bluuebunny/crossref_metadata_2025 huggingface dataset:
MORE THAN JUST A ROOM: RESULTS FROM AN INTERGENERATIONAL HOME SHARING PROGRAM IN TORONTO
Authors: Mirza Raza M , Martinez Laura , Austen Andrea , McDonald Lynn , Klinger Christopher , Hsieh Jessica , Salomons Tonya
Published: November 2019

Older adults prefer to live in their own homes for as long as possible — to ‘age in place’ — but for myriad reasons may be unable to do so. To address this, a number of housing alternatives have been explored, including homesharing, or homeshare, an exchange-based shared housing approach with the potential to empower older adults to age in place by enabling them to obtain additional income, companionship, and assistance with completing household tasks in exchange for renting out a room in their home. An intergenerational homesharing pilot program was launched in Toronto, matching older adults (55+) with postsecondary students. With limited research in the area, a mixed methods research study was embedded within the pilot project with the goals of: 1) conducting a scoping review to map and synthesize the literature related to outcomes of homeshare participation for this population, 2) conducting in-depth interviews with homeshare participants (N=22) to learn about their experiences, and 3) conduct a full evaluation and exit survey to better understand the implications of the project. Results were organized around the following themes: (1) benefits and challenges of participating in homeshare for older adults; (2) intergenerational engagement as social exchange; and (3) the key role of agency facilitation as a determinant of the experience of homesharing for older adults. Results spoke to the unique benefits and challenges of participating in homeshare for this population. Findings were used to derive implications for policy and practice, as well as highlight areas for future research.
BARRIERS AND FACILITATORS TO IMPLEMENTING THE BALANCING INCENTIVE PROGRAM (BIP)
Authors: Beauregard Lisa , Miller Edward A
Published: November 2019

The Balancing Incentive Program (BIP) was an optional Medicaid program within the Affordable Care Act. States spending less than 50% of Medicaid long-term services and supports on home and community-based services (HCBS) were eligible for the program and could participate from 2011 to 2015. Participating states received an enhanced federal match in exchange for rebalancing LTSS spending and adopting structural changes to their long-term services and supports system. The purpose of this study is to understand the barriers and facilitators to implementing the BIP in two states. Data was collected through semi-structured interviews with individuals involved in HCBS policy nationally and in Maryland and Texas, including government bureaucrats, consumer advocates, and provider representatives. Findings indicate that factors that facilitated Maryland and Texas’ implementation of the BIP were regular communication with the Centers for Medicare and Medicaid Services and their consultants, Mission Analytics Group, merging the BIP with existing HCBS programs, and the substantial amount of funding associated with the program. On the other hand, the short duration of the BIP presented a challenge for states because they needed to enact multiple changes within a limited period of time. In addition, state procurement and contracting processes impeded the speed with which BIP requirements could be met. Key stakeholders, including consumer advocacy and provider organizations, often felt as though their state implemented the BIP with minimal input from interested groups. The findings indicate that the structure of the Balancing Incentive Program as well as internal state factors influenced the program’s implementation.
RURAL-URBAN DISPARITIES IN UNMET LONG-TERM CARE NEED AND COMMUNITY CARE SERVICES EXPECTATION AMONG ELDERLY IN CHINA
Authors: Zeng Yanbing , wang lixia , Fang Ya
Published: November 2019

Objective This study aimed to examine the urban-rural differences of unmet needs and their expected LTC services among community-dwelling old people. Methods The data comes from the Chinese Longitudinal Health Longevity Survey (CLHLS) in 2014. A total of 1587 community residents aged 65+ with disability of activities of daily life (ADL) were included in this study. Binary logistic regression was used to estimate correlates of unmet need in LTC. And chi-square test was used to examine the differences of expected community-based LTC services between urban and rural area. Results Over half (55.07%) of the participants reported their need were unmet. For both rural and urban residents, poorer economic status and reluctant caregivers (ORs>1, P＜0.01) seriously affected the unmet need. Besides, of urban older adults, people who were male and lonely(ORs>1, P＜0.05) reported more unmet need. While of rural old ones, people who were with severe ADL disability and poorer self-rated health(ORs>1, P＜0.01) reported more unmet need. And people with available medication and home visit services(ORs<1, P＜0.01) reported more met need. However, the supplies for community LTC care services were far below the demands. Conclusion The risk of having unmet need associated with ADL disabilities in LTC is largely determined by their economic status and caregivers’ willingness to provide care for both rural and urban old people. There is a need for an overall improvement in the planning, provision and financing of long-term care services for elderly individuals in China.
AWRAMBA COMMUNITY-BASED CARE FOR ELDERS LACKING FAMILY SUPPORT IN ETHIOPIA
Authors: Adamek Margaret E , Ali Setegn
Published: November 2019

In rural Ethiopia, land fragmentation, poverty, rural-urban migration, and the expansion of market forces are negatively impacting family support for older persons. This study explored an innovative community-based support system that uses its own wealth redistribution mechanism to support congregate residential care for older persons. The Awramba Community in northwest Ethiopia has different social norms and values that make it unique from surrounding communities. To explore this new approach to meeting the needs of rural elders, primary data were obtained from in-depth interviews with 8 elders who reside in the older adult center, 3 focus group discussions, and personal observations. In addition, key informant interviews were conducted with a full-time caregiver, two community leaders, and members of the Older Persons’ Support Committee. Interviews explored the types of services provided to older persons, the interactions of older residents within the community, and the benefits of congregate living. Community members (N=403) must agree to 4 guiding principles relating to gender equality, respecting the rights of children, discouraging dishonesty, lying and stealing, and helping the less fortunate, ill and older persons. The Older Person’s Support Committee is responsible for coordinating the provision of care for the older persons who live in the congregate center. Residing in a common residential home benefited the elders in multiple ways, including opportunities for socialization with peers and access to a full-time caregiver. As traditional family support wanes and the population of elders increases in developing nations, such alternative support strategies are critically needed.
ASSOCIATIONS BETWEEN DSM-5 PERSONALITY PATHOLOGY AND HORNEY’S INTERPERSONAL TRENDS AMONG OLDER ADULTS
Authors: Segal Daniel L , Stone Lisa E , Coolidge Frederick L , Krus Gabrielle
Published: November 2019

Introduction: The Personality Inventory for DSM-5 (PID-5) is a measure of the alternative model of personality disorders with limited evidence of validity among older adults. This study examined validity of the model through associations with the Horney-Coolidge Tridimensional Inventory (HCTI). Method: Older adults (N=125) completed the PID-5 and the HCTI. Results: Zero-order correlations were computed between the PID-5’s five domains (Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism) and the HCTI’s three domains (Compliance, Aggression, and Detachment). Compliance was moderately negatively correlated with Detachment (r = -.27), as expected. Aggression was significantly positively related to all five PID-5 domains and was most strongly correlated with Antagonism (r = .56), Psychoticism (r = .48), and Disinhibition (r = .32). As predicted, Horney’s Detachment was most strongly related to the PID-5’s Detachment (r = .48). Regression analyses were also conducted with PID-5 domains predicting each HCTI type. The Compliance model was significant, with PID-5 domains predicting 13% of variability in Compliance. Negative Affect (positive) and Detachment (negative) were significant predictors. The Aggression model was also significant, with the PID-5 domains accounting for 40% of variability. Antagonism was the only significant positive predictor. Lastly, the Detachment model was significant, with the PID-5 domains predicting 29% of variance in Detachment scores. Negative Affect (negative) and Detachment (positive) were significant predictors. Discussion: Results indicate that the two measures of personality pathology generally converge regarding theoretically similar constructs and diverge around dissimilar domains, providing evidence of validity of the PID-5 for its ability to capture personality traits.
WHAT DOES MY PERSONALITY SAYS ABOUT MY FRIENDSHIPS IN LATER LIFE?
Authors: Lim Emily , Gallagher Elizabeth A , Bui Cindy N , Beaulieu Celeste , Simpson Elizabeth , Driscoll Laura , Burr Jeffrey
Published: November 2019

Personality traits, such as those identified in the Big Five Personality Model (i.e., openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism), may be associated with different aspects of friendship among older adults. Additionally, men and women form and maintain their friendships differently, which may result in gender differences in their friendships. This study examined the relationship between specific personality traits and friendship characteristics, including friendship quantity, frequency of social interactions with friends, positive and negative friendship quality. The study also explored whether gender moderates the relationship between personality traits and friendships in later life. This study used data from 7,250 community-dwelling older adults, aged 65 years and above (M=75.4 years old, SD=6.91), who participated in 2012 and 2014 Leave-Behind Questionnaire of the Health and Retirement Study. Results from the linear regression analysis indicated significant main effects for the different personality traits and friendship quantity, quality and social interaction frequency, but no main effect for gender was found. However, the moderating effect of gender was significant for the relationship between specific personality traits (i.e. openness to experience, agreeableness and extraversion) and social interaction with friends, as well as for positive and negative friendship quality. For example, older women who scored high on openness to experience reported significantly lower social contact frequency with friends (B=-.16, p<.05) and higher negative friendship quality (B=.08, p<.05) than men who scored high on openness to experience. Study results provide insights for understanding better how personality traits and gender play a role in friendships in later life.
ASSOCIATION BETWEEN SOCIAL SUPPORT AND ANXIETY IN OLDER ADULTS NEW TO LONG-TERM SERVICES AND SUPPORTS
Authors: Hwang Yeji , Hodgson Nancy , Sefcik Justine , Boateng Augustine , Rajpara Anjali , Foley Kierra , Hirschman Karen
Published: November 2019

Anxiety symptoms are common among older adults and are often associated with adverse outcomes. Thus, it is important to examine modifiable factors and manage anxiety symptoms in this population. While many biological and psychological factors related to anxiety symptoms in older adults have been found, little is known about social factors which are essential in one’s mental health. The purpose of this study was to examine the prevalence of anxiety symptoms among older adults new to long-term services and supports (LTSS) and to investigate the relationship between social support and presence of anxiety. This was a secondary data analysis from a study funded to examine health related quality of life in older adults new to LTSS. Anxiety was assessed using a single item, “Recently, how often have you felt anxious?” and the answers were dichotomized into “anxiety” (ratings: ‘very often’, ‘often’, ‘sometimes’, and ‘seldom’) and “no anxiety” (rating: ‘never’). Social support was measured by Medical Outcomes Study Social Support Scale. Prevalence of anxiety symptoms in this sample was 82.7% (n=225). In multivariate logistic regression, adjusting for age, gender, LTSS type, cognitive status, physical and emotional health, and depressive symptoms, older adults with more tangible social supports had lower odds of having anxiety symptoms (Odds ratio=0.515; 95% CI: 0.289-0.919, p=0.025). Improving access to tangible social supports for older adults at the start of LTSS may impact anxiety in older adults. Implications for future research and intervention development to provide tangible social support to older adults in LTSS will be discussed.
FREE TRANSPORTATION SERVICE RECIPIENTS MAY HAVE BETTER QUALITY OF LIFE BUT STILL LACK IN IMPROVING HEALTH
Authors: Tomita Machiko R
Published: November 2019

This study aimed to determine if service recipients (SRs) of free transportation services experience better quality of life, health, and function compared to pre-service recipients (PSRs). We conducted a cross-sectional study using personal interviews with 43 PSRs and 30 SRs belonged to a volunteer organization. Outcome measures were Older People’s Quality of Life (QoL), Center for Epidemiology Study-Depression, and Instrumental Activities of Daily Living (IADL). Total sample (N=73) had a mean age of 78.5 years and mostly female (86.3%). The majority of PSRs wanted to go to Drs’ offices (74.4%) and Grocery stores (60.5%), followed by Drug stores (44.2%), when the service becomes available. The figures were substantially smaller among SR (40.0%, 30%, and 13.3%, respectively). In PSRs, 67.4% expected to improve health once they start receiving the service, and 70. 0% of SRs said it did with the service. Using independent t-tests, SRs were significantly better in depression (p<.001), IADL (p=0.29) and most QoL items (life overall, social relationship, home and neighborhood, psychological and emotional well-being and leisure and activities; p=.047-p=.001), except for perceived health and finance. SRs (100%) were very satisfied with the service and drivers, but 80% of SRs said they wished to use more driving services than the allowable four times per month maximum. This limitation was due to the insufficient number of volunteers compared to a large number of people in need. Availability of more volunteer drivers will likely improve SRs health. Effective approaches to increase the number of driving volunteers are necessary.
VOLUNTEER ACTIVITY CHANGES AFTER MIDDLE YEARS OLD AND THE INFLUENCES OF VOLUNTEERING ON WELL-BEING
Authors: Lee Hyunkee
Published: November 2019

The objectives of this paper are to examine volunteer activity changes over the life courses and the long-term influences of volunteer activity on the well-being. The paper analyzes the KLoSA data from wave 1 to wave 5, and selects 10,254 persons over 45 years old as study samples in the base year. For the statistical analysis, the two-way connected line plot and transition probability analysis techniques are employed and the GEE method is used for the multivariate regression estimation of the coefficients. The results show that the volunteer activities increase highest in one’s late 40s and decrease abruptly from the age, and slow down 50s to one’s late 70s, showing a repeating rise and fall pattern. Entering one’s 80s, the volunteer activities come to be stable relatively than the previous years. And, the probability of continuing the volunteer status after 2 years is about 31.2 percent and the probability of stopping volunteer activity comes to be around 68.9 percent. As a last, the regression analysis results show that there is a positive relationship between volunteerism and well-being variables. Expecially the interaction term is statistically significant, showing a negative sign of the coefficient. This implies that the volunteerism contributes to increasing the well-being but decreasing by engaging excessively. The results support the previous study outcomes that excessive volunteer activities are not good for the health.
TYPES OF SOCIAL NETWORKS AND THEIR ASSOCIATION WITH MOBILITY AND DISABILITY IN LATE LIFE
Authors: Ali Talha , Elliott Michael , Antonucci Toni C , Needham Belinda , Zelner Jonathan , Leon Carlos Mendes de
Published: November 2019

Social networks are critical in maintaining late-life functional health, but, previous studies have focused on isolated dimensions of social networks. We examined whether network types, representing multiple interrelated network characteristics, are associated with mobility and disability among older adults in America. Data are from the National Social Life, Health, and Aging Project, a nationally representative study of 3,005 adults aged 57-85 years at baseline (2005-2006). In a previous analysis, five social network types were derived at baseline, based on nine observed network characteristics. Functional outcomes were examined during two follow-up waves in 2010-2011 and 2015-2016. Mobility-related function was assessed as the time (in seconds) to complete a 6-meter walk. Disability was defined as experiencing any difficulty in performing one of six activities of daily living (ADLs). We estimated the effect of network types on risk of ADL disability onset using logistic regression, and on mobility using generalized linear mixed models. Social network type was associated with mobility over time, such that older adults in the “restricted” network had significantly slower walking times than those in the “diverse” network. There was no association between network types and risk of disability onset in the primary analysis. However, sensitivity analyses showed a protective effect of the “partner-centered” network on a 5-year, but not a 10-year, risk of disability onset. Network types can elucidate older adults’ varied interpersonal and caregiving networks, and identify adults at risk of being socially isolated. However, the utility of network types in predicting late-life functional health may be limited.
INTERGENERATIONAL RELATIONSHIPS AMONG OLDER ADULTS AND ADULT CHILDREN: AMBIVALENT FEELINGS
Authors: Humboldt Sofia von , Leal Isabel
Published: November 2019

Objectives: The relationship of older adults with their adult children involves great emotional complexity and the quality of these relationships is associated with older adults’ well-being. This qualitative study aims to examine how older adults conceptualize intergenerational relationships with adult children. Methods: The present study on qualitative data collected from in-depth interviews was conducted with English and Portuguese older adults living in the community, designed to address their perspectives on intergenerational relations with adult children. 316 older adults participated in our study. The mean age of this group was 71.2 years. 65.3% were women, and a majority (54.7%) had a partner. Results: Content analysis generated four themes: affection and integration; satisfaction in the relationship; privacy and boundaries; financial support. Conclusions: Intergenerational relationships are experienced by older adults with ambivalence and and stress the contradictory expectations of older adults with grandchildren.
SOCIAL NETWORK STRENGTHS: AN EXPLORATORY ANALYSIS OF A MEASURE OF TIES AMONG OLDER PEOPLE
Authors: LeBlanc Raeann G , Chiodo Lisa , Jacelon Cynthia
Published: November 2019

Purpose: To explore a self-report measure of social network features among a sample of older people living with multiple chronic conditions based on the conceptual model of Social Network Influences on Health. Design: A cross-sectional descriptive study design using a telephone survey methodology was used. Methods: An exploratory principle component analysis with a varimax rotation was performed on items that measured the identified components (reciprocity, size, proximity, density, general activation, activation when sick, duration, closeness, involvement in health, interaction frequency) of social networks. All items were standardized prior to analyses. Results: Self-report social network data were collected from eighty-four older people living in the community and managing multiple chronic conditions. The principal components model, operationalized as tie strength, contained six items based on factorability: reciprocity, social network size, proximity, density and perception of the activation in general and when sick of close social network members. Results yielded acceptable factorability (KMO = 0.781, Bartlett p 0.70). Two components that had eigenvalues greater than 1.0, explained 61.7% of the total variance. The first factor was interpreted as total social network resources, while the second factor was identified as social network availability. Conclusion: Exploratory principal component analysis supports a measure of social network features, tie strength, that can be tested in future studies. Assessing these variables is useful in identifying specific relationship features critical to managing chronic conditions in older age and advances current measurement of social networks important to living well in older age.
AGING DISPLAYED IN SELF-PORTRAITS OF ARTISTS
Authors: Gogol Manfred
Published: November 2019

A self-portrait is a common representation of an artist with different techniques by that artist and emerged since the 15th century. Albrecht Dürer was one of the first artists who performed various self-portraits during his life. The fascinating aspect from a gerontological point of view is that artists show themselves throughout the aging process as well as sometimes with manifest signs of diseases. The poster show self-portraits over the life course from Rembrandt van Rijn (1606-69), Vincent van Gogh (1853-90), Ferdinand Hodler (1853-1918), Lovis Corinth (1858-1925), Helene Schjerfbeck (1862-1946), Edvard Munch (1863-1944), Käthe Kollwitz (1867-1945), Pablo Picasso (1881-1973), and Max Beckmann (1884-1950).
NAVIGATING STREET AND SHELTER LIFE: THE CONSEQUENCES OF FORCED MOBILITY FOR OLDER HOMELESS WOMEN
Authors: Gonyea Judith G
Published: November 2019

Older homeless women have largely been an invisible population. Two co-occurring trends however are bringing them into the public spotlight—the aging and the feminization of the adult homeless population. Yet despite the steep increase in their numbers, relatively little research exists about how gender and age intersect to shape the homeless experience. Such information is critical if we are to transform our nation’s homeless system, which is based largely on a male model of homelessness, to better support women at risk or experiencing homelessness. In this presentation, we therefore share findings from our qualitative study of homeless older urban women. Using a phenomenological approach, we conducted and recorded semi-structured, in depth interviews with fifteen chronically homeless women in their fifties. Our analysis process was inductive and iterative with the culminating phases being the generation and interpretation of themes. Our analysis revealed the links between place, social connection, sense of belonging, and identity. The women’s narratives uncovered how the time-space discontinuity, created through homelessness, shaped the struggles they faced in trying to survive in degraded or threatening environments, altering their identities and impacting self-esteem. Also revealed was that mobility is a key factor to maintaining the place-identity connection. The women’s narratives highlighted how forced mobility with constrained choice not only led to their pathways into homelessness but also dominated their daily navigation of street and shelter life. We conclude by exploring the question of how we might redesign policies and programs to disrupt homelessness for women in later life.
REDUCING LONELINESS AMONG OLDER ADULTS WITH ANIMATRONIC PETS
Authors: Tkatch Rifky , Wu Lizi , Albright Laurie , Murphy James , Schaeffer James , Wicker Ellen , Yeh Charlotte S
Published: November 2019

Pet ownership has been examined as a solution for loneliness. However, multiple challenges of pet ownership exist for older adults. Therefore, research efforts are considering the use of animatronic pets to reduce loneliness. The purpose of this study was to determine if ownership of animatronic pets would decrease loneliness and improve well-being among lonely older adults. Individuals were identified as lonely through a prior survey. Participants were provided with their choice of either an animatronic cat or dog and completed T1, T2, and T3 surveys. Response rates were high; 167 (63%) completed T1 and T2, and 125 (48%) also completed T3. T2 data indicated that loneliness decreased, while mental well-being, resilience, purpose in life, and optimism improved. At T3 mental well-being and purpose and life continued to improve. Animatronic pets appear to provide significant benefits for the well-being of lonely older adults.
HISTORY OF CAREGIVING SURVEILLANCE AT THE CDC, 2005 TO PRESENT
Authors: Bouldin Erin D
Published: November 2019

Research on caregiving has been ongoing for decades, but little systematic data collection at the population level occurred until relatively recently. Surveillance data is critical because it provides an evidence base upon which to make informed decisions about allocating resources, targeting programs, and developing policy. In 2005, CDC and the Association for Prevention Teaching and Research funded Dr. Elena Andresen’s proposal to develop a set of questions about caregiving to be used on the BRFSS. This Caregiver Module was piloted in North Carolina and has been used – with some modifications – ever since as an optional module. The Caregiver Module has provided state-level data on the prevalence and types of caregiving provided by community-dwelling adults age 18 and older to people with a variety of conditions and needs. In 2009, the caregiver screening question was included on the BRFSS core, yielding a national estimate of caregiving prevalence of 24.7%.
ELIGIBILITY FOR LOW-DOSE COMPUTED TOMOGRAPHY LUNG CANCER SCREENING IN OLDER ASIAN AMERICAN SMOKERS
Authors: Li Chien-Ching , Choi Kelsey , Matthews Alicia , Shah Raj
Published: November 2019

Lung cancer is the leading cause of cancer-related deaths in Asian Americans. Low-dose computed tomography lung cancer (LDCT) screening is an effective way to decrease lung cancer mortality. This study aimed to examine the difference in LDCT screening eligibility among Asian American subgroups. The National Health Interview Survey data (2006-2016) was analyzed. The U.S. Preventive Services Task Force guideline was used to determine the LDCT eligibility. A higher and statistically significant proportion of current Filipino smokers (35.4%) met LDCT screening eligibility criteria compared to Chinese (26.5%) and other Asian smokers (22.7%) (p=0.02). Hierarchical logistic regression results further showed that Filipino were more likely to meet LDCT screening criteria than other Asian while adjusting demographics (OR=1.87; p=0.01). The differences in LDCT screening eligibility no longer existed after additionally adjusting socioeconomic factors as well as perceived health status. Future targeted outreach and intervention research is needed for Filipinos with lower socioeconomic status.
POSITIVE PSYCHOLOGICAL DETERMINANTS OF DEMENTIA IN JAPAN
Authors: Shirai Kokoro , Shirai Kokoro , Iso Hiroyasu , Sakaniwa Ryoto , Kondo Katsunori
Published: November 2019

We examined the effects of sustained levels of happiness on dementia incidence among Japanese elderly from the Japan Gerontological Evaluation Study. Data were from 12,051 community-dwelling participants aged 65 and over, free from dementia or other chronic conditions at baseline (2010). A survey was conducted in 31 administrative districts from Japan. Participants were followed-up for six years, and the incidence of dementia or death was assessed through National Public Long-Term Care Insurance and Resident Registry, Japan. We conducted survival analysis using the Cox proportional hazard model with a competing risk analysis accounting for death. The adjusted differences in days for dementia onset were estimated using Laplace regression models. In this analytical sample, we observed 520 men and 693 women with dementia and found that higher levels of sustained happiness were associated with reduced risks of onset of dementia among Japanese elderly. These findings suggest a protective role of psychological mood.
THE GOOD, THE BAD, AND THE UGLY: EXAMINING OUTCOMES OF TECHNOLOGY USE AMONG OLDER ADULTS
Authors: Cotten Shelia , Cotten Shelia R , Kadylak Travis
Published: November 2019

Older adults are increasingly using information and communication technologies (ICTs) to communicate with social ties, gather information to make decisions, and for entertainment purposes. Research is increasingly showing that using ICTs has a range of potential benefits for older adults. However, less research examines the potential negative outcomes of ICT use for older adults. Data from a nationally representative sample of older adults in the United States is used to examine positive and negative outcomes of ICT use. Traditional well-being and social connection outcomes are examined as well as new stressors associated with mobile phone use. Our findings suggest that ICT use has varying effects on older adults, depending upon the type, level, and purposes of use. Implications are discussed for entities seeking to encourage ICT use to enhance health and quality of life among older adults.
PERSON-CENTERED CARE TO DECREASE LONELINESS AND SOCIAL ISOLATION IN LONG-TERM CARE SETTINGS
Authors: Inoue Megumi , Hasegawa Mai , Tompkins Catherine , Donnelly Catherine
Published: November 2019

The older foreign/immigrant population is predicted to increase in the U.S. As a whole, this population faces greater challenges associated with loneliness and social isolation due to their smaller social networks, language and cultural barriers. Person-centered care should be considered as a potential solution to decrease loneliness and social isolation in long term care settings. In 2017, researchers conducted a thorough examination on the effects of a senior companion program on a Japanese woman with advanced dementia. Results suggest that the client benefitted from the program in regard to her physical wellbeing, emotional wellbeing, language communication and cultural support. Given the support of Japanese companions, the client was able to express her needs and health symptoms effectively and the staff were subsequently able to provide culturally-sensitive care. This study implies that the companion program may benefit other foreign/immigrant older adult populations in reducing social isolation and declining health.
ACCESSING LONG-TERM SERVICES AND SUPPORTS: HOW DO ETHNIC MINORITIES NAVIGATE THE SYSTEM?
Authors: Ring Lauren , Glicksman Allen
Published: November 2019

The decision to seek Long Term Services and Supports (LTSS) can be challenging for older adults and family members. These challenges can be greater for members of certain ethnic/cultural minority communities who are not fluent in English. Our study examines the ways in which older adults in limited English-speaking communities (Spanish / Mandarin Chinese) navigate the use of LTSS. The findings will be used to evaluate disparities in service perception and access experienced by these populations. Our research examines the ways in which information is shared among community members and how they identify trusted sources of information. Ultimately, we wish to examine how these social networks and trusted neighborhood institutions do, or do not, connect older adults in need to the formal LTSS system. We use a modeling technique called Social Interaction Modeling (SIM), which allows for the inclusion of both conceptual and data based elements, to frame this process.
GROUP-BASED PARTICIPATORY ARTS INTERVENTIONS: PRODUCING ART AND VALIDATION OF PERSONHOOD
Authors: Kaplan Daniel B , Glazner Gary
Published: November 2019

Participatory arts-based interventions for people living with dementia involve the collaborative creation and performance of poetry, story, song, dance, and visual arts. These programs are designed to support self-expression and productive collaboration among people living with dementia while stimulating positive social interactions and feelings of empowerment and validation. This paper explores the use and potential benefits of validation in the implementation of person-centered participatory arts interventions in the context of dementia care. The authors offer a theoretical framework for understanding validation as a common intervention method and participant experience during these interventions, organized into five themes: collaboration, connection, creation, communication, and confirmation. Basic validation techniques are easily learned and can be incorporated into a broad diversity of dementia care strategies and interventions including activity programs designed to stimulate cognitive, physical, and communicative abilities. Participatory arts programs offer tools for connecting to personhood in a population for whom such connections are under constant threat of erosion. 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, such activities are well suited to fostering the person-centered goals of dementia care programming. Clinicians and other transdisciplinary care providers are encouraged to understand, use, and teach these and other validation-focused arts interventions with persons living with dementia. These validation experiences are suggested to offer direct clinical benefits for participants as well as indirect benefits when modeled in the presence of formal care providers and family members.
INNOVATIVE STRATEGIES TO SUPPORT OLDER ADULTS AND THEIR FAMILIES IN HOSPICE AND PALLIATIVE CARE
Authors: Demiris George , Hirschman Karen
Published: November 2019

In order to better support older adults with life-limiting illness and their families, many initiatives utilize information technology and other innovative platforms to increase access to supportive services and bridge geographic distance. Such technologies cover a broad range of systems ranging from smart phone applications to wearables and traditional telehealth platforms. There is a growing evidence base for such interventions but technical, clinical and ethical challenges remain when utilizing technology in the context of hospice and palliative care especially for older adults, including the concerns for caregiver burden, privacy, security, confidentiality, obtrusiveness and accessibility. In this symposium we provide an overview of innovative tools available for interventions in palliative and hospice care designed for patients and/or family caregivers in urban and rural settings. We provide lessons learned from three NIH funded studies testing different technology-based interventions in various settings including home hospice and outpatient palliative care. Discussion will follow focused on the clinical, ethical and practical challenges of innovation and the unique considerations for technology-mediated intervention design in a variety of palliative and hospice care settings. This symposium aims to provide: 1. an overview of existing technology-based interventions for older adults and their families in palliative care and hospice 2. evidence-based recommendations resulting from clinical trials in urban and rural settings for the design and implementation of innovative tools in hospice and palliative care 3. a discussion of challenges and opportunities for the use of technology to support older adults and their families
INTEREST GROUP SESSION—HUMAN-ANIMAL INTERACTION: PETS IN OLDER ADULTS’ SOCIAL NETWORKS: HUMAN-ANIMAL INTERACTION, INTERPERSONAL CONNECTIONS, AND HEALTHY AGING
Authors: Bibbo Jessica , Branson Sandy , Bibbo Jessica
Published: November 2019

Empirical evidence supports positive associations between social support, interpersonal connections, and health as people age. This symposium addresses how human-animal interaction may facilitate connection throughout later life. Each talk presents unique ways pets: fit into social networks; expand interpersonal connections; and thereby, impact health and wellbeing. The first talk presents longitudinal associations of a history of pet ownership and marital status on health, in particular cognitive functioning, over time. The second talk presents qualitative evidence for how pets fit into older adults’ social network and quantitative evidence for the impact of animal and interpersonal companionship on overall and functional health. The third talk builds upon the literature linking dog walking with older adults’ physical health, by providing evidence for the positive impact of dog walking improving interpersonal connections with neighbors. The fourth talk discusses the influence of a unique intergenerational human-animal interaction service-learning course on university students’ attitudes towards older adults and those with disabilities. Enrolled students provide pet care (e.g., brushing, dog walking, delivering pet food and supplies) to low-income pet owners ages 60 and older and disabled adults. Students reported decreased biases towards older adults and those with disabilities after completing the course. The final talk is the first study to focus on the influence of pets in LGBTQ older adults living in rural southern Appalachia. Identifying as a LGBTQ person and living in a rural environment can present unique challenges and these qualitative results provide insight into pets’ influence on aging in this understudied population.
OLDER ADULT PET OWNERSHIP HISTORY, MARITAL STATUS, AND HEALTH OUTCOMES: THE WISCONSIN LONGITUDINAL STUDY (WLS)
Authors: Hackney Alisha , Friedmann Erika
Published: November 2019

We explore the association of PO and marital status to changes in health during aging. This secondary analysis uses 1992, 2004, and 2011 data from healthy participants (N=2,319) in the WLS. Health outcomes (symptoms, illnesses, days in bed due to illness, depression, and cognition) and demographic/ health variables (age, marital status, sex, smoking, BMI, engagement with friends/relatives). PO (ever owned a pet/dog/cat) was assessed in 2011. In linear mixed models, PO, dog ownership, and cat ownership (CO) independently predicted changes in health outcomes. Marital status moderated the association of CO to changes in cognition[F(1,012.85)=4.09,p=0.043]. Both marriage and CO were associated with increased cognition from ages 53 to 64; being unmarried without CO was associated with reduced cognition during aging with the lowest cognition by age 70. Results provide insight into how PO and social support influence healthy aging. Longitudinal PO and health/social data are necessary to better understand these relationships.
LGBT OLDER ADULTS AND THEIR PETS IN SOUTHERN APPALACHIA: RESULTS OF QUALITATIVE RESEARCH AND FUTURE RESEARCH DIRECTIONS
Authors: MacNamara Maureen
Published: November 2019

This session reports on older LGBT adults’ perspectives of roles that pets played in relation to older adults’ aging-in-place experiences. The goal of this study is to advance understanding of the role of pets in the lives of older LGBT adults living in rural communities. The qualitative study used individual, semi-structured interviews with 11 older adults residing in rural Appalachia. Individuals were recruited using purposive sampling techniques, including recruitment through LGBT friendly service providers, a lesbian listserv, and snowball sampling. The majority of respondents reported that pets played a role in social support and some in social capital. One respondent described a utilitarian relationship with animals that is important to understanding the roles animals may play in rural communities in terms of "belongingness". After reviewing study findings, we will provide recommendations for including information about pets in formal social service delivery systems and conclude with implications for future research.
LAGGED ASSOCIATIONS BETWEEN DAILY SYMPTOMS OF OSTEOARTHRITIS AND PHYSICAL ACTIVITY LEVEL
Authors: Smith Dylan M , Parmelee Patricia A
Published: November 2019

Fatigue is commonly reported by persons with lower limb osteoarthritis (OA) and uniquely predicts worse functioning and decreased activity. The current research used a combination of wrist and waist accelerometry along with experience sampling methodology (ESM) in a diverse sample to examine the relationship between reports of fatigue and pain and subsequent physical activity among older adults with knee OA. Three hundred twenty-one participants with physician-diagnosed knee OA completed a baseline interview and mobility testing followed by a one-week observation period using accelerometry at both wrist and waist. During this week, participants also completed an ESM protocol assessing fatigue and pain 4 times daily. Multilevel models examined lagged within-subjects patterns of symptoms and their association with subsequent physical activity using three approaches: 1) wrist accelerometry alone, 2) waist accelerometry alone, and 3) a combined approach using both measures. These models also examined between-subjects predictors including measures of overall functioning, mobility testing, and demographics. Level of fatigue reported in the previous interval was the strongest and most consistent predictor of subsequent lowered physical activity. Other significant predictors included age and functional mobility. Waist and wrist actigraphy estimates were modestly correlated with each other, yet multi-level models showed consistent results regardless of placement at wrist versus waist versus a combined waist/wrist approach. In conclusion, fatigue symptoms are a significant factor in predicting subsequent decreased physical activity in OA. Waist and wrist accelerometry methods produced different estimates of activity level in this population, but similar associations with arthritis symptoms.
ASSOCIATION BETWEEN SUBJECTIVE AND OBJECTIVE COGNITIVE FUNCTION IN CHINA
Authors: Kang Bada , Xu Hanzhang , McConnell Eleanor S , Wu Bei
Published: November 2019

Although subjective cognitive decline is considered as a potential symptomatic indicator of cognitive decline, little is known regarding the relationships in older adults in China. Using the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 data, we examined the association between subjective cognitive function, perceived memory decline, and objective cognitive function among adults aged 50 or older (N=13,367) in China. Objective cognitive function was measured by immediate and delayed recall test, digit span test, and verbal fluency test. Multivariate linear regression models were used to account for sociodemographic, psychosocial, and health-related factors. We found worse subjective cognitive function was associated with poorer working memory and verbal fluency. Greater perceived memory decline was also associated with poorer working memory but not with verbal fluency. Psychosocial factors including social cohesion and social support attenuated the relationships between subjective cognitive function, perceived memory decline, and objective cognitive performance.
FAMILY CAREGIVER SCREENING IN PRIMARY CARE: CLINICIAN AND CAREGIVER PERSPECTIVES
Authors: Riffin Catherine
Published: November 2019

Despite broad appreciation of family caregivers’ relevance to older adults’ health care, few primary care-based interventions have incorporated mechanisms to facilitate systematic caregiver identification, screening, and support. Actionable knowledge regarding how such interventions may be incorporated into clinical practice is remarkably limited. This study used in-depth interviews to elucidate clinicians’ (N=25) and caregivers’ (N=20) perspectives on and suggestions for integrating caregiver screening into primary care practice. Transcripts were analyzed using qualitative content analysis. Participants emphasized the importance of tailoring the caregiver screening intervention to local circumstances and to patient and caregiver preferences. They advocated for an action-oriented approach that would link identified risks with a concrete plan for follow-up (e.g., referral to training) and outcomes relevant to the patient’s care plan. Overall, participants advised that integrating the intervention into practice would require the support of multidisciplinary practice staff, stronger connections between medical and community-based services, and appropriate reimbursement for clinicians.
INCLUDING FAMILY CAREGIVERS IN SERIOUSLY ILL VETERANS' CARE: A MIXED-METHODS STUDY
Authors: Sperber Nina R , Boucher Nathan A , Delgado Roxana , Shepherd-Banigan Megan , McKenna Kevin , Moore Madison , Kabat Margaret , Van Houtven Courtney H
Published: November 2019

Family caregivers often serve as unpaid members of the home- and community-based care workforce for individuals with serious illness; as key partners in the home-clinic continuum, they should be included in healthcare teams. Without formal recognition, inconsistent identification of caregivers will remain, engendering communication gaps between caregivers and providers and difficulty connecting with supportive services. The Campaign for Inclusive Care is an initiative within the Veterans Administration Health Care System to improve practices for including caregivers in treatment planning and decisions. We define inclusive care using literature review, provider interviews, and a caregiver survey. We found that inclusive care involves clear definition of caregiver role, system policies for inclusion, assessment of caregiver capacity, explicit involvement of caregivers, and mutuality in caregiver/provider communication. We recommend solutions based on the definition, informative for development of a national caregiver strategy, required by the 2018 Recognize, Assist, Include, Support, and Engage Family Caregivers Act.
DISRUPTION OF CPG ISLAND-MEDIATED CHROMATIN ARCHITECTURE AND TRANSCRIPTIONAL HOMEOSTASIS DURING AGING
Authors: Beck Samuel , Lee Junyeong
Published: November 2019

Aging causes the global disorganization of nuclear chromatin architecture. In a normal young nucleus, silent heterochromatin is associated with the nuclear lamina layer underlying nuclear envelope, thus spatially separated from euchromatin at the nuclear center. Notably, aging causes the disruption of nuclear lamina and the decondensation of associated heterochromatin. However, it is not clearly understood how these changes of chromatin architectures contribute to age-related diseases. Through large-scale computational analyses, we present that CpG islands (CGIs) give important clues to answering this question. CGIs are DNA elements with high Cytosine-phosphate-Guanine dinucleotide frequencies. In human, about 60% of total genes contain CGIs at their promoters (CGI+ genes) and are broadly expressed throughout the body. The other 40% of genes that do not have CGIs (CGI- genes) exhibit tissue-restricted expression patterns. Our results demonstrate that, in normal young nuclei, only CGI- genes can reside within lamina-associated heterochromatin when transcriptionally inactive, while CGI+ genes associate with nuclear central euchromatin even when they are repressed. In parallel, we show that age-associated heterochromatin decondensation can specifically de-repress tissue-specific CGI- genes leading to their uncontrolled expressions. Our results further demonstrate that global misregulation of CGI- genes increases the noise in gene transcription that, in turn, causes the loss of cellular identities during aging. Taken together, our study establishes critical implication of CGI-mediated chromatin architecture in age-associated degenerative changes and loss of tissue homeostasis.