bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELDER FAMILY FINANCIAL EXPLOITATION: EXPERIENCES WITH SOCIAL SERVICES
Authors: Kilaberia Tina R , Fuhrman Emma , Stum Marlene , Freeman Iris 
Published: November 2019

Abstract
Elder family financial exploitation (EFFE) has attracted the attention of scholars and professionals across disciplines. This qualitative study examines the experiences of help seeking by non-perpetrator family members with a focus on the role of social services. 15 in-depth interviews were examined in which social services were mentioned as being involved. Findings provide insight into the role and involvement of social services, whether wishes expressed by victims to participants made a difference in help-seeking, and gaps experienced. Participants described social services professionals as those who (1) received reports of exploitation; (2) provided education and served as a liaison with families; (3) conducted assessments, including cognitive assessment of elders; and (4) acted as connectors to other systems. In some cases, when elders were assertive about their wishes, they had results such as reporting exploitation or transferring power of attorney to non-perpetrator family members. In other cases, elders were prevented from taking such action because of undue influence by perpetrators, disregard of their wishes, due to being uninformed, or opposing helpful family members. Participants explained experienced gaps in two ways: by attributing responsibility to social services in terms of failure to believe victims, do meaningful cognitive assessments, and navigate family dynamics. On the other hand, participants were not able to clearly ascribe responsibility, and questioned whose fault it was, suggesting opportunities for improved systems functioning. Recommendations for improving the role of social services in addressing the help-seeking needs of concerned family members coping with EFFE follow.
THE EFFECTS OF SIMULATION-BASED EMPATHY ENHANCEMENT PROGRAM FOR CARER OF THE ELDERLY ON COUNSELLING
Authors: Park Sangmi , Kim Tae Hui , Um Tae Rim , Lee Kyuwon , Jung Jisoo , Hong Myounghee , Choi Soyeon , Han Areum 
Published: November 2019

Abstract
Empathy of the caregiver can influence both the caregiver’s performance and the receiver’s enhanced life. The aim of this study is to examine whether Simulation-based Empathy Enhancement program for the Carer of the Elderly (SEE-C) is effective in increasing care receivers’ session satisfaction and positive emotional change. We developed SEE-C by modifying the Dementia Live(TM) program and adding with a brief mindfulness. The effect on counselling was assessed using the Session Evaluation Questionnaire (SEQ), which is self-report tool asking the client about their experience with the session just ended. A total of 100 older adults living alone were interviewed by caregivers who experienced SEE-C (n=12) and by non-experienced (n=12). Participants in this study were randomly assigned to each of the two caregiver groups, and were interviewed about demographics, health and emotional status, and lifestyle using the same protocols. Analysis of covariance was conducted, controlling variables of age of subjects and caregivers’ months of career, which were found to differ significantly between the two groups. Among the four subcategories of SEQ, the experimental group reported significantly higher scores than the control group in three subcategories of session-depth (F(1, 96)=9.647, P=.002), session-smoothness (F(1, 96)=13.699, p&lt;.001), emotion-positive (F(1, 96)=18.056, p&lt;.001), with the exception of emotion-alertness (F(1, 96)=0.366, p=.546). These results suggest that SEE-C could have a positive impact on interviewing the elderly in terms of improving the capacity of the interviewer and raising the satisfaction of the interviewee.
EVALUATING AN INTERVENTION TO PREVENT SELF-NEGLECT IN VULNERABLE ADULT HEALTHCARE PATIENTS
Authors: Rose Miriam , Ejaz Farida , Reynolds Courtney , Ye Minzhi 
Published: November 2019

Abstract
Alleged self-neglect is the most commonly reported type of abuse to Adult Protective Service (APS) agencies nationwide. Researchers, healthcare practitioners and APS staff in Texas collaborated on a project funded by the U.S. Administration for Community Living to develop and evaluate an intervention to prevent self-neglect in older and/or disabled adults. Nineteen primary care clinics in a large healthcare system were randomized to intervention (intensive case management over a four-month period) and control (usual healthcare) groups. Patients with risk factors for self-neglect in these clinics were randomly selected, and 480 patients consented to participate in the study. Baseline EMR data indicated the most common risk factors for self-neglect included depression (54% of these participants), dependence in activities of daily living (28%), and dementia (27%). Social workers conducted a home visit with 287 intervention clinic patients, identified their needs, developed a care plan, and followed up regularly with patients. Based on the Adult Self-Neglect Assessment, 61% were identified as having concerns related to self-neglect. Their most frequently identified areas of need for help were food assistance/nutrition (54%), functional limitations (40%), social isolation (36%), home modifications (34%), and mental health issues (32%). Along with public assistance, and referrals to home- and community-based services, findings are promising for preventing patients from becoming self-neglecting in the future. Only 7 intervention clinic participants were reported by project staff to APS for suspected abuse, neglect or exploitation during the 16-month study. This type of multi-disciplinary collaboration can inform development of evidence-based innovations in practice and policy.
WHOLE-BODY MRI TO ASSESS SUBCLINICAL CARDIOVASCULAR DISEASE AND FRAILTY DEVELOPMENT
Authors: Ambale-Venkatesh Bharath , Sesso Jaclyn , Walston Jeremy , Bandeen-Roche Karen , Lima Joao 
Published: November 2019

Abstract
Cardiovascular disease (CVD) and frailty have been linked at the mechanistic and epidemiological levels. Our goal is to identify if subclinical markers such as atherosclerosis, body composition, and fibrofatty infiltration measured from non-contrast whole-body magnetic resonance imaging (MRI) are markers of physical frailty. Community dwelling older adults with frailty status ascertained by Fried measurement are being recruited from an aging studies registry. MRI is performed using a Canon Galan3T with dedicated coils. Preliminary analysis from 4 frail individuals (86±15 years, 3 female, BMI=22±3kg/m2) and 2 age-matched robust controls (86±1 years, 1 female, BMI=28±0.2kg/m2) is presented. Of 4 frail one had a prior heart attack; one was previously diagnosed with heart failure. Mean atheroma score from 28 vessel segments (0.42±0.26 vs 0.18±0.10) and aortic tortuosity (2.3±0.4 vs 2.1±0.1) were higher in frail compared to robust indicative of higher atherosclerotic burden and vascular stiffness. Mean subcutaneous and visceral adipose tissue volumes were lower in frail compared to robust. However, mean myocardial (1113±27 vs 1089±2), liver (729±92 vs 683±104) and skeletal muscle (1106±25 vs 1072±64) T1 times (milliseconds) were each higher indicative of greater diffuse interstitial fibrosis. Averaged intramuscular fat percent measured across the pelvis, forearm, pectus, thigh, and calf was higher in frail compared to robust (14.8±4.1% vs 8.5±2.3%) indicative of higher fatty infiltration. Although these early results do not reach statistical significance, they support further study to determine cardiovascular and tissue related differences between physically frail and robust older adults, which in turn may inform intervention developments for frailty and CVD.
ATTACHMENT SECURITY AND DEPRESSIVE SYMPTOMS IN OLDER-ADULT MARRIAGES
Authors: Syed Sumaiyah U , Monin Joan K 
Published: November 2019

Abstract
Attachment theory emphasizes attachment security, providing and receiving communication of safety and emotional support, as one of the most fundamental needs in close relationships across the lifespan. Having an insecure attachment style, anxious or avoidant attachment, has been related to depressive symptoms in mostly young adult marriages. This study examined the interpersonal associations between attachment anxiety, attachment avoidance, and depressive symptoms in 98 older adult couples, using self-report measures. The Actor Partner Interdependence model was used to analyze the data. Results show that one partner’s anxious attachment was significantly positively associated with their own greater depressive symptoms (β=2.10, p=0.000). This effect was stronger for husbands than for wives (β=1.13, p=0.002). Results remained when controlling for age, physical functioning, marital length, and socio-demographics. There were no significant cross-partner associations. Findings suggest that attachment anxiety may be particularly impactful for depressive symptoms in husbands.
EVALUATION OF SMART BELT HIP PROTECTION IN A SKILLED NURSING FACILITY
Authors: Tarbert Rebecca J , Singhatat Wamis 
Published: November 2019

Abstract
Hip fractures impact &gt; 300,000 US older adults yearly resulting in 70,000 deaths and are expected to gain in numbers with the rising population. Residents of skilled nursing facilities are among the highest at risk of sustaining hip fractures due to increased risk of falls and frailty. These most vulnerable stand to experience the most serious results of hip fracture with &gt; 50% resulting in total dependency and/or death. Care providers are focused on providing an environment of safety with implementation of traditionally utilized fall prevention measures. Unfortunately, the maintenance of safety in this high-risk population often comes at the price of limiting independent mobility. The utilization of passive hip protector padding for those recognized as being at high risk of hip fracture can decrease the risk of hip fracture by 82%; however, challenges to adherence of hip protectors limit the effectiveness of this widely utilized measure. Emerging technology in the form of a smart belt was evaluated in a skilled nursing setting to offer insight into efficacy and user adherence. The smart belt is capable of sensing when the wearer is experiencing a motion that would likely result in a fall onto the hip, deploy an anatomically conforming airbag and alert caregivers that a fall has occurred. The embedding of the hip protection technology into care planning led to daily patient utilization totaling over 3000 hours. Specific findings of the user derived motion and experience will be articulated through case studies and illustration of the technology captured motion data.
WHAT MAKES A NURSING HOME FEEL LIKE HOME? RESIDENT PERSPECTIVES
Authors: Cater Diana , Hasworth Serena , White Diana , Tunalilar Ozcan , Winfree Jaclyn 
Published: November 2019

Abstract
Providing an environment that feels like home is increasingly a programmatic goal in nursing homes (NH), yet few NH studies have explored “home” as a concept through a large number of residents’ voices. In the current study, 294 residents living in 32 randomly selected NH in Oregon were asked if it felt like home. We followed up with “what makes it feel like home?” or “what would make it feel more like home?” Open-ended responses were classified via open coding. Six major themes emerged: relationships, meaningful possessions, quality of care, personal autonomy, physical environment, and the impossibility of it feeling like home. Overall, 26% percent of residents found that their current setting felt like home. Among residents who perceived their current setting as feeling like home, the most prominent theme was relationships with people at the nursing home (45% of responses). Residents also emphasized the importance of having family or other meaningful relationships from outside the nursing home (22% of all responses) for an environment that was home. Among those who responded that the nursing home did not feel like home, 32% reported that nothing could replace their home. Results indicate that NH can become home environments for their residents and provides additional evidence that relationship building, personal autonomy, and physical environment are likely critical pillars for creating and sustaining feelings of home. Future research will examine variations in responses described here, including resident or facility characteristics, and length of stay.
WHAT'S MOTIVATION GOT TO DO WITH IT? USING LATENT PROFILE ANALYSIS FOR BIOMARKERS & PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Teas Elizabeth , Kimiecik Jay , Ward Rose Marie , Timmerman Kyle 
Published: November 2019

Abstract
Heart disease is prevalent among older adults. The aim of this study was to a) identify different health behavioral motivation profiles among older adults; and b) investigate if these profiles differed in physical activity and cardiometabolic risk factors. Data on 79 participants (mean age = 68.76 years) was collected. Participants’ degree of intrinsic/extrinsic motivation for diet and exercise was assessed using intuitive eating and self-determination scales. Cardiometabolic risk factors included inflammation and blood lipids. Latent profile analysis was used to identify the optimal number of groups and one-way ANOVAs assessed group differences on the variables of interest. Three profiles were found to best represent the data. The most self-determined, or most intrinsically motivated, group comprised the highest number of participants. In line with Self-Determination Theory, this group demonstrated the highest levels of objective and self-reported physical activity as well as the lowest inflammation and most optimal cholesterol measures. The group with the lowest intuitive eating and high identified exercise regulation scores exhibited the worst outcomes among the three groups. The results suggest that among older adults, different types and levels of motivation for diet and exercise can coexist and interact, and these differences produce varying health outcomes. If supported by future work, these findings can inform practitioners in developing more specific and tailored interventions relevant to older adults based on their motivational profile.
THE EFFECTS OF HEARING LOSS AND MOBILITY DECLINE ON COGNITIVE FUNCTION OF OLDER ADULTS
Authors: Sakurai Ryota , Kawai Hisashi , Yanai Shuich , Kim Hunkyung , Hirano Hirohiko , Ihara Kazushige , Obuchi Shuichi , Fujiwara Yoshinori 
Published: November 2019

Abstract
Background: Both hearing loss and mobility decline are well-known risk factors of cognitive impairment among older adults. However, the effects of the accumulation of these functional impairments are still unclear. Thus, the present study examined whether the interactive effects of hearing loss and poor gait performance contribute to cognitive impairments. Methods: Hearing loss and gait performance were assessed in 716 community-dwelling older adults at baseline. Pure-tone audiometry was conducted to determine hearing loss at 1 (i.e., low tone) and 4 kHz (i.e., high tone). Poor gait performance was defined as the lowest quartile (fourth quartile) of age- and sex-appropriate mean gait velocity. Participants were then classified into four groups according to the presence of hearing loss and poor gait performance. Cognitive function was assessed using MMSE and MoCA at baseline and four years later. Results: Older adults who had either hearing loss (low or high tone) or poor gait performance showed lower MMSE and MoCA scores at baseline. Multiple regression models showed that hearing loss and poor gait performance at baseline were significantly associated with decreased cognitive function at follow-up. Among older adults with low tone hearing loss, absence of slow gait was not associated with decreased cognitive function. Conclusions: Our results indicate the possibility that hearing loss and slow gait synergistically increase the risk of cognitive impairment. The results also suggest that the effect of slow gait on cognition exceeds the effects of hearing loss, indicating the importance of maintaining mobility in late life.
ASSOCIATION BETWEEN THE NIH TOOLBOX COGNITION BATTERY AND GAIT IN OLDER ADULTS
Authors: Hamel Kate , Barber Sarah , Ketcham Carl , Lui Kristy 
Published: November 2019

Abstract
The relationship between older adults’ gait and cognition has been well-studied, however there is little consensus regarding a best set of measures to assess cognition. One option that has not been previously examined is the NIH Toolbox Cognition Battery (NIHT-CB), which was developed to be used across the lifespan and across research disciplines. This study examined the relationships between the seven subtests of the NIHT-CB, Trail-Making Tests A and B, and temporospatial measures of gait. One hundred sixty-seven healthy, community-dwelling older adults (115 females, 73.4 ± 4.5 years) completed these cognitive measures and also walked at their self-selected pace back-and-forth five times along a temporospatial-measuring walkway. The mean and coefficient of variation were calculated for each gait variable (stride length, width, time and velocity; stance/swing time and % of stride). After controlling for potential confounders (height, weight, age, sex, education, self-efficacy, health, exercise and falls history), executive function measures were typically the most significant cognitive predictors. More specifically, the Dimensional Change Card Sort task was the best predictor of temporal measures and stride velocity (all ps &lt; 0.001) and the Trail-Making Test Part B was the best predictor for variability measures (five of eight p-values &lt; 0.001). Interestingly, stride length and also stance and swing % of stride were strongly related to a measure of language - Picture Vocabulary (all ps &lt; 0.006). The NIHT-CB appears to be a useful tool for studies of gait in older adults, particularly when used in conjunction with Trail-Making Test B.
CASE STUDY EXEMPLAR OF DETECTING SEVERE DIASTOLIC DYSFUNCTION USING BALLISTOCARDIOGRAM
Authors: Despins Laurel A , Guidoboni Giovanna , Skubic Marjorie , Sala Lorenzo , Enayati Moein , Keller James , Popescu Mihail 
Published: November 2019

Abstract
The specific aim of this case study was to describe how monitoring ballistocardiogram (BCG) waveforms can detect early heart failure (HF) changes. HF significantly impairs quality of life and is the principal cause for hospital readmissions in older adults. HF prevalence in American adults aged 65 years and older is expected to increase over 70% by 2030. Detecting worsening HF is challenging. Invasive arterial waveforms display blood pressure changes with each heartbeat; BCG waveforms display repetitive body motions resulting from ejection of blood into the great vessels. BCG waveforms change as cardiac function changes. Currently, BCG signals can be captured non-invasively using sensors placed under a bed mattress and provide heart and respiratory rates. We have developed a new way to analyze the BCG waveform using an innovative closed-loop physiological model of the cardiovascular system. The subject, a 94-year old female with hypertension, presented to her physician with symptoms associated with a new diagnosis of acute mixed congestive HF. Mean heart and respiratory rate trends obtained from her bed sensor in the prior two months did not indicate HF. We simulated cardiac cycles using normal cardiac function data, mildly impaired diastolic function data, and the subject’s echocardiography data. The results demonstrated BCG waveform changes that correlated with decreasing cardiac output related to worsening diastolic function. New methods for clinically interpreting BCG waveforms present a significant opportunity for improving early HF detection and improving outcomes. Working on a clinical problem from an engineering perspective merges two disciplines, creating a new methodology.
AN ASSESSMENT OF GERIATRIC TTRAINING AND SUPPORT NEEDS FOR CAREGIVERS AND HEALTH CARE PROFESSIONALS IN RURAL TEXAS
Authors: Luk-Jones Susanna , Severance Jennifer J , Green Doni , Smith Donald , Jose Roslin 
Published: November 2019

Abstract
Of the 254 counties in Texas, 69% are rural, and three out of every four counties are designated as whole or partial Primary Care Health Professional Shortage Areas. Rural counties in Texas have a higher proportion of older adults compared to metropolitan counties, and rural older adults with Alzheimer’s Disease and their caregivers face unique challenges of limited access to healthcare and lower earnings, resulting in more health-related problems. As part of a HRSA Geriatrics Workforce Enhancement Program, an academic medical center, two Area Agencies on Aging in North Texas, and an Alzheimer’s Association Chapter partnered to expand access to evidence-based programs into surrounding rural counties for older adults and caregivers of persons with Alzheimer’s Disease. An interdisciplinary workgroup developed focus group questionnaires for older adults, caregivers, and health care providers in rural areas to identify perceived needs, barriers to accessing services, and strategic partnerships. The North Central Texas Council of Governments conducted 11 focus groups in late 2018 and early 2019. Of these, seven consisted of family members caring for persons with memory loss. Four consisted of professionals who treat persons with memory loss. Transcription and thematic analysis identified key themes of training needs (both providers’ and laypersons’), resource needs, providers’ best practices, barriers to quality care, and other support needs. Practice implications of the findings include cross-sector partners and integrating telehealth platforms for program delivery. Collaboration between academic and community partners can expand access to evidence-based programs for rural and other underserved communities and address areas of need.
GERIATRIC WORKFORCE ENHANCEMENT PROGRAM: EDUCATIONAL OUTCOMES OF DEMENTIA CAREGIVER CONFERENCES IN RURAL UTAH
Authors: Dassel Kara B , Rupper Rand , Supiano Katherine , Andersen Troy , Butler Jorie , Telonidis Jacqueline , Edelman Linda S 
Published: November 2019

Abstract
The University of Utah was awarded federal funds to establish a Geriatrics Workforce Enhancement Program (GWEP) focused on integrating geriatric training into 20 long-term care centers across the state of Utah. One specific objective of the GWEP was to: Provide community-based dementia education to 500 community participants from four geographically diverse urban and rural locations. In year four of the project, an interdisciplinary academic and community-based team planned and implemented dementia caregiver conferences in two rural areas in Utah that included American Indian (AI) tribal communities. Educational topics included an overview of dementia, engaging in goals of care discussions, managing caregiver stress, and finding local resources. Demographic surveys and pre-post modified 15-item version of the Alzheimer’s Disease Knowledge Scale (ADKS; Carpenter et al., 2009) were administered. A total of 148 participants attended the conferences. Participants were primarily female (76.6%), white (84.2%), and self-identified as family/informal caregivers (35.0%). Of the participants, 17.8% self-identified as AI. Overall, there were no significant differences on the pre- and post ADKS scores (mean scores of 12.45 and 12.5 out of 15 possible points, respectively). However, AI ADKS mean scores were lower (10.2 and 10.5, respectively; range 9-13) than white participants (12.7 for both, respectively; range 12-13) reflecting a greater need for ADRD education in AI tribal communities. The conferences were well-received with 82.5% of attendees said that the conference met their educational needs and 83.9% reported that the information would improve the type of care they provide to someone with dementia.