bluuebunny/crossref_metadata_2025 huggingface dataset:
OLDER ADULTS EXPERIENCING UNSHELTERED HOMELESSNESS IN LARGE URBAN CITY LACK BASIC RESOURCES
Authors: Kogan Alexis Coulourides
Published: January 2025

Older adults constitute the fastest-growing segment of the homeless population in the US. Previous research has found older homeless adults to have more chronic conditions, premature mortality, greater odds of physical disability, and experience accelerated aging compared to housed populations. To inform programs to better serve this population, improved understanding of how they meet their basic needs is warranted. The purpose of this study was to explore the experience of unsheltered homeless older adults with meeting their basic needs for food, drinking water, toilet, hygiene, and healthcare in Los Angeles County. From 2021-2023 (24-months), we conducted a cross-sectional survey using the HOUSED BEDS assessment with people experiencing unsheltered homelessness and initiating care with Street Medicine (N=637). Quantitative data were analyzed to compare adults (18-49 yrs) and older adults (50+ years). Findings show that 40.3% of those sampled were older adults. Most older adults experiencing unsheltered homelessness identified as male (70%), Hispanic/Latino (46.6%), or Black/African American (25.6%). The majority of older adults had health insurance (79%) yet few (22%) had a primary care provider. Older adults lacked 24-hr bathroom access (22.3%), were forced to practice open defecation (82%), and relied on purchased food (50%) and drinking water (40.6%). Maslow’s hierarchy of needs explains that time and energy spent meeting basic needs of survival (including food, hydration, and sanitation) means time and energy not spent elsewhere, such as seeking healthcare. Results of this study suggest a need for scaling Street Medicine which provides basic needs and comprehensive, accessible primary care.
THE RELATIONSHIP BETWEEN STATE MEDICAID HCBS PROGRAMS AND FAMILY CAREGIVING
Authors: Thunell Johanna , Parrish Elise , Miller Katherine
Published: January 2025

A growing number of persons are opting to age in place in home- and community-based settings. As demand for care in these settings increases, the supply of caregivers – both family and paid care – is not keeping pace. Yet, programs providing financial payments, education, and training for family caregivers may increase the likelihood of successfully aging in place. As no national long-term care insurance system exists in the US, most home- and community-based services (HCBS) are paid out-of-pocket or through Medicaid HCBS waivers. Through waivers, some Medicaid beneficiaries can pay family caregivers for care received. However, payment availability and eligibility criteria vary within and across states. We leverage the geographic-restricted NHATS data (2011–2019) to identify a cohort of respondents with at least one functional limitation. Using multinomial logistic regression, we estimated the relationship between living in state in a year with a Medicaid waiver providing payments to family caregivers and the likelihood of receiving: paid and family care, paid care only, family care only, or no care. After adjusting for demographics and family structure, we found respondents living in a state allowing for payments to family caregivers were 2.2 percentage points more likely to receive care by a family member only and 1.3 percentage points less likely to receive formal care only. Unpacking the mechanisms by which policies can incentivize (or reduce) caregiving has implications for broader policy discussions to (1) ensure an adequate workforce to meet the demand for care and (2) mitigate adverse consequences of family caregiving.
THE UTILIZATION AND INFLUENCING FACTORS AMONG OLDER ADULTS IN HOME CARE SERVICES OF PROPERTY COMPANIES
Authors: Liu Kehan , Li Chunxiao , Chen Zijing , Yang Xiali , He Haiyan , Huang Chongmei , Liu Minhui
Published: January 2025

Property companies offer home care services for older adults, potentially facilitating “aging in place.” However, it’s unclear if the services are being used. This study investigated the utilization of home care services provided by property companies among older adults and explored the influencing factors affecting their utilization. A convenient sampling method was used to recruit 266 older adults in residential areas managed by property companies offering home care. Data was collected using self-designed questionnaires, including demographic characteristics (e.g., age, sex, living arrangements), health characteristics (e.g., self-rated health), and the utilization of services (daily life care, medical care, psychoeducation, emergency rescue). Daily life care includes senior canteens, plumbing and electrical repairs, housekeeping, etc. Medical care includes accompanying treatment, health education, and check-ups. Psychoeducation involves counseling and recreational activities. Emergency rescue includes 24-hour hotline and home visits. Approximately 58.3% of older adults were aged between 60-69 years, 39.1% lived with children, and 46.6% rated their health as average. Among all the services utilized, the highest was participating in recreational activities (59.0%), utilizing plumbing and electrical repairs (56.4%) and 24-hour hotline service (52.6%). Logistic regression models revealed that older adults aged over 80 (OR, 95%CI=0.30, 0.12-0.79) and those with poor self-rated health (OR, 95%CI=0.22, 0.10-0.50) were less likely to participate in recreational activities. Living with children (OR, 95%CI=0.16, 0.04-0.61) negatively correlated with the use of 24-hour hotline service. The low utilization rates suggested a demand for property companies to design targeted services to enhance home care service utilization among older adults.
HOME HEALTH AIDE AND SOCIAL WORK VISITS IN MEDICARE ADVANTAGE AND TRADITIONAL MEDICARE BY RURALITY
Authors: Mroz Tracy , Garberson Lisa , Andrilla C Holly , Patterson Davis
Published: January 2025

Medicare Advantage (MA) enrollment has grown rapidly over the last decade. Prior research suggests MA beneficiaries utilize home health less often than Traditional Medicare (TM) beneficiaries, but research comparing specific services within home health has been limited to individual plans or providers and has not examined rural-urban differences. Home health aide and social work services may be especially important for successful community discharge. Using 2018 100% Medicare files, we conducted hierarchical logistic regression analyses to examine receipt of home health aide and social work visits by MA enrollment and rural-urban status (categorized by Rural Urban Commuting Areas Codes into urban, large rural, small rural, and isolated small rural communities), controlling for beneficiary and community characteristics. Of the 3,143,742 beneficiaries included in analysis, 23% were enrolled in MA versus 77% in TM, and 83% lived in urban communities versus 17% in rural communities. MA versus TM beneficiaries had significantly lower odds of receiving aide and social work visits (OR(95%CI): 0.87(0.82,0.92) and 0.91(0.85,0.98), respectively). Beneficiaries in rural versus urban communities had significantly lower odds of receiving social work visits, with the lowest odds in small rural and isolated small rural communities. However, odds of receiving aide visits were significantly higher in rural versus urban communities and increased as rurality increased. MA beneficiaries in small rural and isolated small rural communities are at particular risk for poor access to social work services, but decreased access to home health aide services for MA beneficiaries may be attenuated for those living in rural communities.
NOVEL APPROACHES TO OBESITY TREATMENT IN OLDER ADULTS
Authors: Nicklas Barbara , Houston Denise , Batsis John
Published: January 2025

The prevalence of obesity (BMI ≥30 kg/m2) among older adults (65+ years) in the U.S. has almost doubled over the last three decades, with approximately 40% of older adults living with obesity. Lifestyle modifications of moderate caloric restriction have been shown to improve the metabolic and functional health in older adults (e.g., lower blood pressure, fasting glucose, and interleukin-6, and improvements in cardiorespiratory fitness and gait speed). While lifestyle modifications of caloric restriction typically only produce modest weight loss – in the range of 5 to 10% - recent FDA approved medications to treat obesity produce significant weight loss – in the range of 15 to 20%. However, trials of anti-obesity medications have included few older adults. Furthermore, caloric restriction – by either lifestyle modification or anti-obesity medications – results in the loss of muscle and bone, potentially exacerbating sarcopenia and osteopenia. As a result, health care providers are often reluctant to recommend weight loss in older adults with obesity due to concerns regarding the overall safety and benefits of caloric restriction. Thus, different approaches to caloric restriction may be needed to minimize the potential risks of caloric restriction in older adults. This symposium will address the following in older adults: 1) whether time restricted eating (TRE) may be an alternative to caloric restriction (Houston and colleagues); 2) whether replacing lost weight externally reduces weight loss associated musculoskeletal tissue loss (Beavers and colleagues); and 3) whether semaglutide improves physical function, muscle mass, and biomarkers of aging (Cortes and colleagues). Obesity and Aging Interest Group Sponsored Symposium
SOCIOECONOMIC DETERMINANTS OF RACIAL INEQUALITIES IN COGNITIVE FUNCTIONING AMONG ADULTS 50+ IN THE US AND BRAZIL
Authors: Farina Mateo
Published: January 2025

Racial inequalities in cognitive health are well-established. Black older adults have worse cognitive health than White older adults. However, evidence has been primarily found using data on the U.S. population, limiting scientific insight into how historically and socially constructed racial structures impact racial inequalities in cognitive health. Using nationally, representative studies from the United States (HRS) and Brazil (ELSI-Brazil), I examine racial inequalities in cognitive functioning (global and domain-specific) and their life-course socioeconomic determinants. I use a series of linear regression models to examine racial differences in cognitive functioning and to determine how accounting for life course socioeconomic conditions (retrospective childhood socioeconomic status, educational attainment, and adulthood income adjusted for household size) attenuate observed differences. Results show different patterns in racial inequalities in cognitive functioning across countries, with Black Americans having the lowest cognitive functioning in the United States and Asian Brazilians having the lowest cognitive functioning in Brazil. In Brazil and the United States, White older adults had the highest levels of cognitive functioning. However, the magnitude of racial inequalities differed by country, with preliminary findings showing greater differences in the United States than in Brazil. Lastly, regardless of country, childhood socioeconomic conditions and educational attainment greatly attenuated racial differences in cognitive functioning, reducing some racial inequalities to non-significance, indicating that the early life opportunities in establishing cognitive functioning may be substantially contributing to racial inequalities in both contexts. This research points to the need to consider context in understanding how and why racial inequalities in cognitive health arise.
NUMBER OF LIVING SIBLINGS AND COGNITIVE DECLINE AMONG OLDER MEXICAN ADULTS
Authors: Quashie Nekehia , Saenz Joseph , Zhang Xing
Published: January 2025

Objectives

A growing body of research examines the associations between sibship size and health in older adults. These studies largely focus on older adults’ physical health or mortality in high-income countries, yet cognitive health is understudied. Sibship size may impact cognitive development in early childhood and shapes opportunities for social support throughout life that potentially influence later life cognitive health. Using a gendered life course framework, this study evaluates how the number of living siblings in later life relates with cognitive health among older Mexican adults.

Methods

Data comes from the 2012, 2015, 2018, and 2021 waves of the Mexican Health and Aging Study (n=14,872 adults age 50+). We use latent growth curve models to evaluate how one’s number of living siblings relates with levels of latent general cognitive ability and nine-year cognitive decline and how these associations may differ by gender.

Results

Among men and women, those with no living siblings or only one living sibling had lower levels of cognitive ability when compared to those with 3 living siblings. However, very large sibship size (having 10+ living siblings) was also related with lower cognitive ability in men. Regardless of gender, the number of living siblings was not related with the rate of cognitive decline.

Discussion

This research broadens our understanding of the salience of siblings, an overlooked family resource, to older adults’ health. Our findings underscore the importance of alternative social support for older adults given Mexico’s changing demographics that challenge the reliance on family support in late-life.
RECENT INNOVATIONS IN INTERVENTIONS TO ADDRESS LONELINESS AND SOCIAL ISOLATION AMONG OLDER ADULTS
Authors: Kotwal Ashwin , Cudjoe Thomas
Published: January 2025

Recent years have witnessed unprecedented national and international calls to action to enhance social connection and reduce loneliness and social isolation among older adults. These calls include a 2020 National Academy of Sciences, Engineering, and Medicine report, a 2023 advisory by the Office of the Surgeon General, legislation introduced by U.S. Senators Murphy and Representative Flood, and a Commission on Social Connection by the World Health Organization (WHO). However, significant knowledge gaps remain on interventions to address these needs among older adults, particularly for diverse populations, across settings (i.e. health systems, different communities) and locations (nationally and internationally). In this session we will present four interventions that can reduce loneliness and social isolation among older adults. Studies will provide detail on recent innovations in program delivery., with particular attention to adaptations related to the COVID-19 pandemic that have been sustained. The implementation, sustainability, and scaling of interventions will be discussed, including health system-community referral networks, considering recent Medicaid funding opportunities, and new populations served. In addition, the session will include a discussion of differences in approach to interventions in different settings across the United States as well as globally. The session will foster dialogue on ongoing challenges and future directions in intervention development and research. Loneliness and Social Isolation Interest Group Sponsored Symposium
‘HELPING ALLEVIATE LONELINESS IN HONG KONG OLDER ADULTS’ (HEAL-HOA): A DUAL RANDOMIZED CONTROLLED TRIAL
Authors: Da Jiang  , Kwok Jojo , Choi Namkee , Yeung Dannii Y , Ho Rainbow Tin Hung , Warner Lisa , Chou Kee-Lee
Published: January 2025

Despite the high prevalence and negative impact of loneliness, research on the effectiveness of behavioral interventions for older adults who are experiencing loneliness has been lacking. The ‘Helping Alleviate Loneliness in Hong Kong Older Adults’ (HEAL-HOA), a dual randomized controlled trial (RCT), tested the effects of telephone-based psychosocial interventions delivered by older-adult volunteers (N=375) for lonely older adults (N=1,151) during the COVID-19 pandemic. The 375 volunteers age 50-70 were randomized into a volunteering condition versus an active control. Those in the volunteering condition received six 2-hour training on behavioral activation (Tele-BA), mindfulness (Tele-MF), or befriending (Tele-BF). Those in the active control condition received psychoeducation on loneliness. Trained volunteers then delivered Tele-BA, Tele-MF, or Tele-BF (active control) as lay counsellors for low-income, lonely, digitally excluded older adults (Mage=76.6, SDage=7.8) who lived alone and were randomized to one of three conditions. Outcomes were assessed at baseline and 6 months post-intervention among volunteer lay counsellors, and at baseline and 4 weeks, 3 months, and 6 months post-intervention among intervention recipients. For volunteer-counsellors, positive effects were observed in loneliness, social network engagement, stress and depressive symptoms as compared to those in the control condition. For intervention recipients, compared to Tele-BF, Tele-BA demonstrated positive effects on loneliness, psychological well-being, perceived support, and sleep quality at 3-month and 6-month follow-ups. Compared to Tele-BF, Tele-MF was effective in reducing loneliness at the 3-month follow-up. This innovative dual RCT demonstrated feasibility of delivering large-scale telephone-based behavioral interventions for older adults by older-adult volunteers and the intervention effectiveness.
MULTISENSORY INTEGRATION IN AGING: LINKS TO MOBILITY
Authors: Mahoney Jeannette
Published: January 2025

Multisensory integration, a rapidly growing field of neuroscience, investigates the simultaneous processing of information from multiple sensory systems. Researchers argue that our brains are designed to simultaneously process information from multiple sensory inputs to produce the most appropriate response to environmental cues. Studies in primates and young adults reveal that flexible multisensory integration is regulated by PFC areas, including dorsomedial and ventrolateral subregions. In fact, considerable strides have been made in defining the underlying properties, neural substrates, and timing of multisensory integration effects in healthy young adults; however, multisensory research in older adults has not been studied comprehensively. Further understanding of multisensory integration in aging could prove valuable, given that increased sensory deficits are associated with aging. Age-related visual and somatosensory impairments have been individually linked to slower gait, functional decline, increased risks of falls, and poorer quality of life. In a series of studies, we provide evidence for robust, but differential visual-somatosensory integration (VSI) effects in healthy aging and report its significant link with clinically-meaningful outcomes. Specifically, we show that older adults with intact levels of VSI demonstrate better balance, faster gait velocity and lower incidence of falls, compared to those with poor VSI. Additionally, we reveal that older adults with MCI and dementia demonstrate significantly reduced magnitude of VSI compared to those without cognitive impairments, which in turn was associated with worse unipedal stance and gait performance. Our current research objectives include elucidating whether VSI is a novel, non-invasive, non-cognitive predictor of Alzheimer’s disease.
HEARING LOSS AND PHYSICAL ACTIVITY AMONG OLDER ADULTS IN THE UNITED STATES
Authors: Assi Sahar , Twardzik Erica , Deal Jennifer , Ginis Kathleen Martin , Palta Priya , Schrack Jennifer , Reed Nicholas , Amezcua Pablo Martinez
Published: January 2025

Background

Hearing loss is associated with adverse health outcomes among older adults, which may be partly explained by lower physical activity levels. Yet, the association between hearing loss and physical activity among older adults remains understudied.

Methods

Cross-sectional analysis of the National Health and Aging Trends Study (2021). The better-hearing ear pure-tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled continuously (per 10-dB) and categorically (no: ≤25 dB, mild: 26-40 dB, moderate or greater: >40 dB hearing loss). Activity measures were 1) wrist accelerometry-derived total activity counts, daily active minutes, and activity fragmentation, and 2) self-reported participation in vigorous activities and walking for exercise in the last month.

Results

Among 504 participants excluding hearing aid users (mean age = 79 years, 57% female, 9% Black), 338 (67%) had hearing loss. Using multivariable regression adjusted for sociodemographic and health covariates, we found that worse hearing (continuously and categorically) was associated with fewer counts and active minutes, more fragmented activity, and greater odds of not reporting recent vigorous activities. Among 472 participants with hearing loss, nonusers of hearing aids (n = 338) had more fragmented activity and greater odds of not reporting walking for exercise compared to users. Conclusions: Older adults with hearing loss are less physically active. This may mediate the association between hearing loss and other adverse outcomes. Recognition of this potential association is essential for providers to better support older adults in maintaining an active lifestyle. Future research is warranted to understand the impact of hearing interventions.
ONLINE ASYNCHRONOUS INTERVENTION FOR FAMILY CAREGIVERS OF PERSONS WITH LEWY BODY DEMENTIA (LBD)
Authors: Zaslavsky Oleg , Kaneshiro Jasmine , Su Yan , Domoto-Reilly Kimiko , Chen Annie T
Published: January 2025

Family caregivers of individuals with Lewy Body Dementia (LBD) experience higher levels of stress and more severe depressive symptoms compared to caregivers of people with other dementias. This pilot study evaluated the efficacy of VOCALE LBD, an online asynchronous 8-week intervention aimed at improving psychological distress among LBD caregivers. We conducted a quasi-experimental study with 39 family caregivers. The program employs a web-based platform and includes text-based peer support, moderation of the discussion by a research team member, didactic training, and problem-solving skills development, all tailored to LBD caregiving situations. We assessed outcomes including caregiver depression, burden, stress, and support, at baseline, post-intervention (eight weeks), and one-month follow-up. We also evaluated problem solving, self-efficacy and mastery mechanistic variables. Participants’ average age was 68 (SD=10), with 69% female, 95% identifying as White, and 79% holding undergraduate and graduate degrees. The eight-week intervention had 18% attrition rate. Effect sizes (Cohen’s d) from baseline to post-intervention and from baseline to follow-up showed reductions in depression (-0.36 and -0.54, respectively), stress (-0.30 and -0.45), burden (-0.31 and -0.26), and increases in support (0.44 and 0.46). Significant improvements were observed in problem-solving skills, though no significant changes were noted in mastery and self-efficacy. The study confirms the acceptability and efficacy of the VOCALE LBD program to reduce psychological distress among family LBD caregivers and suggests activation of the targeted change mechanisms. The study also contributes to the field’s understanding of online support mechanisms and promotes the exploration of innovative caregiver support strategies.
THE 4 S’S OF GERIATRICS EDUCATION: STIGMA, SPEED, STEALTH, AND SOURCES
Authors: Cooney Alissa , Duthie Edmund
Published: January 2025

This symposium covers a conceptual framework developed by the Geriatrics Education Interest Group. The framework includes the 4 Ss of geriatrics education: Stigma, Speed, Stealth, and Sources. Geriatrics Educators have long needed the fortitude factor to face adversity in finding a place for geriatrics education in many curricula. Sharing the experience of geriatrics leaders who have demonstrated fortitude in their approach to geriatrics education fighting against stigma, getting creative with speed, seeking out stealthy opportunities, and leveraging sources, to improve geriatric education for all learners. The first S, Stigma, addresses the persistent ageist attitudes and behaviors found across healthcare by promoting geriatric education anchored in a “patient-centered care” approach addressing the specific, individual-based, concrete, patient care needs. The second S, Speed, explores micro learning in the context of geriatrics education to increase efficiency of learning and retention of knowledge. Multiple web-based platforms for geriatrics micro learning will be discussed including implementation of Geriatrics Fast Facts, a point-of-care micro learning resource. The third S, Stealth, shares how to reframe integration of geriatric principles specifically for non-geriatrics specialties. This segment will dive into case-based perspectives on stealthily integrating basic geriatric principles into learning environments not focused on geriatrics care. The fourth S, Sources, discusses how to leverage sources to enhance geriatric education. This section will explore the experience of geriatricians and inter professional geriatric specialists who have successfully leveraged their knowledge and resources and their institutions and local communities to benefit geriatric education. Geriatric Education Interest Group Sponsored Symposium
REAL LIVES ACROSS THE GLOBE: INSIGHTS FROM THE GLOBAL PRIDE STUDY
Authors: Oswald Austin , de Vries Brian , Fredriksen-Goldsen Karen
Published: January 2025

Research on the intersection of sexuality, gender, and aging is becoming increasingly global; however, scholars in the field rarely have the opportunity to collaborate across national boundaries. This hampers knowledge sharing and limits the global knowledge base on sexuality, gender, and aging. In this presentation, we will explore international and interdisciplinary perspectives on sexuality and gender across the lifespan. Individual and group interviews were conducted with collaborators of the Global Pride study, discussing the challenges and opportunities of global research at the intersection of sexuality, gender, and age. These interviews were video recorded and will be shared during this presentation. The video features global collaborators discussing the resources and cultural influences in various conceptual, qualitative, quantitative, and multi-method approaches for conducting sexuality, gender, and aging research. We will also address the unique cultural influences, dimensions, and dynamic nature of conducting cutting edge research with sexual and gender diverse (SGD) adults across the lifespan. Key insights include: 1) identifying similarities and differences across diverse cultural contexts, including variations in old age itself; 2) understanding the distinct realities and challenges faced by older adults in diverse SGD communities and the strengths and fortitude of these communities worldwide; 3) developing feasible strategies to advance SGD research, practice, and education within differing cultural, social, and political environments. By examining the risk and resilience of SGD older adults globally, we aim to illuminate how innovative research, practice and education can strengthen our understanding of aging in our increasingly diverse society.
UNMET NEEDS OF VETERANS AND CAREGIVERS INCREASE WITH PREDICTED RISK OF LONG-TERM INSTITUTIONAL CARE
Authors: Garcia-Davis Sandra , Munoz Richard , Bouldin Erin , Hansen Jared , Kinosian Bruce , Intrator Orna , Dang Stuti
Published: January 2025

To understand unmet needs, we contacted a random sample of Veterans receiving care at five Veterans Health Administration (VHA) sites and oversampled Veterans with a higher predicted 2-year LTIC risk. Veterans and their caregivers were asked to complete separate comprehensive surveys to assess demographic, social, psychological, functional, and physical domains; unmet needs; experience with home and community-based services; and caregiver support programs experience. Veteran and caregiver surveys were mailed in the same envelope to 20,000 Veterans. We received responses from 8,056 Veterans and 3,579 caregivers. Veteran respondents were mostly men (96.5%), over 65 years (94.9%), married (55.0%), Non-Hispanic White (75.2%), and residing in urban areas (80.7%). Veterans reported unmet needs in activities of daily living (ADLs; 15.7%), instrumental activities of daily living (IADL: 26.0%), nursing tasks (7.9%), pain management (15.1%), communicating with healthcare team (18.2%), and social support (12.1%). The most common unmet IADL needs were medication management (55.4%), housework (55.4%) and preparing meals (53.7%). Compared to Non-Hispanic Whites, Hispanics and Non-Hispanic Blacks were more likely to have unmet ADL and IADL needs. Caregivers averaged 7.3 hours of daily care (SD=5.5 hours); and helped with ADLs (42.5%), IADLs (57.2%), communicating with healthcare team (52.4%), and social needs (36.4%). Degree of need for assistance for all needs varied by predicted risk of institutionalization (PLI). Veterans in the high PLI tier reported the highest prevalence of unmet need. Both Veterans and caregivers described complex unmet needs in medical, functional, psychological, and social domains, which increased as their predicted risk for LTIC increases.
WELL-BEING AND SERVICE USE AMONG VETERANS’ CAREGIVER-SURVIVORS
Authors: Bouldin Erin , Munoz Richard , Trivedi Ranak , Leykum Luci , Hansen Jared , Dang Stuti
Published: January 2025

Transitioning from the role of caregiver to survivor following the death of the care recipient can be difficult. Our goal was to describe well-being and bereavement-related service use among family caregivers of Veterans who had recently died. During June-November, 2023, we sent surveys to caregivers of 1,468 Veterans who had participated in a previous survey and whose Veterans had died 3-18 months prior to this survey; 296 (20.1%) caregiver-survivors completed the survey. We assessed caregiver-survivors’ anxiety (Generalized Anxiety Disorder-2) and depressive (Patient Health Questionnaire-2) symptoms along with physical and mental health-related quality of life (HRQOL; PROMIS 10 mental and physical health) at the time of the survey. We assessed their use of specific support services since the Veteran’s death. 14% of caregiver-survivors screened positive for anxiety and 15% for depressive symptoms. Most had poorer physical HRQOL (67% had t-scores>50) and mental HRQOL (85%) than the general population. Service use was uncommon: 10% of caregiver-survivors had used a bereavement support group, 7% had used counseling/therapy, and 2% each had used a caregiver support group or VA bereavement services. 20% of caregiver-survivors said they were not aware of bereavement/counseling services but would have liked to use them. In this sample of caregiver-survivors, anxiety and depressive symptom prevalence was similar to the general population but physical and mental HRQOL were substantially poorer. Most caregiver-survivors did not use any formal services following the Veteran’s death. While most non-users were not interested in services, some reported they would have used them if offered.
UTILIZING THE PMDC AS A FRAMEWORK FOR THE PROVISION OF PERSON-CENTERED CARE IN NURSING HOME SETTINGS
Authors: Buron Bill , Wright Kathy
Published: January 2025

This symposium showcases the research of the Geropsychiatric Nursing Collaborative, a workgroup affiliated with the NHCGNE. Kitwood (1997) defined Personhood, as ‘a standing or status that is bestowed on one human being, by another in the context of relationship and social being.’ Buron (2008) designed the Personhood Model for Dementia Care (PMDC) based on Kitwood’s definition and Maslow’s (1943) Hierarchy of Needs Theory. The PMDC is an intuitive framework to promote the identification and utilization of person-centered care (PCC) interventions in nursing homes. This symposium begins with an overview of the model as a framework for an integrative review of effective PCC-focused interventions. Next, three specific interventions will be discussed and highlighted, each representing at least one level of personhood as defined and described in the PMDC. The first illustrates how biological needs for nutrition intersect with relational aspects of care during mealtime and introduces an effective strategy for assisting RLWD with their meals. The researchers found more PCC and less task-centered care were associated with improved mealtime behaviors and/or food intake in RLWD. In the next example, the researchers highlight individual personhood through an exploration of resident preferences. The researchers found residents have diverse approaches to expressing their preferences and utilize a range of resident-led, family-involved, and staff-brokered strategies to meet preferences. In the final example, researchers developed an on-line person-centered dementia training for undergraduate nursing students. The aim of this training was to improve nursing care of people living with dementia and highlights the importance of sociologic personhood. Nursing Care for Older Adults Interest Group Sponsored Symposium
MEALTIME BEHAVIORS AND FOOD INTAKE IN OLDER ADULTS WITH DEMENTIA: IMPACT OF PERSON-CENTERED AND TASK-CENTERED CARE
Authors: Liu Wen , Lee Kyuri , Suh Heather
Published: January 2025

Nursing home residents with dementia experience mealtime behaviors and low food intake due to multilevel factors, among which mealtime caregiving is critical. Prior work supported associations between staff mealtime care and resident mealtime behaviors and food intake using small samples of meal-segments. This study examined their associations using 197 full-meal videos (duration=37.85±18.24 minutes), capturing 47 staff (age 45.6±11.8 years; 92.3% female; 80.8% white; 15.5±12.9 caregiving years) and 12 residents with moderately-severe to severe dementia (age 71.9±7.5 years; 91.7% male; 91.7% white). Staff mealtime care approaches (n=12,800) were mostly person-centered addressing modifications of resident abilities (70.3%), dyadic interactions (12.1%), and dining environment (6.8%), followed by task-centered care (TCC, 10.8%). Resident mealtime behaviors (n= 9,424) were resistive behaviors (21%), functional impairments (13.2%), chewing/swallowing difficulties (48.1%), and positive behaviors (17.6%). Resident food intake was 626.23±353.17 gram/meal. Resistive behaviors were associated with fewer modifications of resident abilities (b=-.215, p=.053) and more TCC (b=.202, p=.058). Functional impairments were associated with more modifications of resident abilities (b=.186, p=.048) and more TCC (b=.446, p<.001). Chewing/swallowing difficulties were associated with more modifications of resident abilities (b=.287, p=.006). Positive behaviors were associated with fewer modifications of resident abilities (b=-.310, p=.002) and more modifications of dining environment (b=.330, p=.001). Food intake was associated with more modifications of resident abilities (b=.289, p=.009). Minimizing use of task-centered care may help improve mealtime challenging behaviors. While modifications of resident abilities may not address functional impairments, they help manage resistive behaviors and improve food intake. Modifications of dining environment may help promote positive behaviors.
RESIDENTS’ PERSPECTIVES ON PREFERENCES: EXPLORING HOW NURSING HOME RESIDENTS EXPRESS AND ACHIEVE PREFERENCES
Authors: Block Laura , Madrigal Caroline , Roberts Tonya
Published: January 2025

Providing choice and accommodation of preferences is fundamental to delivery of person-centered care in nursing homes (NH). Studies indicate variability in NH residents’ preferences around a range of daily care routines and activities (i.e., involvement of family, meal choices, morning or nighttime routines) and the widespread challenges NHs face in meeting preferences. Yet, few studies have examined NH resident perspectives on their role as a key player in communicating their preferences. This qualitative study is part of a broader mixed methods exploration of the relationship between preference-aligned care and quality of life. A subset of residents (N=11) was selected for semi-structured interviews to examine resident perspectives on navigating preferences in daily life. Interviews were coded inductively, with thematic analysis guiding abstraction and interpretation. Residents described a range of degree of preference expression, from voicing strong preferences for or against care/activities; deferring to staff; or being uncertain of a preference. Residents shared multiple strategies for meeting their preferences, including communicating with new staff, relying on family, escalating requests, and adjusting to the NH environment. Residents also described staff-led strategies of documenting and sharing their preferences and splitting the work into parts, which often required resident collaboration and input. The importance of consistency in staffing and developing relationships with staff was underscored. Future work should examine the potential role health, cognitive, and functional capacity play in shaping residents’ preference expression.
VOICES OF CARE: INSIGHTS FROM DIVERSE CAREGIVERS
Authors: Campos Barbara Mendez , Lyons Karen
Published: January 2025

Recognized as the backbone of the U.S. healthcare system, informal caregivers face unprecedented challenges amidst an ongoing care crisis. Understanding the profound effects of informal care responsibilities is critical to the health and well-being of our society. According to AARP, in 2020, the number of individuals engaged in caregiving for an ill or disabled family member surpassed 53 million, up nearly 10 million since 2015. There is increasing evidence documenting that social inequalities often compound the negative health and financial outcomes for caregivers as they age, making research that focuses attention on the racial, ethnic, and cultural contexts that shape not only the caregiving experience, but also the outcomes that result, central to our ability to develop interventions. This symposium delves into the intricate realities of caregiving, providing valuable insights into economic, cultural, and health-related dimensions. It proposes solutions to positively influence the experiences of older adults, their families, and the broader healthcare system. The first paper explores the enabling factors and barriers African American women caregivers confront in seeking support. The second paper evaluates a digital storytelling intervention’s impact among African American caregivers. The third paper investigates the repercussions of caregiving on older workers’financial, health, and employment outcomes during the COVID-19 pandemic. The final paper reports a scoping review on the role of interpersonal factors in shaping health behaviors among Hispanic older adults. A discussant will reflect on these studies, underscoring the imperative for ongoing research encompassing diverse voices, methodologies, and the impacts on informal caregivers. Family Caregiving Interest Group Sponsored Symposium
CARE’S ECHO: THE IMPACT OF CAREGIVING DURING COVID-19 ON OLDER WORKERS’ FINANCIAL, HEALTH, AND JOB OUTCOMES
Authors: Matz Christina , Lai Patrick , Campos Barbara Mendez
Published: January 2025

Informal caregivers are a critical resource to their loved ones and an essential component of the health care system in the United States. In the context of an ongoing care crisis, it is more important than ever to understand the effect of informal care responsibilities on individuals and their families as they age to develop appropriate solutions. This study examines how caregiving responsibilities during COVID-19 affected older workers’ financial well-being, health, job turnover, and employment experiences. Using 2020 Health and Retirement Study (HRS) data and the 2021 HRS Perspectives on the Pandemic survey, we examined older workers aged 50 and above. Our logistic regression analysis focused on two caregiving scenarios: 1) individuals with a spouse or partner with ADL/IADL limitations, and 2) those who paused work for at least two weeks due to caregiving during the pandemic. Our findings reveal significant challenges for caregivers. Spousal caregivers were 1.65 times more likely to face financial difficulties and 1.87 times more likely to have health issues due to delayed care compared to non-caregivers. Those who had to stop working for 2 weeks or more for caregiving reported even higher risks (2.69 times for financial difficulty and 3.29 times for health issues). Caregivers also experienced greater job stress, safety concerns, and decreased job satisfaction. The pandemic has illuminated the struggles of older working caregivers, emphasizing the need for supportive workplace policies and societal interventions. These measures are essential to support caregivers, who often sacrifice their well-being and career progress for their caregiving roles.
I’LL TELL YOU IF YOU ASK: MESSAGES ABOUT SUPPORT FROM AFRICAN AMERICAN WOMEN CAREGIVERS
Authors: Galambos Colleen , Keller Abiola , Platt Katherine , Vidal Jennifer
Published: January 2025

Family caregivers are vital for ensuring the health of a growing older adult population. African American women represent a critical population of caregivers, since 60 percent of caregiving among older adults within the African American community is performed by women (Centers for Disease Control, 2024). Additionally, there is added cultural pressure to provide this care to family members and African American women caregivers (AAWC) face multiple competing stressors and demands (Imoh & Charity, 2023). Given these cultural dynamics, it is important to understand what type of assistance AAWC need to enable them to engage in self-care and support themselves in their caregiving role. Furthermore, there may be barriers faced by AAWC in accessing supportive interventions and resources. To increase knowledge about barriers and preferences for interventions and services, qualitative interviews were conducted with 12 AAWC of older adults. Interviews were audio recorded and transcribed using Microsoft TEAMS. To analyze the data, inductive content analysis was employed, responses were coded and emerging patterns determined. This presentation reports on the most frequently mentioned barriers and enablers to receiving support that emerged from the interviews as well as cultural considerations. Some barriers that surfaced from the data include supporting others over self, time constraints and logistical barriers. Some enablers or facilitators include sharing care responsibilities, support of family and friends, and obtaining information/receiving resources. Additional barriers and enablers and other experiences identified by the participants will be discussed. Community stakeholder’s response to the study will be highlighted.
DIGITAL STORYTELLING AMONG AFRICAN AMERICAN CAREGIVERS: EVALUATION OF THE INTERVENTION PARAMETERS
Authors: Keller Abiola , Gubrium Aline , Dixon Saharra , Bell Bethani , Hart Dani , Haglund Kristin
Published: January 2025

Digital storytelling (DST), a process involving creating 1–3-minute videos about an important moment in one’s life, is an innovative approach for data collection and intervention and it is imperative to understand storytellers’ perceptions of the process. This study explores the experiences of African American women caregivers enrolled in a DST intervention. The specific aims are to examine the acceptability, feasibility, and effectiveness of the DST process. Women who self-identified as African American, a caregiver (i.e., taking care of another adult), and agreed to attending all sessions were eligible to participate. Women were invited to participate in an interview via Microsoft Teams after each DST session. Interviews lasted approximately 15 minutes and were audio recorded and manually transcribed. Responses were examined for patterns and key content-related categories using inductive content analysis. In Cohort 1 (Spring 2023), five caregivers consented to participate in the DST sessions, three completed their story, and those three participated in interviews. In Cohort 2 (Fall 2023), five caregivers consented to participate in the DST sessions, four completed their story, and two participated in interviews. Women spoke about three distinct ways the DST process met their needs: 1) having a shared experience, 2) breaking the silence around caregiving, 3) learning and trying new things. Identified challenges included resistance to writing down their story and limited access to technology outside of the sessions. These findings suggest that DST may be used as an additional resource for supporting the well-being of African American women who care for older adults.
WHO FITS AND HOW? SUPPORTING TENANCY AND FOSTERING BELONGING IN HOUSING FOR OLDER PERSONS EXPERIENCING HOMELESSNESS
Authors: Richardson Lena Rebecca , Weldrick Rachel , Perry Tam
Published: January 2025

Homelessness among adults age 50+ years is increasing across North America. The Aging in the Right Place (AIRP) Partnership is a 5-year study of eleven promising practice organizations addressing older adult homelessness in three Canadian cities. This symposium will share findings from AIRP research on what supports a sense of belonging and social integration among older persons experiencing homelessness (OPEH) within temporary and permanent supportive housing programs. Presenters include interdisciplinary researchers with a diversity of perspectives stemming from gerontology, education, and social work. The symposium will begin with Erisman presenting a study of service providers’ perspectives on who is eligible for services and what actions providers can undertake to support clients’ ongoing tenancy in shelter/housing organizations. Weldrick will then discuss mechanisms for successfully supporting social integration from a study with OPEH in a temporary housing program. Following, Richardson will present findings on how multidirectional caring relations can foster belonging in a homeless shelter for older adults fleeing abuse. Finally, Walsh’s study findings will highlight ways to promote AIRP for male veterans in a temporary housing program. Tam Perry, an expert in housing transitions for older adults, will discuss the implications of these papers and reflect on processes of social integration and cultivating belonging for OPEH in temporary and permanent housing. Together, participants of the symposium will advance this emerging scholarship using a wide range of methods and perspectives.
BEING AND STAYING ELIGIBLE FOR SERVICES: PROVIDERS’ VIEWS ON SUPPORTING OLDER ADULTS EXPERIENCING HOMELESSNESS
Authors: Erisman Morgan Cruz , Canham Sarah , Richardson Lena Rebecca , Weldrick Rachel , Mahmood Atiya , Walsh Christine , Sussman Tamara
Published: January 2025

Older people experiencing homelessness (OPEH) are a marginalized population with limited access to shelter/housing supports. Amidst these limited resources, understanding program-specific (in)eligibility criteria, along with strategies to sustain tenancy in different shelter/housing settings, is crucial to supporting OPEH in their housing goals. This study examined providers’ understanding of housing (in)eligibility in different shelter/housing settings, factors that impact the criteria for staying eligible, and interventions and steps providers use in assisting OPEH to maintain their eligibility and move towards their housing goals. Semi-structured interviews were conducted with 15 providers from five shelter/housing organizations serving OPEH across three Canadian cities. These organizations represented a range of shelter/housing services for OPEH, including emergency shelters, temporary/transitional housing, and permanent supportive housing. We conducted a thematic analysis and organized findings into three themes: 1) Medical and behavioral factors that impact (in)eligibility of OPEH for shelter/housing services; 2) Challenges to maintaining eligibility due to medical and behavioral factors; and 3) Provider and organizational support mechanisms to sustain tenancy. Findings provide insight into who is (in)eligible for different shelter/housing programs catered to OPEH, along with different support mechanisms available to support OPEH in their housing goals. Findings highlight the supports and services needed by OPEH with medical and behavioral challenges to remain eligible in different shelter/housing settings and recommendations for how to increase and target services to OPEH with specific needs. Understanding medical and behavioral factors that impact the shelter/housing tenancy of OPEH provides an opportunity to foster client success and promote positive housing outcomes.