults live in senior-living facilities in the USA and the number of beds in senior-living facilities in China has increased to 6.5 million in recent five years. The risk of infections including COVID-19 is tripled in senior-living residents because of age, close living conditions, and underlying health conditions. Infectious diseases account for one third of all deaths in people age 65+ in the USA. COVID-19 has a case fatality rate of 2.3% overall and as high as 15% in patients age 80+ in China. Together with health and services interventions, environmental interventions should be considered to prevent the possible spread of infections in senior-living settings. Based on a literature review and using empirical data of 12 senior-living facility designs collected in both countries, this research analyzed the advantages and disadvantages of existing facility environments in terms of infection control. Environmental interventions to promote infection control are suggested in the context of individual facilities. Proposed interventions are analyzed at two levels: spatial design and design details. Five factors are included: visitors screening, ventilation, isolation rooms, hand washing, and daily temperature checks. From the perspective of infection control, the cross-country similarities and differences of senior-living facility designs are discussed.
Age Differences in Response to Framed Side Effects Information About Hypothetical Medications
Authors: Minton Alyssa , Nievera Madeline , Young Nathaniel , Mikels Joseph
Published: December 2020

Framing equivalent information as a gain (e.g., 90% survival rate) or a loss (e.g., 10% mortality rate) can differentially impact judgments and decision making, such that people make more favorable judgements when information is presented as a positive gain versus a negative loss. The current study investigated how framing and age influences evaluative judgments of hypothetical medications used to treat common health issues when the equivalent probability of experiencing a particular side effect was presented as a gain (e.g., “86% of people who took this medication did not experience rash outbreaks”) or a loss (e.g., “14% of people who took this medication did experience rash outbreaks”). Younger and older adults were presented with health pamphlets for hypothetical medications with three unique side effects for each and indicated the medication’s perceived riskiness, how positively and negatively they felt about the medication, and their likelihood to take the medication. Numeracy, risk-taking behavior, and current affective state were also measured. When information was presented in a loss frame, people reported more negative feelings about the medication, leading to greater perceived riskiness, IE = -.785, SE = .13, p < .001. Age indirectly influenced likelihood via the positive feelings about the medication, IE = .349, SE = .14, p = .013. Younger adults felt more positively about the medications than older adults, leading to an increased willingness to take the medication. These findings provide insight into how framing and age can differentially influence evaluative judgments, perceived risk, and willingness to take medication.
Impact of Instructions on the Positivity Effect in Younger and Older Adults’ Autobiographical Memories
Authors: Siedlecki Karen , Minahan Jillian , Yazdani Neshat
Published: December 2020

The positivity effect (PE) refers to age-related enhancement in memory for positive information or decreased memory for negative information. The PE is thought to be the result of age-associated shifts in motivational goals towards enhancing well-being. Research has demonstrated the PE in laboratory settings, and a meta-analysis showed that the PE was most robust in conditions with fewer instructions/constraints (Reed et al., 2014). Findings related to the PE in autobiographical memory (AM) are mixed. Goals of the current study include examining 1) whether the PE was evident across four increasingly restrictive AM conditions (involuntary AMs, voluntary AM with no constraints, voluntary AM within a specific time frame, voluntary AM within a specific time frame and related to a specific cue word), and 2) whether available cognitive resources (assessed with the Stroop task and a trail-making test) influence the PE, since cognitive control is essential for achieving goals. Participants (N=126) completed the shortened Memory Experiences Questionnaire for each memory, which assesses several phenomenological characteristics, including memory valence. There were no significant differences in memory valence between the younger (n=69, ages 18-34) and older adult (n=57; ages 60-85) groups for involuntary AMs or the less constrained voluntary AMs, but there was a significant difference for the most constrained AM wherein older adults rated their AMs as more positive than younger adults. Performance on cognitive control measures did not influence the AM valence. These results highlight the importance of considering the effects of type of stimuli and instructions when studying the PE.
Exploring Acculturation Experiences of Korean Immigrant Older Adults Through Expressive Writing
Authors: Rhee Stephanie
Published: December 2020

Korean immigrant older adults residing in areas without well-established Korean ethnic enclaves experience acculturative stress and depressive symptoms due to their lingual and cultural barriers. Expressive writing can be used as a culturally sensitive intervention to help those immigrants disclose their deepest thoughts and feelings related to their immigration and acculturation experiences. This study gathered qualitative data from the author’s experimental study using expressive writing for first-generation Korean immigrant adults 60 to 88 years of age residing in Midwestern cities. Participants were instructed to write for 15-20 minutes per day in three consecutive days at their convenience in a comfortable and private setting and asked to return their writings by mail. A total of 22 participants returned their writings: 14 wrote about their past and current stressful experiences related to their immigration and acculturation, while eight wrote about their daily lives. Eight themes emerged from thematic coding processes guided by the grounded theory approach: (1) survival, resilience, hardiness, tenacity, pride; (2) lingual barriers; (3) religious faith; (4) gender difference in roles and values; (5) racial discrimination; (6) traditional strategies of acculturation; (7) family and intergenerational gap; and (8) aging. The themes illustrate the participants’ lifelong efforts to shape their unique voices through heart-wrenching struggles, haunting wounds, and ethnic pride and resilience. The study findings suggest that culturally relevant programs and services are needed to facilitate social relationships and reduce lingual and cultural barriers for Korean immigrant older adults residing in non-ethnic enclaves.
Sex Differences in the Prevalence of Pain Trajectories Over a 14-Year Period in the Mexican Health and Aging Study
Authors: Milani Sadaf , Rodriguez Martin , Ternent Rafael Samper , Wong Rebeca
Published: December 2020

Pain increases with age, disproportionately affects females, and is a major contributor to decreased quality of life. Because pain is dynamic, trajectories are important to consider. However, few studies have looked at longitudinal trajectories of pain, by sex, using population data. We used data from the 2001, 2003, 2012, and 2015 waves of the Mexican Health and Aging Study, a nationally representative sample of Mexicans aged 50 and older. Individuals who had direct interviews at each time point and complete information on analytical variables were included (n=5,135). Pain reported at these time points was used to define pain trajectories as persistent pain, development of pain, diminishing pain, fluctuating pain, and never pain, by sex. Multinomial logistic regression was used to assess the association of sex with pain trajectories, adjusting for baseline demographic, behavioral, and health factors. Females had a higher prevalence of persistent pain (25.1% vs. 11.5%) while males had a higher prevalence of never pain (35.8% vs. 22.2%). Development of pain, diminishing pain, and fluctuating pain was similar between males and females (14.4% and 14.6%; 14.8% and 15.8%; 23.9% and 22.4%, respectively). Females had higher odds of persistent pain (OR: 2.13; 95%CI 1.67-2.70) and development of pain (OR: 1.40; 95%CI 1.11-1.75) compared to males. Overall, females had a much higher burden of persistent pain compared to males. Understanding trajectories of pain in later life and life course mechanisms for this large sex difference observed is crucial to improve quality of life.
Health Behaviors Among Family Caregivers Participating in the Paid Workforce
Authors: Keller Abiola , Garnier-Villarreal Mauricio
Published: December 2020

Up to 20% of family caregivers are also working full-time or part-time. The competing demands of caregiving and working may adversely affect the health of caregivers. In this study, we use data from the 2015 Behavioral Risk Factor Surveillance System Questionnaire-Caregiver module to examine the relationships between participation in the paid workforce and health behaviors among caregivers. Individuals with a positive response to the survey question, “During the past 30 days, did you provide regular care or assistance to a friend or family member who has a health problem or disability?” were identified as caregivers. Participation in the paid workforce was defined as being employed for wages or self-employed. We conducted separate survey-weighted multivariate regression analyses to examine the relationship between participation in the paid workforce and drinking, exercise, and smoking controlling for sociodemographic characteristics. For each outcome, all sociodemographic characteristic variables were entered into the model simultaneously. 55.6% of the 24,034 caregivers participated in the paid workforce. The survey-adjusted multivariate regression analyses showed that those in the paid workforce had an increased likelihood of binge drinking (OR = 1.39, 95% CI [1.14-1.69]) and decreased likelihood of engaging in leisure-time physical activity (OR = 0.83, 95% CI [0.73-0.95]) compared to those who were not in the paid workforce. The odds of smoking less frequently did not differ between the two groups (OR = 0.96, 95% CI [0.85-1.07]). Our findings underscore the need for workplace-based interventions aimed at promoting healthy behaviors among caregivers.
Recognizing Decline and Supporting Care Transitions in Older Adults: Homecare Nurse Perspectives
Authors: Sullivan Suzanne , Mann Catherine , Mullen Samantha , Chang Yu-Ping
Published: December 2020

Older adults with serious illness residing in the community are at risk for decline and death. Homecare Registered Nurses (RNs) are in an ideal position to recognize serious illness and engage older adults and their caregivers in discussions about goals for care, while guiding transitions to supportive care services such as palliative or hospice care. However, little is known about this process, or how homecare RNs act upon this information. Using a grounded theory approach, data were collected through focus group interviews with 35 RNs working in homecare. A social process rooted in relationship-based care over time was identified using the constant comparative method. RNs recognize serious illness and support care transitions by identifying changes in illness trajectories and assessing the impact of such changes on quality-of-life, adapting and accommodating care to support older adults in the home for as long as possible, communicating with the care team, engaging stakeholders, and maneuvering through complex systems of care; ultimately relinquishing care to other providers and settings. Our findings also reveal that RNs feel inadequately prepared and frustrated with a fragmented healthcare system and lack of collaboration among the team in supporting the best care transition for older adults and their caregivers. Our findings reinforce the importance of promoting care continuity in homecare settings whenever possible, suggesting a critical need to develop training and team processes that support and empower RNs, so that they may lead care transitions as changing needs emerge during serious illness management of older adults.
Allostatic Load and Biological Aging Indicators in the MIDUS National Survey
Authors: Hastings Waylon , Shalev Idan , Almeida David
Published: December 2020

Indices quantifying allostatic load (AL) and biological aging (BA) have received widespread use in epidemiological and health science literature. However, little attention has been paid to the conceptual and quantitative overlap between these indicators. By reviewing literature utilizing measures of AL and BA, we highlight differences with respect to biological markers employed and approach toward scale construction. Further, we outline opportunities where AL indices might be improved by adopting analytical features of BA measures. We demonstrate the utility of this approach using data from The MIDUS National Survey, constructing three indices of allostatic load: one standard approach modeled after Gruenewald et al, 2012, and two alternative formulations informed by BA procedures. The performance of AL indices are juxtaposed against two commonly employed indices of biological aging: Klemera-Doubal Method Biological Age and Homeostatic Dysregulation. All measures were significantly associated with chronological age. Alternative AL formulations were more strongly associated with biological aging measures than with the standard approach. MIDUS participants with increased allostatic load and older biological ages performed worse on tests of physical, cognitive, perceptual, and subjective functioning. Further, MIDUS participants with history of childhood-trauma and mental-health problems were measured as having increased AL and BA. Alternative AL formulations tended to have effect-sizes equivalent to or larger than those observed for BA measures. In conclusion, indices of allostatic load and biological age approximate similar processes when constructed with comparable biomarkers and rigor, in line with their conceptual overlap as proxies of cumulative wear and tear.
Applying Innovative Qualitative Methods to Understand the Perspective of Vulnerable and Diverse Populations
Authors: Roes Martina , Koren Chaya
Published: December 2020

The application of a variety of innovative qualitative research methods and analysis as well as the possibilities it offers for the selected population to share their personal experience is the main focus of this symposium. We present the relationships between design, methodological approaches and themes of interest for the people who participate in research. The presenters used designs such as ethnographic field research or phenomenological designs. The used photos taken and analyzed by the participants; using photo-voice and tabletop exercise. All speakers will present their designs and methods linked to a specific research theme. Using examples of recent and highly innovative research practices which meaningfully challenge taken-for-granted assumptions in social science and care research, to open new ground for other ways of thinking about doing research in these fields. Goal for the discussion is a critical reflection of the designs and methods used and to provide take away messages
A Diary-Based Study of Language Use During Cognitive Decline
Authors: Pabst Katharina , Tagliamonte Sali
Published: December 2020

Although the effects of dementia on language have been examined in a variety of ways, there is relatively little data available showing longitudinal effects. In the present study, we examined the effect of cognitive decline on an individual’s language use over time (from age 60-91) by assessing daily diary entries. We focused on a linguistic phenomenon commonly associated with diaries and other informal registers, i.e. subject omission, as in “∅ Made cranberry muffins.” Quantitative analysis revealed a drastic decline in the use of this feature, which is correlated with the stages of the individual’s cognitive decline. We argue that the patterns reflect a systematic reduction in complexity that affects a writing style based on literacy and acquired at a later stage than more basic writing. This corroborates previous findings, showing later-acquired linguistic features are disproportionately affected in cognitive decline and highlights the importance of linguistic analysis in aging research.
Sociolinguistic Markers of Friendship Among Persons With Dementia in Long-Term Care
Authors: Saunders Pamela
Published: December 2020

Sociolinguistics and discourse analysis provide tools through which to examine how friendship is socially constructed through language and communication. Research on social isolation and loneliness reveals the importance of social interaction on the psychological and physical health of older adults. Given that linguistic, communicative, and functional abilities decline as dementia progresses, it is challenging to identify markers of friendship. The Friendship Project is an ethnographic study of social interaction among persons with dementia living in a long-term care setting. The data are from transcripts and field-notes of social interactions among residents with a range of cognitive impairments over a six-month time period. Results reveal that persons with dementia employ specific linguistic features such as narrative, evaluation, evidentials, and pronominal reference to make meaning and create relationships over time. Practical implications will be discussed.
Linking Negative Views of Aging to Cognitive Function: The Dopaminergic Theory
Authors: Robertson Deidre , Bokde Arun
Published: December 2020

Negative views on aging are known to impair cognition, in both the short and long term, but it is not fully understood why. This paper proposes that negative views impair cognition through dysregulation of reward-seeking behaviours and downregulation of the dopaminergic system. In a preliminary study to test this, 70 older adults were exposed to implicit positive and negative views on aging in a within-subject design carried out over 2 weeks, and then played a computerised game that involved deciding whether to expend effort to gain a reward. Over 216 trials, when participants were exposed to negative views, they were less likely to choose the effort-for-reward option. This effect was amplified at higher levels of effort. The paper will discuss how the dopaminergic theory ties into stereotype embodiment and other theories, and why it may explain previous findings that negative views of aging impair specific cognitive functions more than others.
Improving Detection of Cognitive Decline and Impairment Using Everyday Behavioral and Social Markers
Authors: Zhaoyang Ruixue , Cerino Eric , Scott Stacey
Published: December 2020

Early detection of cognitive decline and mild cognitive impairment (MCI) during the pre-symptomatic phase of Alzheimer’s disease is particularly important for maximizing effectiveness of clinical trials and efficiency of resource allocation. However, it is difficult to distinguish early signs of decline and impairment from normative aging, especially with biomarkers and clinical-based assessments that are expensive and challenging to apply widely. Ambulatory assessments in naturalistic settings provide opportunities to capture everyday markers of cognitive decline and offer cost-effective tools for sensitive, early detection of transitions to MCI in community-dwelling older adults. In this symposium, we present four studies that use ecological momentary assessment (EMA) data from the Einstein Aging Study to showcase how everyday markers of behavioral and social functioning assessed up to six times a day for 14 consecutive days can facilitate early detection of cognitive difficulties. Zhaoyang et al. examine whether older adults with intact cognition versus MCI differ in patterns of daily social interactions. Hyun et al. investigate how the diversity of daily activities is associated with ambulatory cognitive deficits. Cerino et al. compare the sensitivity of everyday markers of stress versus global trait-based stress measures to detect MCI. Roque et al. use completion time from EMA surveys as a reliable and unobtrusive way to measure cognition and distinguish those with and without MCI. Stacey Scott will integrate insights gained from these four papers, and discuss the opportunities and challenges faced when combining ambulatory assessments of everyday markers with traditional methods to better detect cognitive decline and impairment.
Advancing Adult Day Services Research: The 2016 and 2018 National Study of Long-Term Care Providers
Authors: Lendon Jessica , Rome Vincent , Caffrey Christine , Singh Priyanka , Sengupta Manisha
Published: December 2020

This presentation demonstrates how researchers can leverage data from the 2018 redesign and new content from the forthcoming NSLTCP survey of adult day services centers (ADSC) conducted by National Center for Health Statistics. For the first time, NSLTCP data will allow analyses at the services-user level. New policy-relevant topics about centers and ADSC participants include reasons for hospitalization, medication use, patient-centered and end-of-life care, staffing turnover, and unmet needs. Additionally, the presentation highlights latest findings from the 2016 survey. About 53% of centers were primarily medical model. Almost 79% of participants in medical model centers used Medicaid, compared to 51% in social model centers. About 4% of participants had at least one 90-day hospitalization. 40% of participants had difficulty bathing. The most prevalent chronic conditions were hypertension (50%), arthritis (38%), and diabetes (31%). Nearly 40% of participants had an advance directive. Findings are contextualized within the broader understanding of ADSCs.
Neurobiology Informed, Mobile Technology Augmented Interventions for Late-Life Depression and Suicidality
Authors: Alexopoulos George
Published: December 2020

Depression is a major risk factor of suicide in late life. Evidence based psychotherapies for late-life depression are underutilized, mainly because of their complexity. In response, we created “Engage”, an innovative streamlined psychotherapy that relies on neurobiology findings to identify core behavioral pathology of late-life depression and targets it with simple cognitive-behavioral strategies of known efficacy, co-designed with community therapists so that its interventions can be mastered my community based clinicians. We demonstrated that “Engage” is non-inferior to the evidence based Problem Solving Therapy and documented that behavioral activation precedes improvement of depression. We have also shown that activities with important others have the strongest behavioral activation value. “Engage” served as a model for three novel, mobile technology augmented psychotherapies that address the clinical and psychosocial context of distinct populations of depressed older adults. Our interventions and mobile apps provide interventions for emotion regulation as a way of reducing suicidality.
Loneliness and Social Engagement: The Unique Roles of State and Trait Loneliness for Daily Prosocial Behaviors
Authors: Lee Yeeun , Lay Jennifer , Mahmood Atiya , Graf Peter , Hoppmann Christiane
Published: December 2020

Loneliness is a distressing yet adaptive emotional experience that alerts us to socially re-engage. However, loneliness can also lead to social withdrawal and isolation. To reconcile the seemingly contradictory consequences of loneliness, we unpack the timing of the underlying processes by distinguishing between the roles of state loneliness (i.e., daily variations in loneliness) and trait loneliness (i.e., person-average loneliness) in predicting social re-engagement. Using ten days of electronic daily assessments from 95 older adults (M age = 67.0 years; 64.2% women), initial findings indicate that trait loneliness moderates time-varying associations between state loneliness and prosocial behavior: On days of elevated state loneliness, older adults low in trait loneliness report increases in prosocial behavior, whereas older adults high in trait loneliness show decreases in prosocial behavior. Findings suggest that transient loneliness may motivate older adults to actively re-engage with others; chronic loneliness may undermine such adaptive responses.
Empathic Accuracy: Helpful to Avoid Negative Affect in Old Age?
Authors: Wieck Cornelia , Katzorreck Martin , Gerstorf Denis , Schilling Oliver , Lücke Anna Jori , Kunzmann Ute
Published: December 2020

Past work suggests age-related declines in empathic accuracy and that these declines may put older people at risk for heightened stress reactivity and low affective well-being. We addressed these questions using data from the fourth wave of the Interdisciplinary Longitudinal Study of Aging (ILSE). To assess empathic accuracy, the young-old (N=115, Mage=63.4, SDage=1.13) and old-old (N=31, Mage=82.3, SDage=.87) participants of ILSE watched six film clips of individuals, who thought-aloud about an emotional autobiographical event, and were asked to rate each individual’s emotions. Subsequently, participants watched a film about Alzheimer’s disease and their subjective and cardiovascular stress reactions were assessed. Empathic accuracy was lower in old-old, as compared with young-old, individuals. Furthermore, empathic accuracy was only associated with low levels of stress reactivity among young-old but not old-old individuals. This suggests that empathic accuracy is not only compromised in very old age, but also appears to be of lower adaptive utility.
Loneliness and Social Isolation Among Older People in Northern Ireland
Authors: Neville Charlotte , Devine Paula
Published: December 2020

Loneliness and social isolation are increasingly recognised as being public health concernsparticularly in older people. Social isolation can be defined as the lack of social connections, whilst loneliness is a more subjective concept and relates to negative feelings about a lack of connections. This research explores the patterns of loneliness and social isolation of over 5,000 people aged 50 years or over living in Northern Ireland who participated in the first wave of the NICOLA study (Northern Ireland Cohort for the Longitudinal Study of Ageing). Data were obtained by computer-assisted personal interviews and self-completion questionnaires. We focused on loneliness and social interaction, in relation to key demographic and socio-economic variables including age, gender and marital status. Key findings were that loneliness patterns varied according to gender, age, income, health and living circumstances. Future waves of NICOLA will help to longitudinally explore the effects of transition on loneliness and social isolation.
The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers
Authors: Eaton Jacqueline , Cloyes Kristin , Paulsen Brooke , Madden Connie , Ellington Lee
Published: December 2020

Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.
How Assisted Living Staff Conceive of Dementia Care
Authors: Dobbs Debra , Zimmerman Sheryl , Miller Stephanie , Carder Paula , Beeber Anna , Hodgkinson Jennifer , Thorp Julia
Published: December 2020

For those who provide care to the more than 40% of persons with dementia in assisted living (AL) communities, behavioral expressions (BEs) can be challenging. The objective of this mixed-methods study was to understand how AL staff conceive of BEs and what strategies they use to address them. Staff from 250 AL communities in seven states were asked to describe one successful and unsuccessful case of care. A conceptual model related to antecedents, behaviors, and consequences was developed and expanded to include staff strategies and outcomes of care; organizational characteristics associated with care practices were examined. Anxiety/restlessness, combativeness and resistance to care were the most prevalent BEs. Medical interventions (e.g., inpatient psychiatric assessment, medication management) were used in two-thirds of cases. Person-centered care was used more often in successful cases. Respondents in dementia-only communities identified antecedents to BEs more often than those in other communities.
Honoring Older Latino Immigrants’ Perspectives on Cancer: Informing the Future
Authors: Carrion Iraida , Neelamegam Malinee , Roberts Jane
Published: December 2020

Cancer is the leading cause of death among Latinos in the U.S. Approximately 32.2% of Latinas and 44.1% of Latinos aged 60 years or older have a lifetime probability of developing invasive cancer (ACS, 2018), with lower survival rates for most cancers even when allowing for age and stage distribution. There is some evidence that older Latino/Latina immigrants lack knowledge about cancer treatment options and are often adversely impacted by healthcare inequities regarding cancer treatment and care options. This study compared the cancer beliefs and attitudes of 58 Latinos and 110 Latinas with a mean age of 67.9 years who reside in the Greater Tampa Bay area. Recruitment occurred in community-based settings, and interviews were conducted in Spanish and transcribed into English. The qualitative methods of constant comparison and thematic analysis will be presented along with the results related to diagnosis, medical decisions, finances, death, and family.
Older Caregivers’ Positive and Negative Experiences With Caregiving
Authors: Chisholm Latarsha , Unruh Lynn , Lamanna Jacqueline
Published: December 2020

U.S. population growth is greatest amongst the oldest-old who are most likely to need temporary or permanent reliance on formal or informal care-giving. With co-survival of older spouses, and greater longevity, informal care-giving is increasingly provided by older adults for other older adults. Little is known about the positive and negative care-giving experiences of older informal caregivers. This observational study examines the relationship between the care-giving situation and the positive and negative perceptions of care-giving in caregivers age 65 and older. A survey of 108 older informal caregivers utilizes well-validated instruments to measure perceptions of two positive (positive self image, positive life) and two negative (stress, uncertainty) experiences due to care-giving. Regressions statistically assess the relationship between care-giving situations and these positive and negative perceptions. We find that while some care-giving situations, such as higher amounts of unpaid support, are related to positive care-giving experiences, others, such as care-giving a recipient with a greater number of ADL deficits, having more care-giving responsibilities, and having increased hours of work due to care-giving, are related to more negative experiences. Some situations, such as lower income and greater involvement in care-giving, are related to both positive and negative perceptions. Higher levels of emotional support were related to mixed positive and less negative perceptions of care-giving. Result indicate that healthcare system and community support is needed to provide opportunities for unpaid support and assistance with caregivers of recipients with a high number of ADL deficits and caregivers who have more care-giving responsibilities.
Relationship Quality With Adult Children Among Grandparent Caregivers
Authors: Jang Heejung
Published: December 2020

For the increasing number of grandparent caregivers, relationship quality with adult children has important implications for the well-being of grandparents. Based on solidarity, conflict, and ambivalence, the present study examines how parent-adult children's relationships differ by grandparent caregiving status on depressive symptoms and psychological well-being. This study uses The 2014 Health and Retirement Study from a sample of 1,197 grandparent caregivers age 51 and older. Latent class analysis is applied to measure affection and conflict in older grandparents-adult children relationships. Results from the latent class analysis identified four clusters: amicable, ambivalent, detached, and disharmonious. OLS regression models are estimated the association between relationship types and depressive symptoms and psychological well-being by grandparent caregiving. For the depressive symptoms, disharmonious relationships with adult children increase depressive symptoms among co-parenting and custodial grandparents. Also, ambivalent and disharmonious relationships with adult children reduce the psychological well-being of older grandparents. The study discusses the variances of the relationships with adult children and their effects on grandparents’ well-being. The results will shed light on the importance of familial relationships and will be beneficial for the development and maintenance of policies and practices that support the families of grandparent caregivers.
The Integral Role of Hospice Nurse Educators in a Palliative Care Education Program for Nurses in Assisted Living
Authors: Dobbs Debra , Meng Hongdao , Haley William , Buck Harleah , Hyer Kathryn , Templeman Maureen , Vogel Carlyn
Published: December 2020

Persons with dementia (PWD) are increasingly cared for in assisted living (AL) settings with an annual mortality rate of close to 20%. Palliative care (PC) for PWD in ALs can improve end-of-life care. From May, 2019 to February, 2020 a 4-week PC education in AL (PCEAL) program for nurses who provide care to PWD, facilitated by hospice nurses in Florida, was tested in a sample of nurses (N=20) in a cluster randomized trial (9 ALs, 4 treatment/5 control). We examined if PC knowledge increased from pre to post-intervention using a validated measure (Thompson, 2011). All intervention nurses (N=10) completed all four sessions of the PCEAL. While the baseline score was lower for the intervention group compared to the control group, the intervention group improved (M=2.20 to 2.37) compared to the control group (M=2.83 to 2.75) post-intervention. Two-month booster sessions indicate nurses have integrated PC care learned in the PCEAL program.
Prevalence of Insomnia Symptoms and Need for an Intervention Among Direct-Care Workers in Long-Term Care
Authors: Lee Soomi , Vigoureux Taylor , Hyer Kathryn , Small Brent
Published: December 2020

This study examined the prevalence of insomnia symptoms among direct-care workers at an assisted-living community and their perceived need for a sleep intervention. Thirty-five participants reported their main sleep-related concerns, willingness to participate in a sleep intervention, and preferred delivery forms/content of the intervention. They also reported nightly sleep characteristics via ecological momentary assessment (EMA) for 2 weeks. 80% reported any sleep-related concern; insomnia-related concern was most prevalent (57%). This was also evident in their EMA reports of waking up in the middle of the night or early morning for 72% of the days. Most (66%) expressed interest in participating in a sleep intervention either online or in group sessions. Mindfulness strategies were most preferred, followed by cognitive-behavioral therapy, and sleep hygiene education. The high prevalence of insomnia symptoms in direct-care workers needs to be addressed by future interventions for their well-being as well as for the quality of care.
Potential Antipsychotic Side Effects and Adverse Events of Assisted Living Residents With Dementia
Authors: Beeber Anna , Zimmerman Sheryl , Wretman Christopher , Miller Stephanie , Patel Kush , Sloane Philip
Published: December 2020

This presentation provides the findings from a descriptive study examining the potential adverse events and side effects of antipsychotic medications prescribed to assisted living (AL) residents with dementia drawn from interviews with family members and chart review on 238 AL residents, from 91 AL communities in seven US states. We found that 85% of family reported that medication had been administered for agitation or aggression, 93% of the sample experienced at least one potential side effect, and 19% experienced five or more. The most common potential side effects were neurologic/psychological effects (89% of residents), and somnolence during the day (81%). Six percent of the sample experienced at least one potential adverse event. This work implies a need for caution when prescribing antipsychotics to older adults with dementia in AL. Medication management efforts should extend to monitoring AL residents for potential side effects and adverse events from specific psychoactive medications.
Affordable Rental Housing and Older Adults: A Case Study for Community Development Initiatives
Authors: Qureshi Muhammad , Mahmood Atiya , Akbarnejad Ghazaleh , Adeli Rahil , Sharon Dana
Published: December 2020

Older adults living in rental housing with limited income are at-risk for experiencing life-course disruptions, including social isolation, loneliness and homelessness. To address these needs, one Vancouver-based affordable housing provider for older adults has implemented community development initiatives (CDIs), including resident-led community gardens, workshops, and social events. Based on data from three focus groups, resulting in a total of fifteen participants, this study explored the efficacy of five different CDIs in supporting residents’ social connection and sense of community. Findings revealed that CDIs contribute to increased social engagement and inclusion of older adults living in affordable rental housing. In particular, resident-led community gardens were identified as the most impactful CDI in supporting both social engagement and inclusion, with the added benefit of addressing resident’s food insecurity. We discuss how CDIs can be implemented in various housing settings for low-income older adults as an effective method of supporting aging-in-the-right place. Part of a symposium sponsored by the Environmental Gerontology Interest Group.
The PATH to Caregiving: Assessing Caregivers and Developing a Caregiver Plan of Care in the Acute Care Setting
Authors: Camicia Michelle , Lutz Barbara
Published: December 2020

Family caregivers of older adults report lack of preparation for their role, particularly upon acute hospital discharge following a medical event. Addressing the needs of family caregivers in the acute care setting prior to hospital discharge requires the identification of the caregiver, an assessment of caregiver preparedness, and a plan of care to address gaps in preparedness. The Preparedness Assessment for the Transition Home 7-item (PATH-7) is a valid and reliable instrument developed to assess family caregivers readiness for the caregiving role during acute care. The PATH-7 paper-pencil self-administered assessment was implemented in clinical care in medical-surgical nursing units in 2 acute care hospitals. Interventions to address gaps in preparedness were selected from a catalogue of interventions to develop a caregiver plan of care. The most frequent challenge identified by family caregivers was fulfilling the caregiving role on top of their other roles and responsibilities. This illustrated the need to assist family caregivers with exploring options for recruiting others to help with their roles and responsibilities and identify solutions soliciting and organizing help. This novel program promotes addressing the needs of the family unit, moving to a family-integrated are delivery model. Implementation challenges included in-person contact with caregiver to administer assessment, resources to respond to identified gaps in readiness, and lack of technology-enabled assessment administration. Positive staff experience with identifying and addressing needs of caregivers was a facilitator of staff engagement. Identifying, assessing, and addressing the needs of family caregivers of older adults is feasible in the acute care setting.
Co-Created Research Assessing the Exclusionary Impacts of Low Living Standards on Older People
Authors: Waldegrave Charles , Cunningham Chris , Love Catherine , Nguyen Giang
Published: December 2020

The aim of this research is to identify the impacts of material resources such as income, assets, housing and living standards on quality of life, health status and social relations. Amartya Sen’s capabilities approach has formed the conceptual basis of the theoretical framework. This paper will report on the results of co-created research with older Māori in New Zealand aged 50 years and older. Objective measures of income, wealth, housing and living standards are compared with a range of scales including overall wellbeing and subjective health status and co-created scales of indigenous loneliness. The results demonstrate significant relationships between material resources and quality of life, health status and other social relations indicators. They quantify the impact material resources have on key indicators of social relations and social exclusion which enables informed and targeted policy interventions for social inclusion.
The Evolution of the Healthy Brain Initiative
Authors: McGuire Lisa
Published: December 2020

The Healthy Brain Initiative (HBI) seeks to advance public health awareness of and action on ADRD as a public health issue. The HBI Road Map Series, State and Local Public Health Partnerships to Address Dementia: The 2018–2023 Road Map (S&L RM) and Road Map for Indian Country (RMIC), provide the public health with concrete steps to respond to the growing burden of ADRD in communities, consistent with the aim of the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L. 115-406). This series of RMs for state, local, and tribal public health provide flexible menus of actions to address cognitive health, including ADRD, and support for dementia caregivers with population-based approaches. This session will describe how the initiative evolved over the past 15 years including policy and implementation success stories.
Functional Modulators of Resilience to Age-Associated Dopaminergic Neurodegeneration in C. elegans
Authors: Caldwell Guy
Published: December 2020

The societal costs of neurodegenerative diseases demand a sense of urgency and innovative strategies toward therapeutic intervention. We have exploited the experimental attributes of roundworm, C. elegans, as a model to expedite discovery of genetic and chemical modifiers of the age-dependent progressive neurodegeneration of dopaminergic neurons commonly associated with Parkinson’s disease (PD). Our model of transgenic nematodes overexpressing the misfolding-prone familial PD gene product, alpha-synuclein, has proven prescient in illuminating key aspects of PD pathology, including vesicular trafficking, autophagy, stress response, lipid dynamics, as well as the first evidence of endolysosomal function in effecting dopaminergic neurodegeneration. Subsequent chemical-genetic analyses reveal a mechanism whereby dopamine transport intersects with epigenetic control of gene expression through proteins functioning in endocytic regulation to modulate neuroprotection. We theorize this reflects a “tunable” nexus of gene-by-environmental regulation where dopamine levels, which impact alpha-synuclein misfolding, are coordinately controlled with epigenetic response to mediate resilience to age-dependent neurodegeneration.