bluuebunny/crossref_metadata_2025_split huggingface dataset:
DOMICILIARY SERVICES IMPROVE ACCESS TO DENTAL CARE FOR FUNCTIONALLY DEPENDENT OLDER ADULTS
Authors: Lim Mathew A , Borromeo Gelsomina L 
Published: November 2019

Abstract
There is growing evidence demonstrating links between oral diseases and general health. The increased retention of teeth among functionally-dependent older adults presents a unique challenge in maintaining the oral health of these individuals from basic oral hygiene to accessing dental services. The results of our cross-sectional study demonstrate the important role domiciliary dental services play in reducing the barriers to accessing oral health care in this cohort. In our study, most individuals treated by domiciliary services lived in residential aged care facilities and were significantly older than those treated by hospital and community-based dental services dedicated to the specialized care of individuals with additional health care needs. A significantly higher number of those receiving domiciliary care were unable to self-consent for treatment compared to those managed in other settings. 27.4% of these patients had a diagnosis of dementia. More than half (56.9%) of patients treated by domiciliary services received some form of treatment with almost half (48.1%) of these requiring a dental extraction. Only two of these patients were not diagnosed with a chronic condition known to affect oral health (dementia, Parkinson’s disease, diabetes mellitus, arthritis, stroke, osteoporosis). 23.7% of domiciliary appointments were used for denture fabrication. The results depict the worrying level of unmet treatment need in residents of aged care facilities. However, they also demonstrate the potential for domiciliary dental services to play a role in developing partnerships between carers and oral health professionals to improve the oral health of functionally-dependent older adults.
HEALTH CARE AND SOCIAL CARE AMONG FRAIL OLDER ADULTS IN SWEDEN: A REGISTRY-BASED STUDY
Authors: Bravell Marie Ernsth , Finkel Deborah G , Johansson Linda 
Published: November 2019

Abstract
In 2010 the Swedish government made a large investment to improve the quality of care for the “frailest older adults” but there have been few follow-ups of the care of this group. The aim of this study is to therefore describe use of care over the time in 2010-2014. Methods: In 2014, 9 National Quality Registries, 3 Care Registries (drug-, patient and death-registers) and the registry for care and social services for older persons (SOL) were individually matched to an older population in the Swedish Twin Registry (n≈45000). Identification of the “frailest older adults” was achieved via SOL and the Patient Registry. Results: 280 persons were identified as “frailest” in 2010 these were followed over time. About two thirds (60,7%) were women, mean age: 81.2±7.7, about one third (35%) lived in a nursing home, one third (34%) had more than three hospitals stays, almost three quarters (72.5%) had more than 19 hospital days and almost one third (28%) had more than seven outpatient care visits. By the end of 2012, 119 persons (42.5%) were deceased. Among those alive (n=161) 42 persons did not receive any inpatient care between 2010-2012, but more than 85% received outpatient care and 44.1% were living in nursing homes. In 2014, 90 persons (32.1%) were still alive and half of them lived in a nursing home. In conclusion, over time the use of care as well as the risk of mortality was high confirming the need of further improvement of the care for these persons.
CHALLENGES IN RECEIVING, ORGANIZING, AND PROVIDING CARE IN ACTIVITIES OF DAILY LIVING: A WORLD-CAFé DIALOGUE
Authors: Cremer Svenja , Bleijlevens Michel , Metzelthin Silke F , Ginkel Janneke M de Man-van , Zwakhalen Sandra M 
Published: November 2019

Abstract
Activities of Daily Living are a series of basic activities performed by individuals on a daily basis necessary for independent living at home or in the community. ADL are part of basic nursing care which describe aspects of care that are fundamental to all patients’ health and well-being, regardless of diagnosis, cultural background or healthcare setting. In daily practice, nursing staff is confronted with challenges when providing ADL-care. In order to provide nursing professionals with practical tools to tackle daily challenges, a deeper insight into the perceived challenges by nursing staff, care receivers and informal caregivers is necessary. Therefore, two ‘world-café’ sessions were organized to explore daily challenges in ADL-care. In a World Café, participants are regarded as experts of their own lived experience and experiential knowledge. By creating a hospitable environment (i.e. a café-style ambience) individual and collective knowledge and ideas can be shared. Care receivers, informal caregivers and professionals including nurses, nursing-assistants, physical therapists, occupational therapist, and other stakeholders (N=53) participated in these ‘world-cafés’. The session’s output comprised ‘graphic recordings’ (paper tablecloths and post its) of the conversations that have been analyzed using content analysis. Findings showed reported challenges regarding receiving, providing and organizing ADL-care. Challenges on organizational level comprised for example both bilateral agreements and communication. Whereas reported care related issues related to challenges such as the assessment of care receivers’ needs and the use of assistive devices in the provision of ADL-care. The inventoried challenges will be addressed in an ADL-quality standard for nursing staff.
FUNCTIONAL INDEPENDENCE, ACCESS TO KIDNEY TRANSPLANTATION, AND WAITLIST MORTALITY
Authors: Chu Nadia M , Sison Stephanie , Muzaale Abimereki , Haugen Christine , Wang Jacqueline Garonzik , Norman Silas , Segev Dorry , McAdams-DeMarco Mara 
Published: November 2019

Abstract
Although functional independence is a health priority for patients with advanced CKD, 50% of those who progress to end-stage kidney disease (ESKD) develop difficulties carrying-out essential day-to-day activities. Functional independence is not routinely assessed at kidney transplant (KT) evaluation; therefore, it is unclear what percentage of candidates are functionally independent and whether independence is associated with access to KT and waitlist mortality. We studied a prospective cohort of 3,168 ESKD participants (1/2009-6/2018) who self-reported functional independence in basic Activities of Daily Living (ADL) and more complex Instrumental Activities of Daily Living (IADL). We estimated adjusted associations between functional independence (separately) and listing (Cox), waitlist mortality (competing risks), and transplant rates (Poisson). At evaluation, 92.4% were independent in ADLs, but only 68.5% were independent in IADLs. Functionally independent participants had a higher chance of listing for KT (ADL:aHR=1.55,95%CI:1.30-1.87; IADL:aHR=1.39,95%CI 1.26-1.52). Among KT candidates, ADL independence was associated with lower waitlist mortality risk (SHR=0.66,95%CI:0.44-0.98) and higher rate of KT (IRR=1.58,95%CI:1.12-2.22); the same was not observed for IADL independence (SHR=0.86,95%CI:0.65-1.12; IRR=1.01,95%CI:0.97-1.19). ADL independence was associated with better KT access and lower waitlist mortality; clinicians should screen KT candidates for ADL independence, and identify interventions to maintain independence to improve waitlist outcomes.
FALL INJURY CHARACTERISTICS ASSOCIATED WITH EMERGENCY DEPARTMENT VISITS AND HOSPITALIZATIONS AMONG OLDER ADULTS
Authors: Choi Namkee G , DiNitto Diana M , Kunik Mark E 
Published: November 2019

Abstract
Fall injuries and related healthcare use among older adults are increasing in the US. Based on the 2013-2017 US National Health Interview Survey public use data, this study examined fall injury characteristics that are associated with emergency department (ED) visits and hospitalizations among those aged ≥60 years who received medical attention for their fall injuries within a 91-day reference period (N=1,840). Our findings show that nearly a third of these older adults received care from emergency medical services (EMS), presumably for a “lift assist” to get off the floor and/or for ED or hospital transport; a little more than one-third had an ED visit only; and a little less than a fifth had an overnight hospital stay. Multivariable analysis showed that hip and head injuries, face injuries, and broken bones/fractures (from any type of injury) were likelier causes of hospitalization than injuries to other parts of the body. Fall injuries sustained inside the home, falls from loss of balance/dizziness, and living alone were also more likely to result in hospitalization, while fall injuries that occurred away from home and those with lung disease and memory problems were associated with higher risk of ED use only. These healthcare use data indicate the significant toll that fall injuries exact upon older adults and healthcare system. Fall prevention programs should target risk factors that are specific to serious injuries and be made more accessible. Strategies for implementing scalable, adaptable, and measurable fall prevention models by EMS providers and ED staff are also needed.
PHYSICAL ACTIVITY PREFERENCES OF OLDER ADULT MEDICAID HOME AND COMMUNITY-BASED SERVICES WAIVER CLIENTS
Authors: Davila Victoria S , Pietzak Lauren , Rossi Danielle , Phipps Karen , Danilovich Margaret 
Published: November 2019

Abstract
Despite the known effectiveness, physical activity (PA) is not currently offered to older adult clients receiving Medicaid Home and Community Based Services (HCBS). To optimize PA implementation within Medicaid HCBS, understanding client preferences for PA programming is needed. Thus, the objective of this exploratory qualitative study was to identify the PA preferences of HCBS clients including mode, duration, implementation strategy, and frequency, as well as barriers and motivators to PA. We recruited participants from the Illinois’ Department on Aging Community Care Program. We conducted semi-structured interviews in participants’ homes which were audio recorded, transcribed, and analyzed using Dedoose (version 7.0.23). We derived semi-structured interview questions from the Health Belief, Social Cognitive, and Health Action Process Approach framework. We used a structured coding approach using conventional content analysis to derive codes from the text, then applied these codes to each interview and examined the frequency to determine themes. The most frequently referenced theme was barriers to PA, primarily co-morbidities. The primary motivator was social support by a peer or instructor. The preferred PA program components were walking 2-3 days per week with duration varying from 20 minutes to 2 hours. Clients also preferred individualized PA instruction versus a passive strategy such as pamphlets or videotapes. Our findings show that individual-level factors most significantly influence PA participation and should be addressed among Medicaid HCBS clients. We recommend Medicaid HCBS consider a personalized approach of PA implementation with their clients.
VALIDATION OF A NEW FUNCTIONAL COGNITION SCREENING MEASURE
Authors: Edwards Dorothy F , heizan Muhammad O Al- , Marks Timothy , Giles Gordon M 
Published: November 2019

Abstract
Identification of cognitive deficits that contribute to functional dependence in acute and post-acute care settings is important. The Menu Task (MT) is a brief cognitive 12 item screening measure designed to identify older adults at risk for IADL impairment in community settings. The objective was to compare the psychometric properties of the Menu Task a series of neurocognitive and functional cognitive performance measures including the Brief Interview of Mental Status (BIMS), the Montreal Cognitive Assessment (MoCA) the Weekly Calendar Planning Activity (WCPA) and the Performance Assessment of Self-Care Skills (PASS) in a sample of 200 community dwelling older adults. Participants were administered the MT, BIMS, MoCA, WCPA, and the PASS checkbook and shopping tasks. ROC analysis identified an MT cut score, sensitivity and specificity. We computed Cronbach’s alpha, correlations among study measures and t-tests between groups impaired or unimpaired on the MT. Mean age of participants was 70.44(SD 8.3), the sample was predominately female ((76%), and white (81%). Mean MT score was 8.22 (SD 2.01) and the mean completion time was 185.5 sec (SD 108.11). The Menu Task has moderate internal consistency (α= 0.65). The AUC statistic was 0.83 with an optimal MT cut score of “7” and sensitivity of .90 and specificity of .70. Significant differences (p &lt; 0.01) were observed between impaired and not impaired MT groups on BIMS, MoCA, WCPA, and PASS. The Menu Task has moderate to strong evidence supporting its psychometric properties and the value of screening for functional cognitive deficits.
THE INTERVIEW FOR DECISIONAL ABILITIES: DEVELOPING THE EVIDENCE BASE FOR ADULT PROTECTIVE SERVICES
Authors: Sivers-Teixeira Theresa , Stevens Gregory , Sadamitsu Kelly , Penate Christina , Olsen Bonnie 
Published: November 2019

Abstract
Adult Protective Services (APS) workers assess clients for abuse and neglect and are asked to determine the client’s understanding of risks they face. Yet, APS workers have little structured training in how to make such judgements. The Interview for Decisional Abilities (IDA 3.0-CA) is a tool designed for use by APS workers to assess the ability of suspected victims of elder mistreatment to make decisions about the risks they face. This study evaluates the impact of training and use of this tool on the knowledge, experiences and ability of APS workers to determine decisional ability. APS workers and supervisors were recruited from central and northern California APS programs and randomized into either control (n=94) or IDA 3.0-CA training groups (n= 95). Baseline surveys measure knowledge of, and experiences with, assessing decisional ability and determining next steps for case management. Additionally, respondents determine the decisional ability of three case scenarios. Three months post-training, controls and trained subjects complete the same survey with a new set of cases. Preliminary results at baseline indicate there were no statistically-significant differences between trained subjects (n=42) and controls (n=50) in their knowledge scores (78.6% correct vs. 81.0%, p=0.6641) or performance assessing decisional ability in the case scenarios (60.1% correct vs. 63.3%, p=0.3497). Reported experiences assessing decisional ability and determining next steps in case management were also similar for trained subjects and controls. Complete results will be presented regarding change in knowledge scores, experiences, and assessing decisional ability in case scenarios compared across trained subjects and controls.
PSYCHOMETRIC APPRAISAL OF THE GERIATRIC SOCIAL WORK COMPETENCY SCALE II WITH LIFELONG LEADERSHIP SKILLS
Authors: Wilks Scott E , Choate Sarah , Eugene Danielle , Du Xi 
Published: November 2019

Abstract
The Council on Social Work Education (CSWE) Gero-Ed Center and Hartford Partnership Program in Aging Education (HPPAE) emphasize five competency areas specific to social work practice with older adult clientele (i.e., gero social work), namely knowledge and skills applicable to (a) values, ethics and theories; (b) assessment; (c) intervention; (d) aging programs, services and policies; and (e) leadership in aging environments. Accordingly, CSWE/HPPAE created a standardized measure – Geriatric Social Work Competency Scale II with Life-long Leadership Skills (GSWCS II) – to assess empirically these practice competencies among social work students and gero social work practitioners. A scant amount of literature exists that reports properties of this measure. Consequently, the purpose of this study was to conduct a psychometric examination of the GSWCS II, namely its factor structure and reliability among the competency areas. The sample consisted of three, advanced year MSW cohorts (N=170) from a state flagship university in the southern United States. Almost one-third of the sample were enrolled in a gerontology specialization during their advanced year. The typical participant was a 27-year-old female enrolled full time, completing the 60-credit hour MSW program. Principal axis factor results indicated unidimensionality, using the traditional 1.0 eigenvalue threshold, for each competency scale. All items loaded moderately-to-strongly on their respective competency scales; loadings ranged from 0.569 to 0.906. Regarding internal consistency for each of the competency scales, Cronbach’s alphas ranged from 0.932 to 0.959; Guttman split-half coefficients (lambda-4) ranged from 0.896 to .941. Implications for gero practice competency assessment are discussed.
FACTORS INFLUENCING STAFF-RESIDENT INTERACTIONS IN NURSING HOMES
Authors: Paudel Anju , Galik Elizabeth , Resnick Barbara 
Published: November 2019

Abstract
Staff-resident interaction is an integral part of daily life of nursing home residents and has an influence on residents’ well-being. However, less is known about the factors that influence these interactions. The purpose of this study was to describe the quality of interaction between staff and residents with dementia in nursing homes, and explore the factors associated with ‘positive’ and ‘negative/neutral’ interactions. This cross-sectional analysis utilized baseline data from the first two cohorts in a randomized clinical trial, EIT-4-BPSD, including 338 residents from 35 nursing homes. Generalized linear mixed model (GLMM) was used to explore the factors associated with interactions. It was hypothesized that the resident factors (age, gender, race, marital status, cognition, comorbidities, depressive symptoms, agitation, functional status) and facility factors (facility ownership, facility size, RN hours, LPN hours, CNA hours, and star rating) would be associated with staff-resident interactions. The staff-resident interactions were mostly positive. Overall, the models for ‘positive interactions’ and ‘negative/neutral interactions’ correctly classified 82.8% and 85.3% of the cases respectively. Both ‘positive’ and ‘negative/neutral’ interactions were significantly associated with marital status, and profit status of the facility. Being married and living in a not for profit facility was associated with lower odds of positive interaction and higher odds of negative/neutral interaction. There is some evidence that marital status influences staff-resident interactions and that profit status of facilities are associated with staff resident interactions. Future studies could explore staff factors such as consistent assignment, job satisfaction, staff characteristics, and training.
THE STRUCTURE OF CARE MANAGERS’ PRACTICE RESPECTING THE AUTONOMY OF THE FRAIL ELDERLY IN JAPAN
Authors: Hata Chiemi , Kasahara Sachiko 
Published: November 2019

Abstract
The objectives of current study are to clarify the structure of practice respecting the autonomy of the frail elderly under the Long-Term Care Insurance system in Japan and to discuss the related factors to the practice. The mailed self-administered questionnaire survey was conducted on 1398 care managers who working in In-Home Long-Term Care Support Providers in A City in Osaka with the condition that “office with multiple care managers engaged and one care manager with more than 5 years’ experience”. The response rate was 51.0% (713persons) and no missing data 615 (44.0%) was analyzed. Analysis was carried out using Mplus.ver8. The structure of practice respecting the autonomy of the frail elderly and the rerated factors were examined as a causal model using structural equation modeling. As the result, it was confirmed the goodness of fit to the data (RMSEA=0.049, CFI=0.927). By the confirmatory factor analysis, the care manager’s practice respecting the autonomy of the elderly was confirmed associating with three-factors structure; (1)data collection and assessment, (2) strength perspective and (3) professional relationship. Furthermore the practice was significantly affected by self-esteem of care-managers performance (β=0.494) and self-reflection to own work (β=0.269). In conclusion, the current study supported the hypothetical consideration in which self-esteem and self-reflection in care manager’s practice significantly affected the practice respecting the autonomy of the frail elderly.
PERSON-CENTERED CARE, BURNOUT, AND BARRIERS AMONG DIRECT CARE PROFESSIONALS: TARGETED TRAINING INTERVENTION 360
Authors: Stratton Lauren , Dannewitz Hannah , Margrett Jennifer , Shelley Mack , Brown Linda , Drobot Ann C 
Published: November 2019

Abstract
Long-term care staff outcomes, such as job satisfaction and providing personalized care, are positively influenced by person-centered interventions. Implemented in eight facilities across Iowa, the Targeted Training Intervention 360 (TTI) program aimed to increase person-centered care among direct care professionals (DCP). Throughout the course of TTI, three waves of data were collected from DCPs regarding person-centered care (Person-Centered Care Assessment Tool; P-CAT) and feelings of burnout (Maslach Burnout Inventory; MBI). Analysis of variance tests were employed to identify significant differences in subscale scores across the three waves. Between waves one and two, results revealed significant increases in the P-CAT Extent of Personalizing Care (p=0.03) and Amount of Organizational Support subscales (p=0.001). Additionally, significant decreases from waves one and two were found in the MBI Emotional Exhaustion subscale (p=0.04). Between waves two and three, there were no significant changes in the P-CAT subscales; however, there was a significant increase in the MBI Emotional Exhaustion subscale (p=0.04). To supplement these findings, in wave three DCPs indicated barriers to implementing person-centered care, which included lack of time (49.0%), lack of experience (29.4%), and lack of administrative support (21.6%). Though there were no significant changes in P-CAT scores between the last two waves as well as barriers that must be addressed, DCPs described positive organizational and personal changes regarding person-centered care in the facility, including consistent staffing, using person-centered techniques in care, and individualized activities. Discussion focuses on ways to address barriers to person-centered care and sustain efforts in implementing change.
SERVICE PROVISION IN RESIDENTIAL CARE COMMUNITIES FOR RESIDENTS WITH DEMENTIA AND DEPRESSION
Authors: Sengupta Manisha , Caffrey Christine 
Published: November 2019

Abstract
Assisted living and similar residential care communities (RCCs) are an important source of care for older adults, many of whom have dementia or depression. In 2016, 42% of residents in RCCs were diagnosed with dementia and 31% were diagnosed with depression. About two-thirds of RCCs (63%) provided social work and mental health services and 37% provided neither service. Using the 2016 National Study of Long-Term Care Providers, this study includes bivariate and ANOVA modeling to (1.) examine the variation in dementia and depression between RCCs that provide social work and mental health services and those that do not, and (2.) assess if there is an interaction between provision of services and RCC bed size in their association with dementia and depression. Bivariate results show that the prevalence of dementia does not vary by service provision, but the prevalence of depression does. The percent of residents with depression varied from 34% in RCCs that provided both social work and mental health services to 31% in RCCs that provided only one service to 28% in RCCs that provided neither service. The prevalence of dementia was around 4 in 10 residents, regardless of service provision. Fitting a two-way ANOVA model for dementia indicated that the effect was 4 percentage points higher for RCCs that provided services than those that did not, but only among small RCCs. Findings from this study can inform strategies to care for the needs of residents with dementia and depression across the various sizes of RCCs.