bluuebunny/crossref_metadata_2025 huggingface dataset:
TAILORED CARE FOR TERMINALLY-ILL OLDER ADULTS: INTEGRATED COMMUNITY-BASED END-OF-LIFE SUPPORT TEAM MODEL (ICEST)
Authors: Zhang Anna Yan , Fang Estelle Xun , Chun Gloria Ka Ming
Published: January 2025

Background

The integrated community-based end-of-life support team (ICEST) tailored the physical-psychosocial-practical care for community-dwelling terminally ill patients and enhanced the capacity of family caregiving through ongoing assessments and seamless interdisciplinary cooperation. The study evaluated the deceased patients’ first three-month care profiles and outcomes.

Methods

An intervention study with three-time-point repeated measures. Public hospitals identified and referred eligible older adults (age ≥ 60, life expectancy ≤12 months) to receive ICEST services. Patients’ clinical symptoms were measured at baseline, one month, and three months after, and the care they received was recorded. Deceased cases (n=756) were extracted for analysis. Repeated ANOVA was used to analyze the changes in care profiles and clinical outcomes using SPSS 27.0.

Results

The ICEST could significantly reduce patients’ physical and psycho-social-spiritual symptoms. Except for patients with a short survival period (≤3 months), they experienced a sharp worsening of pain (F (3,188)=2.82,p<.05) and weakness (F (3,188)=5.32,p<.01) and drowsiness remained consistently high (F (3,190)=6.29,p<.001). Depression levels of patients with a longer survival period (>12 months) decreased more after 1st month (F(3,168)=2.68,p<.05). The highest input was in psychosocial care. No significant change was found in its input or physical care, and practical support increased after the 1st month. Psychosocial care for patients with shorter survival periods (≤3 months) was higher initially and decreased later, whereas others showed the opposite trend.

Conclusion

Various care profiles indicated the moment-by-moment changes in care demands among community-dwelling terminally ill patients. Timely assessments and corresponding adjustments of interventions to address real-time needs are essential.
CARING FOR CANCER PATIENTS LIVING WITH DEMENTIA: CHALLENGES AND WAYS FORWARD
Authors: Canning Shelley , McKenzie Michael , St-Martin Genevieve , Kaur Jagbir , Percival Nicole , Hung Lillian , Jackson Lynn , Wan Rachel
Published: January 2025

The purpose of this study is to address the inequity of care outcomes for patients living with both cancer and dementia through exploring current challenges and barriers, with the goals of creating dementia-friendly cancer care practice recommendations and education. Cancer patients also living with dementia have been found to experience poor outcomes, receiving less cancer screening, staging, and curative treatment than patients without dementia, thus they are typically diagnosed at later stage cancers with lower survival rates. We are conducting a qualitative applied health study drawing on Interpretive Description methodology underpinned by a person-centred philosophy. Phase one of the study has involved conducting interviews with patients, their care-givers, and cancer care providers. In this presentation we are focusing on the findings from our interviews with cancer care providers. Our sample includes 15 RNs, and 15 participants including physicians, therapists, and counsellors. Although they are experts in cancer, care providers often lack confidence and knowledge regarding dementia-care. Findings from their interviews led to themes reflecting both challenges and barriers to providing care. Specific themes related to care challenges include: Difficulty Following Instructions; Balancing Treatment Risks with QOL; Including Care-givers; and Ethical Dilemmas. Additionally, specific themes related to barriers include: Lack of Communication Processes; Lack of Continuity of Care; Lack of Resources; and Lack of Dementia Education. These themes will inform Phase two of the study which will involve creating dementia aware education and recommendations for dementia-friendly policies and processes to better tailor cancer care for patients living with dementia ensuring equity.
DEVELOPING AN ONLINE TRAINING COURSE FOR OLDER-ADULT VOLUNTEERS TO LEAD DEMENTIA ACTIVITY PROGRAMMING
Authors: DiFranco Lacey , Orsulic-Jeras Silvia , Gorzelle Gregg , Powers Sara , Skrajner Michael
Published: January 2025

Research over the last decade has strongly supported the use of music intervention to treat symptoms of dementia. Making Connections Through Music (MCTM), a group music intervention designed for persons living with dementia (PLWD), utilizes older adult volunteers as session leaders, addressing both staff shortages in residential care and the high need for engaging socialization activities. This poster describes the development of MCTM’s online volunteer training course and presents findings from a focus group study (N=7 focus groups) aimed to test course prototypes. Two prototypes of the training were developed and tested with older adult volunteers (n=25; Mage = 76.5; 76% female) and long-term care staff (n=25; Mage = 47.2; 88% female). A thematic analysis yielded a list of recommended changes and identified critical content areas for preparing volunteers to be effective session leaders. Volunteer and staff focus group findings determined a large number of themes including the following: 1) Specific training modules on responsive behaviors, communication challenges, and dementia education; 2) Format preferences such as a self-paced structure and interactive features; 3) Hesitancy with technology-based training; 4) Desire for having supplementary materials available; and 5) Importance of leveraging technology to support long-term program sustainability. Results are currently being utilized in the development of the complete MCTM volunteer online training course. Development of such a training is critical not only for MCTM but also in providing non-professionals the tools to adequately facilitate engaging activities, including group programming, for PLWD across a variety of care settings.
EXPLORING THE DIAGNOSTIC AND THERAPEUTIC JOURNEY OF PRIMARY PROGRESSIVE APHASIA: A CASE STUDY FROM A RURAL SETTING
Authors: Villaseñor Abigail Avendaño , Saidi Ladan Ghazi
Published: January 2025

Primary Progressive Aphasia (PPA) is a young-onset neurological disorder that affects a person’s language, behavior, and executive function abilities, caused by a focal degeneration of the frontal and temporal lobes in the brain. It is considered a frontotemporal dementia (FTD) due to the neuroanatomical areas it affects and the similar etiology it has with other neurodegenerative disorders. Differential diagnosis is difficult for health professionals due to the recent description of clinical variants, and the limited options for clinical treatment. In this cross-sectional and descriptive study, we reviewed the case of a 76-year-old male patient diagnosed with agrammatic primary progressive aphasia (nfvPPA) who lives in a rural area in Nebraska, living with his caregiver. The objective of this case study was to analyze the difficulties experienced by the patient before and after he was diagnosed with nfvPPA, as well as his current progress with treatment. We identified the main challenges they encountered during the diagnostic and therapeutic processes were: a delayed differential diagnosis, inadequate communication from practitioners, inefficient interprofessional communication, and limited treatment/management options. In addition, they had limited access to educational and support group resources, a lack of intervention implementation, failed efforts in the follow-up of treatment by each care provider, and difficult access to health care services. Our findings highlight the necessary changes needed in the management of patients through a collaborative model, to provide sufficient and accessible resources to navigate this diagnosis, and the importance of following up on the therapeutic progress of patients.
IN-HOSPITAL MORTALITY AMONG DEMENTIA PATIENTS IN CHINA: EVIDENCE FROM HOSPITAL ADMINISTRATIVE DATA
Authors: Lin Zhuoer , Ba Fang , Allore Heather , Chen Xi
Published: January 2025

Despite the fast-growing dementia patient population, dementia care in China is still inadequate and inequitable that may lead to undesirable disease outcomes. We assessed the in-hospital mortality for dementia patients in China and its variations across patient and hospital characteristics. Inpatient medical records of Chinese older adults admitted to 1,917 hospitals during 2017-2019 with a primary diagnosis of dementia were analyzed; and multivariate logistic regression was used to assess the association of in-hospital mortality with age bands, sex, working status, insurance type, major comorbidity, admission type, and hospital level. Out of 51,525 included admissions, 363 dementia patients died in a hospital (0.70%, 95% CI, 0.63% - 0.78%). The odds of in-hospital mortality were significantly higher for patients aged 80 and over, having lung diseases, and for those admitted through emergency room or hospital transfers, or those admitted to lower-level hospitals compared to their higher-level counterparts. These findings suggest large variations in dementia in-hospital mortality that can be associated with both patient-level and hospital-level factors. Targeted and coordinated dementia care should be promoted to reduce in-hospital mortality and provide more equitable and quality dementia care.
REDUCING CARE REFUSAL IN OLDER ADULTS WITH DEMENTIA THROUGH HUMANITUDE CAREGIVER TRAINING
Authors: Araújo João Pärtel , Van Son Catherine , Luz Helena , Melo Rosa
Published: January 2025

Background

Care refusal by older adults with cognitive impairment creates significant challenges for professional caregivers. Humanitude is a multimodal care method that promotes well-being during care for both care recipients and caregivers. This study evaluated the impact of Humanitude training for professional caregivers on refusal of care behaviors in older adults with cognitive impairment in an acute care setting.

Methods

Two 4-day Humanitude care method (HCM) trainings were conducted for 23 healthcare professionals from six geriatric wards of an acute hospital. Training included theory, simulation, and clinical practice of Humanitude techniques with identified older adults. The participants identified 17 older adults with cognitive impairment who routinely refuse care. Refusal of care was measured at baseline and after Humanitude training using the Refusal of Care Informant Scale (RoCIS).

Results

Most of the 23 healthcare professionals participating in the training were nurses, 78%, with an average of seven years of experience. The older adults identified were women (65%), with an average age of 83. All the older adults identified had a diagnosis of a major neurocognitive disorder, and the average Functional Assessment Staging Tool score was 4.9. The average RoCIS scores decreased by 71.4% after the participants used Humanitude techniques during the training’s clinical practice.

Conclusion

A brief 4-day HCM training reduced care refusal by older adults with cognitive impairment. Implementing Humanitude care methods could improve caregiver capacity to address care refusal challenges and mitigate its effects on caregiving. Studies on Humanitude’s sustainability and outcomes are needed for caregiver and organizational adoption.
TRAINING, SUPPORTING, AND ENGAGING VOLUNTEERS 55+ IN VIRTUAL COMPANIONSHIP FOR PEOPLE WITH DEMENTIA
Authors: Herpst Jessica , Samus Quincy , Marx Katherine , Kirchner Kathleen
Published: January 2025

Volunteers play an essential role in our communities and societal health. Engaging, training, and mobilizing a critical mass of volunteers to address social isolation and other dementia care needs may be a potent approach to address the dementia care crisis, and one that is attractive to older volunteers seeking to remain in impactful post-retirement roles. A collaboration between Johns Hopkins University and the Alzheimer’s Association evaluated the feasibility and acceptability of a virtual companionship program for community-residing people with dementia (PWD) delivered by trained Volunteers 55 years and older in the MEMORI Corps trial. We aim to describe the feasibility and lessons learned for recruitment, training, and support of the program volunteers. 52 eligible volunteers were recruited and 35 completed initial volunteer onboarding and training modules and were matched to provide regular virtual visits to a person living with dementia for a 12-week intervention. An approachable and responsive training program and learning environment was created that included didactic learning modules as well as initial and experiential learning opportunities supported by an interdisciplinary clinical team and weekly group-based training support. Common implementation challenges included volunteer long term commitment, difficulty using technology or low confidence using Zoom, scheduling of sessions, maintaining professional boundaries, and addressing dementia symptoms during sessions. Perceived benefits included camaraderie among volunteers; building confidence in using technology, in working with PWD and interpersonal skills; learning about healthy aging; and feeling more productive and connected to the community. Overall, volunteer engagement was feasible for volunteers and had perceived benefits.
VISUALIZING EATING EXPERIENCES IN DEMENTIA: USING MASLOW’S HIERARCHY OF NEEDS AND THE MUNSELL COLOR SYSTEM
Authors: Wang Zih-Ling , McHale Jenna
Published: January 2025

Eating experiences among individuals with dementia represent a multifaceted, subjective, and unique life journey. Despite their complexity, studies analyzing these experiences are limited. This study aims to explore the various domains that shape the trajectory of eating experiences in individuals living with dementia, adapting the Maslow’s Hierarchy of Needs five-stage model and Munsell Color System to map these experiences visually. This presentation introduces an innovative model for visualizing the antecedents of eating experiences. It proposes strategies to enhance positive outcomes and nutritional health in individuals with dementia throughout their experience trajectory. Eating experiences are described across five domains: Aesthetic, Esteem, Sociocultural and Belonging, Safety, and Physiological and Biological. As dementia progresses, increased dependency, the domains measured by degree inward towards the center, can significantly affect these eating experiences. These domains are situated by their degree, with each domain independently fluctuating in size and shape based on the degree of maintained personhood as dependency needs shift. Minimal variation within these domains is essential for optimizing the eating experience. Each domain-related experience is subject to fluctuation over time, influenced by both external and internal life events. The trajectory’s shape is a visual representation of changes in experience over time. By identifying positive and negative cases within the eating experiences, this presentation illustrates how deficiencies in specific domains can lead to negative eating experiences. Additionally, the presentation offers health professionals a method to tailor care strategies for enhancing eating experiences by interpreting current and trend domain mappings.
LABOR MARKET PROSPECTS AND FINANCIAL AND HEALTH OUTCOMES OF ADULT CHILDREN CAREGIVERS AFTER THEIR PARENTS’ DEATH
Authors: Mudrazija Stipica , Ornstein Katherine , Hernandez Fernando
Published: January 2025

As the population ages, an increasing number of adult children provide unpaid care to their parents who require help with health or function. While research and policy attention has focused on improving the caregiving experience, including workplace leave practices, little is known about the outcomes and challenges of family members once their caregiving role ends post-death. The context of caregiving, including factors such as the age of deceased parent, duration of care, level of (family) support, and caregiver gender, among others, may all impact the labor force trajectory and other adult children caregivers’ outcomes following their parents’ death. For this analysis, we use data from the 1998-2020 waves of the Health and Retirement Study, focusing on labor market trajectories, financial wellbeing and health outcomes of former caregivers ages 53-61 at the time of their parents’ death. Our preliminary results suggest that within two years of their parents’ death, adult children caregivers remain 6 percentage points less likely to work than those whose parents have not passed away. This suggests that former caregivers continue to be less likely to work than non-caregivers following the death of their parents. Additional analyses will focus on examining longer term labor force trajectory of former family caregivers as well as other outcomes of interest, including their financial wellbeing and physical and mental health status.
BUILDING CAPACITY TO ADDRESS HOARDING AND CLUTTER AMONG OLDER ADULTS: DEVELOPING A NETWORK OF TRAINED PROVIDERS
Authors: Keefe Bronwyn , Nizza Megan , Muroff Jordana
Published: January 2025

Hoarding disorder (HD) is a challenging mental health and public health problem characterized by difficulty discarding possessions, and excessive acquisition that contribute to substantial clutter and impaired functioning. HD occurs in 2-5% of adults and worsens with age. Clutter limits the ability to utilize space and function in a home, poses significant health risks, and creates housing instability. The lack of people trained in HD limits access to evidence-based assessments and interventions and home-based support that may mitigate risks. To address this, the Center for Aging and Disability Education and Research developed an online course on Hoarding Disorder in Older Adults to increase the knowledge and skills of those working in community-based agencies, including housing and local health departments. A total of 110 people completed the training, with 96% strongly agreeing it expanded their knowledge and understanding and 93% saying this training will help them to apply new practice skills. The learners showed significant improvements (p<.001) in all learning competencies from the pre-post-course self-assessments. The largest change was in the area of being able to identify intervention options and current treatment approaches with hoarding. This program can serve as a model to improve the attitudes, knowledge, and practice behaviors of a wide range of people who work with older adults. The goal is that this will lead to successfully engaging those with hoarding, which may increase openness to services, improve their mental health, and reduce public health risks so older adults can continue to live independently.
NUMERACY SKILL USE AND SKILL PROFICIENCY AMONG OLDER WORKERS IN THE UNITED STATES
Authors: Yamashita Takashi , Narine Donnette , Chidebe Runcie , Cummins Phyllis , Kramer Jenna , Karam Rita
Published: January 2025

Recent studies linked numeracy—the ability to understand numeric information -- and a variety of economic well-being outcomes (e.g., employment, income). However, aging is generally associated with lower numeracy skills, and in turn, older workers may face disadvantages in the labor market. The key to maintaining and promoting numeracy skills over the life course is continuous use in everyday life as well as at work. Yet relatively little is known about how older workers use their numeracy skills. Nationally representative data of older workers aged 50 years and older (n = 1,760) were obtained from the 2012/2014/2017 U.S. Program for the International Assessment of Adult Competencies (PIAAC) restricted-use-file pooled data. Latent class analysis was conducted to identify underlying numeracy skill use patterns. Results showed that three classes or subgroups with distinctive numeracy skill use patterns were identified. Subgroup 1 (infrequent users) only used specific and basic numeracy skills, such as calculating prices and costs at home. Subgroup 2 (occupational users) used a variety of numeracy skills, such as preparing graphs and tables, and using formulas, mostly at work. Subgroup 3 (ubiquitous users) used a variety of basic to advanced numeracy skills both at work and at home. Subgroups 1, 2, and 3 had significantly different numeracy skill proficiency scores, 247, 265, and 280 out of 500 points, respectively. Detailed demographic and socioeconomic characteristics were also examined by the identified latent classes to inform education interventions and policies to promote numeracy skills and in turn, economic well-being of older workers.
OLDER WORKERS’ DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS BY DIGITAL SKILL USE PATTERNS IN THE UNITED STATES
Authors: Yamashita Takashi , Narine Donnette , Chidebe Runcie , Cummins Phyllis , Kramer Jenna , Karam Rita
Published: January 2025

In the current technology-rich society, having sufficient skills to use information and communication technology (ICT) for problem-solving is advantageous in the labor market from a human capital perspective. However, older workers tend to have lower digital problem-solving skills than their younger counterparts. Practice engagement theory suggests that continuous use of skills can promote and maintain skill proficiency over the life course. The current study examined the digital problem-solving skills use patterns among older workers in the United States. Nationally representative samples of workers aged 50 years and older (n = 1,700) were obtained from the 2012/2014/2017 U.S. Program for the International Assessment of Adult Competencies (PIAAC) restricted-use-file pooled data. Latent class analysis with seven ICT use indicators, such as email, spreadsheet, and virtual discussions, at home and work (14 in total) identified two distinctive underlying subgroups, including ubiquitous ICT users and infrequent ICT users. The ubiquitous ICT users had a greater average digital problem-solving skills score (280 out of 500 points) than infrequent ICT users (244 points). About 25% of the ubiquitous users used virtual discussions at work, while only 3% of the infrequent users did. Subsequent binary logistic regression showed that the ubiquitous users were more likely to be younger, women, college-educated, and higher income earners than the infrequent users. Findings are useful to identify older workers who may be at risk of being digitally left behind in the labor market, as well as to inform digital problem-solving skills promotion interventions based on the ubiquitous users’ characteristics.
BUILDING BRIDGES ACROSS GENERATIONS: THE INTERGENERATIONAL CLASSROOM
Authors: Hsieh Jessica , Mirza Raza , Klinger Christopher , Hill Julianna , Janes Heather , Osmond Claudia
Published: January 2025

The issue of aging demands greater attention in education systems, and intergenerational approaches help to combat ageism and improve the lives of older adults, now and in the future. Taking an intergenerational approach to contextualizing the experiences of older adults within post-secondary classrooms settings is a novel approach towards building interest in the field of aging. The University of Toronto (UofT) partnered with Christie Gardens, a retirement community and long-term care home, to launch an innovative experiential learning initiative: The Intergenerational Classroom. Half the learners were UofT undergraduate students (n=24); the other half were older adults residing at Christie Gardens (n=25). Through interactive seminar-style discussions, collaborative projects and mentorship, the course, which was held at Christie Gardens, provided a semester-long exploration on aging. To evaluate the program, pre/post-surveys were administered to all learners, and following the semester, students (n=6) and older adults (n=6) participated in focus group discussions. Outcomes of program success were identified across domains, including meaningful friendships and bonds created, increased awareness of aging issues, reduced ageist attitudes, and greater sense of community and civic engagement. Evaluations revealed that 92% had an excellent learning experience, 95% found the course intellectually stimulating, and that 100% would recommend the course to others. The Intergenerational Classroom explored aging from a viewpoint that considered the perspectives of both older and younger generations. Intergenerational approaches can help to create a brighter and more inclusive future for all generations, ensuring that individuals can grow up and grow older with dignity, rights, and opportunity.
EFFECTS OF ADVANCE CARE PLANNING TRAINING ON STUDENTS’ KNOWLEDGE, COMFORT, AND CONFIDENCE
Authors: Barnes Stacy , Breakwell Susan
Published: January 2025

Students report feeling unprepared to engage in advance care planning (ACP).

Methods

A 2-hour, interprofessional workshop was held in-person in April 2018 and 2019, and virtually in 2021 and 2022 for students from medicine, nursing, physician assistant, speech pathology, counseling psychology, biomedical sciences, communication, and sociology (N=223). The workshop aimed to educate students about ACP, foster exploration of personal preferences for end-of-life care, and empower them to initiate ACP conversations with others. It incorporated highly engaging activities including personal reflection, drawing, writing, video clips, case presentations, as well as small and large group discussions. A Qualtrics survey, using a retrospective post- then pre- questionnaire design, elicited feedback 1-day post-workshop.

Results

Regardless of delivery format, respondents rated the workshop highly (97% excellent or good) and liked interacting with peers from other disciplines in small group discussions best. Paired-samples t-tests revealed statistically significant differences following the workshop in four of five areas (p< 0.001) i.e., increased understanding of advance directives, comfort completing their own advance directive, comfort talking with their family and/or personal doctor, and confidence in starting an ACP conversation with others. No significant change was detected in students’ comfort exchanging ACP ideas in a team discussion (p=0.19).

Discussion

A workshop can increase students’ self-reported knowledge, comfort, and confidence with ACP, as applied to themselves and/or family. However, results suggest working in an interprofessional healthcare team requires additional training and experience. These findings can help guide ACP curricula in health professions education.
ENGAGING THE PAST FOR THE FUTURE: APPLYING ANTIRACIST PEDAGOGY TO HEALTH DISPARITIES IN LATER LIFE
Authors: Karasik Rona , Kishimoto Kyoko , Boateng Isaac Asirifi , Hafner Camryn , Zuniga Claudia Burgos
Published: January 2025

Pervasive health disparities among racial groups are well documented throughout the life course and across generations. The continued persistence of these disparities, however, suggests that simply recognizing their presence is insufficient for preparing future gerontologists, care-providers, and policymakers to address them. How can educators help gerontology students not only acknowledge the existence and impact of such disparities, but also to consider their root causes - an essential step toward effecting social change? Moreover, how can we prepare gerontology educators to guide students through this exploration? Building on previous content compilations regarding housing (Kishimoto & Karasik, 2018) and retirement (Karasik & Kishimoto, 2022), and integrating emerging research and educational approaches from fields such as Public Health (e.g., Braveman et al., 2022; Jones et al., 2018; Yearby et al., 2022), this presentation showcases newly developed/adapted educational materials and activities geared toward facilitating gerontology students’ exploration of racial health disparities from an antiracist perspective. Central to the provided lesson plans is an annotated timeline pairing key historical events with health care related policies and programs in the U.S., as well as multi-media resources on related topic areas. Given the current political climate (e.g., the dual influences of Black Lives Matter and anti-DEI legislation) and the varying extent of students’ (both domestic and international) prior understanding of US history, strategies for supporting productive classroom discussions on racial health disparities in later life are also shared from both faculty and student perspectives.
OCCUPATIONAL THERAPY AND NEUROPSYCHOLOGY: INTERDISCIPLINARY COLLABORATION IN CURRICULUM DEVELOPMENT
Authors: Christopher Theresa , Christopher Jennifer
Published: January 2025

Interdisciplinary care models have a positive impact on older adult care (Harris, 2006). This is especially true for people diagnosed with dementia (Galvin et al., 2014). Neuropsychologists and occupational therapists are vital team members in providing care to people diagnosed with dementia. However, there is a lack of research highlighting the collaboration between these two professions. The current authors believe that graduate education is an opportune time to initiate these collaborations. The current poster aims to showcase a partnership between a neuropsychologist and occupational therapy professor. This collaboration resulted in a one-hour lecture provided by a neuropsychologist to masters of occupational therapy students in a geriatric theory course. The lecture outlined the role of the neuropsychologist in differential diagnosis of dementia and the opportunities for interdisciplinary collaboration between occupational therapists and neuropsychologists. The authors believe that this lecture is beneficial to routinely include in standard occupational therapy geriatric curriculum. In the future, the authors hope to conduct a quantitative study to examine the effectiveness of this lecture in promoting students’ understanding of dementia and the partnership between neuropsychology and occupational therapy. References Galvin, J. E., Valois, L., & Zweig, Y. (2014). Collaborative transdisciplinary team approach for dementia care. Neurodegenerative disease management, 4(6), 455-469. doi: 10.2217/nmt.14.47. Harris, B. A. (2006). Interdisciplinary education: What, why, and when? Journal of Physical Therapy Education, 20(2), 3-8.
PRIORITIZING GERIATRIC EDUCATION FOR HEALTH CARE PROVIDERS
Authors: Brown Lana , Morrison Wanda , Smith Julie , Sullivan Dennis
Published: January 2025

Within the United States, there is a deficit of Geriatricians providing care for older adults, and this deficit will only grow as the population continues to age, meaning all health care providers will be responsible for the care of older adults. A learner needs assessment is a systematic approach to examining what individuals or groups need to learn in relation to health care practice. A learner needs assessment is a core element of designing effective, targeted geriatric educational interventions. In 2022, a brief six question online survey was distributed to all health care providers within the South Central Veterans Affairs (VA) Health Care Network to determine the top geriatric education needs. Within the survey, provider demographics requested were primary discipline and primary work setting (inpatient/outpatient). Respondents were requested to choose at least 5 out of 50 topics provided that would be the most useful for future geriatric education. Responses were received from 143 health care providers with the majority of the responses being from social workers 59(41.3%) and nurses 45(31.5%). There were 103 health care providers from outpatient areas and 40 from inpatient areas. The top geriatric education topics requested were mental health (50.4%), Alzheimer’s disease/dementia (48.3%), legal issues (38.5%), chronic pain (35.0%), depression (32.2%), and management of chronic conditions (30.1%). Experts were recruited to provide geriatric education on the highest priority requested topics. Providing geriatric education improves care for older adults ensuring health care providers are prepared to care and advocate for this diverse and often vulnerable population.
PROMOTING GERONTOLOGICAL TRAINING AND POSITIVE ATTITUDES OF AGING THROUGH HIGH-IMPACT TEACHING PRACTICES
Authors: Fox Aimee , Riding Bethany
Published: January 2025

Despite being the youngest state, Utah, along with the rest of the United States, has a growing aging population. There is demand from state leaders and employers for individuals, families, and a workforce that are knowledgeable about the experiences and needs of older adults. Utah Valley University (UVU) is Utah’s largest public university, with a dual-mission of a first-rate teaching university and open-admissions promoting easy access to higher education. Yet, efforts at UVU to promote gerontological training in the social sciences have been minimal. Students at UVU are often unaware of what gerontology is and the importance of gerontological training, and report negative attitudes and fears about aging and older adults. This descriptive case study is the first stage of a larger project aimed at promoting enrollment in UVU’s gerontology certificate and shifting student attitudes about aging to promote positive perceptions of and interactions with older adults and aging experiences. During this first stage, the gerontology certificate was adjusted to align with AGHE gerontology competencies, and an Adult Development and Aging course was re-designed with high-impact practices, including a common intellectual experience focused on service- and experiential-learning activities. This study reports on re-design efforts, the engagement and feedback of 80 students across two sections of the course, and the impact of learning activities on students’ attitudes about aging and older adults. Also addressed are theoretical and practical suggestions for promoting gerontological training, potential pitfalls to avoid, and recommendations for implementing these changes across a variety of higher education settings.
THE RELATIONSHIP BETWEEN BIOGRAPHY, EDUCATION, AND ICT USE IN AGE: A LIFE COURSE PERSPECTIVE
Authors: Klank Christina , de Vries Tjard , Himmelsbach Ines , Doh Michael
Published: January 2025

The digital transformation of society is challenging for many older adults, especially those living in institutionalized settings. Support systems are needed, but often lacking. This study first presents a learner-centered approach that focuses on individual interests and abilities of the target group: older adults in institutionalized settings. In order to sustain ICT use (information and communication technology), professionals need to develop programs based on the needs of the target group. Therefore, this study secondly uses a narrative approach to analyze biographies of older adults in order to exploit their potential for conclusions about ICT use. An interdisciplinary German research project established a participatory design for the target group. This design pairs advanced peers with beginners to introduce ICT (e.g. tablets, Internet) based on beginners’ interests and needs. Advanced peers were recruited as volunteers and participated in a train-the-trainer program beforehand. In this study, biographical-narrative and problem-centered interviews were conducted with 42 older German adults (White; age=62-95; 57% female; beginners=24, advanced=18). The interviews were analyzed within a narrative approach to compare subjective narratives about biography, education, and ICT use. Different biographical patterns were identified and are illustrated by two contrasting cases from each group. The results provide evidence that older adults’ biographies influence and partially predict older adults’ motivation and educational interests, which in turn influence ICT use. Additionally, ICT is perceived as either a lifestyle (e.g. meeting communication needs) or a tool (e.g. maintaining independence). When developing educational activities for older adults, we recommend including biographical components in curricula.
ASSESSMENT OF CAREGIVER REPORTED VISIT-ASSOCIATED LOGISTICAL CHALLENGES FOR CLINICAL VISIT COORDINATION
Authors: Ngo Victoria , Marfeo Elizabeth , Shirk Steven , Chamberlin Elizabeth , Moo Lauren
Published: January 2025

Family caregivers (FCG) of persons living with dementia face high care burden as the care recipient ages, especially with care coordination of in-person healthcare visits. As FCG burden increases, there is an increased likelihood of missed appointments and negative health outcomes for both the FCG and the care recipient. Limited evidence exists describing the impact of managing complex visit-associated logistical challenges FCGs face when coordinating appointments. To address this gap, this study uses a care coordination framework to develop a new assessment—the Visit-Associated Logistics Assessment (VALA). We adopted a three-phased approach: (1) multidisciplinary expert feedback to establish content coverage; (2) cognitive interviews to refine item wording; and (3) field testing to establish the feasibility and usability of the VALA among a clinical sample of FCG of persons living with dementia (n = 20). Results from the first two development phases yielded six functional domains: (1) scheduling, (2) visit preparation, (3) time/travel, (4) occupational impact, (5) routine disruption, and (6) psychosocial well-being. Initial end-user feasibility was established. The VALA had a low respondent burden, shown by minimal missing data, and appropriate content coverage, as indicated by an acceptable distribution of responses across items and response categories. The VALA represents the first FCG-focused assessment characterizing logistical factors for helping older persons attend medical visits. Initial phases of content validation and usability testing support the use the VALA within clinical and community-based settings to better support management and care coordination of in-person clinical visits for FCGs of persons living with dementia.
EFFECT OF AN AI-BASED NEGOTIATION TRAINING FOR FAMILY CAREGIVERS OF OLDER ADULTS WITH ALZHEIMER’S DISEASE
Authors: Murawski Alaine , Joblin Celie , Tschoe Marianne , Ramirez-Zohfeld Vanessa , Olvera Charlie , Mell Johnathan , Brett Jeanne , Lindquist Lee
Published: January 2025

Family caregivers (CGs) of older adults with ADRD (OADRD) may experience conflicts when providing care, yet are often ill-equipped to handle these challenges. We evaluated NegotiAge (NA), a web-based intervention leveraging artificial intelligence (AI) to teach CGs negotiation skills, and assessed the impact that NA had on how CGs resolve conflicts and retain negotiation knowledge. CGs of OADRD were recruited nationally and enrolled in a randomized controlled trial. CGs accessed negotiation training resources through NA and were randomized to negotiate conflict scenarios in real-time, with AI-powered avatars exhibiting emotions and behaviors simulating real-life interactions. CGs were assessed at baseline (T1) and 1-week post-intervention (T2) with the Dutch Test for Conflict Handling (which examines yielding, compromising, forcing, problem-solving, and avoiding conflict domains) and with a 15-item panel consisting of negotiation terminology and conflict statement (interests, rights, power) identification. Matched pair t-tests were performed between T1-T2. 119 CGs (mean age 53.5, 75.6% female, 32.8% Black) completed both surveys. CGs receiving more negotiation exercises scored lower in avoiding (Δ=-0.97, t=-2.2, p=0.03) and compromising (Δ=-0.53, t=-3.5, p=0.0006) at T2. Mean total negotiation knowledge score increased between T1-T2 (Δ= 2.07, t=1.18, p = 0.07), as did identification of interests-based conflict statements (Δ=4.49, t= 4.48, p = 0.01). NA positively impacted CG conflict resolution skills: CGs improved both in avoiding and compromising during conflict, and in identifying common interests, essential to determining root causes of conflicts. Future research will examine NA’s impact on long-term CG outcomes (e.g. well-being, stress, burden) and care of the OADRD.
EXAMINING THE FEASIBILITY AND BENEFITS OF SELF-QUANTIFICATION FOR FAMILY CAREGIVERS: A MIXED-METHOD APPROACH
Authors: Wakui Tomoko , Okubo Suguru , Fujihara Satoko , Moriyama Yoko , Nakagawa Takeshi , Obuchi Shuichi , Awata Shuichi , Kai Ichiro
Published: January 2025

Supporting family caregivers poses significant challenges because of their inability to seek assistance amid limited time and burden. This study aimed to explore the feasibility of implementing a self-quantification program for family caregivers of community-dwelling older adults. We developed the Caregiving Visualization Program (Care-VIP) allowing family caregivers to document their daily caregiving and life activities and emotional well-being. Initially, an online survey was conducted with 3,256 family caregivers, who were proportionately distributed based on the percentage of the nation’s older population requiring care, to investigate their caregiving situations. Subsequently, 201 participants, who requested the program participated, engaged in the self-quantification program for 60 days and provided feedback in a follow-up survey. Feasibility was evaluated based on participant characteristics, completion rates, and the qualitative benefits of self-quantification. Logistic regression analysis revealed that participants were more likely to be fully employed (OR:1.79; p<.01) and experience higher levels of burden (OR:1.01; p<.01) and daily caregiving demands (OR:1.50; p<.01). The completion rate after 60 days was 87.9%, with a 90% completion rate at 98.5%. The content analysis of open-ended responses identified several benefits, including “purposeful and attentive care”, “identifying improvements”, “establishing daily routines”, and “enhancing emotional and self-awareness” derived from “systematic care analysis” facilitated by “reflection”. Furthermore, self-quantification led to “instrumental record-keeping”, encouraging “articulated insight,” fostering “information sharing”. This study discusses the significance and limitations of reflective practices and documentation activities with Care-VIP in supporting more frequent and heavily burdened family caregivers.
EXPLORING THE HEALTH CARE UTILIZATIONS AND OUTCOMES OF FAMILY CAREGIVERS FOR OLDER ADULTS WITH DEMENTIA
Authors: Cheng Yu-Qi , Li Ying-Chun
Published: January 2025

Family caregivers of older adults with dementia usually face more negative issues, such as family relationships, personal career, financial status, and mental and physical problems. Therefore, family caregivers could increase healthcare utilizations and worsen healthcare outcomes. Nevertheless, previous studies results were inconsistent, which could be due to different health policies or healthcare systems in the studied countries. Whether family caregivers receive better care and reduce their burdens under Taiwan’s universal healthcare system with free access to healthcare. This is a very important policy research question. We linked outpatient data, inpatient records, medical care facility factors, and registration files from the National Health Insurance Program Data to form the analyzed datasets. Family caregivers for people over 65 with dementia were identified in 2008 and followed for five years. As a result, Family caregivers of older persons with dementia faced long time pressure which led to an increased probability of diseases, such as depression, anxiety, and chronic diseases (all were p< 0.01). These caregivers with disease disorders also significantly consumed more total, outpatient, inpatient, and emergency expenditures (all were p< 0.01). In addition, caregivers for those with dementia who had low and middle-income status used more medical resources (OR=2.16, p< 0.01) and had worse mental health outcome (OR=1.11, p< 0.01). In summary, the empirical results indicated that family caregivers who stay in high stress for a longer time are more likely to cause physical and mental health problems. These family caregivers will use more healthcare resources and experience poorer healthcare outcomes.
PREVALENCE OF FIREARM OWNERSHIP AND MENTAL HEALTH CHALLENGES AMONG CAREGIVERS: INSIGHTS FROM A NATIONAL STUDY
Authors: Dayrit Jessika , Islaya Cesz , Medcalf Robyn , Charitou Lauren , Alladi Renuka
Published: January 2025

Despite studies on the association between firearm accessibility and suicide, there is a gap in understanding the prevalence of firearm ownership among caregivers. This study aims to analyze the prevalence of firearm ownership and mental health challenges among civilian and U.S. military veteran caregivers using data from CDC Behavioral Risk Factor Surveillance System (BRFSS) 2021. Employing a cross-sectional study design, with a total sample size of N=17,625, data analysis was conducted using Stata 17, incorporating appropriate weighting and 95% confidence intervals for demographic variables. Binary logistic regression was employed to analyze the data. Findings suggest that both civilian caregivers (OR=1.17, 95% CI=1.07-1.29) and U.S. military veteran caregivers (OR=1.98, 95% CI=1.55-2.54) were more likely to own a firearm at home compared to non-caregivers. Furthermore, civilian caregivers (OR=1.26, 95% CI=1.14-1.40) and U.S. military veteran caregivers (OR=2.14, 95% CI=1.64-2.78) exhibited higher odds of experiencing depression rates, along with an increased likelihood of serious difficulties in concentrating, remembering, or making decisions due to depression (civilian caregivers: OR=1.40, 95% CI=1.23-1.59; U.S. military veteran caregivers: OR=1.65, 95% CI=1.18-2.30). This nationally representative survey highlights critical insights into firearm accessibility, mental health challenges, and safety among caregivers, emphasizing the importance of interventions to prevent unintentional death and suicide. Firearm safety discussions with patients and caregivers help reduce the risk of accidental death or suicidal behavior. Assessment of firearm ownership and safety, as part of the practitioner-patient-caregiver relationship, is as crucial as evaluating chronic illnesses. Promoting comprehensive approaches to addressing firearm safety in clinical practice ensures patient-caregiver well-being.
PRIORITIES TO IMPROVE DEMENTIA CAREGIVING IN CHINESE IMMIGRANT FAMILIES: REPORT OF A CAREGIVER WORKSHOP
Authors: Ma Kris (Pui Kwan) , Saw Anne , Cheng Joyce
Published: January 2025

Linguistically diverse caregivers of people with dementia represent a growing but under-recognized segment of the dementia care workforce in the U.S. There is a continued shortage of culturally and linguistically responsive dementia caregiving interventions for older U.S. Chinese immigrants with limited English proficiency. To address the unmet needs of Chinese-speaking caregivers, integrating caregivers’ input is vital to studies to ensure that research aligns with their experiences. This was a focus group study of 10 Chinese-speaking caregivers (mean age 73.7, eight women) conducted during a dementia caregiving workshop, in partnership with a community health resource center in California. During the in-language workshop, caregivers identified their needs in surveys, then discussed with one another in the focus group. Consensus was built to establish priority areas of research and clinical practice to address caregivers’ experiences and needs. We used descriptive and thematic analyses to summarize caregivers’ priorities. Caregiver-identified priorities included information and practical support in a) management of behavioral and psychological symptoms of dementia (BPSD), b) communication with care recipients and other family members, c) care for caregivers’ physical and mental health, and d) assistance to connect to in-language community resources. We identified ways in which these priorities can inform dementia caregiving research and practice for Chinese-speaking caregivers and immigrant families in the U.S. It is recommended that future research and interventions for Chinese-speaking immigrant caregivers in the U.S. prioritize BPSD management skills training, adopt a family-centered approach and include family outcomes, and address service barriers via community-clinic partnerships and outreach.