bluuebunny/crossref_metadata_2025_split huggingface dataset:
LATER-LIFE LIVING ARRANGEMENTS OF CHILDLESS AMERICANS: A LIFETABLE APPROACH
Authors: Raymo James , Xu Xiao , Liang Jersey , Kim BoRin , Ofstedal Mary Beth 
Published: November 2019

Abstract
The large body of research on living arrangements at older ages pays little attention to the growing population of childless men and women. We begin to fill this gap by using data from the Health and Retirement Study (HRS) over a period of 14 years (2000-2014) to describe the number of years between ages 65-90 that childless Americans live in four different living arrangements: alone, with spouse, with others, and in a nursing home. Because the number of childless HRS respondents is not large (n = 835 in 2000), we first estimate sex-specific single decrement life tables by race/ethnicity and by educational attainment. We then use Sullivan’s method to calculate living arrangement-specific life expectancy for each group, thus providing a comprehensive descriptive portrait of sociodemographic differences in living arrangements across older ages for childless Americans. Preliminary results show that differences in living arrangement-specific life expectancy by race/ethnicity and educational attainment primarily reflect group differences in mortality. The proportion of later life spent in different living arrangements is generally similar across racial/ethnic groups and education levels. This stands in contrast to large racial/ethnic and educational differences documented in earlier studies of older Americans with at least one living child. Results also show that the proportion (and years) of later life spent living alone is substantial, especially for women (over 50%). We discuss the potential implications of these findings with reference to both projected trends in the childless population and research on associations between living arrangements and health of childless older Americans.
REFRAMING AGING: PRACTICES AND MEASURES TO HARNESS THE STRENGTH OF INTERGENERATIONAL NETWORK TIES
Authors: Jarrott Shannon E , Hooker Karen , Morrow-Howell Nancy 
Published: November 2019

Abstract
GSA and other agencies have undertaken to “Reframe Aging” to reduce pervasive global ageism, which has been associated with negative attitudes towards and disinterest in working with older adults and poor health in old age. Familial and non-familial intergenerational contact, that is between members of non-adjacent generations, provides valuable opportunities to reduce ageism through relationships. However, much of the research on intergenerational relationships focuses on attitudes, usually those young people hold about older adults and aging. We propose that attention should shift towards measuring the relationship and giving voice to both younger and older partners. Presenters will address a range of intergenerational relationships focusing on their measurement as a means to advance the Reframing Aging initiative, including examples, challenges, and recommendations. Jarrott will provide an overview of the Reframing Aging initiative and address measurement of non-familial intergenerational relationship. This will be complemented by Pillemer’s focus on how universities can reframe aging through intergenerational network ties, including the Cooperative Extension System. Mendoza and Fruhauf will shift attention to familial connections, focusing on grandparent-grandchild caregiving relationships. Turner, Hooker, and Jarrott will present new efforts to develop a validated theory- and evidence-informed measure of intergenerational relationships that can be completed by young and old persons. Discussant Morrow-Howell, past GSA President, will address how a long history of diverse intergenerational solutions can support efforts to reframe aging through enhanced measurement tools and strategies.
REFRAMING AGING: UNIVERSITIES AS AN ENGINE FOR EVIDENCE-BASED INTERGENERATIONAL APPROACHES
Authors: Pillemer Karl 
Published: November 2019

Abstract
Societal changes are decreasing opportunities for youth to engage with older adults. Geographical mobility, the digital divide, and the growth of age-segregated communities for older people increase age segregation. The lack of interaction can lead to negative attitudes and stereotypes among young and older people. A solution is increasing meaningful contact between youth and older adults. This presentation proposes that higher education can play a unique role in reframing aging through intergenerational programs. Colleges and universities can integrate innovative bodies of research and practice, foster more rigorous research designs to study the effectiveness of intergenerational programs; and discover new ways to provide youth with needed skills and knowledge on how to interact with older adults. The national Cooperative Extension System is presented as a model for how evidence-based practice in intergenerational programs can be translated to communities, with a focus on collaborative program design, evaluation, and broader uptake.
AN MDS 3.0 BEHAVIORAL INDICATOR: RELIABILITY AND VALIDITY WHEN MEASURING BEHAVIOR SYMPTOMS OF DEMENTIA IN CLCS
Authors: Curyto Kim , Jedele Jenefer M , Mach Jennifer J , Mohr David C , Wray Laura O , Eaker April , Intrator Orna 
Published: November 2019

Abstract
Persons with dementia frequently demonstrate behavior symptoms of dementia (BSD), associated with poorer outcomes. A measure of BSD was created for routine use in VA Community Living Centers (CLCs). Reliability and validity of Minimum Data Set (MDS 3.0) behavior items was established using exploratory factor analysis and a multitrait, multimethod correlation matrix. 385 CLC residents with BSD were assessed using validated measures of BSD, depression, and anxiety, and team ratings of the frequency and severity of target behaviors identified for intervention. Factor analysis on MDS items closest to baseline resulted in two stable factors. MDS behavior factors related to validated clinical measures in predicted ways at baseline and post-intervention. MDS distress behavior factor sensitivity to change was evaluated by using change score correlations with validated clinical measures. The MDS distress behavior factor can be used routinely, evaluate the impact of intervention effectiveness, and provide quality improvement feedback.
FACILITY CHARACTERISTICS, STAFF INJURY, AND DISRUPTIVE BEHAVIOR REPORTING RATES IN VA COMMUNITY LIVING CENTERS
Authors: Mohr David , Curyto Kim J , McConeghy Kevin W , Jedele Jenefer M , Vance Kelly 
Published: November 2019

Abstract
Facility characteristics’ influence on staff injuries was evaluated from 2013-2018 for 105 VA CLCs. Nursing hours, nurse skill-level, resident case-mix (percent of residents with mental health or other conditions) and facility size were evaluated in a multivariable regression model. Overall the average injury rates per year were 2.7 (standard deviation 4.3) and 1.5 (2.7) in STAR-VA enrolled vs. never enrolled sites (p=0.04). Statistically significant predictors for higher staff injury rates included percent of residents with dementia, larger bed facilities, and more mental health employee coverage. Lower staff injury rates were associated with facilities with more short-stay residents. After adjustment for facility characteristics, STAR-VA sites were not an independent predictor for staff injury rates. Sites selected for enrollment in STAR-VA have higher overall injury rates which may be due to facility differences in size, staffing and proportion of residents with dementia. Implications for training and monitoring CLC sites will be discussed.
VARIATIONS IN SUSTAINING IMPLEMENTATION OF STAR-VA: THE ROLE OF KNOWLEDGE RESERVOIRS AND OTHER FACTORS
Authors: Sullivan Jennifer L , Curyto Kim , adjognon Omonyêlé l , Pendergast Jacqueline , Wray Laura O , Karel Michele 
Published: November 2019

Abstract
Variation in STAR-VA sustainability across 20 trained VA Community Living Centers was explored using prospective qualitative methods utilizing the knowledge reservoirs framework including seven domains: People, Routines, Artifacts, Relationships, Information space, Culture, and Structure. We conducted directed content analysis of transcripts to identify facilitators and barriers of successful program sustainment. We found that people, usual routines, information sharing, and team relationships were the most often mentioned facilitators by CLC staff. Common reported barriers were people, team relationships, and work culture. Overlap was found in knowledge reservoirs acting as both facilitators and barriers at the same site, most often for people/teams, team relationships, and work culture. Results will be used to develop a sustainability intervention focused on addressing reported barriers. Most notably, a focus on having the appropriate team members, positive team relationships, usual routines, and a supportive work culture are critical for STAR-VA sustainability efforts.
ASPREE SUB-STUDIES
Authors: Woods Robyn L , McNeil John J , Murray Anne 
Published: November 2019

Abstract
To maximize opportunities provided by a large-scale clinical trial, we established sub-studies during the ASPREE trial to investigate specific areas of interest to the health of older persons. A biobank now stores multiple aliquots of blood, urine or saliva collected from &gt;15,000 healthy ASPREE participants across the US and Australia, most at baseline (pre-randomization) and/or after 3 years post- randomization. Other sub-studies included ALSOP (ASPREE Longitudinal Study of Older Persons; sets of questionnaires administered every 2 years focused on medical or social issues) and neuroimaging projects with brain MRI and retinal vascular imaging to investigate anatomical changes linked with cognitive or cerebrovascular outcomes. Further sub-studies addressed the impact of aspirin on cerebral microhemorrhages, age-related macular degeneration, age-related hearing loss, severe sepsis, and falls and fractures. Biomarker analyses underway include plasma androgens in older women and DNA sequencing of the cohort to investigate contributions of genomics to aging health and disease.
PROFESSIONAL QUALITY OF LIFE, LONELINESS, AND EMPATHY IN PROFESSIONAL CAREGIVERS
Authors: Beadle Janelle , Boron Julie Blaskewicz , Masters Julie 
Published: November 2019

Abstract
Retaining professional caregivers is an ongoing challenge for home care agencies. Thus, understanding emotional factors associated with caregiver burnout is critical. While professional caregivers are at risk for burnout and loneliness, less is known about how these factors relate to empathy and professional quality of life. Professional caregivers (n=31) currently employed at two U.S. non-skilled home care agencies participated by completing several questionnaires. Surveys included: UCLA Loneliness Scale (loneliness), Interpersonal Reactivity Index (empathy), and the Professional Quality of Life Scale (compassion satisfaction, compassion fatigue, and burnout). Participants were adults (M=56.8, SD=11.5, Range=24-75 years; 90.3% female) who had obtained an Associates degree (education years: M=14.2, SD=1.7). Overall, participants reported average to high levels of loneliness (M=37.5, SD=9.8), and emotional (M=23.2, SD=3.7) and cognitive (M=20.3, SD=4.6) empathy. Caregivers generally reported positive feelings about their work (compassion satisfaction: M=42.8, SD=5.0) and low levels of burnout (M=17.1, SD=4.2). In contrast, they reported relatively high levels of compassion fatigue (M=17.7, SD=4.0). Burnout was positively associated with compassion fatigue (r=.7, p&lt;.001), and loneliness (r=.5, p=.004), whereas a negative association was found between burnout and cognitive empathy (r=-.5, p=.008). Using a linear regression, the associations between compassion fatigue, loneliness, and cognitive empathy were examined in relation to burnout. This model was statistically significant (r2=.72; F change (3,21)=17.8, p&lt;.001), but only compassion fatigue (p=.002) and cognitive empathy (p=.002) were significant predictors of burnout. This study highlights the importance of the contributing role of socioemotional factors to burnout experienced in a professional caregiving setting.
NOT ENJOYING THE MEAL WAS ASSOCIATED WITH DEPRESSIVE SYMPTOMS, DESPITE THE SIZE OF SOCIAL CONNECTIONS
Authors: Takase Mai , Murayama Hiroshi , Hirukawa Sayaka , Tanaka Tomoki , Ono Sachiko , Minami Sugimoto , Kimata Mari 
Published: November 2019

Abstract
Conventional studies report that the enjoyment of the meal is related to likelihood of contracting depressive mood. The Japanese assisted living facilities currently support seniors build social connections to maintain their health and well-being, but psychological feeling during mealtime is often left unquestioned. Because seniors engage in conversation with tablemates while dining, the feeling during mealtime should not be ignored. This study aimed to explore the relationship among social connection, enjoyment during mealtime, and depressive mood. A cross-sectional questionnaire study was performed for independent residents at assisted living facility in Kanagawa Prefecture, Japan. The size of social connection (the number of facility residents that one can easily talk to) and enjoyment during the meal were assessed by a single item, respectively. The 15-item Geriatric Depression Scale was used to measure depressive symptoms. The analysis included 190 questionnaires. A logistic regression analysis showed that enjoyment during mealtime was associated with less likelihood of depressive symptoms, but the size of social connection was not, after adjusting for socio-demographics and health conditions. Moreover, a significant interaction between social connection and enjoyment during mealtime was observed. This indicated that greater size of social connection was inversely related to depressive symptoms among those who enjoyed the meal; however, among those who did not enjoy the meal, the likelihood of depressive symptoms were stably higher despite the size of social connection. The findings suggested that along with helping seniors build social connection, care takers should focus on improving the dining environment of seniors.
LIVES WORSE THAN DEATH: ADULT CHILDREN ARE POOR AT ESTIMATING PARENTS’ QUALITY-OF-LIFE VALUATIONS
Authors: Pichiello Matthew , McDarby Meghan , Kozlov Elissa K , Carpenter Brian 
Published: November 2019

Abstract
Adult children often help older parents make medical decisions when their health is compromised. To do so in a way that respects parent values requires children to know how their parent views health states and consequent quality of life. The current study compared older parent and adult child valuations of quality of life in different health contexts. Families consisted of older parents (n = 37) and their adult children (n = 66). Parents rated perceived quality of life in 14 compromised health states on a scale from 1 (difficult but acceptable) to 5 (not worth living). Children estimated how their parent responded to each health state, yielding an index of their knowledge of parent perceptions. Overall, parents described all compromised health states as less acceptable than adult children thought they would, t(99) = 2.19, p &lt; .05. Notably, parents believed situations that caused financial or emotional burden to their family were much less acceptable than their children estimated. Children were more knowledgeable about parent valuations for more extreme circumstances, such as living with a feeding tube. Within families, children demonstrated only slight knowledge about parent quality of life valuations (kappa = .081). Across the entire sample of families, there was a broad range of knowledge (kappas = -.181 – .351), but at best, knowledge was still only fair. Results from this study suggest that adult children may underestimate the impact of compromised health states on parent estimations of quality of life, which could affect collaborations on healthcare decisions.
INFERRING ADL BEHAVIORS FROM HIGH DENSITY, AMBIENT, INTERNET OF THINGS SENSOR DATA USING MACHINE LEARNING
Authors: Keohane Susann M , Gerard Scott N 
Published: November 2019

Abstract
To address the growing desire for older adults to age-in-place, there has been an influx of research and development in telehealth services that utilize smart home and ambient assisted living (AAL) technology. AAL technology is designed to care for, remotely monitor, and support healthy aging. The challenge with AAL technology is to accurately classify an older adults’ activities and provide a baseline for detecting changes in physical and cognitive state. We employ (1) rules-based, (2) Latent Dirichlet Allocation (LDA) and (3) auto-encoders (a type of neural network) to infer activities of daily living and instrumented activities of daily living behavior from low-level Internet of Things sensor data. We apply our techniques to a large dataset over 5 older adults in independent living apartments, for over 5 months with 30 to 50 ambient sensors per apartment. Findings highlighted three main themes: (1) lessons learned, (2) an evaluation of the various approaches employed, and (3) a semi-automated methodology to label large volumes of raw sensor data.
WOULD YOU RATHER BE AT HOME OR IN A HOME? AN EXPLORATION AND COMPARISON OF OLD-AGE SOCIAL CONNECTEDNESS
Authors: Berlin Melissa 
Published: November 2019

Abstract
Aging-related changes challenge older adults’ experience of social connectedness and increase their risk of perceived isolation. As seniors cope with these changes, they often face the question of whether to age in place or move to a senior living facility. While many studies explore these scenarios separately, there is little research comparing these two living arrangements. Therefore, this study examined the following questions: how do older adults experience social connectedness and perceived isolation? How does this experience vary between older adults living alone in private homes and those living in assisted living facilities? I conducted 16 qualitative interviews with middle-old and old-old women (ages 75+) who lived alone in a private home or in an assisted living facility in southeast Michigan. The themes that emerged revealed differences in three aspects of social connectedness; interactions, relationships and belonging. Community dwelling respondents’ interactions were characterized by intentionality, with minimal investment in forging new or deeper relationships and an emphasis on belonging to the world in terms of awareness, contribution, and cognitive ability. Assisted living respondents’ experiences where characterized by availability of interactions and casual relationships within the facility and an emphasis on belonging to the facility community, while positioning oneself between the status of resident and staff. Surprisingly, neither group reported a notable degree of perceived isolation. Both had adapted their social connectedness expectations to reflect their current situation. These findings have meaningful implications for older adults facing decisions about where to age, as well as for the communities that serve them.
SOCIAL CAPITAL AND HOME- AND COMMUNITY-BASED SERVICE UTILIZATION AMONG URBAN OLDER CHINESE ADULTS
Authors: Peng Changmin , Burr Jeffery A , Kim Kyungmin , Lu Nan 
Published: November 2019

Abstract
Home- and Community-Based Services (HCBS) are increasingly important for older adults who want to maintain their independence and remain in their communities. Although HCBS systems have been developed widely in many western countries and in some countries in Asia, China is just beginning to grapple with its rapidly aging population by offering HCBS in a limited fashion. The purpose of this study was to investigate the relationship between structural (e.g., citizenship activities, volunteering) and cognitive (e.g., social trust, a sense of belonging) social capital and HCBS utilization among older Chinese adults. The study also examined the mediating effect of structural social capital for the the relationship between cognitive social capital and HCBS utilization. We frame the study within the Andersen behavioral model of health services utilization and argue that within this framework social capital is an enabling factor. We analyzed survey data from 456 community-dwelling older adults living in the Gusu district of the city of Suzhou, China in 2015. Structural equation modeling was used to test the hypothesized relationships. The results showed that both cognitive and structural social capital were significantly associated with HCBS utilization. Structural social capital also served as a mediator between cognitive social capital and HCBS utilization, even after controlling for sociodemographic characteristics and other relevant covariates. The findings supported the utility of employing Andersen’s behavioral model and social capital theory for better understanding older Chinese adults’ utilization of HCBS. Interventions for increasing social capital may be useful for improving HCBS utilization in Chinese urban communities.
TESTING THE RELIABILITY AND VALIDITY OF THE RESIDENT SATISFACTION INDEX
Authors: Holmes Sarah D , Galik Elizabeth , Resnick Barbara 
Published: November 2019

Abstract
Understanding residents’ life satisfaction in assisted living (AL) is essential for creating supportive environments that are targeted toward the needs and desires of residents. Unfortunately, few measures have been developed and tested to evaluate residents’ life satisfaction in AL. The purpose of this study was to test the reliability and validity of the Resident Satisfaction Index (RSI) which was designed to measure residents’ life satisfaction in AL. Baseline data was used from a study testing the Dissemination and Implementation of Function Focused Care in AL. A total of 501 residents from 54 AL facilities were included in the sample. Based on Rasch analysis, there was evidence of internal consistency with an alpha coefficient of 0.95 and validity based on INFIT and OUTFIT statistics which ranged from 0.4 to 1.6. Item mapping showed the easiest item to endorse was item 10 which referred to perceptions of staff’s kindness. The hardest item to endorse was item 17 which asked about staff’s responsiveness to residents’ needs. Differential item functioning (DIF) analysis was done to examine differences in item responses by age, gender, and cognitive status. The measure was equally appropriate for those with and without mild to moderate cognitive impairment and between males and females, 5 out of 22 items were answered differently based on gender. 117 (23%) participants scored so high in satisfaction that they could not be differentiated. Findings support the reliability and validity of the measure although we recommend adding more difficult items to better differentiate between residents.