bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial Differences in Post-Acute Transition After Hip Fracture in Medicare Patients With ADRD
Authors: Roy Indrakshi , Karmarkar Amol , Kumar Amit , Warren Meghan , Pohl Patricia , Shaibi Stefany , Rivera-Hernandez Maricruz , Rudolph James 
Published: December 2020

Abstract
The incidence of hip fractures in patients with Alzheimer’s disease and related dementias (ADRD) is 2.7 times higher than it is in those without ADRD. However, there are no standardized post-acute transition models for patients with ADRD after hip fracture. Additionally, there is a lack of knowledge on how post-acute transitions vary by race/ethnicity. Using 100% Medicare data (2016-2017) for 120,179 older adults with ADRD, we conduct multinomial logistic regression, to examine the association between race and post-acute discharge locations (proportion discharged to skilled nursing facility [SNF], inpatient rehabilitation facility [IRF], and Home with Home Health Care [HHC]), after accounting for patient characteristics. Compared to non-Hispanic Whites, Hispanics have a significantly lower odds ratio for discharge to HHC 0.62 (95%CI=0.53-0.73), IRF 0.44 (CI=0.39-0.51), and SNF 0.26 (CI=0.23-0.30). Improving care in patients with ADRD and reducing racial and ethnic disparities in quality of care and health outcomes will be discussed.
Balancing Practicality and Validity of Elder Abuse Measures: Data From Adult Protective Services Investigations
Authors: Conrad Kendon , Liu Pi-Ju , Hass Zachary , Conrad Karen 
Published: December 2020

Abstract
Research in Adult Protective Services suffers from the problems of small sample size, low completion rates, and poor data quality. To address the “small sample size” issue, data were generated on 1,472 elder abuse cases over six months in California using the Identification, Services and Outcomes (ISO) Matrix. The problem of poor data quality was addressed by testing psychometric properties of Short-Forms on each type of abuse. Good reliability and predictive validity were found for all measures except those that were very rare. Finally, even shorter Mini-Forms were developed and tested in order to contribute to improved completion rates. Mini-Form results were mixed, and some will require further research on their reliability and validity, as well as examination of their ability to improve completion rates. Ongoing adoption by two California counties and the State of Montana demonstrate sustainability and increasing sample sizes using the ISO Matrix for research and practice.
Age Also Matters for Gerontologists: Personal and Professional Perspectives on Growing Older
Authors: Clark Phillip , Perkinson Margaret 
Published: December 2020

Abstract
Gerontology is a unique field of scientific inquiry, because it embodies both professional and personal dimensions of experience and poses questions for its researchers. How does our work help us understand our own personal experience of aging? How does the reality of growing older change our teaching and research? As gerontologists, we embody two narratives of the aging experience, one academic and professional (with its dependence on theory and scientific research), the other intimately personal (with its own lived experience and practical insight acquired over the life course). How this dynamic unfolds is as personal as each of us as individuals, and embodies our own disciplinary backgrounds; yet collectively it has implications for how we approach an understanding of what it means to grow old. This symposium explores different facets of this dynamic from four perspectives of different individuals and differing disciplines. The first paper assesses the limitations of both quantitative and qualitative research paradigms in revealing the deeply idiosyncratic nature of personal aging. The second develops the metaphor of “double agent of aging” to characterize the two narratives of professional and personal aging. The third uses Erikson’s theory of psychosocial development to weave together the professional, practical, and personal dimensions of gerontology. Finally, the last develops the metaphor of arcs and stages in conceptualizing a gerontological career. The symposium concludes with recommendations for the integration of theoretical, practical, and personal insights into teaching, research, and service in a way that embraces, enhances, and extends the field of gerontology.
Ageism and Its Impact on Older Persons’ Health
Authors: Levy Becca 
Published: December 2020

Abstract
Ageism has been called a silent epidemic. The extent to which ageism impacts the health of older persons in different countries was not well understood. In this presentation we will focus on the reach of ageism including negative age beliefs, on older individuals’ health. In an exhaustive systematic review, we found that ageism influenced older individuals in 45 countries and 11 health domains, with the prevalence of significant findings increasing over time (p &lt; .001). In this presentation, we will also explore the mechanism by which this impact occurs and steps that can be taken to address this epidemic.
Future Nursing Home Placement, Health, and Relationships by Sexual Orientation: Findings From the HRS
Authors: Singleton Mekiayla , Gassoumis Zach , Enguidanos Susan 
Published: December 2020

Abstract
This study compares LGB and heterosexual adults on anticipated need for future nursing home (NH) placement and factors that influence NH placement. Using data from the 2016 HRS, we found a trend toward higher anticipated NH placement among LGB adults (M=34.0, SD=29.2) as compared to heterosexual adults (M=26.9, SD=27.3; p=0.05). Compared with LGB respondents (n=137), heterosexual adults (n=3,469) were more likely to have living child/children (37% vs. 82%, p&lt;.001). Although there was no statistical difference in marital status between LGB (50% married/partnered) and heterosexual adults (65% married/partnered; p=.06), married/partnered LGB respondents were more likely to be very/quite close to their spouse/partner (99% vs. 90%, p&lt;0.01) compared to heterosexual respondents. There was no difference in number of health conditions between groups. This study suggests that LGB adults may have higher rates of anticipated need for NH, thus NHs must ensure their workforce is educated and prepared to support this growing population. Part of a symposium sponsored by Rainbow Research Group Interest Group.
Serious Mental Illness and Dementia in Assisted Living
Authors: Hua Cassandra , Cornell Portia , Thomas Kali 
Published: December 2020

Abstract
Little is known about trends in the prevalence of serious mental illness (SMI) and Alzheimer’s disease and Related Dementias (ADRD) in assisted living (AL). We summarize changes in the prevalence of SMI and ADRD in larger AL settings (25+ beds) from 2008-2017 using Medicare claims data. We compare these changes to nursing home (NH) and community rates of SMI and ADRD. We also examine state variability in SMI and ADRD in AL in 2017. The prevalence of SMI in AL increased 37%, from 7.8% in 2008 to 10.7% in 2017; ADRD prevalence increased 34%, from 27% to 36.4%. Over time, NHs exhibited the greatest increases in SMI (53%), followed by AL (37%) and the community cohorts (27%). Increases in ADRD were highest in AL. Rates of SMI in AL ranged from 3.5% in Wyoming to 28.7% in New York. We discuss implications for future research and policy.
Learning Lessons From Long-Term Care Policy Financing Efforts in the United States
Authors: Lepore Michael 
Published: December 2020

Abstract
A decades-long policy impasse has crippled our national capacity to finance long-term care (LTC) sufficiently or equitably, leaving large swaths of the US population at risk of going broke paying privately for LTC or having unmet LTC needs, while also draining state and federal budgets. By reviewing past LTC financing policy efforts—from the passage of the Social Security Act and the enactment of Medicaid and Medicare, to the LTC financing proposals advanced by 2020 presidential candidates—the political interplay of budgetary concerns in government spending and social justice concerns regarding access to care emerged as a primary LTC policymaking issue. Establishing national consensus on the prioritization of these fiscal and social justice concerns, and their respective values, could help lawmakers craft policy capable of generating the political will needed to overcome political gridlock. Clarifying how LTC benefits would be paid for appears to be a relatively straightforward technical task in comparison.
Challenges for Private LTC Service Providers for Preventing Elder Abuse
Authors: Ikeda Naoki , Tsukada Noriko 
Published: December 2020

Abstract
his paper aims to identify factors that differentiate long-term care (LTC) service providers into the two categories: those who are successfully growing and those who are going out of business. During the past 5 years, about one out of 100 private LTC service providers has gone bankrupt in part due to issues of client abuse. This paper uses case studies to demonstrate differences between LTC service providers who have histories of elder abuse and those that do not. Business traits such as mission, client trust, and quality of LTC workers is considered along with implementation of abuse prevention practices including management approaches, oversight of workers, and atmosphere where LTC workers have their working conditions and concerns addressed, which in turn enhances workers satisfactions, accordingly, yielding better quality of care provisions.
Economic Uncertainties in Retirement: Risk Factors, Strategies, and Resilience
Authors: Bishop Christine , Zurlo Karen 
Published: December 2020

Abstract
Even with forethought and planning, a lot can threaten economic wellbeing in the years ahead for older adults retiring at typical retirement ages. Although results for any individual cannot be predicted with certainty, some risks are quantifiable: for example, mortality/ longevity and disability risks are reasonably well-defined. Risk of dementia is not so well understood, and may be changing. Financial risk might be seen as manageable, but older adults relying on retirement income sources can be especially vulnerable to unprecedented shocks to the general economy. We consider four aspects of this dilemma. First, older adults retiring with outstanding debts may have difficulty weathering financial shocks. Our first presentation provides up-to-date information about trends in indebtedness at older ages, especially focusing on newly salient types of indebtedness: medical and student loan debt, and debt incurred to smooth finances in the recent recession. Stewardship of finances during retirement can be a challenging personal management undertaking. Our second presentation will consider how dementia can complicate this process. Protection against outliving one’s resources is more complex and costlier in the era of defined contribution retirement accounts. Our third presentation will discuss strategies to combine retirement assets, including Social Security claiming, to hedge longevity risk. Finally, needs for long-term services and supports may be met with either paid or informal (family) care, or both, but cannot be predicted with certainty. Our fourth presentation examines the long-term impacts on families due to the difficulty in insuring against this risk. Economics of Aging Interest Group Sponsored Symposium.
Grandparents Caring for Grandchildren, Family Structure, and Depressive Symptoms in China
Authors: Tang Fengyan , Li Ke 
Published: December 2020

Abstract
It is a cultural norm for Chinese older adults to engage in co-parenting and caring for grandchildren. Previous research documented health advantages for grandparents who provide occasional, extensive, or even custodial care to grandchildren in China. Yet there is little information regarding the impacts of living arrangement and its interaction with grandchild care on grandparents’ psychological well-being. Using three waves of the 2011-2015 China Health and Retirement Longitudinal Study (CHARLS) data, this study examined the longitudinal association of depressive symptoms with grandchild care intensity and living arrangement among adults aged 40 and above (N=5,037). Mixed effects regression models were applied to examine changes in depressive symptoms and the associations with explanatory variables. At baseline, about half of respondents reported caring for their grandchild (ren). And nine percent lived with grandchildren only, that is, in a skipped-generation household and taking a custodial grandparent role. Overall, depressive symptoms did not change over time. After controlling for sociodemographic and health covariates, we found that providing medium level of care (i.e., between three to 10 hours per day) was associated with fewer baseline depressive symptoms, whereas grandparents living with grandchildren had more symptoms at baseline relative to those living with others. Further, an increased level of caregiving in the skipped-generation households was associated with more depressive symptoms. Given that custodial grandparenting is a growing phenomenon in China, further research needs to investigate how to reduce caregiving burden and associated adversary effects and how to promote overall well-being in this population.
Older African Americans’ Perspectives on Exposure to Structural Discrimination Across Contexts and the Life Course
Authors: LaFave Sarah , Szanton Sarah , Thorpe Roland 
Published: December 2020

Abstract
This presentation reports on findings from the first phase of a mixed methods study aimed at developing an instrument to assess older African Americans’ exposure to structural racial discrimination. We conducted semi-structured interviews with older African Americans about their perspectives on and exposure to structural discrimination. Participants (n=20) were community-dwelling African Americans aged fifty and older in Baltimore, MD. Participants described exposure to structural discrimination that had accumulated across the life course and across the contexts of education, employment, healthcare services, criminal justice system, neighborhood factors, media and marketing of unhealthy products, environmental toxin exposures, and income, credit and wealth. In the next phase of the study, we will incorporate these findings into the development of instrument items. Developing and testing a tool to assess exposure to discrimination beyond the interpersonal level is an important step in identifying solutions to mitigate the contribute of discrimination to racial health disparities.
Identifying Care-Related Needs of Family Caregivers of People With Dementia: Beyond the Stress Process Model
Authors: Moss Sara , Gebhardt-Kram Lauren , Dabelko-Schoeny Holly , Cheavens Jennifer 
Published: December 2020

Abstract
The psychosocial stress process model (Pearlin et al., 1990) remains a dominant theoretical framework characterizing the transactions between factors affecting outcomes of informal caregivers of people with dementia (PWD). Despite widespread agreement that the model provides an important framework for understanding caregiver experiences and predicting caregiver outcomes, it is not sufficient to clarify the needs of caregivers. Needs are conceptualized as the skills and resources that could be used to ameliorate the negative impacts of caregiving and promote quality of life (Gitlin & Hodgson, 2015). Determining caregiver needs requires appreciation of the complex background, contextual, and stress-related variables described in the stress process model and requires empirically- and theoretically-driven understanding of the diverse resources, materials, and skills that individuals require for global health and functioning. In this study, we conducted a content analysis of existing measures of dementia caregiver needs (N = 54), content analysis of materials related to evidence-based dementia caregiver interventions and government reports and documents (N = 28), and semi-structured in-depth interviews with current caregivers of PWD (N = 12) to identify the personal and care-related needs of family caregivers of PWD. We propose a framework of five inter-related need categories (Health-related needs, environmental needs, psychological needs, social needs, and needs related to the care and functioning of the PWD) that transact with the factors described in the stress process model, ultimately influencing functioning. In the future, we plan to test this model empirically with a nationally representative sample of caregivers.
Caring for Older Patients With Cancer: Estimates of the Prevalence, Burden, and Unmet Needs of Caregivers in the United States
Authors: Kent Erin 
Published: December 2020

Abstract
In 2020, ~1.8 million Americans are expected to be newly diagnosed with cancer, with approximately 70% of cases diagnosed over the age of 65. Cancer can have a ripple effect, impacting not just patients themselves, but their family caregivers. This presentation will provide an overview of the estimates of the number of family caregivers caring for individuals with cancer in the US, focusing on older patients, from several population-based data sources: Caregiving in the US 2020, the Health Information National Trends Survey (HINTS, 2017-2019), the Behavioral Risk Factors Surveillance System (BRFSS, 2015-2019), and the National Health and Aging Trends (NHATS) Survey. The presentation will compare features of the data sources to give a comprehensive picture of the state of cancer caregiving. In addition, the presentation will highlight what is known about the experiences of cancer caregivers, including caregiving characteristics, burden, unmet needs, and ideas for improving support for family caregivers.
Where to Begin: Assessing Caregiver Readiness
Authors: Marx Katherine , Gitlin Laura 
Published: December 2020

Abstract
There have been many interventions targeting family caregivers for people living with dementia (PLwD) that have been found to have efficacy and effectiveness. However, very few of these interventions have been widely adopted. One reason may be that clinicians and other professionals working with caregivers are unsure of what intervention to use. One measure that may help with where to begin is Caregiver Readiness. This presentation will provide case studies on the use of the Caregiver Readiness Scale in one intervention, the Tailored Activity Program (TAP). We will highlight three cases that have low, moderate and high readiness scores and how the TAP interventionists use the readiness scores to tailor the intervention to match the caregiver’s need. Knowing a caregiver’s readiness to receive an intervention may help clinicians and providers identify where to being in helping the caregiver.
Cardiometabolic Risk Among Older Renters and Homeowners
Authors: Mawhorter Sarah , Ailshire Jennifer , Crimmins Eileen 
Published: December 2020

Abstract
Researchers consistently find adverse long-term health outcomes among renters as compared with homeowners, yet more proximal health measures are needed to understand whether there is a direct link between tenure and health. In this paper, we compare cardiometabolic risk (CMR) levels among older renters and homeowners, and ask whether this health disparity can be explained by socioeconomic differences between renters and homeowners, or poor housing conditions for renters. Using Health and Retirement Study 2010/2012 biomarker data for adults aged 50-84 (N=10,480), we measure CMR by a scale of C-reactive protein, hemoglobin A1C, cholesterol, heart rate, blood pressure, and waist circumference metrics. We find that renters have greater CMR, even accounting for socioeconomic characteristics and health behaviors. Certain housing and neighborhood conditions, such as perceived safety, are associated with CMR. These results suggest potential pathways through which homeownership confers health advantages over renting.
The Implementation of the Music and Memory Intervention in Nursing Facilities in Virginia
Authors: Inoue Megumi , Ihara Emily , Tompkins Catherine , Rumrill Kristen Suthers , Barrett Kendall , McNeil Kathryn , Clark Christi 
Published: December 2020

Abstract
The Music & Memory intervention is a person-centered, non-pharmacologic intervention for people living with dementia. It is considered a personalized music intervention because the playlist comprises music genres that the individual prefers. Music has shown positive effects on behavioral and psychological symptoms of dementia. However, the findings from previous studies are often based on small sample sizes, insufficient descriptions of treatment fidelity, and lack of randomization. To address these issues, we began a randomized controlled trial implementing the Music & Memory intervention in nursing facilities in Virginia with support from the Centers for Medicare and Medicaid (CMS) Civil Money Penalty. We will present our research strategies as well as preliminary results suggesting that nursing facilities with higher occupancy rates are more likely to participate in this type of a program. In addition, study participants with dementia show positive emotional and behavioral reactions when listening to their favorite music.
Sexual and Gender Minority Caregivers of People With Dementia and Their Care Recipients
Authors: Anderson Joel , Flatt Jason , Tree Jennifer Jabson , Gross Alden , Rose Karen 
Published: December 2020

Abstract
Little is known about the unique experiences of sexual and gender minority (SGM) caregivers of people with dementia or their care recipients. We used an electronic survey to assess psychosocial measures within this caregiving population, including measures related to the care recipient. The majority of caregivers (N=285) were gay men (62%). Most respondents were white (80%), with a quarter identifying as Latinx. The majority of caregivers were a spouse/partner (59.3%) and were providing care for someone who identified as LGB (70%), with 20% caring for someone transgender. Half of care recipients did not have an advance directive. The majority of care recipients needed assistance with ≥5 instrumental activities of daily living (83%) and ≥1basic activities of daily living (74%). This study is the first to provide data regarding the unique needs of SGM caregivers of someone with dementia and will support the development of targeted interventions for this population.
We Want to Go, but There Are No Options: Facilitators and Barriers of Transportation Among Diverse Older Adults
Authors: Cao Quichang , Maleku Arati , White Katie , Ozbilen Basar , Dabelko-Schoeny Holly 
Published: December 2020

Abstract
Transportation plays an important role in social connectedness and quality of life among older adults. Despite the increasing number of diverse older adults in the U.S., few studies have explored the barriers and facilitators of transportation among this group. We conducted eight 90-minute focus groups in six languages (English, Nepali, Khmer, Somali, Russian and Mandarin) with older volunteers (N=70) in a large Midwestern metropolitan city. Using the Rapid and Rigorous Qualitative Data Analysis (RADaR) technique, four transportation determinants emerged: (1) Service: affordability, accessibility, availability, and reliability, lack of options, and service coordination (2) Built environment: safety and walkability; (3) Social environment: language barriers and lack of information, neighborhood cohesion; and (4) Individual determinants: ability to drive, walk, and family support system. Results reveal the interconnectedness of multi-level determinants and the need for a systematic approach to improve transportation access among diverse older adults.