bluuebunny/crossref_metadata_2025 huggingface dataset:
Late-Life Cognition and Dementia in India: New Insights From LASI-DAD
Authors: Lee Jinkook
Published: December 2020

With more than1.35 billion people, India, the second-most populous country in the world, is soon to experience rapid aging of its population. By2050, India’s older population is projected to reach320 million (about the current size of the entire U.S. population). In this session we introduce the Longitudinal Aging Study in India – Diagnostic Assessment of Dementia (LASI-DAD), a new cohort study designed to advance dementia research to better understand late-life cognition, cognitive aging, cognitive impairment, and dementia, as well as their risk and protective factors. LASI is a prospective, multi-purpose population survey of older adults aged45 and older, representative of the entire country and of each state (N~72,000). LASI-DAD is an in-depth study of late-life cognition and dementia, drawing a sub-sample of older adults aged60 and older from LASI (N~4,300). It administered the Harmonized Cognitive Assessment Protocol (HCAP), which consists of a pair of in-person interviews, one with the target respondent and one with an informant nominated by the respondent. The respondent interview includes a neuropsychological test battery designed to measure a range of key cognitive domains affected by cognitive aging and Alzheimer’s Diseases. We organize the session to showcase LASI-DAD. Specifically, the session consists of four papers, including: (1) the introduction of the design and methodology, (2) the latent structure of neuropsychological test results, (3) the investigation of the relationship between visual impairment and cognition, and (4) the examination of female disadvantage in dementia and its association with cross-state variations in gender inequality.
Telegroup Visits for Caregivers and Patients With Dementia
Authors: Thielke Stephen , Fredrickson Kris
Published: December 2020

Group visits have shown promise for caregiver support and medical management of patients with dementia. In-person visits can be challenging to schedule and complete, particularly in rural areas where there are few specialists. We describe our experience with using telehealth modalities to hold group dementia visits. For the last four years, we have held telegroup appointments with Veterans with dementia and their caregivers. A geriatric psychiatrist and geriatric social worker appear from the main facility, and the Veterans and caregivers are at remote sites. Participants have actively engaged. They have expressed that the structure allows them to support and be supported by peers, and to have frequent contact with care providers. This has led to improved care metrics. The technology requirements are minimal. We discuss the advantages of this approach, including flexibility and maximizing use of specialist resources. We address challenges to scaling up such programs.
Telehealth-Delivery of a Multicomponent Obesity Intervention in Older, Rural Adults With Obesity
Authors: Batsis John , Petersen Curtis , Al-Nimr Rima , Gooding Tyler , Cook Summer , Mackenzie Todd
Published: December 2020

Older, rural residents with obesity aged ≥65 years have reduced access to health promotion programs due to geography. We conducted a 26-week intervention of 24 older obese adults (BMI≥30kg/m2) in a geographically isolated area in Northern New England. The telemedicine delivered intervention consisted of individual, weekly, dietitian visits focusing on caloric restriction, and twice-weekly physical therapist-led group strength training classes. Participants’ age was 73.4±4.4years (79% female); pre-post assessments consisted of bioelectrical impedance-based body composition, functional measures, and satisfaction questionnaires. Feasibility was high (50% enrolled, 85% completed). Weight decreased 4.5±3.8kg (4.5±0.5%; 48% achieving ≥5%), 30s sit-to-stand improved (+3.8±4.1repetitions), as did 6-minute walk, +76.2±70.1m (all p<0.001). Appendicular mass did not change (+0.20±2.3kg); % body and visceral fat both decreased (-1.8±2.8% [p=0.009], -1.2±2.7L [p=0.025]). Participants endorsed telemedicine (96%); 78% preferred a home-based study. Satisfaction was high (4.2/5) and only 17% faced difficulties. Despite geography, this intervention holds promise in improving physical function.
Gender-Specific Determinants of Instrumental Activities and Associations With Cognitive Decline in TILDA
Authors: McGarrigle Christine , Donoghue Orna A , Orr Joanna , Kenny Rose Anne
Published: December 2020

Detecting functional decline is critical in recognizing clinical progression into mild cognitive impairment and dementia as people age. This study aimed to investigate differences in Instrumental Activities of Daily Living (IADL) and associations with cognition by gender. Data are from five waves of TILDA, a nationally representative cohort of 8,175 aged ≥50 years, measured every 2 years between 2009 and 2018. IADL assessed were preparing a hot meal, doing household chores, shopping for groceries, making telephone calls, taking medications, and managing money. Cognition was assessed using the Mini-Mental-State Examination (MMSE). Latent class analysis and growth mixture modelling techniques were used to identify IADL and cognitive latent classes and examine change trajectories. IADL trajectories differed by gender and were associated with cognitive decline. Functional decline discrepancies between men and women may be driven by domestic tasks within IADL which are associated with social gender roles, rather than determining differential cognitive trajectories.
No Decision About Me Without Me: International Views on Providing Care Against Someone’s Will
Authors: Bleijlevens Michel , Hamers Jan , Capezuti Elizabeth
Published: December 2020

People with cognitive impairment may experience the care provided by their caregiver(s) as unnecessary or undesirable, which is expressed by behaviors such as resisting the efforts of a caregiver or preventing the caregiver to perform or assist with ADL such as bathing, dressing and toileting. This can lead to stress, agitation and aggression for both the care recipient and the caregiver, and places the caregiver in a complex dilemma. Should the caregiver force hygiene or respect the person’s autonomy to refuse care? It is difficult for caregivers to find a balance between quality of care and safety, while accepting the person’s autonomy. Caregivers in long-term care often feel the necessity to provide care against the will of people with a cognitive impairment, including physical restraints, psychotropic medication, and non-consensual care. This symposium provides an international perspective with presenters from Belgium, Switzerland, Germany, and the Netherlands. The first presenter explores the use and factors associated with physical restraint, psychotropic medication, and non-consensual care in people with dementia receiving home care in the Netherlands and Belgium. Second, a presenter from Switzerland focuses on the prevalence of restraint use in nursing homes. The third presenter introduces an Advance Care Planning intervention from Germany that aims to ensure that personal wishes in home care are followed. The last presenter assesses the feasibility of an approach to prevent and reduce care against a person’s will in the Netherlands. To conclude, our discussant will integrate these insights and draw conclusion for policy, practice and further research. Systems Research in Long-Term Care Interest Group Sponsored Symposium
Engaging Mind, Body, and Spirit: Less Isolation Through More Stimulation With YUMMY Time
Authors: Corley Connie , Groove Spring
Published: December 2020

Loneliness and social isolation in community-residing older adults is drawing increasing attention. Yet the needs of nursing home/assisted living residents is critical as well. Engaging professionally-trained musicians who are certified yoga instructors in providing a structured, yet flexible, program offered regularly in such settings is an innovation meriting examining what is observed as a profound experience for both older adults and care providers. Y.U.M.M.Y. Time (through music, meditation and yoga) is a paradigm created by Spring Groove (Gross) offering a unique intersection between the performance arts and the contemplative arts. We are studying the benefits of this approach combining sensory stimulation with inner engagement, with the goal to expand into community settings. As staff members note: “Although the ingredients are simple, the results are profound.” “The program is very enriching, full of great music moments, yoga and meditation to relax our residents. It is very much enjoyed by everyone!”
Through the Gerontological Looking Glass: Perspectives From Later Life
Authors: Ansello Edward
Published: December 2020

Do dominant gerontological research and education models help us understand our own aging? “(These) seemingly made no impact on my expectations for my own late life” (Cohen, 2017). The gerontological looking glass tends to favor research and teaching that identify large patterns, populations, and research cell sizes of “sufficient” numbers to produce data about external, descriptive assessments; and are compliant with nomothetic ideology: general, universal, and consistent. Even qualitative data rely on numbers of respondents to identify themes. In contrast, idiographic ideology emphasizes the individual and unique. While not meant to yield general findings, neither does it produce the incompleteness of descriptive statistical approaches, i.e., trying to capture the external persona. As human aging is both inherently universal and profoundly individual, one is likely to appreciate idiographic gerontology with awareness of one’s own aging. Various complementary perspectives—including humanistic gerontology, positive and conscious aging, and the curriculum palette—are relevant.
Approaches to Anti-Ageism Interventions
Authors: Gendron Tracey , Inker Jennifer
Published: December 2020

Ageism, a multidimensional construct, is also understood as a relational process whereby perceptions and behaviors toward older individuals by younger individuals not only damage the self-esteem of elders, but also create a hostile environment for their own future social interactions and their own future self-development as elders. Anti-ageism interventions have the hefty task of improving attitudes and behaviors toward aging within all of these contexts. This presentation will discuss findings from two different anti-ageism interventions both designed to mitigate the negative impacts of ageism. Results from a study on an intergenerational arts-based program found that after participation students demonstrated a positive change in their attitudes toward older adults. Findings from a video-based ageism intervention among a sample of 265 staff members in 15 senior living communities demonstrated decreased internalized aging anxiety as well as decreased ageist behaviors directly after the training and at three month post follow-up. Given the complex and systemic nature of ageism, diversity is necessary in scope and type of intervention in order to reach the broadest audience.
Why Age Matters: The Importance of Historical Context in the Study of Minority Stress in Sexual Minorities
Authors: Vale Michael , Bisconti Toni
Published: December 2020

Currently, there is support that links experiences of stigma/discrimination, known as minority stress, with depressive symptomatology in older sexual minorities (OSM). Yet, the context of cohort is ignored, despite OSM having been exposed to greater stigma across their lifetime. The current project explores how cohort informs the minority stress process by comparing three minority stressors and their relationships with depressive symptomatology across a younger (18-39, N=129) and older sample (40-80, N=104). It was found that OSM had significantly less overall stress, had different significant links between each stressor and depressive symptomatology, and significantly used social support to buffer stress contrasting their younger counterparts. These results highlight the need to consider cohort and discover why OSM are more resilient to minority stress. Considering the role of cohort improves aging and minority stress theories, is useful for professionals improving well-being in OSM, and informs our understanding of the lived experiences of OSM. Part of a symposium sponsored by Rainbow Research Group Interest Group.
Bridging the Gap in Quality Among High Medicaid Nursing Homes: The Role of Management and Community Factors
Authors: Weech-Maldonado Robert
Published: December 2020

Nursing home quality has been a matter of long-standing policy interest at the federal and state level, as it concerns the health and well-being of one of our most vulnerable populations. Mor et al. (2004) described the nursing home industry as a ‘two-tiered’ system, with the lower-tier nursing homes operating in a resource-constrained environment given their high proportion of Medicaid residents (85% or higher). Medicaid is the largest payer of nursing homes but its reimbursement rates typically lag Medicare as well as private pay. Lower tier facilities are characterized by lower professional staffing and occupancy rates, and worse quality. Such facilities have a higher proportion of minority residents and are generally located in communities with significant proportions of poor and minority residents, exacerbating the existing disparities in nursing home care. However, there are performance variations among high Medicaid nursing homes, with some facilities performing significantly better than others on both quality and financial performance. What may explain the superior performance of certain nursing homes that are operating in a similarly resource-constrained environment? Factors, such as management resources and environmental resource availability, may be the critically important differentiators. The purpose of this symposium is to examine the organizational/management and community factors that may be associated with high-performance among a similar group of resource-constrained nursing homes. Using survey, secondary, and qualitative data analysis, this symposium will explore the role that culture change, leadership style, human resource management practices, knowledge management, and community factors can have on nursing home performance.
The Impact of Leadership Styles on Quality and Financial Performance in High Medicaid Nursing Homes
Authors: Lord Justin , Ghiasi Akbar , Davlyatov Ganisher , Weech-Maldonado Robert
Published: December 2020

This study examined the association between leadership styles (autocrat, consultative autocrat, consensus manager, and shareholder manager) and resident quality and financial performance in under-resourced nursing homes. Survey data from 391 Directors of Nursing were merged with secondary data from LTCFocus, Area Health Resource File, Medicare Cost Reports, and Nursing Home Compare. Two multivariate regressions were used to model the relationship between leadership styles and the dependent variables: nursing home star ratings (1-5) and operating margin. The independent variables were composite scores for leadership styles, while control variables included organizational and county-level factors. Results show that compared to autocratic leadership, the consultative autocrat (solicits feedback but has total authority) was associated with lower quality (p < 0.05), while the consensus manager (delegates authority to the group) was associated with lower profit margin (p < 0.05). Under-resourced facilities need to recognize trade-offs of different decision making styles for performance.
The Meaning of Age or Generational Differences in U.S. Political Values and Priorities
Authors: Gonyea Judith , Hudson Robert
Published: December 2020

Nations globally are facing the fiscal consequences of being aging societies, including the redistribution of wealth resources across sectors that influence generational relations (i.e., healthcare, education, public pensions). Political differences or clashes between youth and older adults is not a new phenomenon. However, questions are being raised about whether current political systems, governing structures, and social trends are eroding generational solidarity which traditionally has a role in promoting equity and protecting vulnerable individuals from rapid social change. Reflecting on the 2020 national election results and political opinion surveys, we explore the meaning of age or generational differences in political attitudes in an increasingly partisan society. We suggest that the use of a generational location or habitus lens, which focuses on the distinct sociohistorical realities (i.e., different reference points, systems of aspiration, sets of anxieties) that shape age groups and their interrelations, may offer insights into current political debates and divides.
Caregiver Needs: Navigating Services, Technology, and Information
Authors: Whiting C Grace
Published: December 2020

Data suggests that caregivers may be taking on this role without adequate and affordable services and supports in place. Few caregivers report access to paid help and find it difficult to navigate a healthcare system that is complex and that changes continuously. Caregivers find it challenging to coordinate their recipients’ care across various providers, and the lack of affordable services make it difficult to be a caregiver today. While many caregivers rely on health care professionals (such as doctors, nurses, or social workers) as a source of information about providing care, few caregivers report having conversations with them about what they need to care for their recipient or to support their well-being. In this section, the presenter will discuss the needs of caregivers (respite, transportation, information, and training), focusing on policy and programmatic solutions geared to improving the well-being of caregivers and those under their care.
Efforts for Construction of More Effective Prevention and More Inclusive Protection Systems in Matsudo City
Authors: Wada Tadashi , Suda Hitoshi , Sato Kana
Published: December 2020

Matsudo City is preparing to implement an ordinance so that 3 protective services for children, older persons, and people with disabilities can work together for efficient prevention. Supporting pregnant women is sometimes effective for prevention of future child abuse. Supporting people with disabilities is often prevention of future neglect caused by them. Supporting perpetrators and victims of domestic violence is effective to prevent future elder abuse by interruption of abusive behaviors. We expect to prevent abuses by affiliation of various protective and supportive services. According to the Elder Abuse Prevention Law, elder abuse is defined as those inflicted by caregivers. Therefore, there is a big problem that abuses by non-caregivers are excluded from the coverage of the law. We are currently investigating abuses by non-caregivers to clarify the proportion of excluded cases among those reported to Elder Protective Services. I would like to talk about preliminary result of our investigation.
Advocacy as an Academic and Nurse Practitioner
Authors: Martin-Plank Lori
Published: December 2020

The first speaker is Dr. Lori Martin-Plank, an established academic at the University of Arizona, College of Nursing. Dr. Martin-Plank will provide her experiences in advocating for older adults in Pennsylvania and nationally through professional organizations, meeting with coalition partners to promote access to care for vulnerable older adults in rural areas by promoting full practice authority for nurse practitioners, and advocating for full home health authority for nurse practitioners. Dr. Martin-Plank will share how she is active in advocacy and policy at the local, state and federal levels, and how to build a presence and relationship with legislators on The Hill and State Capitol. Dr. Martin-Plank is a family, gerontological, and mental health nurse practitioner, practicing in Pennsylvania, New Jersey, and Arizona.
Involvement in State and Federal Aging Policy
Authors: Solway Erica
Published: December 2020

The fourth speaker is Dr. Erica Solway. Dr. Solway will discuss her experience working in policy at the federal level as a Health and Aging Policy Fellow and a policy advisor with the U.S. Senate Committee on Health, Education, Labor, and Pensions Subcommittee on Primary Health and Aging and in her current involvement in policy-relevant research at the state and national level at the University of Michigan Institute for Healthcare Policy & Innovation. Dr. Solway is a senior project manager forthe evaluation of the Healthy Michigan Plan, Michigan’s Medicaid expansion program, and is also an associate director of the University of Michigan National Poll on Healthy Aging.
Developing Age-Friendly Communities: Comparative Research on the Role of Social Infrastructure and Inclusion
Authors: Phillipson Chris , Yeh Jarmin , Phillipson Chris
Published: December 2020

Aging experiences are often framed by the forms in which communities take shape. In turn, the material forms of communities provide the conditions in which aging experiences and processes are produced. These multidirectional pathways of influence between micro-macro contexts comprise an assemblage of networks that usually go unnoticed, except on breakdown. Applying Leigh-Star’s (1999) charge to study these networks as infrastructure, we examine their “invisible work” in the ecological analysis of aging in community. This symposium presents research using community-embedded methods to illuminate how paradoxical forms of transparent and opaque infrastructure facilitate and mediate interactions between people, things, and the environmental shapes that hold these interactions. Yarker’s comparative case analysis of two Manchester neighborhoods highlight the critical importance of social infrastructure in supporting the diversity of relations needed to develop age-friendly communities and new forms of community action amongst older people. Grove’s qualitative and geo-spatial approaches demonstrate how planned and unplanned social interactions, and variety of social infrastructural forms, contribute positively and negatively to ageing well for older people in Dublin. Simon-Rusinowitz’s three-part intervention addresses unmet needs of older Baltimore residents in a low-income community; finding, in part-one, that housing is a platform for providing health and social services needed to age successfully. Yeh compares the conceptual frames undergirding age-friendly community initiatives with expert knowledges and lay perspectives of older San Franciscans, revealing tension between the rational dreams and material realities of aging in the community. These presentations contribute to gerontological discourse, providing new insights for policy and practice considerations.
Race, Class, and the Nursing Home Workforce: Experiences of Staff of Color in High-Minority-Proportion Nursing Homes
Authors: Akosionu Odichinma , Dill Janette , Nkimbeng Manka , Skarphol Tricia , Shippee Tetyana
Published: December 2020

The long-term services and supports workforce is an important part of delivering quality care for nursing home (NH) residents – and increasingly includes staff who are from diverse communities. Our study captured staff (n=61) perspectives on resident quality of care and quality of life through semi-structured interviews, using thematic analysis in six Minnesota high proportion minority NHs. Findings show that although staff of color are valued for the diversity they contribute to the workforce, and the culturally sensitive care they provide, they are also exposed to discriminatory events. In addition, tensions exist between U.S. and non-U.S. born staff of color in NHs. Overall, staff of color who are lower ranked may feel less empowered. Research is needed to explore the impact of negative and discriminatory exposures on staff wellbeing and related outcomes in addition to the direct and indirect impact on the quality of care delivered to NH residents.
Family Caregiver Assessments: What Have We Learned From Assessments Across Populations and Health Conditions?
Authors: Prudencio Gabriela , Gitlin Laura
Published: December 2020

This symposium will bring together research on assessments of family caregivers for older individuals with different health conditions and discuss the components of effective assessments. Comprehensive characterizations of caregivers are essential due to an increase in the demand on caregivers, and how intense care contexts contribute to the caregiver’s decline in health and diminished capacity to provide quality care. According to Caregiving in the U.S. 2020 (n=1,400), only 13% of caregivers were asked by healthcare professionals what they needed to take care of themselves. Peer-reviewed studies have reported that caregivers are often reluctant to self-identify and to ask for the help that they need for themselves and those in their care. Since supports to caregivers have historically relied on this self-identification, the first presentation (Grace Whiting) will focus on the work NAC has done to build pathways between caregivers and supportive services to increase availability, accessibility, and patient-centeredness. The second presentation (Esther Friedman) will identify and discuss the barriers to fully incorporating family caregivers into the health care team, as well as the solutions for removing barriers. The next two presentations, respectively, will focus on characterizing the prevalence, burden, and unmet needs of caregivers of cancer patients (Erin Kent), and the unmet needs of families of adults with intellectual and development disabilities (Tamar Heller). The final presentation will explore caregiver readiness in dementia care using the Tailored Activity Program (TAP) and how TAP interventionists can use readiness scores to determine caregiver’s capacity (Katherine Marx).
Poetry Brings Out the Best in Us: Structured Poetry-Based Group Activity in Long-Term Care
Authors: Kaplan Daniel , Glazner Gary
Published: December 2020

The Alzheimer’s Poetry Project has a proven track record at over 500 facilities in 35 states and six countries, serving over 50,000 people worldwide, and has the ability to bring high-quality creative arts programming to people living with dementia in long-term care. We describe how volunteers and recreation and care staff can be trained to deliver the intervention, offering direct benefits for participants and indirect benefits when modeled in the presence of providers and family members. Basic validation techniques are easily learned and incorporated into diverse dementia care strategies. As activity programs based in creative arts help to support self-expression among participants and serve as a vehicle for generating feelings of self-efficacy, we explain how such activities are well suited to fostering the person-centered goals of dementia care programming. Clinicians and other transdisciplinary care providers are encouraged to use and teach validation-focused arts interventions with persons living with dementia.
Improving Communication for Older Adults During Disaster Events
Authors: Gibson Allison , Kusmaul Nancy , Brown Lisa
Published: December 2020

Management of any disaster event (i.e., hurricanes, flooding, wildfires, viral pandemic) is a complicated task. An important and frequently overlooked aspect of efficient disaster response is effective information exchange among emergency managers, aging and social service providers, and those impacted by the disaster. Breakdowns in communication are regularly cited as failures in actual emergency situations. Older adults have unique challenges to effective communication during a disaster event. Further, messaging platforms may be inaccessible to older adults. Given the lack of data collected on the role of effective communication for older adults in a disaster event, we developed this symposium to highlight lessons learned for facilitating disaster communication among older community members and discuss how policy can further disaster communication efforts. The first presentation highlights the advantages of using targeted marketing communication channels to encourage older adults to prepare and recover from a disaster, as well as the value of collaborative partnerships in this communication. The second presentation introduces results from research collected from older adults on their use of social media to stay informed before and after Hurricane Matthew. The third presentation explores whether assisted living communities in Florida’s affected counties evacuated or sheltered in place in the context of emergency management communications concerning evacuation. The fourth presentation highlights the experiences of older persons in Houston’s communication post-Hurricane Harvey from an aging service provider’s perspective. The final presentation discusses disaster literacy and how this model can be used to enhance outcomes at all phases of a disaster. Disasters and Older Adults Interest Group Sponsored Symposium.
A Tale of Two Disasters
Authors: Mermelstein Tammy
Published: December 2020

Preparing for or experiencing a disaster is never easy, but how leaders communicate with older adults can ease a situation or make it exponentially worse. This case study describes two disasters in the same city: Hurricane Harvey and the 2018 Houston Texas Ice Storm and the variation in messaging provided to and regarding older adults. For example, during Hurricane Harvey, the primary pre-disaster message was self-preparedness. During the storm, messages were also about individual survival. Statements such as “do not [climb into your attic] unless you have an ax or means to break through,” generated additional fear for older adults and loved ones. Yet, when an ice storm paralyzed Houston a few months later, public messaging had a strong “check on your elderly neighbors” component. This talk will explore how messaging for these events impacted older adults through traditional and social media analysis, and describe how social media platforms assisted people with rescue and recovery. Part of a symposium sponsored by Disasters and Older Adults Interest Group.
The Long-Term Effects of Financial Hardship on Health: Pre and Post the Great Recession
Authors: Marshall Gillian
Published: December 2020

Purpose: Now 10 years after the Great Recession of 2018, we examined the impact and long-term health outcomes impacting adults (≥ 50 years). Methods: Data from the Health and Retirement Survey (sample n=5,160), was used to examine how changes in financial hardship pre-post the Great Recession of 2008 impacted the likelihood of developing new chronic conditions in 2016. Results: Preliminary results suggest that reduced medication use during the recession was significantly correlated with a higher likelihood of developing arthritis, lung disease, psychological conditions, depression, and greater deterioration of mental and physical health relative to an absence of reduced medication use in 2006 and 2010 (1). Conclusion: These findings underscore the adverse influences of increased financial hardships that impact medication use during recessionary periods on long term health and wellbeing of older adults. They also provide evidence of deleterious effects on health of difficulty paying bills throughout the study period.
Women’s Social Empowerment and Gender Differences in Adults’ Cognitive Competences
Authors: Weber Daniela
Published: December 2020

Female social empowerment has the potential to enhance women’s cognitive abilities. Our previous work investigating the role of gender equity in education and improved living conditions during early adulthood suggest that European women gain more from societal improvements over time than their male counterparts. This study extends this work by investigating the association between women’s social empowerment during childhood and gender differences in adults’ cognition for more than 30 OECD countries. We analyze established cognitive competence measures in literacy and numeracy with mixed effect models using the national survey data PIAAC collected within three rounds in 2011, 2014, and 2017. Our preliminary findings suggest that gender equity factors associated with women’s empowerment, are more beneficial for women’s cognitive key competences than men’s. High cognitive competences are particularly relevant at advanced age to enable an independent life and long economic activity.
Lest Death Do Them Part: Protection of Older Women From Intimate Partner Injury and Fatality
Authors: Wilson Janet , Benefield Lazelle
Published: December 2020

Protecting and preventing older women from fatal and near fatal violence by current or former intimate partners are public health and international human rights concerns. Older women are most often killed (“femicide”), injured in the home by a spouse, partner, x-partner, or family member. Older women experience physical, psychological, sexual abuse, neglect, and financial exploitation. Wherein there is more research on risk factors, study of protections lags behind. Through three very different studies, risks and protections will be explored with national and international policy implications for each.
Injury of African American Women by Financial Exploitation
Authors: Jackson Kimethria , Smith Patsy , Wilson Janet
Published: December 2020

Financial exploitation (FE) is one of the most common forms of older adult mistreatments. The World Bank defines FE as financial violence and the World Health Organization describes FE as financial or material abuse. Both international organizations recognize that FE causes deprivation/neglect leading to physical and emotional injury to victims. Older African Americans (OAA) are disproportionately affected by FE, impacting their health and welfare. A qualitative phenomenological study explored the lived experiences of FE among OAA. A Community Based Participatory Research approach was used to partner with a predominately African American-faith based community. Participant recruitment (n=12) was through community sponsored seminars that included verbal presentations, group discussions; individual surveys, Older Adult Financial Exploitation Measure (OAFEM). OAFEM data was analyzed to identify risks. Analysis of the interviews included Open and Axial coding, and data categorization. Using NVivo, Stevick-Colaizzi-Keen analysis as modified by Moustakas, five themes emerged.
Identifying the Transportation Needs of a Rural Aging Community: Findings From a Community Assessment
Authors: Miller Vivian , Wilfong Jordan , Burek Melissa , Lanson Logan
Published: December 2020

Community senior centers are tasked with providing aging adults services and programs, congregate meals, and transportation, set forth by the Older Americans Act. The overall function of senior centers is especially critical for rural communities, as rural communities are home to a greater proportion of older adults compared to metropolitan and low-density urban areas. To assess the current needs of the aging population in rural Northwest, OH, a total of 9 focus groups were held (N=45) as part of a larger mixed-methodological study. Through this work, older adults identified limitations of the current senior center transportation. A lack of transportation and accessibility of current transportation were noted as barriers to full senior center use. Findings from this study confirm disparities in rural transportation; a lack of transportation is a major obstacle to program completion. Recommendations address the unique challenges and needs for transportation services for in rural communities are presented.
Service Development and Implementation: Learning From Diverse Case Examples
Authors: Ayalon Liat , Wyman Mary , Martin-Matthews Anne
Published: December 2020

The development of health and social services should be based on a thorough needs assessment with all stakeholders, followed by ongoing monitoring of implementation and subsequent short and long term outcomes. Relying on four different service models, this symposium reviews their evaluation processes and summarizes the main lessons learned, in order to inform future efforts. Wyman and colleagues outline efforts to develop culturally-sensitive dementia care services for American Indian and Alaska Native older adults and caregivers using qualitative interviews and community-based participatory research methods. Findings offer guidance for culturally-tailored implementation of services. Shepherd-Banigan et al. report on a quantitative needs assessment of over 1,500 caregivers of older Veterans enrolled in Veterans Administration healthcare. Providing care to individuals with co-morbid conditions predicted higher levels of distress and burden among caregivers, pointing to likely benefit from additional caregiver-focused support programs. The paper by Gum and co-authors moves to assessment of outcomes by examining mortality and other outcomes among older adults screened by an Area Agency on Aging and either receiving or waiting for services. Finally, the paper by Ayalon and Shinan-Altman use service evaluation to demonstrate the importance of needs assessment and the gap between the vision of service developers and real life constraints. The included papers discuss the value of various methodologies, illustrating the important role that assessment and evaluation play in service development and implementation for older adults and caregivers.
Perspectives on Dementia Service Use and Family Caregiving Among the Oneida Nation of Wisconsin
Authors: Wyman Mary , Lambrou Nickolas , Miller Debra , Wheelock Sunshine , Petri Florence , Summers Marlene , Gleason Carey , Edwards Dorothy
Published: December 2020

Prevalence of dementia among American Indian/Alaska Natives (AI/AN) is higher than in white populations, and AI/AN communities experience dementia care service gaps. This study explored perspectives within AI/AN communities regarding dementia, the family caregiver role, and home and community-based service use. Using tenets of Community-Based Participatory Research, qualitative interviews and a brief survey were conducted with 22 members of the Oneida Nation of Wisconsin (mean age 71 years, 73% female). Of the sample, 63.6% identified as a past or current family caregiver for a loved one with dementia. Awareness of services varied; 82% were aware of memory cafes, 75% knew of the caregiver support group, and 43% were familiar with dementia care specialist services. Thematic analysis revealed shared values of involving the family and community in dementia care, and offer guidance to support greater engagement in services. Implications for culturally-tailored service provision within AI/AN communities are discussed.
Housing Context and Social Networks Among Lower Income Older Adults
Authors: Webster Noah
Published: December 2020

Housing context among lower income older adults plays an important role in shaping access to resources and ultimately well-being. We know very little about how housing influences access to social resources. This study examines the association between housing context (multi-unit vs. free-standing homes) and network structure among a U.S. nationally representative sample of independent living, lower income (<$15,000 in past year) adults age 65+ from the National Health and Aging Trends Study (N=1,795). Regression analyses indicate the housing-networks link is moderated by martial/partner status and gender. Among those married/living with a partner, living in multi-unit buildings (compared to free-standing homes) is associated with larger networks (i.e., more people to talk with about important things). Among women, living in multi-unit buildings was associated with more friends and neighbors in one’s network. Findings highlight variation in access to social resources across housing contexts. Findings should inform policy aimed at reducing social isolation.
Something Old, Something New: The Modernization of the Older Americans Act
Authors: Bangerter Lauren , Prusaczyk Beth , Kaskie Brian
Published: December 2020

The Older Americans Act (OAA) is the foremost federal law focused on the wellbeing of aging adults in the US. Since its conception 1965, the OAA has sought to optimize the lives of aging Americans, with emphasis on low-income adults, through programs that promote nutrition, transportation, support caregivers, offer employment, and combat elder abuse. This symposium will explore the modernization of the 2020 OAA, which was last reauthorized in 2016. Presentations 1 and 2 will focus on important updates to the definitions used throughout OAA (Title I). Presentation 3 will cover several noteworthy changes to improving grants for states and community programs on aging’s (Title II). Presentation 4 will provide additional context to amendments made to modernize activities for health, independence, and longevity (Title III) prioritize senior Community Service Employment Programs (Title IV) and enhance grants for Native Americans (Title V). Presentation 5 explores the modernizing allotments for vulnerable elder rights protection activities and other programs (Title IV) included changes in funding and home and community-based best practices and elder justice activities. Collectively, these presentations will provide an overview of the key changes in the reauthorization of the OAA. This work will allow GSA attendees to understand the specific efforts to modernization this critical legislation to better serve the aging US population.
Title 1 Changes: Bringing the Older Americans Act Definitions to 2020
Authors: Eagen Thomas
Published: December 2020

This session will review the changes to Title I of the Reauthorization of the Older Americans Act. This title provides important updates and modernization to the definitions used throughout the Older Americans Act. Some definitions were modified such as adding the prevention of sexually transmitted diseases, chronic pain management, and screening for suicide risk to evidence-based health promotion programs under the definition of disease prevention and health promotion services. Other changes include services to provide screening for fall-related injuries, services that are responses to public health emergencies, and services to prevent and address negative health effects associated with social isolation. Title I also includes a series of important including access to person-centered services and coordinating services provided by aging and disability resource centers. Several other changes to Title I will be discussed.
Positive Attributes of Aging and Connections to Health: Evidence From the National Poll on Healthy Aging
Authors: Solway Erica , Allen Julie Ober , Kirch Matthias , Singer Dianne , Kullgren Jeffrey , Malani Preeti
Published: December 2020

This study explored the prevalence of positive attributes of aging among older adults in a nationally representative sample age 50-80 ((N=2,048, 52% female, 71% White). Nearly 70% of older adults reported that people sought their guidance because of their wisdom and experience. Older adults reported that, as they have gotten older, they have become more comfortable with themselves (88%), have a strong sense of purpose (80%), feel more positively about aging (67%), and have found their life to be better than they had thought it would be (65%). Over half (52%) of those who said their lives were better than they thought reported very good or excellent physical health. Among those who disagreed, only one out of four (25%) reported very good/excellent physical health; similar results were found for mental health (48% vs. 22%). This session will describe positive attributes of aging and their association to physical and mental health.
Socioeconomic Inequalities in Care Receipt at Older Ages: A Comparative European Study
Authors: Floridi Ginevra , Carrino Ludovico , Glaser Karen
Published: December 2020

This study is among the first to investigate whether and how socioeconomic inequalities in the receipt of formal and/or informal care by disabled older adults vary across long-term care (LTC) systems. We link data from the SHARE survey with LTC system indicators for 136 regions in 12 European countries in 2015. Using multinomial multilevel models with cross-level interactions, we test whether and how income and wealth gradients in the receipt of only informal, only formal, and mixed care vary with the number of beds in residential LTC facilities across regions. We find pro-rich inequalities in the receipt of formal and mixed care only in regions with low or intermediate numbers of LTC beds, and no inequalities in regions with greater availability of residential beds. Our findings suggest that the presence of extensive formal LTC services may lead to a fairer distribution of formal and mixed care use across socioeconomic groups.
Policy Series: The Older Americans Act Reauthorization: Major Successes and Shortcomings
Authors: Lindberg Brian
Published: December 2020

This session provides an update on the2020 Older Americans Act (OAA) reauthorization process and passage of the new law “Supporting Older Americans Act of2020.” Presenters will provide insights on both the content of the new law and the process that led to the bicameral, bipartisan legislation. Speakers will include representatives of the aging network and other stakeholders, who will discuss key changes to the OAA and how they may be implemented over the next five years.
Age-Friendly Care, PA: A Collaborative for Age- and Dementia-Friendly Care
Authors: Husser Erica , Fick Donna , Hupcey Judith , Knecht Fredo Jenny
Published: December 2020

The Penn State College of Nursing (including the Center for Geriatric Nursing Excellence [CGNE] and Center for Nursing Research [CNR]) has partnered with the Primary Health Network (PHN) to work collaboratively toward implementing the 4Ms framework of an Age-Friendly Health System at PHN’s primary care sites in Pennsylvania. PHN is the largest FQHC in the state and spans 16 counties in PA and 2 in Ohio. Twenty of PHN’s PA primary care sites are in rural counties, and both rural and urban sites serve older adult populations with major health disparities. Connecting primary care practices with local community resources and programs is an important step in serving rural populations, and we have used the ECHO model to help facilitate connections. This session will focus on how we are using the ECHO model to engage our partners in a collaborative learning environment.
Using Subjective and Objective Measures of Financial Situation to Improve Program Outcomes for Older Adults
Authors: Ortiz Hector , Mutchler Jan
Published: December 2020

Researchers in the field of aging rely on various measures of financial security to assess the needs of older adults and the outcomes of interventions. Recently, subjective measures have gained attention among researchers and organizations that serve older adults. This symposium brings together researchers from academia, government, and the non-profit sector to discuss the relationship between subjective financial well-being and objective financial situation. The first project describes the relationship between the Consumer Financial Protection Bureau’s Financial Well-being Score and the Elder Index. The CFPB Financial Well-Being Score provides a standardized and validated measure of a person’s sense of financial security and freedom in the present and future. The Elder Index provides a measure of older adults’ income against the average income needed for adults age 65 or older to live independently in their communities. The second project discusses the findings of a study into the changes in outcomes among older adults assisted through the National Council on Aging’s Benefits Enrollments Centers. The third project describes the overall findings and changes in financial well-being among SCSEP participants who attended a series of financial education workshops offered through the Benjamin Rose Institute on Aging’s subsidiary Empowering and Strengthening Ohio’s People. Together, the studies show that both measures are, on average, strongly correlated and predictive of a range of factual experiences such as material hardship and financial stress. The studies, however, show that subjective measures may help identify and target underlying behavioral and attitudinal factors that influence people’s satisfaction with their economic situation.