bluuebunny/crossref_metadata_2025_split huggingface dataset:
IN-PERSON FIDELITY MONITORING: HOME-BASED INTERVENTION DELIVERY FOR PERSONS WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Sefcik Justine S , Hodgson Nancy A 
Published: November 2019

Abstract
The gold standard for ensuring satisfactory delivery of an intervention remains fidelity monitoring. In-person observations for fidelity monitoring has received less attention in the literature compared to evaluating sessions via video and audio-recordings. This presentation focuses on a qualitative analysis of field notes from 15 scheduled fidelity visits of a home-based intervention involving persons with dementia and their caregivers (Healthy Patterns, NCT03682185). The findings of advantages (e.g., being able to complete observations in real time), disadvantages (e.g., additional time needed from staff to coordinate and attend visits), and ethical considerations (e.g., potential intrusiveness in the home when observing staff) with be discussed. Future research recommendation is to explore participant perspectives on having an in-person fidelity monitor in the home.
EMPOWERING OLDER ADULTS IN HEALTHCARE SETTINGS: COMMUNICATION SKILLS TRAINING FOR SURGICAL RESIDENTS
Authors: Roberts Linda , Cornell Charles , Bostrom Mathias , Goldsmith Sandra , Ologhobo Titilayo , Roberts Timothy , Robbins Laura 
Published: November 2019

Abstract
Older adults often perceive themselves as stigmatized and powerless in healthcare settings. Communication with them is complicated by age-related issues and negative stereotypes about older adults and aging. It is therefore vital for physicians and surgeons, who encounter the most vulnerable elderly, to communicate successfully with this population, who wish to maintain quality and dignity in their lives. Successful patient communication leads to better recall of information, compliance, adherence to medications, satisfaction, and overall better outcomes. We developed a two-part training program comprised of small group interactive didactic sessions on aging issues with third year surgical residents, and workshop demonstrations given by the residents to a group of older adults, followed by a question and answer session. Residents were assessed using a 22-item pre–post questionnaire covering medical knowledge of aging, attitudes toward older adults, and personal anxiety about aging. Since its inception, the program has reached 88 residents and 711 older adults. For residents, knowledge scores (p ≤ 0.001), six of nine attitude items (p ≤ 0.01) and one of four anxiety items (p ≤ 0.001) improved significantly. This is notable as well since attitudes and anxiety levels are attributes that are deep-seated and hard to change. For older adults, post surveys showed that 96% strongly agreed/agreed that residents had demonstrated sensitivity toward them and 96% were very satisfied/satisfied with the program. Our replicable, low-cost program enables residents to learn and realistically practice universal underlying communication skills in order to maintain effective and sensitive communication with this vulnerable population.
HOW TO PREPARE PHYSICIAN ASSISTANTS FOR THE CARE OF OLDER ADULTS? PARTNER WITH GERONTOLOGY
Authors: Eaton Jacqueline , Honda Trenton 
Published: November 2019

Abstract
Approximately 80% of older adults have chronic illness which requires complex care. Primary care providers require special training to improve the care they provide older adults. As primary care shortages increase, and the older adult population swells, physician assistants (PA) will increasingly be relied upon to provide care and advocacy for older adults. The purpose of this presentation is to describe the development of a dual degree program that facilitates enhanced gerontological training for students pursuing a Masters of PA Studies degree. The Gerontology Interdisciplinary Program and the PA Program at the University of Utah collaborated to assess program objectives, competencies, and coursework, while identifying student interest in this dual MS venture. Students were interested in increasing their skills to meet the growing need for geriatric care while also saving time and money. In addition, it was important that the combined program of study did not overburden students and accommodated participants off-site. Faculty and administrative buy-in was sought from within departments and colleges. Revisions to the proposed program of study included altering course offerings, changing program start dates, and removing course overlap. A 30-month dual MS was developed that incorporates 87 PA Program credits, 25 Gerontology Credits, and 6 credits shared through practicum, geriatric content, and evidence based practice. Students who graduate will complete a Gerontology focused Masters Project that combines their work from the two programs. This dual MS program prepares students to be competitive in the job market, while also targeting an area of need in primary care.
IS GHANA READY FOR GERIATRICS? MEDICAL STUDENTS’ INTEREST AND INTENTION TOWARD GERIATRIC SPECIALIZATION IN GHANA
Authors: Karikari Grace , Huber Lesa L , Lohrmann David K 
Published: November 2019

Abstract
Aging is a global phenomenon, and the population of elderly persons continues to increase in many communities around the world. Ghana is not an exception. As the demographics are changing, it is vital that health care providers are trained to effectively diagnose, care for, and manage aging-related conditions to improve the quality of life of the elderly. The aim of this study is to explore the underlying reasons for medical students’ interest in geriatrics and their intentions, likelihood of selecting geriatrics as a specialty for future practice. This exploratory study involved (n =12) fourth, fifth and sixth year medical students in a Ghanaian public university. Semi-structured interviews guided by the theory of planned behavior were conducted. The findings show a lack of geriatric education or training for students in this institution and region. Students’ interest and preferences for geriatrics were mainly influenced by the lack of knowledge and exposure to the specialty, as well as what it entailed to be a geriatrician. Although some students expressed interest in working with older patients, none had the intention to pursue geriatrics as a career option. Creating positive exposure to geriatrics through educational and vocational opportunities are necessary. The findings from this study can be instrumental in developing a knowledge-base of aging and caring for the elderly. Findings can also serve as the foundation for a more comprehensive study, leading to effective geriatrics education interventions in Ghana and Africa at large.
NAVIGATING FINANCIAL CONVERSATIONS ABOUT STUDENT LOAN DEBT AMONG OLDER BORROWERS AND THEIR FAMILIES
Authors: Brady Samantha , Miller Julie , Balmuth Alexa , D'Ambrosio Lisa , Coughlin and Joseph 
Published: November 2019

Abstract
Currently, approximately 44 million people in the United States carry the weight of over 1.4 trillion dollars of student loan debt. As the cost of education continues to rise, the decision of taking on student loans is increasingly a family decision rather than an individual one. While the majority of research focuses on younger borrowers, little research has been done to understand the experiences of parents and grandparents taking on student loans for a loved one. In order to financially and emotionally manage this burden, borrowers may benefit from support from their social networks, including family and friends. For many, navigating these difficult conversations presents a challenge of its own. This presentation will spotlight an MIT AgeLab mixed methods study about how student loan borrowers between the ages of 51 and 75 experience and manage their student loans within family systems and how these loans may impact family dynamics. Data were collected through focus groups and a national survey. Preliminary findings suggest that older borrowers demonstrate several distinct communication typologies within their families in regards to finances, particularly regarding student loan accrual and repayment. Each of the four primary communication styles regarding loans impact borrowers’ financial and emotional wellbeing throughout the life course, as well as perceived relationship dynamics. Moreover, older borrowers are more likely to report family conflict if student loans are less frequently discussed with family members. Findings also suggest strategies to help parents and grandparents facilitate conversations abound student loans based on their unique family communication styles.
CREATING STRENGTH IN AGE: HARNESSING THE POWER OF ARTS AND HUMANITIES NETWORKS
Authors: Hanna Gay P , Saunders Pamela , Dhokai Niyati 
Published: November 2019

Abstract
Arts and Humanities networks harness social capital in the service of older populations creating strength in age. This symposium will feature presentations in aging, arts, education, health and humanities exemplifying enormous and often underutilized resources readily available to engage older people across the spectrum of aging to combat decline and frailty at cognitive and physiological levels. Presenters will describe innovative partnership projects such as Sound Health, an initiative developed by the National Institutes of Health and the John F. Kennedy Center for the Performing Arts to expand knowledge and understanding of how listening, performing, or creating music could be harnessed for health and well-being; hybrid arts and humanities in health programs based within medical systems such as the Center for Performing Arts in Medicine at Texas Medical Center: Houston Methodist promoting research/evaluation of arts inventions to improve overall quality of patient care; and, MedStar Georgetown Lombardi Arts and Humanities Program providing a continuum of support for older patients and their caregivers from diagnoses through treatment processes. A Georgetown University case study will be presented on how arts, ethics and humanities are necessary and ideal components of an interdisciplinary master’s degree program in aging studies to ensure understanding a diverse and inter-generational cohort and student’s cultural value systems. The symposium will conclude with a presentation from the National Endowment of the Arts describing program service infrastructures across the country supporting arts engagement of older people, their families and caregivers focusing on lifelong learning; health and well-being; and age friendly design
MEDICAID FINANCING IN ASSISTED LIVING AND CHARACTERISTICS OF MEDICARE DUAL-ELIGIBLE RESIDENTS
Authors: Fabius Chanee D , Cornell Portia Y , Thomas Kali S 
Published: November 2019

Abstract
An increasing number of assisted living (AL) residents rely on Medicaid waivers or state plans to pay for personal care and other supportive services. States may finance services for duals residing in AL through Medicaid waivers and state plans, but the availability of coverage varies – some states offer little to no Medicaid coverage for services in AL, and others offer multiple pathways to receiving assistance. Little is known about duals in AL, including how many have access to AL and the quality of care they receive there. The present study compares the characteristics of Medicare beneficiaries residing in large AL settings, by dual-eligibility status, and investigates the variability in the share of duals in AL among states. We identified 586,397 Medicare beneficiaries residing in AL in 2014. Medicare claims were used to measure health characteristics and health care utilization. Duals represented 16% of AL residents in our cohort. Compared to non-duals, duals were more often older adults of color (24 vs 4%), and more likely to qualify for Medicare due to disability (46 vs 7%). Duals had higher rates of hospitalizations (24 vs 21%) and skilled nursing facility use while in AL (11 vs 10%), and more chronic conditions than non-duals. States varied in the share of AL residents who are duals, ranging from 6% in New Hampshire to 41% in New York. State policies that may contribute to variation in the prevalence of duals in AL and implications of these findings for policy-makers and residents will be discussed.
GENDER DIFFERENCE IN RETIREMENT TIMING
Authors: Kim Hansol , Kang Hyun , Ekerdt David J 
Published: November 2019

Abstract
The aim of this research is to examine the retirement timing of older men and women in the United States and to find what factors impact such timings. This research used the 2014 Health and Retirement Study datasets. A total of 2,401 respondents were included in this research. All of the participants were over 60 years old, half were women, and the majority of participants were full-time workers (81.8%). The dependent variable was expected years until retirement which was measured as a continuous variable, asking when the respondent thinks he/she will stop work or retire. Controlling for age, race, marital status, education, health, full time, and a number of children, the results revealed that males expect to work 1.2 years longer than women. Yet women have reasons for working longer that are not found among men. Older age and poor health predict a sooner retirement for both men and women. Yet women differed from men in wanting longer work lives if they are African American, employed part-time, and have large families. Women are living longer than men, and the labor participation of women is increasing. Older women will have more challenge in preparing for retirement than men due to their greater need to extend work to secure income. Gender differences in expectation for retirement financial security and their effect on retirement timing. Deserves future research, to understand women’s decision making at this life stage.
HOME CARE EXECUTIVES SAY MEDICARE HOME HEALTH PAYMENT SYSTEM ENCOURAGES LESS-IS-BETTER PRACTICE
Authors: Cabin William D 
Published: November 2019

Abstract
There has been an increasing trend for Congress and the Centers for Medicare and Medicaid Services (CMS) to add non-skilled services to coverage under Medicare Advantage and Medicaid inpatient hospital. At the same time there has been a 75% decline in home health aide visits, the only Medicare home health non-skilled service, as a percentage of all Medicare home health visits from 2000-2016. A literature review indicates no studies addressing the potential factors accounting from these seemingly contradictory trends. The present study is based on interviews of five Chief Executive Officers (CEOs), five Chief Financial Officers (CFOs), and eight Chief Nursing Officers (CNOs) from Medicare-certified home health agencies between October 2017-July 2018. Results indicated agreement among interviewees on three themes: the Medicare home health relies on a medical model which focuses on intermittent skilled care; the Medicare home health prospective payment system (PPS) exacerbated the focus on skilled care by rewarding higher reimbursement for skilled care based episodes; and a synergy has evolved of “less is better” regarding utilization of home health aide services and reimbursement. Policymakers are urged to consider adding coverage of non-skilled services under Medicare home health, similar to Medicare Advantage, by funding demonstration projects with appropriate changes in reimbursement.
SEXUALLY TRANSMITTED INFECTION KNOWLEDGE AMONG OLDER ADULTS: PSYCHOMETRICS AND TEST-RETEST RELIABILITY
Authors: Smith Matthew L , Coffey Tammy , Bergeron Caroline D , Shacham Enbal , Goltz Heather H , Boolani Ali 
Published: November 2019

Abstract
Sexually transmitted infections (STI) among older adults have dramatically increased in recent years, especially among those who are widowed and divorced. The purposes of this study were to: (1) identify STI-related knowledge among older adults; (2) report the psychometric properties of a tool commonly used to assess STI-related knowledge among youth and young adults; and (3) determine the test-retest reliability of the tool. Data were analyzed from 43 adults between the ages of 65 and 94 using a 27-item Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). Participants completed identical instruments on two separate days with approximately two weeks between. After responses were coded for correctness, composite scores were created. Cronbach’s reliability coefficients were calculated to determine response consistency, and Pearson’s r coefficients were used to assess test-retest reliability. Of 27 possible correct answers, participants reported an average of 11.6 (±6.6) correct responses on Day 1 and 11.7 (±7.3) correct responses on Day 2. Cronbach’s alpha coefficients for the 27-item composite scale were high for both days (0.89 and 0.92, respectively), which indicates strong response consistency. Pearson’s r coefficients were high between responses for the 27-item composite scale on Days 1 and 2 (r=0.88, P&lt;0.01), which indicates strong test-retest reliability. Pearson’s r coefficients were high between responses for all but three of the 27 items when assessed separately. Findings suggest the utility of the STD-KQ to assess STI knowledge among older adults. However, the consistently low knowledge scores highlight the need for educational interventions among this population.
OLDER LESBIAN HEALTH VIA RELATIONSHIP STATUS: HEALTH CONDITIONS AND HEALTH BEHAVIORS
Authors: Yang Jie , Averett Paige 
Published: November 2019

Abstract
Existing research has demonstrated that those in committed relationships are healthier than those who are not. However, very little research on same-sex relationships and particularly older lesbian relationships exists. The current study fills the gap by providing a health profile of lesbians in different relationship status, including partnered, widowed, casual dating, single—not dating, and celibate. The outcomes include diagnosed health conditions (include arthritis, high blood pressure, diabetes, depression, heart problems, and stroke) and health behaviors (exercise, smoking, and drinking). Data are from an original sample of 456 older lesbians aged 55 and over. Convenience sampling was adopted for this hard-to-reach population. Bivariate analysis results showed that widowed and celibate lesbians are more likely to report depression than other relationship groups. No disparity was found regarding health behaviors among different relationship groups. To further understand the unique group identifying as celibate, multivariate logistic regression analysis was performed to examine celibacy’s impact on lesbians’ reported depression after controlling for demographics and reported physical health. Multiple imputations was performed to handle missing values. Results showed that being celibate was associated with higher odds of reporting depression compared with having a partner or casually dating. Being celibate was also associated with lower odds of reporting depression compared with widows and singles who are not dating. To our knowledge, this study is the first to examine in details the health consequence of different relationship status among older American lesbians. Findings have important implication for health promotion among older lesbians.
REJECTION SENSITIVITY AS A MEDIATOR OF PERCEIVED SOCIAL ACCEPTANCE OF LGBTQ OLDER ADULTS
Authors: Brunson Kirenia , Morehouse Sarah Nanami , Stripling Ashely M 
Published: November 2019

Abstract
As the US population becomes older and more diverse, examinations exploring intersections of identity become increasingly important. Specifically, lesbian, gay, bisexual and transgender (LGBT) adults face unique challenges as they move into late life including issues related to caregiving, social isolation, and access to competent care. As such, understanding the role of moderating psychological factors, such as rejection sensitivity, within this population becomes instrumental to providing appropriate healthcare. Thus the purpose of this review is to (a) increase understanding of role of rejection sensitivity in LGBT older adults (b) understand the effect of treatment setting on this relationship. Source documents for this literature review were identified through PsycInfo, PsyARTCILES and Google Scholar using the following keywords, and combinations: “Older Adult,” “Gerontology,” “LGBTQ,” “gay,” “sexual minority,” “Rejection Sensitivity,” and “Social Acceptance”. Consistent with a thorough analysis, all English-Language abstracts were read, as were the full articles of those texts that appeared relevant to this literature review. After applying relevant exclusion criteria (i.e. young age), 6 texts warranted inclusion including: 2 books and 4 articles. A thorough review of the literature revealed that internalized homonegativity and rejection sensitivity mediate the degree of emotional dysregulation, internalization of symptoms and rejection-based proximal stress across multiple settings. However, the impact of these relationships in long-term care settings remains unknown. Implications of the current presentation include improving awareness of psychological health factors in LGBT older adults and provision of recommendations to reduce barriers to optimal care.
SEXUAL ATTITUDES IN MIDDLE-AGED AND OLDER ADULTS: DEVELOPING AN UPDATED AND AGE-RELATIVE MEASUREMENT SCALE
Authors: Graf Allyson S , Johnson Viviane 
Published: November 2019

Abstract
Sexual attitudes in later life contribute to sexual and psychological well-being. Existing scales of sexual attitudes specific to aging adults are narrowly focused on specific settings or population sub-groups and are not inclusive of the diverse range of sex-related activities and sexual identities represented in present and upcoming older cohorts. The aim of this study was to create and validate a multi-dimensional measure of sexual attitudes appropriate for a sexually-diverse aging population. Following focus groups and feedback, 51 survey items were constructed; other measures of sexual attitudes, knowledge, and behaviors were included for the purposes of validation. A sample of participants (N = 291; Mage = 56.69, SD = 8.82, range = 45-99; 63.2% female) was recruited through Amazon’s Mechanical Turk and the local community to complete a survey on sexual attitudes, well-being, and health. Psychometric properties of the measure were assessed using exploratory factor analysis to reduce items and identify existing factor structures; construct validity was confirmed using correlations with existing measures of sexual attitudes; and internal consistency was assessed for each sub-scale. Five factors emerged: core personal values (8-items; α = .99), communication and expression (13-items; α = .92), sources of knowledge (9-items; α = .87), traditional taboos (9-items; α = .89), and consent within established relationships (4-items; α = .94). Results provide a relevant and multi-faceted measurement of sexual attitudes for use with middle-aged and older adult populations. Future studies may benefit from an alternative to dated, restrictive measures. Validation should be ongoing with more diverse samples.