bluuebunny/crossref_metadata_2025 huggingface dataset:
TRANSMISSION OF RELIGIOSITY BETWEEN GRANDPARENTS AND GRANDCHILDREN AS A BASIS FOR ELDERCARE RESPONSIBILITY
Authors: Silverstein Merril , Lee Seonhwa , Harris RianSimone , Zhang Wencheng
Published: December 2023

Different branches of research demonstrate that religiosity is effectively transmitted from grandparents to grandchildren and that religiosity strengthens norms of eldercare responsibility. This paper unites these two branches of inquiry by proposing that eldercare norms in emerging adulthood are directly and indirectly formed through an intergenerational religious pathway. Data derive from 149 grandparent-grandchild dyads from the 2021-22 wave of the Longitudinal Study of Generations. Religiosity is defined as a composite consisting of self-assessments of religious importance, religious intensity, and religious service attendance. Eldercare norms are assessed based on an evaluation of the obligation that adult children should have to provide support and care to older parents in six areas of assistance. Intermediate factors include grandchildren’s familistic values and emotional closeness to grandparents. Structural equation modelling was used to examine direct and indirect pathways linking these factors. Results indicate significant continuity in religiosity between grandparents and grandchildren. The impact of grandchildren’s religiosity on their eldercare norms is fully mediated by their familistic values and emotional closeness with grandparents. This analysis reveals that the transmission of religiosity to grandchildren begets eldercare norms through an ideational route of strengthening values of familism, and a personal route of promoting closer, and possibly more empathetic, relationships with grandparents who have or may soon have support needs. Results demonstrate the “hidden” impact of religious orientations of older grandparents on grandchildren and serve as a counterpoint to potentially specious reports about the adverse impact of declining religiosity and weakening intergenerational cohesion on aging families in American society.
A CLOSER LOOK AT OLDER ADULTS AS PEER EDUCATORS IN LIFELONG LEARNING INSTITUTIONS IN THE US
Authors: Casanova Giuliana , Weil Joyce , Cerqueira Margarida
Published: December 2023

Productive engagement in later life refers to paid or unpaid activities that can provide beneficial outcomes for individuals and society. This qualitative study examines the experiences of 17 peer educators, aged 61 to 84 and without cognitive deficits, who teach at three institutions of lifelong learning in Florida, USA. Data were collected through field notes, document analysis, a sociodemographic questionnaire, individual in-depth interviews, and brief interviews with each institution′s director. Descriptive statistics were used to examine the profiles of the peer educators, and emerging themes were identified through thematic analysis of the interview data. Preliminary results suggest that volunteerism and altruism played a role in their decision to become peer educators. Descriptive statistics showed that, on average, peer educators have obtained higher education degrees and have past teaching experience. The study identified several emerging themes related to the experiences of peer educators, including the need for purpose, the value of social connections, enjoyment of their role, and the importance of mutual learning. The analysis also revealed some challenges, including the need for environmental modifications to improve teaching conditions and assistance with marketing to promote classes and increase attendance. Overall, this study provides preliminary evidence to aid in understanding older adults in productive roles and fighting ageism. Identify current gaps in each institution′s approach, capacity to promote their participation and enhance their teaching experience while highlighting their contributions to society.
EMERGING TECHNOLOGY-BASED INTERVENTIONS TO SUPPORT FAMILY CAREGIVERS
Authors: Washington Tiffany , Ruggiano Nicole , Gaugler Joseph
Published: December 2023

There are 53 million family caregivers in the U.S., most of whom experience difficulty coordinating care, health and mental health decline, social isolation, and loneliness. Furthermore, accessing community support services remains challenging. This gap in access can create a significant threat to caregivers’ wellbeing and quality of life. The need to develop innovative interventions to support family caregivers is urgent. This symposium will describe the potential of leveraging emerging technology-based interventions to support family caregivers. Speaker one will outline considerations for design and development of social engagement interventions for caregivers delivered via video-conferencing platforms. Speaker two will describe the development and initial testing of a touchscreen mobile application that supports communication between people living with dementia and their caregivers to promote person-centered care. Speaker three will describe the human-centered design of a digital health solution to improve symptom management in advanced cancer care for older adults, emphasizing specific strategies to incorporate evidence-based principles of digital inclusivity. Speaker four will present findings from a proof of concept study examining the acceptability of a virtual respite program for caregivers of individuals with dementia. Speaker five will explore the potential for crowdsourced mapping technologies to support caregivers of people living with dementia. The discussant will tie together themes, offer recommendations for future intervention research with family caregivers, and discuss implications of emerging technologies on practice, policy, and research.
ENVISION: A DIGITAL TOOL TO IMPROVE SYMPTOM MANAGEMENT AMONG OLDER ADULTS WITH ADVANCED CANCER
Authors: Washington Karla , Donehower Allison , Oliver Debra Parker , Benson Jacquelyn , Demiris George
Published: December 2023

Hospice is a largely community-based healthcare service provided by an interdisciplinary team of professionals who partner with patients and their family members to control pain and other distressing symptoms commonly encountered at end of life. Research has shown that, despite receipt of hospice care, older patients with advanced cancer experience high rates of symptom distress. This presentation will describe the human-centered design of ENVISION (ENgagement and Visualization to Improve Symptoms In ONcology care), a digital health solution designed to improve hospice symptom management by strengthening patients’ and families’ symptom management self-efficacy and increasing the caregiver-centeredness of communication with hospice teams. Particular emphasis will be placed on design considerations adopted to enhance the digital inclusivity of the tool, resulting from research conducted to address the following research question: To what extent is ENVISION accessible, adoptable, and applicable to the strengths and needs of older hospice patients and their family caregivers? In answering this question, researchers conducted a multi-method qualitative study during which 34 users (including hospice nurses, social workers, physicians, chaplains, and family caregivers) were individually observed using the tool and interviewed about their experiences. Data were analyzed via conventional content analysis. Findings informed recommendations to address both digital and health literacy concerns, simplify data visualizations, and focus more specifically on high-priority symptoms and other wellbeing indicators, resulting in a more digitally inclusive tool with promise to improve the lives of older adults with advanced cancer and the family members who care for them.
DEVELOPING A TOUCHSCREEN COMMUNICATION DEVICE TO EMPOWER PEOPLE WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Brown Ellen , Ruggiano Nicole , Allala Sai , Puche Gabriel , Roberts Lisa , Framil C , Munoz Mariateresa , Hough Monica
Published: December 2023

People living with dementia (PLWD) often experience communication deficits that create frustration and challenges to caregiving and clinical care for this population. It also constrains person-centered care. To address communication challenges, an interdisciplinary team developed a mobile communication app that promotes communication by PLWDs about their daily care preferences and experiences. This app, My Person Assisted Touchscreen Interface (My PATI), empowers PLWDs and their caregivers by supporting communication with a fully-customizable platform. This platform allows the PLWD to express preferences for daily activities, such as preferred foods and clothing options. It also enables the PLWD to express their experiences relevant to symptoms of pain, depression, and sleep quality. This presentation will describe a multi-phase Quality Implementation Framework that the research team has applied in developing My PATI to maximize its potential for being adopted into the home and residential care settings and used by multiple caregivers. The presentation will include the My PATI implementation video and foundational research: qualitative interviews with PLWDs, caregivers of PLWD, alpha and beta testing with dyads of caregivers and PLWDs, and extensive assessment and development planning with clinicians, geriatric researchers, computer scientists, and a graphic artist to inform My PATI functions and design. The presentation will also describe the designs of future pilot testing and randomized control trial studies that are planned for 2024.
THE PAID AND FAMILY DEMENTIA WORKFORCE IN THE COVID-19 PANDEMIC ERA
Authors: Donelan Karen
Published: December 2023

The COVID-19 pandemic has had a disproportionate impact on persons living with dementia and their carers. The early period of the pandemic led to drastic changes in dementia care at home, in healthcare services, community programs, and institutional care settings, with lasting effects (Capstick et al., 2022; Giebel et al., 2022). This symposium describes the impact of the COVID-19 pandemic on a variety of individuals providing care for persons living with dementia through different stages of the pandemic. Our work will be presented within a translational framework and include a discussion of ways of leveraging findings to improve resources for individuals and caregivers living with dementia in the COVID-19 era. Karen Donelan will provide an overview of the dementia workforce and describe study procedures. Michael Vetter will describe findings from a survey study of self-efficacy of dementia caregiving for family caregivers of individuals in community and assisted living facilities (ALF). Inga Antonsdottir will describe survey data on family caregivers in community and ALF – focus on newer experiential members; how lives changed, how COVID impacted them. Esteban Barreto will present findings describing the impact of the COVID-19 pandemic on frontline staff. Finally, Sarah Bannon will present findings from a qualitative study identifying family caregivers’ impressions of their psychosocial stressors and enacted coping strategies in the post-vaccine era of the COVID-19 pandemic.
IMPACT OF THE COVID-19 PANDEMIC ON FRONTLINE PAID DEMENTIA WORKFORCE STAFF
Authors: Barreto Esteban
Published: December 2023

Background

Patients, families and the frontline paid workforce caring for persons with dementia faced dramatic change and high risk in the time of COVID-19 due to underlying vulnerability toward the disease as well as isolation, lockdown, and visitation restrictions. Purpose: The purpose of this study was to examine the paid and informal care workforce caring for persons with dementia at home, in assisted living and skilled nursing facilities. This analysis will focus on the impact on paid workers in ALF and SNF.

Methods

We conducted online and paper surveys of 182 workers caring for persons with dementia during the COVID-19 pandemic in several assisted living facilities in New England (n=82) and a large skilled nursing facility in Florida (n=100)

Results

A majority of workers were not married and had less than college level education. 66% knew patients who died of COVID-19; 90% or more said they were exposed to the virus personally. Half reported mild, moderate or severe changes due to the pandemic on their personal access to health care, food security and sleep. Workers in ALF were more likely to report only good or fair personal health status. Most workers indicated they had sufficient education about infection control.

Conclusion

The workforce in long term services and supports has been the slowest to recover from job losses during the pandemic. Further studies are needed to inform the health and social needs of workers caring for persons with dementia.
LESSONS FROM FOUR DECADES IN AGING POLICY AT THE UNIVERSITY OF SOUTHERN CALIFORNIA: WHAT A LONG FINE TRIP IT’S BEEN
Authors: Wilber Kathleen , Henke Maria , Jacobson Mireille
Published: December 2023

Aging policy has come a long way over the last four decades. Building on the history of leadership in policy and aging at the University of Southern California’s Leonard Davis School of Gerontology, we offer six lessons from the intersection of policy, practice, and research for researchers and for those interested in careers as policy gerontologists. Lessons include: 1) Researchers must communicate scientific truths clearly, humbly, often, relevantly, and broadly to a wide array of key stakeholders; 2) To continue to build the bench for the next generation of leaders, interested educators should convene to plan a Policy Leadership Program 2.0. 3) Researchers and practitioners should remember: If everything is going according to plan, something is wrong; 4) Those considering policy research, program development, or program evaluation should recognize that it can be funded by a variety of sources with different strengths and constraints; 5) Given a host of innovative ideas, perspectives, programs and services, in the aging policy space, evaluators and researchers will learn far more from those doing policy and practice work than they can ever hope to repay; 6) Progress is not linear nor does it consistently advance in the hoped for direction. It requires patience, persistence, and stamina.
IT WORKS FOR US: BRIDGING THE GAP BETWEEN EDUCATION, PRACTICE, AND POLICY IN GERONTOLOGY AT MIAMI UNIVERSITY
Authors: Kinney Jennifer , Abbott Katherine , McLaughlin Sara , Janssen Leah , Applebaum Robert
Published: December 2023

We describe a unique and successful partnership between the Department of Sociology and Gerontology and the Scripps Gerontology Center at Miami University in Oxford, Ohio. This partnership concurrently facilitates research that informs aging policy and gerontological training for students. After a brief description of the partnership, examples of current research that contributes to public policy at the federal, state, and local/provider levels are presented, along with students’ roles in these efforts. Next, we share factors that contribute to our success (e.g., attracting students from diverse backgrounds, using a shared mentorship model) and challenges (e.g., that research and policy move at different paces). We conclude with a look to the future, specifically, the need to engage students in our academic programs, maintain our long-standing relationships, and build new, cross-organizational ties so that future gerontologists will continue our mission of doing work that positively impacts older people.
UNDERSTANDING AGE DIFFERENCES IN GRIEF SUPPORT NEEDS: RESULTS FROM A COMMUNITY-WIDE SURVEY
Authors: Collins-Pisano Caroline
Published: December 2023

Experiences of grief and bereavement differ across the lifespan. As such, needs for community grief services may vary based on age. This presentation outlines age differences found in the community-wide survey conducted during the Exploration and Preparation phases of the EPIS framework. A total of 668 community members within an age range of 18-65+ completed the survey. The majority of participants were 18-29 (n = 358, 54%), 28% were 65 or older (n = 186), 11% ages 50-64 (n = 71), and 8% ages 30-49 (n = 52). Survey results revealed both age differences and similarities in experiences of loss, participation in past grief services, likelihood of participating in future grief services, and barriers to participating in services. Respondents aged 65 or older experienced significantly greater lifetime loss compared to other age groups, with 100% reporting having experienced the death of someone significant to them. Yet, older adults and adults aged 30-64 reported similar rates of participation in past grief services. However, while older adults shared the least barriers to participating in grief services, they reported similar likelihoods of participating in a variety of future grief services as adults aged 30-49 or 50-64. The survey demonstrated that while older adults experienced the greatest amount of loss, they did not report the highest overall likelihood of utilizing grief services. Rather, each age-group presented a distinct and nuanced hierarchy of preferred grief services and needs, the details of which will be explained further in this presentation.
IMPLEMENTING GRIEF SERVICES FOR OLDER ADULTS: TRANSLATING SURVEY FINDINGS INTO TARGETED PROGRAMMING
Authors: Weiskittle Rachel
Published: December 2023

This presentation will identify and describe the team’s ongoing efforts in actuating the Implementation phase of the EPIS Framework. Evidence-based strategies include formulating a multidisciplinary implementation team, organizing purveyor and intermediary support, and developing a Monitoring, Evaluation, and Learning (MEL) plan. We will highlight the ways in which survey findings were disseminated to the general public and organizational leaders, such as presenting result summaries at city council meetings and in local newspaper articles. The challenges of negotiating survey findings into cohesive program implementation will be discussed, as well as management strategies towards age-related gaps in the implementation process that had not been identified previously. Recent program launches and the ways in which survey results directly informed their delivery will also be reviewed, namely, a free educational guest-speaker event for which over 700 community members attended and a grief-support holiday vigil hosted at a local long-term care facility. This presentation will also review considerations for the project’s next steps as it continues to hone its program delivery parameters and eventually enters into the last EPIS phase, Sustainment. Specific foci will include deciding the long-term methods of quality assurance evaluation and program adaptations to revolving community bereavement needs.
EXPLORING INEQUALITIES IN HEALTHY AGING: MANY APPROACHES BUT WHICH IS MOST USEFUL FOR POLICY?
Authors: Hanratty Barbara , Muniz-Terrera Graciela
Published: December 2023

Promoting healthy ageing requires an in-depth understanding of health inequalities. There are many different ways in which experiences of health and care may be inequitable, and numerous ways of studying this. In this symposium, we present findings from five disparate studies, united by an intention to shed light on unequal ageing. Our work utilises individual characteristics (frailty), aspects of care received (polypharmacy), access to services (digitalisation), different data sources (social care) and evidence synthesis methods, to characterise inequalities in later life, and inform policy. We start with a multi-method study of digitalisation in health services during the coronavirus pandemic, examining the impact of digital exclusion on inequalities in later life. Analysis of cohort data from the English Longitudinal Study of Ageing investigates associations between socio-economic measures and frailty free life expectancy in the over 50s. The impact of years of education on polypharmacy is explored in the Cognitive Function and Ageing Studies, and the value of information on social care provision exploited in analysis of real-world data. The final presentation will cover the development of a conceptual framework to ensure inequalities are considered within evidence synthesis Discussion will draw together the commonalities and differences of these approaches, and consider which have utility for policy makers, and how methods and approaches can be combined to produce an in-depth understanding of inequalities in healthy ageing.
DEVELOPING A HEALTH INEQUALITY/INEQUITY CONCEPTUAL FRAMEWORK TO SUPPORT EVIDENCE SYNTHESIS STUDIES
Authors: Kunonga Tafadzwa Patience , Bower Peter , Hanratty Barbara , Craig Dawn
Published: December 2023

This study aimed to develop a conceptual framework to guide people conducting evidence syntheses, to enable them to visualise links, and intersectionality between various factors that affect health inequality or inequity. Currently, there is no clarity or guidance on how health inequality or inequity should be defined or considered in evidence synthesis, despite recent improvement in reporting standards. In addition, current guides are limited in their ability to provide a roadmap for reviewers that enables them to visualise the links and intersectionality between various factors that affect health inequality or inequity. A series of consensus development workshops were conducted in Spring 2023. Experts in evidence synthesis and health inequality or inequity participated. The workshops were based on methods used previously by researchers developing clinical guidelines. Workshop discussions were centred on (1) important issues/barriers that prevent researchers from having a consensus definition for health inequality or inequity, and (2) how researchers could consider intersectionality of factors affecting health inequality or inequity? Thematic analysis of workshop data and a prioritisation workshop informed the development of a novel conceptual framework. This will be presented and address in particular, ideas around the accumulation of advantage and disadvantage across the life course alongside other dimensions of health and health inequality or inequity.
NOVEL BEHAVIORAL HEALTH APPROACHES FOR OLDER ADULTS IN UNDERSERVED COMMUNITIES
Authors: Mace Ryan , Vranceanu Ana-Maria , Heffner Kathi
Published: December 2023

Chronic conditions and related stressors among older adults are leading drivers of disability, morbidity, and healthcare costs in the US. Underserved communities have the highest rates of chronic conditions and are at the greatest risk for negative health outcomes. Novel behavioral health approaches are needed to address barriers faced by these communities (e.g., stigma, discrimination, structural inequalities) that exacerbate health disparities. Consistent with the GSA 2023 theme, this symposium will showcase multidisciplinary initiatives to build bridges to clinical care, catalyze community-engaged research, and empower underserved older adults. Presenter 1 will present the protocol, preliminary results, and “lessons learned” recruiting ethnoracially diverse older adults for a fully-powered efficacy RCT (target N=260) of Active Brains, a virtual group mind-body walking program aided by Fitbit targeting comorbid chronic pain and early cognitive decline. Presenter 2 will present focus groups with patient and medical provider stakeholders to culturally adapt a mind-body activity program (GetActive) for disadvantaged older adults with chronic pain in community clinics. Presenter 3 will present the rationale, design, and challenges of an RCT testing the effectiveness of a peer support program (Peer Enhanced Depression Care) to alleviate depressive symptoms in ethnoracially diverse and/or low-income older adults (N=160). Presenter 4 will present a stakeholder-partnered approach to equitable home care for older adults and caregivers in diverse communities by eliminating transportation-related barriers. The Discussant will contextualize these initiatives in the broader field of gerontology and share research from their Roybal Center to engage community agencies and ethnoracially diverse older adults.
ADDRESSING COMORBID CHRONIC PAIN AND EARLY COGNITIVE DECLINE IN OLDER ADULTS: THE ACTIVE BRAINS EFFICACY TRIAL
Authors: Mace Ryan , Vranceanu Ana-Maria , Choukas Nathaniel , Rochon Elizabeth , McDermott Katherine , Hooker Julia , Ritchie Christine
Published: December 2023

Chronic pain (CP) and early cognitive decline (ECD) are costly, highly prevalent, and challenging to treat among community-dwelling older adults. CP and ECD commonly co-occur, exacerbate each other, and can accelerate dementia. Our interdisciplinary team has developed Active Brains (AB), a virtual group mind-body walking program aided by Fitbit, to address this comorbidity. We are conducting a single-blinded, NIH stage 2 RCT to establish the efficacy of AB versus a time- and dose-matched education control (Health Enhancement Program; HEP) in 260 older adults with CP and ECD. In this symposium, we will describe the study design, recruitment numbers, and maximizing the inclusion of racial and ethnic minoritized older adults (38% benchmark). Participants are recruited through providers, social media, and community partnerships. Participants wear an ActiGraph to monitor steps and are randomized to 8 weeks of AB or HEP delivered via Zoom by an MGH psychologist. The AB group receives a Fitbit to reinforce activity goals. Primary (multimodal physical function) and secondary (cognitive and emotional function, pain) outcomes are collected at baseline, post-intervention, and 6 months. We have recruited 37 participants (4 cohorts). All 37 completed the baseline, 26 completed the post-test, and 9 are currently enrolled (total dropout = 5%). Session attendance (92.8%) and watch adherence (93.5%) have been excellent. The trial will establish efficacy, test mechanisms, and inform a future multi-site effectiveness-implementation trial. Consistent with the GSA 2023 theme, AB has the potential to catalyze non-pharmacological interventions for CP–ECD and empower older adults to maintain active and meaningful lives.
ADDRESSING THE CHRONIC PAIN EPIDEMIC AMONG OLDER ADULTS IN UNDERSERVED COMMUNITY HEALTH CENTERS
Authors: Vranceanu Ana-Maria , Greenberg Jonathan , McDermott Katherine , Ehmann Madison , Lecvy Nadine , Brewer Julie , Ritchie Christine
Published: December 2023

Current nonpharmacological treatments are inadequate for addressing chronic pain among older adults from disadvantaged backgrounds. These treatments have been developed for affluent populations and are not implemented in underserved community health centers (CHCs) where most older adults with chronic pain seek care. We conducted 4 focus groups with 23 providers (e.g., primary care doctors, nurse practitioners, medical interpreters and support staff) and 4 focus groups with 15 English- and Spanish-speaking patients at a CHC. Our goals were to: 1) understand barriers and facilitators to sustained implementation of the GetActive+ mind-body activity program delivered by a nurse practitioner; 2) gather perceptions of program skills to facilitate cultural tailoring; and 3) gather information to support a future hybrid type 1 effectiveness implementation trial of GetActive+ versus usual care to improve pain outcomes. Qualitative analyses were conducted using a deductive-inductive approach and the Framework method. Questions were informed by Aaron’s implementation model and the Socioecological model. Results revealed multiple barriers at the individual (e.g., pain misconceptions, perceived bias, stigma, shame, treatment expectations and loneliness, language barriers, food and financial insecurity), health clinic (e.g., provider burnout, understaffed clinic, budget cuts, multiple languages) and environmental levels (e.g., lack of technology, lack of reliable transportation to clinic, billing challenges). Clinic providers felt unprepared to support older adults with chronic pain. Both patients and providers endorsed the need for, and skills of GetActive+. Nuanced differences between patient-provider and English-Spanish patients as well as modifications to the program manual, protocol, and interventionist training will be discussed.
ASSESSING MOTOR FUNCTION IN FRAIL OLDER ADULTS IN THEIR HOME SETTING: CHALLENGES AND OPPORTUNITIES
Authors: Yin Lijuan , Song Woojin , Skowronski Jordan , Caceres Maria
Published: December 2023

Motor function is essential for older adults to perform daily activities and remain in their home as they age. Mounting evidence suggests that physical activity (PA) helps maintain motor function in older adults. However, few evidence-based PA programs exist for home-bound older adults who have difficulties walking or standing. They are typically excluded from randomized controlled trials (RCT). Evidence is difficult to establish, because of the lack of instruments and protocols for assessing motor function safely and effectively in this population. The goal of this paper is to present challenges and opportunities that we encountered in assessing motor function in 119 participants of the Pro-Home study right before the COVID-19 pandemic. As expected, participants had significant physical limitations. One third of the participants did not feel safe doing balance tests or chair stand test included in the Short Physical Performance Battery. Of those who did the balance tests, two thirds had to use compensatory movement or hold on to an object to maintain balance. Interestingly, 30% of participants had cognitive impairment as defined by 1.5 Standard Deviation below the normative mean measured by NIH Toolbox Cognition Battery, although they passed a six-item cognition screener to be eligible for Pro-Home. The challenges of assessing frail older adults have led to opportunities to adapt assessment protocols. We made instructions clear and easy-to-follow and developed a new measure appropriate and safe for our target, frail older participants. Additional safety measures are needed to facilitate motor function assessments in frail older adults.
PALLIATIVE CARE IN RESIDENTIAL CARE HOMES: IMPLEMENTATION CHALLENGES AND EARLY FINDINGS IN THREE CLINICAL TRIALS
Authors: Unroe Kathleen , van der Steen Jenny
Published: December 2023

This symposium will describe, compare and contrast three active clinical trials implementing palliative care models for people with dementia in residential care facilities and nursing homes. SPA-LTC is a pragmatic clinical trial in three Canadian provinces, providing training to palliative care teams and a process for triggered palliative care conferences. EMBED-Care, based in the United Kingdom, is testing a digital clinical support tool to improve integrated palliative care for people with dementia using holistic assessment and promoting shared decision-making. UPLIFT-AD is a multi-state U.S. based clinical trial, providing training for in-facility Palliative Care Leads and facilitating specialty palliative care clinician consults for people with moderate to advanced dementia. This symposium provides an opportunity to compare methodologic choices in study design, including intervention design, use of internal (care facility) based resources vs. external supports, and outcome assessment. Presenters will describe implications of these design choices for the implementation of the trial and for longer term sustainability. Implementation experience, including barriers and facilitators to palliative care programs for people with dementia, will be described.
WORKPLACE EMOTIONAL EXPERIENCES, TIME SAVORING, AND HELPING BEHAVIORS IN AN AGE-DIVERSE SAMPLE OF ADULTS
Authors: Growney Claire , Chu Li , Carstensen Laura
Published: December 2023

Socioemotional selectivity theory suggests that as future time perspective grows limited with age, older adults place greater priority on emotionally meaningful experiences and social relationships. Older adults are also theorized to savor time spent in emotionally meaningful activities and social interactions. A preliminary study found that age was associated with higher experience of positive emotion at work. In addition, we found that age was positively associated with trait-level reports of time-savoring, which in turn predicted higher engagement in helping behaviors. We will present findings from a study utilizing the day reconstruction method (DRM) that examines associations between time-savoring at work and engagement in positive workplace behaviors in full-time workers. For one full workweek, participants (N = 200, aged 25–80) complete a survey at the end of each day asking about their workdays parsed into three segments. They report on their social and emotional experiences, the extent to which they were savoring their time engaged in different workplace activities, and their helping (e.g., providing advice to a co-worker) and learning (e.g., developing new ideas or solutions to problems) behaviors during each segment of their workday. Findings have implications for workplace productivity in increasingly age-diverse workplaces. Time-savoring at work may be conducive to intergenerational transfers of knowledge.
FUTURE PREOCCUPATION AND WELL-BEING: EXPANDING CONCEPTUALIZATION OF FUTURE TIME PERSPECTIVE
Authors: Chu Li , Matteson Tyler , Carstensen Laura
Published: December 2023

Socioemotional selectivity theory posits that people prioritize emotionally meaningful goals as time horizons grow shorter and this shift in goals contributes to enhanced well-being. However, studies using the future time perspective (FTP) scale have yielded mixed findings regarding the association between time horizons and well-being. The present study aims to explore alternative constructs of time horizons to better understand well-being across the life span. In this preliminary study, a sample of 101 adults (age M = 46.99, SD = 19.20; 33 males, 66 females, and 2 indicated other gender identity) filled out an online questionnaire regarding time horizons and well-being. Exploratory and confirmatory factor analyses resulted in a new time horizon construct - time preoccupation, which captures the worries and fixations associated with future preparation. Serial mediation modeling shows the trend that people experience reduced future preoccupation with age, which contributes to more time savoring, and thus better well-being outcomes. Together, our findings suggest a promising role of future preoccupation in people’s well-being across the life span. These findings have important implications for future interventions that aim to improve younger adults’ well-being.
TECHNOLOGY-BASED ASSESSMENT OF EMOTIONS AND SOCIAL BEHAVIORS IN OLDER ADULTS’ AND COUPLES’ HOMES
Authors: Chen Kuan-Hua , Levenson Robert
Published: December 2023

As people age, emotions and close social interactions are increasingly important because our social circle tends to shrink. Research on social and emotional aging typically relies on questionnaires and laboratory assessments. However, most emotions and social behaviors occur in naturalistic and interpersonal contexts. Advances in modern technologies, including telecommunications, mobile or embedded devices and sensors, provide researchers with exciting opportunities for naturalistic, long-term, objective, and timely assessment of emotions and social behaviors outside of the lab. Increased accessibility of technologies further allows community-based, large-scale assessment. The proposed symposium highlights recent advances in-home assessment of emotions and social behaviors from four different institutions that leverage various active (e.g., ecological momentary assessment, portable lab) and passive (i.e., motion and door sensors, wearables) technologies to assess multiple aspects of emotions and social behaviors (e.g., physiological responses, emotional experience, behaviors and interpersonal behavioral synchrony, apathy, agitation) in healthy and clinical aging. Four presentations covering four different exemplary studies will be given by researchers at different career stages with diverse ethnic/cultural and training backgrounds (e.g., mechanical engineering, psychology, neuroscience). An integrated discussion will be given by a senior researcher and leading expert in the area. Together, the symposium will provide the general audience with an overview of recent advances in in-home assessment technologies. This symposium will also launch communication and collaborations between researchers from different disciplines who use (or plan to adopt) contemporary technologies to conduct research in naturalistic settings to promote a better understanding of human social and emotional aging.
THINKING ABOUT TIME INFLUENCES EMOTIONAL EXPERIENCE DIFFERENTLY IN OLDER AND YOUNGER ADULTS
Authors: Chen Enna , Growney Claire , Carstensen Laura
Published: December 2023

According to socioemotional selectivity theory (SST), as future time horizons shorten with age, people come to prioritize present-oriented, emotionally meaningful goals. SST posits that present orientation contributes to emotional well-being. Using experience sampling, the present study examined (1) age differences in momentary time orientations, (2) associations between momentary time orientations and emotional well-being, and (3) age moderation of these associations. A sample of 190 people, aged 18 to 94 years, participated in an ecological momentary assessment study where they simultaneously reported time orientations and experienced emotions at five randomly selected times every day for seven days. . We found that age was not associated with time orientation. However, on occasions when people thought about the past, they experienced less positive affect and more negative affect. On occasions when people thought about the present, they experienced more positive affect. All of these effects were weaker for older as compared to younger participants. However, the association between thinking about the future and positive or negative affect did not vary by age. Findings suggest that younger adults, even more than older adults, benefit emotionally from focusing on the present.
SOCIAL CONNECTEDNESS ACROSS THE LIFE COURSE: CORE NETWORKS AND EVERYDAY SOCIAL INTERACTIONS OF AMERICAN ADULTS
Authors: Peng Siyun , Roth Adam , Perry Brea
Published: December 2023

Scholars have been monitoring the signs of social isolation and weakening of family ties among Americans. This paper asks: (1) Do Americans socially disengage from society as they age? (2) Are family ties replaced by work or friends as Americans grow out of their original family? Using a state representative sample of egocentric network data (Person to Person Study: P2P) and a national representative sample of time dairy data (American Time Use Survey: ATUS) during 2018-2021, we found that although people spent less social time with others as they age, they maintained a stable sized core network of confidants for discussing important and health matters. This refutes the view that old age has a universal negative influence on social connectedness. We found little evidence that family ties are replaced by non-kins at any age in both core network and daily social contact. By combining core network and time dairy data, we found that although people spent substantial time with coworkers daily when they enter the workforce, they rarely included even a single coworker into their core network. This suggests that people’s core network is less influenced by current daily social interactions than many theories on social contact would predict. We speculate that people may organize their core network based on cumulative time they spend with a particular person over the life course rather than current time. The roles of life events and age in shaping changes in daily interactions and core network over the life course are further discussed.
HEALTH CARE ACCESS AND USE AMONG ADULTS AGING WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
Authors: Stokes Jeffrey E , Waldron Danielle A , Sauer Jacquelin , Hartford Emily
Published: December 2023

Adults with intellectual and developmental disabilities (IDD) are living longer than ever before, a testament to advancements in healthcare. However, adults with IDD face a number of challenges accessing healthcare, and particularly preventative healthcare targeted towards midlife and older adults, which have previously been far less utilized by adults aging with IDD. This study uses longitudinal data from the National Core Indicators In-Person Survey (NCI-IPS) to examine factors associated with adults with IDD’s utilization of two preventative healthcare measures specific to mid- and later life: mammograms and colonoscopies. Both mammogram and colonoscopy utilization exhibited curvilinear age trajectories, with usage increasing through ages 60 and 65 respectively, before decline at older ages. For both mammogram and colonoscopy utilization, living with family was associated with a 50% lower likelihood of utilization, while poor health, access to transportation, and community inclusion were associated with increased usage. For mammograms, participating in a community activity was also associated with increased utilization. Women with IDD were also about 25% less likely to receive a colonoscopy than men. Interestingly, the likelihood of receiving a mammogram dropped significantly in 2018-2019 compared to a decade prior, whereas the likelihood of receiving a colonoscopy increased over time. No racial/ethnic differences were found. Results highlight a number of factors associated with preventative healthcare use among the population of adults aging with IDD. These were similar for mammogram and colonoscopy utilization, and highlight the importance of living situation, transportation, and community engagement for adults with IDD’s access to preventive medicine.
EVALUATION OF EDUCATION INITIATIVES TO INCREASE DELIVERY OF AGE-FRIENDLY CARE IN CONVENIENT CARE CLINICS
Authors: Schiltz Nicholas , Bender Anna , Armstrong Grace , Foradori Megan , Duffy Evelyn , Pohnert Anne , Dolansky Mary
Published: December 2023

The Age-Friendly Health Systems model of care reliably provides four evidence-based elements of high-quality care, to all older adult patients: What Matters, Medications, Mentation, and Mobility (the 4Ms). MinuteClinic at CVS implemented the 4Ms model in all 1100+ locations nationwide in May 2020. To prepare MinuteClinic providers to deliver 4Ms care, educational modules were developed to provide an understanding of the gerontology that supports the 4Ms model of care: an orientation module with two scenarios illustrating the usual care of an older adult patient followed by the same patient receiving 4Ms care, monthly grand rounds (case studies of older adult conditions with the 4Ms), and ten video vignettes regarding integration of 4Ms care. Our goal was to evaluate the effectiveness of these education initiatives, as measured by changes in the mean number of Ms delivered per visit. Over 70% of 3,188 providers completed at least one education module. The rate of 4Ms delivery was 1.7 times higher (p< 0.001) among those completing at least one education module, and 5.7 times higher (p< 0.001) among those completing ten or more modules compared to those who completed none. Each course was associated with significant within subject increases between 10% and 38% in 4Ms delivery in the month following course completion. The self-directed learning environment (e.g., providers self-select into number and type of courses) reflects real-world variation in engagement; despite this variation, improvements in 4Ms delivery were observed at any educational dose, underscoring the value of prioritizing education time with quality improvement initiatives.
SOCIAL RELATIONSHIPS AND DUAL FUNCTIONALITY IN LATER LIFE
Authors: Thomas Patricia , Sauerteig-Rolston Madison , Bauldry Shawn , Nemeth Samuel , Ferraro Kenneth
Published: December 2023

Longer lives are often accompanied by greater risk of cognitive and physical impairments, but we investigate whether social relationships reduce the risk of those impairments. We examine dual functionality – the absence of both dementia and activities of daily living impairments – and draw upon stress process and social integration theories to examine the impact of positive and negative dimensions of relationship quality with friends and family to better understand how social factors may affect how long people maintain both their physical and cognitive functioning in later life. We use nationally representative panel data from the Health and Retirement Study (2006-2016, N=6,985) and Weibull accelerated failure-time models. Higher strain with family members and with friends was associated with a loss of dual functionality at earlier ages (Time Ratio = .97 [95% CI: .95, .99] and TR = .96 [CI: .94, .98], respectively). Greater social support from family members was beneficial, related to a longer time as dual functional (TR = 1.04, CI: 1.02, 1.06); however, more support from friends was related to loss of dual functionality at earlier ages (TR = .98, CI: .96, .99). Findings reveal the implications of social support and strain in different types of relationships for dual functionality.
CARING SELF-EFFICACY AND BEHAVIORS OF MIGRANT NURSING ASSISTANTS WORKING IN RESIDENTIAL AGED CARE FACILITIES
Authors: Shrestha Sumina , While Christine
Published: December 2023

Data show a significant proportion of nursing assistants from migrant backgrounds in the Australian aged care industry. However, compared to locally-born counterparts, they are more likely to be employed as casual staff and offered shorter shifts, irregular hours, and lower pay, often without employment benefits. Previous studies have shown that the working environment of an organization influences employees’ self-efficacy, affecting their performance. This study hypothesized that migrant nursing assistants from non-English-speaking countries have lower confidence in caring for older residents and, thus, execute less-satisfactory caring behaviors than their local, English-speaking colleagues. The caring self-efficacy was quantitatively measured from the perspective of nursing assistants in residential aged care facilities (N = 280), and caring behaviors were explored from older residents’ perspective (N = 13). Results showed that nursing assistants whose first language was not English had lower levels of caring self-efficacy than native English speakers. However, older residents found that they frequently met residents’ individual needs and were more competent, emotionally present, respectful, and amiable, despite communication issues. Older residents insisted that the personalities of nursing assistants have a greater impact on their job performance than their backgrounds. These findings suggest that although migrant nursing assistants from non-English-speaking countries had low self-efficacy to carry out their job, their performance was appreciated by older residents. This study supports the Australian government’s strategy of using immigration to prevent or respond to an aged care workforce crisis, but it also advocates for improved working conditions, organizational resources and benefits for those with non-English-speaking backgrounds.