bluuebunny/crossref_metadata_2025_split huggingface dataset:
PAACC: A MINDFULNESS-BASED MULTICOMPONENT PROGRAM FOR FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Hagemann Lauren , Luci Katherine , Sapra Mamta , Savla Jyoti , Jacobs Lindsey , Yates Tonda 
Published: November 2019

Abstract
Few interventions for family caregivers of persons with dementia (PwD) focus on both dementia care skill-building and the enhancement of acceptance and compassion towards oneself and the PwD. We designed a multicomponent, mindfulness-based 4-session caregiver intervention (Practice of Acceptance, Awareness, and Compassion in Caregiving, or “PAACC”) to reduce burden in caregivers of family members with Alzheimer’s disease and related dementias (AD/ADRD) and TBI-related AD. A prospective, randomized trial design is being implemented to compare the effectiveness of PAACC to the well-known, evidence-based REACH-VA intervention. Seventeen family caregivers (Mean Age = 68.71 years; 82% women; 30% had high school or less education) have participated in the trial thus far and provided qualitative responses to acceptability questions. High acceptability was noted for all intervention components of PAACC. Participants completed 95% of mindfulness homework during the study period. A majority also reported practicing spontaneous, informal mindfulness while engaged in daily activities (e.g., going for a walk, cooking). One participant noted incorporating mindfulness in her daily spiritual practice. The majority remarked that PAACC taught them to be more aware and accepting of the PwD’s illness. Others mentioned becoming more aware of which stressors triggered them, and that they were able to avoid arguments with the PwD because of this increased awareness. Overall, our results suggest that this mindfulness-based multicomponent intervention is a promising method for promoting stress reduction for family caregivers of persons with dementia regardless of age, stage of dementia, education level, or rurality. Implications for research and practice will be discussed.
SUPPORTING FAMILY CAREGIVERS: HOW DOES RELATIONSHIP STRAIN OCCUR IN CAREGIVING DYADS? A QUALITATIVE STUDY
Authors: Avent Elizabeth S , Rath Laura , Meyer Kylie , Benton Donna , Nash Paul 
Published: November 2019

Abstract
Family members and spouses are usually the primary caregivers for older adults. Providing direct care can be stressful, strenuous, and time-consuming for caregivers, potentially leading to frustration and anger towards care recipients. This can be detrimental to the relationship quality of the caregiving dyad. Though caregiver strain and burden have been extensively studied, there is limited information on the development of relationship strain. To explore how relationship strain occurs between caregivers and care recipients, 8 focus groups (N=62) and 8 semi-structured telephone interviews were conducted with caregivers in Los Angeles, inquiring about relationship quality with their care recipients and when frustration and anger occurs. Inductive coding was used to create coding schemas. Findings showed that most caregivers reported relationship strain occurring after taking on the caregiving role, and frustration and anger arose when providing ADLs, especially during bathing and toileting. Although these caregivers had initially experienced strain in their relationships, a recurring theme that emerged was that they developed strategies to decrease frustration and anger and improve the quality of their relationships with their care recipients. Direct communication with caregivers is important in designing a structured and effective intervention. These findings help inform an intervention for new caregivers to help them identify what can lead to relationship strain, as well as teach them reliable strategies to manage frustration and anger towards their care recipients.
ASSOCIATION BETWEEN COGNITION AND FALL RISK BASED ON THE STEADI ALGORITHM: PROJECT VIBE
Authors: Hughes Tiffany F , Carramusa Cara , Van Dussen Daniel J 
Published: November 2019

Abstract
Falls are a growing concern among older adults with estimates that one in four fall each year. Older adults who experience a fall are at higher risk for poor health outcomes that threaten independence and increase risk of death. Impairment in cognitive function is known to be associated with greater fall occurrence; however, cognitive testing is not an integral part of clinical fall risk assessment. The purpose of this study is to examine cognitive performance in relation to fall risk level and its components determined using the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) algorithm. One hundred eight community dwelling older adults (mean age 79(SD 7.3) years, 76% women, and 56% college or higher education) were included. Cognition was assessed with the Montreal Cognitive Assessment (MoCA; &gt;= 26 normal). The STEADI algorithm was used to assess fall risk (low vs. moderate/high) based on the Stay Independent screening (&gt;= 4), impairment in gait (Timed Up and Go (TUG)), strength (30-second chair stand), and balance (4-stage balance), and number of falls (&gt;= 2). Associations between cognition and fall risk and its components were assessed using logistic regression adjusting for age, gender, and education. Normal cognitive status was marginally associated with lower likelihood of moderate/high compared to low fall risk (OR 0.42, 95% CI 0.17-1.04), and with a lower likelihood of TUG impairment (OR 0.22, 95% CI 0.07-0.66). These results suggest cognitive status may contribute important information about older adults’ fall risk and should be considered an integral part of fall risk assessment.
USABILITY OF A MOBILE APP TO IMPROVE GOAL-DIRECTED BEHAVIOR: CHANGING APATHY INTO ACTION IN PERSONS WITH DEMENTIA
Authors: Massimo Lauren M , Miller Alexander , Schiffrin Daniel , Lydon Sean , Mechanic-Hamilton Dawn 
Published: November 2019

Abstract
Impairment of goal-directed behavior, often labeled apathy, is the most common and disabling of the behavioral and psychological symptoms of dementia. Activi-daily is a mobile app that targets key and distinct components of goal-directed behavior (initiation, planning and motivation) found to contribute to apathy in persons with dementia. This presentation will focus on usability testing of Activi-daily in persons with dementia and their caregivers. After 1 week of at-home use, we gathered feedback via focus groups on features and usability of Activi-daily. Usability of Activi-daily and its’ potential as an intervention for treating apathy were viewed favorably. Feedback regarding usability revealed that the app was easy for dyads to use and enhanced the patients’ ability to complete their daily tasks with greater independence. Suggestions to improve app usability included adding a voice to text feature, a progress bar to visualize progression towards daily goals and gamification features to enhance motivation.
FRAILTY IN REACH II CAREGIVERS: A SECONDARY DATA ANALYSIS
Authors: Elkins Jeananne , Griffiths Patricia C 
Published: November 2019

Abstract
Frailty, a reduction in reserve capacity in people who are otherwise considered healthy, affects between 9 and 13% of adults who are older. Frailty is a poorly understood syndrome; however, frailty is correlated with negative CV procedure outcomes, falls and institutionalization. Little is known about frailty in caregivers. A secondary data analysis was conducted using the REACH II publicly available dataset and the Groningen Frailty Index (GFI). At consent two percent of REACH II caregivers had difficulty going to the toilet while 11% had difficulty walking outdoors. More than 1/3 had hearing and vision losses. 75% felt sad or dejected. 82% were taking more than 4 medications. Based on their calculated GFI, between 61% and 64% of the REACH II caregivers were frail. Frail caregivers and their care recipient were less likely to go to the emergency department (-0.110 coefficient; p = 0.004 95% CI -0.184 -0.035) and were less likely to be hospitalized overnight during the past 6 months (-0.121 coefficient; p=0.004; 95% CI -0.203 -0.040). Frailty is an under-recognized syndrome in caregivers. Little is known about the impact of frailty on the caregiving dyad; however, ED utilization and hospitalization was decreased in these caregivers and their care recipients. This decrease may imply a delay in seeking care; and, in fact, lead to worse health outcomes for the dyad. With the aging of Baby Boomers and the continued dependence for long term care delivered by unpaid caregivers, implementation of programs to prevent and treat frailty in caregivers is essential.
THE BUILT ENVIRONMENT INFLUENCED THE INCIDENCE OF FALLS IN OLDER ADULTS LIVING IN THE UNDERSERVED COMMUNITY
Authors: Suzuki Rie , Blackwood Jennifer , Shah Shailee , Ganai Sabah , Warden Kimberly 
Published: November 2019

Abstract
The built environment is commonly cited as a facilitator to local walking. Although health promotion programs targeting physical activity are available, few studies have investigated the associations of the perceived neighborhoods with the incidence of falls in the minority communities. Hence, the purpose of this preliminary study was to understand whether the perceived built environment influenced the fall experiences in older adults living in the underserved community. The preliminary cross-sectional survey was conducted at the regional health clinic in Flint, MI. Descriptive statistics and analysis of variance (ANOVA) were performed using SAS v8.4. The eligibility criteria included over 65 years old and Flint residents. Of 132 participants, the mean age was 69.75 (SD=5.00). The majority were female (68%), African Americans (80%), single, divorced or widowed (80%), and &gt; GED (84%). The ANOVAs supported that “had fallen in the past year” was associated with “stores are within easy walking distance,” “easy to walk to a transit stop” and “there is a dirt strip that separates the streets from the sidewalks.” The fall experience was more likely to associate with the sedentary lifestyle and the comorbidities such as diabetes, fatigues, muscle spasms, and chronic pain. To summarize, the built environment increased the incidence of falls in the past year. Those who had fallen had poor health conditions. Further studies are needed for older adults to engage in physical activity. It is essential to develop the age-friendly support systems and accommodations to local walking in this community.
SOCIAL ISOLATION AND FALLS RISK AMONG COMMUNITY DWELLING OLDER ADULTS: THE MEDIATING ROLE OF DEPRESSION
Authors: Burr Jeffrey , Quach Lien 
Published: November 2019

Abstract
Relatively little is known about the relationship between social isolation and the risk of falls among older adults. Yet, a considerable amount of research demonstrates that lack of sufficient social relationships, broadly defined, represents a modifiable risk factor for many indicators of well-being in later life. This study examines the association between two types of social isolation and the risk of falls. The study also examines whether depression mediates the association between social isolation and risk of falls. Longitudinal data from the Health and Retirement Study (2006-2012) were collected from community-dwelling participants aged 65 and older (N=8,464). The outcome variable was number of falls self-reported over the observation period. Independent variables included perceived isolation (feeling lonely, perceptions of social support), social disconnectedness (e.g., having no friends or relatives living nearby, living alone), and number of depressive symptoms. Results from regression models indicated that social disconnectedness was associated with a 5% increase in the risk of falls (IRR=1.05, 95% CI=1.01-1.09). Perceived social support was associated with a 21% increase in the risk of falls; when examined together, perceived social support and loneliness were associated with a combined 37% increase in falls risk. Depression was associated with a 47% increase in falls. Depression mediated the association between perceived isolation and falls. Further, perceived isolation mediated the association between social disconnectedness and falls. Reducing perceived social isolation and social disconnectedness may be an avenue for designing interventions to reduce the risk of falls, especially for older adults with depression.
A MIXED-METHODS EVALUATION OF A NURSE-LED INTERPROFESSIONAL INTERVENTION FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: Montano Anna-Rae L 
Published: November 2019

Abstract
This study aims to assess the relationship between an Interprofessional Collaborative Practice (IPCP) intervention for community-dwelling older adults, Geriatric Outreach and Training with Care! (GOT Care!), and the observed 26% reduction in Emergency Department (ED) visits for the 51 older adults who participated. This study utilized a convergent parallel mixed-methods design that included a historical prospective matched cohort study and semi-structured interview surveys. The 51 GOT Care! participants were retrospectively matched to 51 control participants on several variables and ED visits were assessed for each group at 6, 8 and 12 months. Mixed effects generalized linear modeling, with a Poisson response, a log link function, and a random effect for pair, was conducted to analyze the quantitative data. Stakeholders, including hospital administrators and faculty clinicians, of GOT Care! responded to electronic semi-structured interview surveys regarding the relationship between GOT Care! and the observed reduction in ED visits. Content analysis of the responses was completed. The themes from the stakeholder interviews were integrated into the historical prospective matched cohort study to further explore the relationship between GOT Care! and the reduction in ED visits. The results of this study are still pending. This study has implications regarding the utilization of an IPCP model within an academic-practice partnership in the aim of reducing ED visits for vulnerable community-dwelling older adults. Hospital administrators can also utilize the results of this study to gauge the value of IPCP models within their hospital systems.
ASSESSMENT OF PALLIATIVE CARE TRAINING NEEDS FOR CERTIFIED NURSING ASSISTANTS
Authors: Kim Jinsook , Gray Jennifer A 
Published: November 2019

Abstract
It is unknown whether certified nursing assistants (CNAs) receive up-to-date palliative care training through continuing education. Also unclear is whether existing trainings cover the issues that CNAs encounter at work or are tailored to CNAs’ learning styles and preferences. This study aimed to assess the palliative care training needs of CNAs working at skilled nursing facilities (SNFs) in northern Illinois. CNAs (n=127) from 6 SNFs completed an online survey regarding palliative care training experience, perceived needs for palliative care training, and demographic and work-related information. The majority of the participants were female (88%) and White (58%) or African American (20%). On average, participants were 34 years old and worked for 8 years in the field. Four out of five preferred a training 90 minutes or shorter. Approximately one half preferred in-person training, and the rest preferred a hybrid (32%) or online delivery (19%). Discussions and videos were most preferred in training, while quizzes and mobile apps were least preferred. CNAs who worked longer in the field were less likely to have received training than their counterparts. The least-trained areas included utilizing advance directives and discussing death with patients. The most needed training areas were talking to a patient who wants to hasten death and addressing the complex needs of dying patients. The results indicate a relative deficiency of palliative care training among CNAs who have worked longer in the field. Training areas needing more attention include advance directives, discussing death with patients, and the complex needs of dying patients.
EFFECTIVENESS OF A SIMULATION-BASED EMPATHY ENHANCEMENT PROGRAM WITH MINDFULNESS ON SOCIAL WORKERS
Authors: Han Areum , Kim Taehee 
Published: November 2019

Abstract
Empathy enhancement programs and mindfulness-based practices may reduce care practitioners’ burnout and stress while increasing satisfaction, caring efficacy, and well-being. No study has been conducted to measure the effectiveness of a simulation-based empathy enhancement program combined with mindfulness practice on professionals working with older adults living alone. This study, therefore, assessed the effectiveness of a simulation-based empathy enhancement program with a brief mindfulness practice session on social workers working with older adults living alone. This study was a quasi-experimental study involving 105 social workers in South Korea. The experimental group received a simulation-based empathy enhancement program with mindfulness practice, and the attention control group watched a 30-minute-long educational video about empathy. Data were collected prior to the intervention and at two weeks after the intervention using self-reported questionnaires measuring empathy, caring efficacy, psychosocial stress, compassion satisfaction, burnout, and secondary traumatic stress. The experimental group had significantly lower levels of psychosocial stress compared to the attention control group. Both groups showed significant improvements in empathy but in different empathy measures. Also, the experimental group only showed significantly lower levels of burnout and secondary traumatic stress after the intervention while the attention control group only showed significant improvements in compassion satisfaction and caring efficacy. Although between-group differences were found in psychosocial stress only, pre-and post-test differences in different outcome measures from experimental and attention control groups indicate limited but possible effectiveness of each of the empathy enhancement programs on people in caring professionals.
VIRTUAL REALITY MEDICAL EDUCATION PROJECT ENHANCES EMPATHY
Authors: Gugliucci Marilyn R 
Published: November 2019

Abstract
Introduction: It is particularly important that innovative learning modalities are utilized to augment medical students’ learning about empathy in relation to older adult health care. As the older population increases and lives longer, their health care utilization is predicted to increase dramatically. Methods: 1st year osteopathic medical students (N=174) at the University of New England were required to complete the National Network of Libraries of Medicine (NN/LM) New England Region (NER) grant funded Embodied Labs’ “We Are Alfred” Virtual Reality (VR) module (15 min) and a pre/post-test. The students assumed the role of Alfred, a 74 y/o African American male with macular degeneration and hearing loss. “We Are Alfred” utilizes a virtual reality headset, headphones, and a hand-tracking device to immerse students into Alfred’s experiences as a patient. Descriptive statistics and t-tests were applied for data analyses. Results: Learning was broad and significant: 94% reported increased empathy; 92% reported increased learning about macular degeneration; and 90% reported increased learning about hearing loss. Qualitative data collected from the pre-tests and post-tests supported learning on empathy with 4 associated themes (Personal Experiences, Perceptions of Older Adults, Thoughts about Health, Descriptors of Aging).. Conclusion: Virtual reality was deemed a successful medical education learning tool for these medical students. Utilizing this technology to create an immersive case study taught these medical students about the aging experience from the first-person patient perspective.
MEDICARE COVERAGE CHANGES: THE ROLE OF INDIVIDUAL CHARACTERISTICS AND INTERNET USE
Authors: McGarry Brian E , Grabowski David C 
Published: November 2019

Abstract
An important challenge to the success of consumer choice within the Medicare program is older adults’ proclivity to assess their coverage on an annual basis and make changes when appropriate. Every year, relatively few beneficiaries alter their coverage (e.g., by switching Part D plans, switching between MA and traditional Medicare coverage) despite annual coverage changes and new market entrants. Little is known about the factors that encourage re-evaluation of Medicare coverage choices or the role of technology in facilitating changes. The latter knowledge gap is particularly relevant as the internet is an increasingly important delivery mechanism for Medicare information and consumer support tools. This study uses a nationally-representative sample of Medicare beneficiaries to describe Medicare coverage changes, the individual factors that predict such changes, and the relationship between Medicare-related internet use and plan switching. On average, 12% of Medicare beneficiaries made changes to their coverage in a given year, with 25% of beneficiaries making a change at any point during the study period. Between 2011 and 2015, the self-reported rate of using the internet to handle Medicare/insurance matters increased from 5% to 11%. In adjusted models that included individual-level fixed effects and other time-varying characteristics (e.g., health status, prescription drug needs), Medicare-related internet use was associated with a 65% increase in the probability of making a coverage change. Although using the internet to handle insurance matters remains relatively rare among older adults, it may an important mechanism for obtaining information that encourages plan changes, facilitating such switches, or both.
SEX AND THE BIOPSYCHOSOCIAL MODEL: SEXUAL ACTIVITY AND GENDER DISPARITY IN OLDER ADULTS
Authors: Reinhardt Rebecca , Moore Zaver D , Nuccio Alexandria 
Published: November 2019

Abstract
The biopsychosocial model emphasizes relational factors such as quality and availability as key components to older adult sexual activity (Gillespie, 2017). Supporting these findings, a previous study found that older adults aged 65 and over reported having more sex in the past six months but fewer sexual partners in the past year than younger adults. The current study seeks to further explore sexual activity by gender specifically, number of sex partners in the last year, and frequency of sex over the past six months in older adults. To better understand sexual activity and gender differences, 499 (male=59.7%, female 40.3%) participants aged 65 to 93 were selected from the de-identified Survey of Midlife in the US database (MIDUS-3). A Weltch T-test was used examining sexual activity among older adults based on gender. Results indicated that the number of sex partners within the past year was similar for females (M=1.10, SD=.49) and males (M=1.04, SD=.28), t(477)=1.62, p=.10, d^=.07. Further, results indicated sex frequency within the last six months was similar between females (M=3.41, SD=1.55) and males (M=3.66, SD=1.48), t(415)=1.76, p=.08, d^=.14. Contrary to previous research, the present findings suggest there are no gender differences in number of sex partners or sex frequency for older adults. The current findings draw attention to potential discrepancies within this under-explored subject area. While implications of these findings can improve communication regarding sexual health, future research should focus on how aspects of the biopsychosocial model can be a protective factor for the sexual health of older adults.