bluuebunny/crossref_metadata_2025 huggingface dataset:
Early-Life Circumstances and Late-Life Loneliness: Findings From In-Depth Interviews
Authors: Tiilikainen Elisa
Published: December 2020

This case study examines loneliness from the perspective of two older men, who were interviewed three times as part of a five-year qualitative longitudinal study on loneliness in later life. Both interviewees self-identified as feeling lonely “often” or “all the time” and had experienced loneliness also in previous life phases. The interviews revealed trajectories of long-term loneliness which were impacted by life events and circumstances in early life, childhood and youth. Two critical experiences were identified: childhood bereavement and sexual abuse. These factors contributed to emotional insecurities and impacted the ways the interviewees perceived their selves and their relations with others. The acknowledgement of past life experiences is important for the theoretical and conceptual understanding of loneliness and the development of different intervention strategies. However, more longitudinal analysis is needed on the cumulative disadvantages making people vulnerable to long-term loneliness.
Aging in an Increasingly Technology-Based Society: Past, Present, and Future
Authors: Boot Walter
Published: December 2020

While it took over 70 years for the telephone to reach 50% of U.S. households, it took only 14 years for the cellphone, and 6 years for the MP3 player. Aging takes place in the context of a rapidly evolving technological landscape. What are the implications of such radical and rapid changes for how we age? And how can existing and emerging technologies help support aging adults’ health, wellbeing, social connectivity, and cognition? This talk will explore these issues, starting with the “digital divide” between younger and older adults, the reasons for this divide, and interventions to close the gap. The potential of emerging technologies to support older adults will be summarized, as well as potential pitfalls in the design and implementation of these technologies. The talk will conclude with speculation on the future of the digital divide and whether it can ever be entirely eliminated.
Defining Rurality: Structural Relationships, Regional Differences, and Applications for Research With Older Adults
Authors: Cohen Steven , McIlmail Julia , Greaney Mary
Published: December 2020

There is no universal definition of rurality due to the heterogeneity in what makes a place “rural” or “urban”. This study explored how elements of rurality are related to each other, and how the elements that define rurality vary by region. Data were abstracted for all 1948 non-metropolitan counties in the contiguous 48 states on rurality. K-means cluster analyses (k=4-8) were conducted to examine classification structures among component variables examining regional differences. In the South region, the majority (51.2%) were “Type 2” counties: low population size and density but higher urbanized population. The Midwest had a majority of “Type 3” counties (56.4%): intermediate for population size and density, but higher distances to metro areas. These exploratory findings underscore the heterogeneity and regional variability in rurality and how those measures are structurally related to each other, and essential to understanding those factors that truly drive rural-urban health disparities for older adults. Part of a symposium sponsored by the Rural Aging Interest Group.
Social Isolation as a Mechanism Linking Sensory Impairment With Cognitive Functioning
Authors: Yorgason Jeremy , Tanner Corinna Trujillo , Richardson Stephanie , Burch Allison , Stagg Brian , Hill Melanie
Published: December 2020

Hearing and vision loss have been linked with cognitive decline in older adults. There may be various pathways through which sensory impairments impact cognitive functioning. Sensory impairments may lead individuals to be less socially connected, which may impact cognitive functioning due to less cognitive stimulation. As such, sensory impairments and social isolation may cascade to negatively impact cognitive functioning. Using data from 8,334 individuals aged 65-90+ in waves 6, 7, and 8 of the NHATS study, we estimated a longitudinal mediation structural equation model. Findings indicate that both self-reported vision and hearing impairment in wave 6 of NHATS were linked to concurrent cognitive functioning through social isolation. Only hearing impairment demonstrated longitudinal impact through social isolation across 2 and 3 waves. Findings suggest that medical professionals working with older adults with vision or hearing impairment should assess social isolation, as a point of intervention to maintain cognitive function.
How Is Sleep Related to Anxiety or Depression in Older Adults With Dementia?
Authors: Hwang Yeji , Hodgson Nancy
Published: December 2020

Anxiety and depression are one of the most distressing symptoms for the family caregivers. Little is known about the relationship between sleep impairments and anxiety/depression in this population and how objective and subjective sleep measures differ in relation to anxiety. This study was designed to examine the relationship between sleep impairments and anxiety/depression in people with dementia, using both subjective and objective sleep measures. Among the 170 study participants, 50% (n=85) reported to have anxiety/depression. In univariate logistic regression analyses on anxiety/depression, adjusting for dementia stage, people with more subjective sleep impairment had higher odds of having anxiety/depression (OR=1.111; 95% CI: 1.020-1.211, p=0.016) and people with poorer subjective sleep quality had higher odds of having anxiety/depression (OR=1.702; 95% CI: 1.046-2.769, p=0.032). Objective sleep measures from actigraphy did not show any significant relationships to anxiety/depression. The results suggest that subjective sleep measures are closely related to anxiety/depression in this population.
Relationship Between Sleep and Quality of Life in Older Adults With Mild Cognitive Impairment
Authors: Petrovsky Darina , Varasse Miranda , Hodgson Nancy
Published: December 2020

Our objective was to examine the independent relationship between sleep characteristics and quality of life (QOL) in community-dwelling older adults with cognitive impairment. Objective sleep variables were derived from actigraphy and included total sleep time, wake after sleep onset (WASO), efficiency, and number of awakenings. Subjective sleep quality was measured using Pittsburgh Sleep Quality Index and daytime sleepiness was measured with the Epworth Sleepiness Scale. Caregiver reported QOL-AD was used for QOL. Analyses included Spearman’s correlation and multivariate linear regression. In bivariate analyses, QOL was significantly related to clinical dementia rating scale, sex, depression, daytime sleepiness, sleep quality, WASO, and number of awakenings. Controlling for depression, daytime sleepiness remained independently associated with QOL (β= -0.24; p= 0.03). In addition, number of awakenings trended towards significance (β= -0.13; p= 0.07). Results suggest daytime sleepiness and awakenings are associated with QOL in this population.
The Complex Role of Discrete Emotions in Successful Aging
Authors: Hamm Jeremy , Wrosch Carsten
Published: December 2020

Research shows that emotions play an important role in successful aging. However, previous studies have largely focused on the implications of dimensional indicators of emotion, such as positive and negative affect. This approach may fail to capture important distinctions between discrete emotions such as sadness, loneliness, calmness, and empathy that could become more or less adaptive with age. The present studies adopt a discrete emotion perspective to examine age-related changes in the consequences of different positive and negative emotions for successful aging. Drawing from an evolutionary-functionalist perspective, Haase, Wu, Verstaen, and Levenson investigate whether sadness becomes more salient and adaptive in old age using a multi-method approach. Lee, Lay, Mahmood, Graf, and Hoppmann address the seemingly contradictory consequences of loneliness by examining how state- and trait-loneliness interact to predict older adults’ prosocial behaviors. Hamm, Wrosch, Barlow, and Kunzmann use two studies to examine the diverging salience and 10-year health consequences of discrete positive emotions posited to motivate rest and recovery (calmness) or pursuit of novelty and stimulation (excitement). Barlow and Mauss study the co-occurrence of discrete emotions and their age-dependent associations with well-being using an adult lifespan sample. Finally, Wieck, Katzorreck, Gerstorf, Schilling, Lücke, and Kunzmann examine lifespan changes in the adaptive function of empathy by assessing the extent to which empathic accuracy protects against stress-reactivity as people age. This symposium thus integrates new research on the role of discrete positive and negative emotions and will contribute to a deeper understanding of the complex relationships between emotions and successful aging.
When Concerned Family Members Intervene in Elder Family Financial Exploitation: Goals and Outcomes
Authors: Stum Marlene
Published: December 2020

The role and experience of non-abusing concerned family members (CFMs) in elder family financial exploitation (EFFE) is largely unexplored. This paper examines the experience of “trying to do the right thing,” focusing on what CFM’s were trying to accomplish (motivating goals), and resulting outcomes utilizing data from a qualitative study of 28 CFMs (primarily female adult children of an older victim, and siblings of primary perpetrator). Five common goals appear to be motivating CFM involvement, driven by a priority to ensuring the victim’s quality of life, as well as the desire to honor and respect the victim’s wishes, protect the victim’s financial well-being, preserve family relationships, and deal with the perpetrator(s). CFM help-seeking resulted in a wide range of outcomes, from making a difference by connecting victims to supportive services and interrupting the financial exploitation, to mixed results, and in other cases frustration with no desirable outcomes.
Exploring the Help-Seeking Experience of Concerned Persons: Findings From an Elder Abuse UK Helpline
Authors: Dominguez Silvia Fraga , Storey Jennifer , Glorney Emily
Published: December 2020

Despite their potential role in elder abuse cases, knowledge about concerned persons outside of North America is scarce. This paper will discuss findings from a study focusing on concerned persons in the UK, by addressing their profile, the impact of helping, and several variables relating to help-seeking. Researchers used secondary data from a charity’s helpline, encompassing a year of recorded cases (N = 1623). Concerned persons (n = 1352) were often related to the victim (80%) and/or perpetrator (59%). In 43% of cases, they reported impact as a result of their awareness of the situation or supporting the victim. This impact was thematically analysed and ranged widely in terms of severity, from slight worry to being subjected to the perpetrator’s homicide threats, and it often affected the person’s mental health or financial situation. Concerned persons reported substantial barriers to action relating to the access to and responses from formal services.
Perceived Elderly Stigma and Emotional Well-Being Among Korean Older Adults: The Mediating Role of Self-Esteem
Authors: Namkung Eun Ha , Chung Soondool
Published: December 2020

This study examined whether self-esteem mediates the association between perceived elderly stigma and emotional well-being (loneliness and emotional isolation) among Korean older adults, and how these processes differ by marital status. Using the 2018 Age Integration Survey, a cross-sectional national survey of adults in Korea, we analyzed data from 266 older adults aged 60 and older. Older adults who perceived greater elderly stigma reported higher levels of loneliness and emotional isolation. Self-esteem played a significant indirect role in the association between perceived elderly stigma and the two emotional well-being outcomes. Moderated mediation analyses further revealed significant differences by marital status; self-esteem was a more powerful mechanism among unmarried older adults relative to their married counterparts. The findings suggest that efforts to minimize public and internalized stigmatization of older adults and to improve their own self-esteem may be critical for their emotional well-being.
Life Stressors, Social Capital, and Mental Distress in Multiethnic Groups of Older Asian Americans
Authors: Cho Yong Ju , Hai Audrey , Jang Yuri
Published: December 2020

Using data from older participants from the 2015 Asian American Quality of Life survey (n = 533), the present study assessed direct and interactive effects of life stressors and social capital. The sample includes diverse Asian ethnic groups (Chinese, Asian Indian, Korean, Vietnamese, and others). Among all groups, high levels of mental distress were found in Koreans and Vietnamese. In the multivariate analyses, Korean ethnicity (compared to Chinese) was found to be a significant predictor to mental distress. As significant risk factors to mental distress, all stressor variables accounted for 9% of the variance of mental distress. Social capital variables explained the variance by 4%. None of the interaction terms reached statistical significance. Findings confirmed the negative effects of stressors and the positive effects of social resources across older Asian Americans. However, it was interesting to note that ethnic variations disappeared when stressors and social capitals were taken into considerations.
Experiences of LGBT Patients and Families With Hospice and Palliative Care: Perspectives of the Palliative Care Team
Authors: Berkman Cathy , Stein Gary
Published: December 2020

The lesbian, gay, bisexual, and transgender (LGBT) community experiences discrimination and stigma in accessing health care and social services – including palliative, hospice, and long-term care. Healthcare providers not recognize or address disparities in care. Providers and institutions may be uncomfortable with sexual orientation and gender identity and expression issues, and often don’t inquire about these. LGBT patients fear being open about their identities, not receiving equal or safe treatment, and having their family of choice and designated surrogates disrespected or ignored by healthcare staff. This study examines the degree to which hospice and palliative care providers report inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey was completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely than non-LGB patients to experience discrimination at their institution; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Qualitative data are presented to illustrate discomfort with LGBT patients and spouses/partners, disrespectful care, gossip and ridicule, inadequate care, and denial of care. Implications and suggestions for implementing non-discriminatory and respectful institutional and public policy, and for staff education and training to provide competent and respectiful care to this population are presented.
Do Competing Demands Elevate Caregiver Challenges?
Authors: Blieszner Rosemary , Savla Tina , Roberto Karen , McCann Brandy Renee , Knight Aubrey , Hoyt Emily
Published: December 2020

Family members caring for relatives with dementia simultaneously hold other roles and face other everyday challenges related to employment, finances, interactions with others, and the like. Using the Pearlin stress process model as a foundation, we evaluated contributions of secondary role and intrapsychic stressors such as health, relationship, and financial worries, and role captivity and overload, to 157 rural caregivers’ morale and well-being. Whereas family conflict and role overload contributed significantly to higher agitation, money worries, poor health, and role captivity interfered with positive mental health (p<.05). Nevertheless, some caregivers characterized employment and volunteering as respite from caregiving and appreciated informal help even when family ties were complicated. Findings highlight complex responses to dementia-related caregiving and point to the need for a range of resources and support deployed creatively to assist caregivers in places such as rural Appalachia where geography, underfunding, and low income limit access to services.
It's Like We Speak a Different Language: Support Needs and Preferences of Older LGB Women Who Have Lost a Spouse or Partner
Authors: Valenti Korijna
Published: December 2020

Needs during and following end-of-life (EOL) experiences are distinctive for sexual and gender minority (SGM) people and, in particular, older lesbian, gay, and bisexual women (LGB) women; however, access to supportive services is limited. This poster presents findings from a qualitative study of older (60+) LGB women who have lost a spouse or partner. This work draws on queer gerontological theory, addressing issues of individual agency, systemic silence, and marginalization by invisibility of older SGM women in order to illuminate specific areas in which policy may be changed and improved. The study analyzed participants’ (n = 16) reflections on their experiences of losing a loved one, including how they sought out and received essential grief support and the type of support they would have preferred and from whom, particularly immediately following their spouse or partner’s death. Thematic analysis revealed three main findings: 1) having a women-identifying support presence at the time of death for both themselves and their spouse or partner; 2) needing LGB women (or women allies) during EOL for support; and 3) preferring grief groups comprised of other LGB women (or women allies) based on their feelings of difference from gay men and heterosexual/non-SGM women and men. Findings reveal the need for a better understanding among healthcare and social work support professionals regarding LGB women’s grief needs and preferences; grief options (e.g. lesbian and non-monosexual (bi+) grief groups); and how to implement policy changes reflecting these needs and preferences.
Transforming Cultural Ideas of Aging and Disability to Improve Policy and Practice
Authors: Ordway Anne
Published: December 2020

Aging and disability are normative processes that extend across the lifespan. However, ageism and ableism are incorporated into many of our practices, programs, and policies—devaluing the lives of older adults and people aging with disabilities and ultimately preventing their full participation in society. Ageism and ableism are closely connected. For example, both systems identify impairment as an individual and social liability. As recent studies have demonstrated, this has real world implications for the quantity and quality of health care requested, delivered, and received by both older adults and people with disabilities. In this session, we discuss the connections between these two forms of oppression and present recent work by researchers in both fields and the FrameWorks Institute that shows how to transform our cultural ideas of aging and disability and development more inclusive policies and services. Part of a symposium sponsored by the Lifelong Disabilities Interest Group.
Developing Digital Home Assistant User Guides for Older Adults With and Without Long-Term Mobility Disabilities
Authors: Kadylak Travis , Blocker Kenneth , Ramadhani Widya , Koon Lyndsie , Khaleghi Roshanak , Kovac Chris , Sreenivas Ramavarapu , Rogers Wendy
Published: December 2020

The aim of the current study was to understand how to integrate digital home assistant technologies and smart appliances into older adults’ homes by developing supportive user guides that facilitate adoption and continued use. We conducted a series of interviews among older adults, with and without mobility disabilities, to understand their attitudes towards digital assistants and to identify needs for instructional support and user guides. Subsequently, we developed and tested specific user guide modules for older adults aimed at addressing the identified concerns and desired instructional support. Specifically, we developed and field-tested user guides for the initial Amazon Echo device setup, basic device use (e.g., playing music and checking the weather), and separate modules for other domestic use cases (e.g., how to pair an Alexa enabled device with smart lights or appliances). Our results provide guidance for implementation of smart voice technologies to support older adults with long-term mobility disabilities.
Older Adults’ Persisting Beliefs About the Death Panel Myth and Advance Directives
Authors: Coldiron Allyson , Bennett-Leleux Lauren , Lee Diamond , Childers Lucas , Donnell Rachel , Sandlin Alexandra , Marsden Arthur , Barnett Michael
Published: December 2020

The political debate preceding passage of the Affordable Care Act included controversy over a bill that some claimed would establish a “death panel” to judge if older adults were worthy of receiving medical care. This claim was false, as the bill would instead incentivize physicians to inform Medicare patients about advanced directives: legal documentation of one’s end-of-life preferences. However, the death panel myth led to the removal of this bill from the Affordable Care Act, and a poll five years later found 41% of Americans still believed in the death panel myth. We investigated the effects believing in this myth had on older adults, hypothesizing that those who believed in the myth would have lower advance directive completion rates and more negative attitudes towards advanced directives. Community-dwelling older adults aged 65 to 102 years (N = 182) in a large city in the southern United States completed an interview survey. No relationship was found between belief in the death panel myth and advanced directive completion; however, older adults who believed in the myth had lower perceived need for advanced directives than those who did not. Surprisingly, 47.1% of older adults who believed in the myth also supported incentivizing doctors to inform patients about advanced directives, suggesting that many older adults who believe in the myth do not know that the controversial bill was about advanced directives. Results suggest that the death panel myth may have long-lasting effects, specifically persistent distrust about policies promoting advance directives.
¿Dónde Viven Los Latinos? The Types of Neighborhoods Older Latinos Live in and Their Implications for Diabetes
Authors: García Catherine , Ailshire Jennifer
Published: December 2020

The spatial distribution of Latinos in U.S. neighborhoods is highly patterned due to a complex set of social, cultural, and economic forces, which leads to the differential distribution of and exposure of resources and opportunities across space. However, less is known about the types of neighborhoods older Latinos live in and how it impacts their health. Using census tracts from the year 2000, we employed a latent class analysis to explore how social and socioeconomic characteristics cluster together to create distinct neighborhood typologies. These typologies were then combined with data from the 2006-2016 Health and Retirement Study (n=3,047). We found that Latinos were more likely to live in predominantly Latino neighborhoods with low socioeconomic status (SES) (40%), multiracial neighborhoods with moderate SES (27%), and predominantly white neighborhoods with moderate SES (15%). Latinos living in predominantly Latino neighborhoods with low SES were more likely to have diabetes than other neighborhood typologies.
Social Exclusion and Suicidal Ideation: Analysis of the Bereaved Living Alone
Authors: Choi Bomi , Jun Hey Jung , Lee Sun Ah
Published: December 2020

The aim of this study is to explore the relationship between social exclusion and suicidal ideation among bereaved older people living alone. When people with a significant loss in the familial relationship are exposed to social exclusion, they likely experience poor mental health and suicidal ideation. Using the Korean Community Health Survey 2017, logistic regression model was applied to the bereaved older people living alone, 65 to 110 of age (N=14,659). Social exclusion was comprised of three network-based components: exclusion from relationships, social participation, and community. Relationship exclusion means the lack of contact with family, friends, and neighbors, respectively, at least once a week. Social participation exclusion refers to the lack of participation in a religious, socializing, and leisure activity, respectively, at least once a month. Community exclusion covers two indicators of trust in neighbors and perception of neighborhood reciprocity. Results showed that indicators of relationship, social participation, and community exclusion were associated with suicidal ideation. Bereaved, living-alone older people were likely to have suicidal ideation when they lack contact with neighbors (OR=1.13, p<.05), participation in the religious activity (OR=1.12, p<.05) and socializing activity (OR=1.20, p<.05), and trust in neighbors (OR=1.29, p<.001). The moderation analysis showed that exclusion from socializing activity was associated with suicidal ideation only among females. The results of the analyses imply that interventions that promote social participation could improve the mental health of the bereaved older adults living alone.
Religion and Aging in a Context of Secularization
Authors: Idler Ellen
Published: December 2020

Religion and aging has been a persistent topic of interest to gerontologists, notably Vern Bengtson over his long career. It is increasingly obvious that this research has taken place against a decades-long backdrop of declining religious attendance, with each successive cohort showing lower levels of participation. Data come from the Health and Retirement Study, a representative sample of the noninstitutionalized US population (N=20,091), ages 24-107. We examined the patterns of religious involvement during the period 2004-2014 stratified by five age groups, 24-49, 50-64, 65-74, 75-89, 90+. Attending religious services has an age-graded pattern; each older cohort has a higher level of religiosity than the one following it, with the exception of those 90. Patterns for other measures of religious involvement are less dramatic but similar in direction. Lower levels of religious participation in younger cohorts imply a smaller proportion for whom these protective social ties are available. Part of a symposium sponsored by the Religion, Spirituality and Aging Interest Group.
Enrolling Incident Caregivers and Matched Controls From a Nationwide Epidemiological Study
Authors: Roth David , Haley William , Sheehan Orla , Rhodes J David , Howard Virginia
Published: December 2020

Participants in the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) study were asked about family caregiving responsibilities at enrollment (2003-2007). Among the 88% of participants who were not caregivers at enrollment, 1,229 reported becoming caregivers before a follow-up interview 12 years later. The Caregiving Transitions Study screened these participants and enrolled 251 as incident caregivers. All reported 5 or more hours of care per week, provided assistance with at least one ADL or IADL, and were caregivers for at least 3 months before a 2nd blood sample was obtained in the REGARDS study. A total of 251 noncaregiving control participants who reported no caregiving responsibilities over this 12-year period were also enrolled. Each control was matched to a caregiver on age (+ 5 years), sex, race, other demographics, and baseline (pre-caregiving) health variables. Descriptive analyses confirm the unique comparability of the samples compared to previous caregiving studies.
Measurement and Structure of Cognition in the Longitudinal Aging Study in India—Diagnostic Assessment of Dementia
Authors: Gross Alden , Khobragade Pranali , Meijer Erik , Saxton Judith
Published: December 2020

We tested whether a complex model of human cognitive abilities based on Cattell-Horn-Carroll (CHC) theory, developed in English-speaking samples, adequately describes correlations among tests in the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) (N=3,224). Tests in the neuropsychological battery were chosen for their appropriateness for measuring cognition in older adults in India and suitability for co-calibration with the core LASI survey (N=72,000). We evaluated the factor structure and its conformity with a classical CHC factor model incorporating measurement models for general cognition, 5 broad domains (orientation, executive functioning, language/fluency, memory, visuospatial), and 5 narrow domains (abstract reasoning, attention/speed, immediate memory, delayed memory, recognition memory) of cognitive performance. Model fit was adequate (RMSEA:0.051; CFI:0.916; SRMR:0.060). We demonstrated configural factorial invariance of a cognitive battery in the Indian LASI-DAD using CHC theory. Broad domain factors may be used to rank individuals with respect to cognitive performance and classify cognitive impairment.
Age Matters: The Impact of Ageism on Health, Cognitive Impairment, Work Lives, and Anti-Ageist Interventions
Authors: Rozario Philip , Morrow-Howell Nancy
Published: December 2020

Age is a social constructions. The treatment of people on the basis of their age, imposes serious psycho-emotional, social and economic costs on society and older people. The experiences of ageism may be exacerbated when other forms of acute and chronic forms of oppression are experienced due to racism, sexism, etc. The first paper looks at the impact of ageism on older people’s health. Their systematic review of studies showed that ageism detrimentally and consistently impacted older individuals in 11 health domains, with the prevalence of significant findings increasing over time. Informed by NIA’s Health Disparities Framework, the second paper examines the relationships between discrimination and protective factors on cognitive functioning. Their analyses of the Health and Retirement Survey data reveal, among other things, that everyday experiences of ageism significantly worsen older adults cognitive functioning. Using survey data of adults throughout the life-span, our third presenter examines how multiple identities (such as age and gender) influence employees’ perspectives on workplace fairness in hypothetical situations. The findings are informative to human resource departments in ensuring workplace fairness within the context of a multigenerational workforce. The final paper examines two efforts to disrupt ageism, specifically interventions that target students in an intergenerational program and staff members of senior living communities. Results from these evaluations point to an increase in positive attitudes among students and a reduction in ageist behaviors among staff members. All presenters will discuss policy, practice and research implications of their studies.
A Pilot Study Using the Life Space Assessment Among Community-Dwelling Older Adults in Ireland
Authors: Stapleton Tadhg
Published: December 2020

Forty older adults (27, 67.5% female), mean age 74.3 years (range 65- 89), current drivers 31 (77.5%), 23 (57.5%) rural dwellers and 17 (42.5%) urban dwellers participated in the survey. Median LSA score was 74 (range 27-102). All participants were readily accessing life spaces within and immediately outside their own home. Over half (n=23, 57.5%) accessed spaces in their neighbourhood on a daily basis. Decreased frequency of access to spaces outside of local neighbourhood and town was noted. No significant difference in LSA scores between genders (P=0.549), current driving status (P=0.235), but urban dwellers had significantly higher LSA scores than rural dwellers (P=0.024). Spearman correlations found statistically significant negative correlation between age and LSA scores (rho= -0.445, P=0.004), and significant positive correlation between LSA and Euroqol (EQ) VAS scores (rho=0.405, P=0.010). Findings are limited by the small sample size but highlight decreasing frequency of wider community participation with increasing age.
Navigating Religious and Moral Exemptions in Serving LGBTQ Residents in Long-Term Care Facilities
Authors: Perone Angela
Published: December 2020

Almost immediately after the U.S. Supreme Court mandated marriage equality, a surge in policies carved out exceptions to LGBTQ rights for religious or moral reasons. This study examines how long-term care workers, managers, and administrators respond when staff, visitors, or residents challenge LGBTQ rights based on these exemptions. Building on street-level bureaucracy theory, this study employs an advanced multi-method qualitative design with semi-structured staff interviews (n=85), content analysis of facility policies (n=110), and observation of two facilities. Data analysis revealed three key themes: visibility, bodily autonomy/respect, and safety. While nearly all workers expressed universal concern for LGBTQ rights, direct care workers and managers wavered when religious or moral exemptions arose in serving transgender residents. Workers invoked facility policies regarding gender and bodily care to justify differential treatment. This research provides new knowledge and guidance for workers, facilities, and policymakers and theoretical contributions to street-level bureaucracy. Part of a symposium sponsored by Rainbow Research Group Interest Group.
Incorporating Guided Autobiography, Portfolios, and SoulCollage Into Undergraduate Gerontology Courses
Authors: Cox Lisa , Maguire Gina
Published: December 2020

Although undergraduates don’t eagerly choose gerontology classes first, a hefty number of students have enjoyed content they have explored as they were enrolled in “Aging and Spirituality” and “Therapeutic Arts with Older Adults” courses. The ten universal life themes that help people tell their stories, through the empirically validated methodology of Guided Autobiography (GAB) are incorporated in classes designed for an inter-generational group (older adults and students). Student assembled portfolios created from activities connected to ‘the arts’ and spiritual literacy have enhanced the acquisition of gerontological competencies. Also, through the use of SoulCollage® (developed in the late 1980s by Seena B. Frost, M. Div.) students of all ages, with and without artistic abilities, use a creative collaging process to get in touch with their ego integrity—the eighth stage of development conceptualized by Erik Erikson. Over three years, students have grown in their knowledge of aging and artistic processes.
Religion, Spirituality, and Well-Being: An Underexplored Aspect of Growing Older in the United Kingdom?
Authors: Victor Christina , Lamont Ruth , Rippon Isla , Clare Linda
Published: December 2020

There is a rich literature from The United States looking at the importance of religion and spirituality in the lives of older adults where it is positively linked with wellbeing. Despite the increased interest in wellbeing in the UK comparatively little interest has been show in the role of religion and spirituality in promoting wellbeing including quality of life, life satisfaction and loneliness. In this paper we explore these issues using three data sets: the European Social Survey (ESS), the English Longitudinal Study of Ageing (ELSA) and the IDEAL cohort of people with dementia and their carers to examine (a) the variation in religious practice by older adults, those aged 50+, across Europe; (b) the epidemiology of religious practice among older adults within England and (c) using both ELSA and IDEAL consider the relationship between religion and wellbeing in later life.
Spirituality and Sexuality: Not Necessarily a Binary Choice for LGBTQ+ People
Authors: Thomas Michael
Published: December 2020

This paper reports on a qualitative study on the impact of marriage and civil partnerships for lesbian, gay and bisexual (LGB) couples. Drawing on data from 50 dyad interviews in the UK, US and Canada, the paper investigates the ways in which couples make sense of spirituality in the context of a stigmatised sexuality. For some, the task of arranging a wedding or civil partnership ceremony provided a powerful reminder of their exclusion from mainstream religious denominations. This sense of stigma (Goffman, 1963) was also present in later life, when the lack of social esteem granted to same-sex relationships gave rise to a sense of disenfranchised grief (Doka, 1989). Whereas some participants tended to frame sexuality and spirituality as a kind of binary choice, others resisted this marginalisation from religious and spiritual activities, even if this meant finding a personal sense of spirituality beyond the confines of organised religion.
Policy Series: Building Momentum for a New Future in Politics and Aging: Examining Economics, Values, Language, and Care
Authors: Lepore Michael , Accius Jean
Published: December 2020

Coinciding with the 2020 presidential election, the 75th anniversary of the Gerontological Society of America arrives amid the contentious creation of a new future for politics and aging. Increasing inequality, spreading disinformation, and mounting despotism are escalating threats to constitutional democracy, but at the same time other social changes are promoting the development of a more thoroughly caring, intergenerationally just, and robustly democratic society. At the crux of this societal transformation, relentless political inertia on core aging issues, like the role of government in the care and support of older adults, continues to inhibit meaningful change in federal policy, dampening the potential for older Americans to achieve desired future states, like living well despite advanced age or disability. This session examines major contemporary trends at the intersection of politics and aging in the United States. Papers address the economics and demographics of aging, drawing attention to increasing federal spending on older adults, decreasing availability of caregivers, and geographic clustering of older people; changes in the age of the electorate, intergenerational political values, and the growing politically polarization of American society; the tendency for federal initiatives to fail to support caregivers, for reasons of policy history, policy traits, and mass public features, like the political isolation of informal caregivers; and the role of linguistic and metaphorical practices in shaping our experiences and views of aging. Discussion addresses opportunities for the country to become more age-friendly while also sustaining democratic institutions and national unity.
Caregiving in the U.S. 2020: What Does the Latest Edition of This Survey Tell Us About Their Contributions and Needs?
Authors: Prudencio Gabriela , Young Heather
Published: December 2020

Family and friends comprise the most basic unit of any society. For individuals who take on the responsibility of caring for another person through sickness or disability, it can often be challenging to see beyond the individual experience. Yet in the aggregate, family caregivers—whether they be families of kin or families of choice—are woven into the fabric of America’s health, social, economic, and long-term services and supports (LTSS) systems. As the country continues to age, the need to support caregivers as the cornerstone of society will only become more important. A national profile of family caregivers first emerged from the 1997 Caregiving in the U.S. study. Related studies were conducted in 2004, 2009, and 2015 by the NAC in collaboration with AARP. Caregiving in the U.S. 2020 presents a portrait of unpaid family caregivers today. A nationally representative survey (n=1,499), it replicates the methodology used in 2015. Therefore, during this symposium, AARP and NAC will present trend data from 2015 in comparison to 2020, and explore key subgroup differences. The presentation will cover prevalence, demographic characteristics, intensity and duration of care, the well-being of caregivers, the financial impact of family caregiving on caregivers themselves, and the degree to which technology supports caregivers today.
Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study
Authors: Inagaki Asa , Igarashi Ayumi , Noguchi-Watanabe Maiko , Sakka Mariko , Fukui Chie , Yasaka Taisuke , Shinohara Masumi , Yamamoto-Mitani Noriko
Published: December 2020

Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.
Co-Designing Age-Friendly Health System Materials With Older Adults and Caregivers
Authors: Emery-Tiburcio Erin , Regan Carol , Hilman Judith , Newman Michelle
Published: December 2020

Achieving better care for older adults requires that they advocate for their own health needs. As health systems become Age-Friendly, education for older adults about the 4Ms is essential. Community Catalyst (CC) is working with older adults at six GWEPs to co-design materials explaining the interconnected 4Ms. In November 2019, CC hosted two focus groups (n=17) with older adults from Rush University Medical Center to understand their views on health care and introduce the 4M concepts. Key themes included the importance of being listened to, of each M and how they are connected, and for materials with graphics and personal stories. Based on this information, prototype educational materials were developed and three additional groups were held in February 2020 (n=30, including family caregivers) to solicit feedback on content and design. The co-design process, evaluation methods, and implications of including older adults in educational design will be discussed.
Helping Caregivers to be Ready, Willing, Able, and Healthy
Authors: Golden Robyn , Rompala Vikki , Carbonell Ellen
Published: December 2020

Given extended life expectancy, family caregivers are needed to provide care for older adults at home. Research has documented the deleterious effects of caregiving on mental and physical health for many. The Caregiver Health and Well-Being Initiative is a systems approach to support family caregivers of older adults by standardizing processes for identifying caregivers in ambulatory and inpatient settings, assessing caregivers’ needs, and providing relevant services and resources, including caregiver health services, a Teach Back clinic for skills development, and extended goals of care conversations. N=104 caregivers have completed assessments. Participants reported the following at baseline: depressive symptoms (54%); anxiety symptoms (69%); health being affected by the care situation (59%); financial situation decreasing (58%); feeling torn between demands of their family and demands of care (63%); and some feelings of burden from caregiving (97%). Intervention components will be discussed along with a larger systems change framework for implementation.
Older African Immigrants’ Experiences of Discrimination in the United States
Authors: Nkimbeng Manka , Taylor Janiece , Roberts Laken , Winch Peter , Commodore-Mensah Yvonne , Thorpe Roland , Han Hae-Ra , Szanton Sarah
Published: December 2020

Discrimination is implicated in the disproportionate burden of disease and health disparities in racial/ethnic minorities. This qualitative descriptive study explored the experiences of discrimination and its impact on the health of older African immigrants. Semi-structured interviews were conducted with 15 participants. Three main themes and six sub-themes were identified. These included: 1) types of discrimination: a) accent-based, b) unfair treatment during routine activities, c) experience with police and other systems; 2) costs of discrimination; 3) surviving and thriving with discrimination: a) “blind eye to it”, b) reacting to it, c) avoiding it. These themes describe common forms of discrimination that these older adults have experienced, current strategies used to deal with discrimination, and the impact of discrimination on the wellbeing of this sample. To improve the emotional and mental health of older African immigrants, providers serving them should assess for perceived discrimination, and refer participants with any concerns for treatment.
Homeownership Among Older Adults: Source of Stability or Stress?
Authors: Molinsky Jennifer , Herbert Christopher
Published: December 2020

For older adults, homeownership can be an important source of housing stability and personal wealth that can be tapped in later life, including for long-term care. Nonetheless, owning a home is not without physical and financial challenges for aging households, and many owners are reluctant to take advantage of housing equity later in life. This paper reviews the conditions of older homeowners to assess the degree to which owning a home is—or is not—associated with financial security and housing stability. We review trends in homeowning among older adults, including differences by race/ethnicity and income. We then describe the extent of housing affordability challenges among homeowners, the degree of mortgage indebtedness, and the extent and use of housing equity. Finally, we examine issues related to housing quality and accessibility. The paper concludes with a discussion of policy implications.
Older Persons’ Use of Social Media for Communication During Hurricane Matthew
Authors: Gibson Allison , Kusmaul Nancy , Engelhardt Ethan
Published: December 2020

Older persons are frequently identified as more vulnerable during natural disasters due to age-related changes and chronic conditions. Over the last decade, the use of social media has grown, even among the older adult population. While many communities and organizations have utilized social media as a platform to communicate news and information about natural disasters among the public, little is known regarding how older adults utilize social media to plan, evacuate, and recovery from natural disaster events. This study examined the experiences of 23 older adults (n=23) use of social media following Hurricane Matthew. Individuals were able to speak about what they perceived as helpful in the information communicated, and recommendations they had for how such communications could be improved. The presentation will conclude with recommendations on how individuals helping with evacuation and recovery can utilize social media as a communication resource for older adults during disasters. Part of a symposium sponsored by Disasters and Older Adults Interest Group.