bluuebunny/crossref_metadata_2025_split huggingface dataset:
ETHNIC AND DEMOGRAPHIC DIFFERENCES IN THE UTILIZATION OF ANCILLARY HOSPICE SERVICES
Authors: Halli-Tierney Anne D , Bell Gregg , Allen Rebecca S 
Published: November 2019

Abstract
Background: Research shows that ethnic differences exist in hospice service election, with fewer African American patients enrolling in hospice and having lower satisfaction with care compared to Non-Hispanic Whites. Hospice is interdisciplinary, with nursing care and “ancillary” services (social work, chaplain, nurses’ aide, volunteer). Little research exists about whether disparities exist in ancillary service election, and if patient demographics correlate with service utilization. We examined if ethnic or demographic differences exist among hospice beneficiaries in utilization of hospice services. Methods: Mixed-methods data collection took place from two community hospices. The quantitative arm involved retrospective chart review on new admissions from 2012 to 2016: acceptance of ancillary services and demographic data were collected as well as code status and outcome of hospice admission. The qualitative arm collected interview data from hospice personnel about thoughts on hospice care, which patients they think might decline ancillary services, and why. Results: Chart review was completed on 491 patient charts: interviews of hospice staff are ongoing. Sample was 55% female, 77% white, average age 77.8 years. Initial analysis on demographic data did not show statistical significance in utilization. Declination was lowest for social work (3.4% declined) and highest for hospice volunteer (88.9% declined). Initial interview themes involved need for patient education and role of health literacy. Discussion: Initial research does not show statistical ethnic or demographic differences in ancillary service utilization. However, broad utilization differences exist between services. Data can identify areas where hospices can improve care accessibility through patient education and personalization of services.
IDENTITY AND RESPONSIBILITY: WHAT IT MEANS TO BE A CAREGIVER AND ITS IMPLICATIONS FOR POLICY AND HEALTH CARE
Authors: Raj Minakshi , Platt Jodyn , Fitzgerald Tom , Anthony Denise , Daniel Lee Shoou-Yih 
Published: November 2019

Abstract
Improving health care and quality of life for older adults in the U.S. requires increased attention to the informal caregivers supporting aging relatives. Studies estimate that over 40 million unpaid caregivers provide more than $400 billion of unpaid care; however, there is little research examining the scope and variety of support caregivers provide. Less research has examined how caregivers conceptualize their experience beyond “caregiver burden”. A more comprehensive understanding of the types of support caregivers provide and caregiver perceptions of their role and purpose are critical to enhancing policies, e.g., the Family and Medical Leave Act, to be more responsive to caregiver needs. This study seeks to (a) identify the ways informal caregivers provide support and (b) describe what it means to be a caregiver from the perspective of informal caregivers. We conducted four focus groups with informal caregivers (relatives or partners) in Southeastern Michigan (n=18) and conducted qualitative thematic analyses. Support that caregivers provide ranges from financial planning to medical decision-making to social engagement. While caregivers face frustration and isolation consistent with “caregiver burden,” they also recognize positive attributes of being a caregiver such as overcoming adversity and helping elderly relatives maintain dignity. These attributes contribute to their identity of what it means to be a caregiver and perceived capacity to improve their relative’s health. Our findings suggest that we are underestimating the scope of work involved in care-giving and that a wider range of activities should be considered when developing workplace policies and resources to promote caregiver wellness.
INTERNET USE, MENTAL HEALTH, SOCIAL SUPPORT, AND CARE BURDEN OF INFORMAL CAREGIVERS
Authors: Yi Eun-Hye G , Adamek Margaret E 
Published: November 2019

Abstract
Given the psychological stress and health difficulties that stem from caregiver burden and lack of support, various technology-based supports have been introduced. This study aimed to understand the relationships of internet and social network use on informal caregivers’ health status, social support, and care burden. Outcomes were compared for three groups: Alzheimer’s caregivers (AC), other types of caregivers (OC), and non-caregivers (NC). A secondary data analysis of national data from the Health Information National Trends Survey 5-cycle for 2018 was conducted (N=3,297; NC= 2,918, OC=443; AC=113). Using Stata SE 15.1, various statistical analyses (Chi-square, ANOVA, logistic regression) with jackknife bias correction were used to compare the 3 groups. In general, OC experienced the most serious depression/anxiety. More OC (32%) were diagnosed with depression/anxiety by health professionals than NC (22.64%) and AC (19.82%) (F(2,48)=5.58, p&lt;.001). The Other Caregiver group also had higher scores in PHQ-4 (M=2.42, SD=3.07) than NC (M=1.75, SD=2.71) and AC (M=1.63, SD=2.42) (F(2,48)=3.97, p&lt;.05). Regarding care burden, AC provided more support for their care recipients for ADLs (M=2.93, SD=1.65) and IADLs (M=3.75, SD=2.00 for AC) than OC (F(1,49)=4.39, p&lt;.05 for ADLs; F(1,49)=3.17, p&lt;.10 for IADLs). OC (M=2.57, SD=2.43) and AC (2.96, SD=2.39) had fewer social supports than NC (M=3.41, SD=2.38) who can instantly assist them (F=11.60, p&lt;.001). OC (21.68%) and AC (29.00%) more frequently than NC (12.01%) participated in social network (F(2,48)=5.72, p&lt;.01) and online support groups (OC: 13.68%; AC=12.73%; NC=4.68%) (F(2,48)=9.84, p&lt;.001). Developing practical online approaches for informal caregivers can supplement their limited in-person social support.
WHAT SHAPES ADULT SONS’ INCENTIVE FOR PARENT CARE IN JAPAN? EFFECTS OF WORK AND FAMILY CIRCUMSTANCES
Authors: Wakui Tomoko , Hirayama Ryo , Agree Emily M , Kai Ichiro 
Published: November 2019

Abstract
In Japan, because of marked sociodemographic shifts such as a growing number of older adults in need of care and fewer siblings in younger generations, adult sons are increasingly likely to be called upon to meet parental care needs while at working age. Using data from 1,183 employed men (M age = 44.6), our aim in this study was to explore work- and family-related factors that affect their incentives for parental caregiving, a potential component of their psychological preparedness for fulfilling care responsibility. Specifically, focusing on these sons’ workplace environment, living arrangements, and the quality of relationship with parents, we sought to identify whether and how these factors influenced their desire to provide different types of care (e.g., domestic help, ADL assistance). Regression analysis revealed differential associations between work- and family-related factors and sons’ desire for parental caregiving depending on type of care and parents’ gender. For their desire to provide domestic help and attend parents when seeing a doctor, live-in sons were more likely to desire to provide care regardless of parents’ gender. Whereas the quality of parent-child relationships was significantly associated with their desire to care for both parents, whether they had a supervisor to talk with about family issues had a significant effect only on that for their mother. On the basis of these findings, we discuss workplace needs for support to help sons continue work when they need to provide care.
TRANSLATIONAL ADVISORY BOARDS IN RESEARCH: EXPERIENCES FROM A PRAGMATIC RESEARCH TRIAL
Authors: Anderson Keith A , Dabelko-Schoeny Holly , Gitlin Laura N , Gaugler Joseph E , Koeuth Sokha , Marx Katherine A 
Published: November 2019

Abstract
Translational Advisory Boards (TABs) are select groups of researchers, practitioners, and, in some cases, service recipients (e.g., patients, caregivers) that convene regularly to advise researchers on ongoing studies. TABs provide direction and support, knowledge and insight, alternative points of view, and suggestions for overcoming obstacles and improving research functions. TABs are especially valuable in applied research in which “real world” conditions create challenges ranging from the anticipated (e.g., participant drop out) to the unanticipated (e.g., government shutdown). In this presentation, the researchers evaluate one TAB involved with an ongoing pragmatic research trial of Adult Day Services Plus (ADS Plus), an intervention for family caregivers to persons with dementia. Including individuals with diverse points of view was critical in the composition of the TAB. The TAB consisted of four seasoned researchers, four ADS industry professionals, and six program directors from the ADS Plus treatment and control groups. Creating meetings that were productive was imperative. TAB sessions were held bi-annually and had highly structured agendas soliciting guidance on specific issues. Qualitative analysis of the TAB sessions revealed three themes: assistance with recruitment; fidelity of the intervention; and sustainability of the intervention. This guidance helped the researchers to shift directions in recruitment and to consider further refinement of the intervention to increase sustainability. In looking at costs, the annual research personnel, TAB personnel, and overhead expenses were estimated at $2,500-$3,000 and $4,000-$5,500, respectively. In conclusion, TABs can be an effective tool to support research and should be considered for use in large-scale projects.
CONSIDERING AN INTERDISCIPLINARY DEMENTIA INTERVENTION, COMBINING BEHAVIORAL AND OCCUPATIONAL THERAPY
Authors: Frankenstein Lou 
Published: November 2019

Abstract
Behavioral therapy for people diagnosed with dementia and their informal caregivers can enhance the quality of life and the accomplishment of daily routines. The effectiveness of occupational therapy in dementia has also been proven several times. Still those therapies are often not part of the regular treatment. Through literature analyses and three focus group discussions with experts of both professions four occupational (ESP, WHEDA, Ergodem and HED-I) and two behavioral interventions (CBTAC, cordial-program) were compared to clarify how much and in what ways behavioral and occupational therapy in dementia overlap and differ. The interventions are similar with respect to intervention characteristics: They are non-pharmacological, client-centered, put a major emphasis on involving the caregivers and are similarly structured. Whilst occupational programs focus on practical issues, such as empowerment to perform daily activities or adjustment of the environment, cognitive-behavioral interventions specialize on planning activities, communication and reminiscence. These differences result from the theoretical basis and the primary goals of the professions. Behavioral therapy developed from learning theories and cognitive techniques. In contrast occupational therapy is based on environmental theories and the idea of empowerment. In addition two activating programs were included (CST, MAKS-active) to promote physical activity and social interactions since both positively influence the course of the disease. The focus group participants supported the idea of an interdisciplinary cooperation. The results suggest, that an intervention offered by both professions, ideally in cooperation, encompassing key elements identified in the studied programs would be an advance in dementia therapy.
PROMOTING OLDER ADULTS’ INTERGENERATIONAL COMMUNICATION AND MOTIVATION TO REGULAR EXERCISE THROUGH EXERGAMING
Authors: Li Jinhui , Li Chen , Chia Bing Xun , Chen Xinran , Pham Tan Phat , Salmon Charles T , Theng Yin Leng 
Published: November 2019

Abstract
Exergaming has become an important part of community programs to promote regular exercise and improve well-being for healthy aging. This study examines how different types of social playing and competitive information in exergaming affect older adults’ inter-generational communication with youth, as well as their motivation to regular exercise through exergaming. A 2 (time: pre-test vs. post-test) * 3 (social play: play alone vs. play with elderly vs. play with youth) * 2 (competition: competition informed vs. non-competition informed) mixed experiment with 319 Singaporean older adults conducted over six weeks in 2018, analyzed through a series of three-way repeated ANOVAs. Results show significant three-way interaction effects among time, social type, and competitive information on older adults’ inter-generation communication (F (2, 300) = 3.206, p = .042, η2 = .021), extrinsic motivation (F (2, 301) = 3.364, p = .036, η2 = .022) and intrinsic motivation (F (2, 303) = 4.528, p = .012, η2 = .029). The inter-generational communication of participants in play with youth shows significant improvement over time in both competition conditions, while those in play with elderly was only significantly improved in competitive informed condition. Social play is found to significantly affect the changes of both intrinsic and extrinsic motivation over time, while competitive information only affects intrinsic motivation significantly. The findings make contributions to aging research and understanding of potential factors that promote inter-generational communication and adherence to regular exercise via exergaming.
OLDER ADULT KIDNEY TRANSPLANT RECIPIENTS: THE LIVED EXPERIENCE OF ADAPTATION AND INTEGRATION
Authors: Kimberly Laura L , Burnette Denise , Lukens Ellen , Gelb Bruce 
Published: November 2019

Abstract
As the prevalence of end-stage renal disease increases in the United States, a growing number of adults aged 65 and over are receiving kidney transplants. While older adult recipients tend to fare well from a clinical standpoint, far less is known about their psychosocial wellbeing following transplantation. This study seeks to better understand the lived experience of older adult kidney transplant recipients, focusing on the ‘liminal’ period of adaptation following organ transplantation that has been reported elsewhere in the literature. Applying the hermeneutic phenomenology of philosopher Paul Ricoeur, the study explores the lived experience of 10 deceased donor kidney transplant recipients aged 65 and over. Guided by Ricoeur’s conceptual approach to identity as constituted through two forms, idem and ipse, preliminary findings suggest that despite expressing some distress around the ‘strangeness’ of integrating part of another into oneself (disruption of the idem sense of self), participants also constructed powerful narratives of resilience and coping that were rooted in the continuity of a deeply held ipse sense of identity over the life course. In particular, participants emphasized their ability to overcome adversity as an anchor of their ipse sense of self that enabled them to navigate the idem corporeal changes of transplantation. Moreover, they described kidney transplantation as a form of liberation, ultimately restoring their idem sense of self that had been profoundly disrupted by ‘machine life’ (time spent on dialysis). These findings will have significant implications for ensuring the provision of optimal support to older adult kidney transplant recipients.
THE IMPACT OF NEGATIVE SOCIAL EXCHANGES ON ADULT PHYSICAL AND MENTAL HEALTH
Authors: Nehrkorn-Bailey Abigail M , Patrick Julie Hicks , Marello Madeline M 
Published: November 2019

Abstract
As some health components may change across adulthood (CDC, 2019), social support for aging adults may be one way to optimize physical and mental health (U.S. Department of Health and Human Services, 2018). When social encounters are negative, however, physical and mental health may be negatively affected (Chen & Feeley, 2013; Hawkley & Cacioppo, 2010). Negative social exchanges (NSE) have been linked to an increase in negative affect and a decrease in positive affect (Newsom et al., 2003), along with an increase in physical symptoms (Edwards et al., 2001). In order to examine the relations between age, NSE, and two components of health (chronic health conditions and mental health) two moderated regression analyses were conducted using data from 848 adults (Mage = 32.5 years). Studying chronic health conditions, the overall model was significant, [F(3, 838) = 40.31, p &lt; .001; R2 = .36]. Significant main effects emerged for NSE and age, along with a significant interaction between age and NSE (b = 0.010, p &lt; 0.05). As NSE increased, the number of chronic health conditions increased, especially for older adults. For mental health, the overall model was significant [F(3, 845) = 52.96, p &lt; .001; R2 = 0.16]. A significant main effect emerged for NSE, but neither the main effect for age nor the interaction were significant. Thus, although NSE can have deleterious effects on both mental and physical health, special attention needs to focus on the physical health of older adults who experience a higher number of NSE.
AN ACTING AND IMPROV CLASS: WELL-BEING AND COMMUNITY BELONGING FOR OLDER AFRICAN AMERICANS IN LOW-INCOME HOUSING
Authors: Sutherland Laura , Dunkle Ruth E , Pace Garrett T , Kennedy Ariel , Baldwin Pat 
Published: November 2019

Abstract
Arts-based interventions can enhance the quality of life of older adults, but community-dwelling older adults may have reduced access to such interventions. The purpose of this study was to examine whether a creative arts program can improve the overall health and well-being of older adults in low-income housing. A university social work department and community agency collaborated in establishing a professionally run theater group of older adults in two low-income housing buildings in an urban area. All residents were encouraged to participate. The study consisted of three twelve-week acting and improvisation courses, focusing on either staged reading of monologues and dialogues, co-writing a script, or staged reading of a complete play. Each class culminated in a public performance for the building. Fourteen participants enrolled, all African American (11 women, 3 men; mean age 66 years; mean ADL = 1.4 (range of 1-2.5)). Attendance on average was 8 classes. Data were collected through pre- and post-test questionnaires, participant observation of class sessions, semi-structured interviews with building managers, and post-session participant reflections. Thematic analysis was performed, and revealed key themes of increased community belonging, increased confidence, and increased daily coping abilities. Additional themes included the gaining of new artistic skills and interest in continuing classes. Barriers to participation included difficulty in recruitment and absence due to ongoing health conditions and caregiving responsibilities. This project has implications for the potential of arts-based programming to increase well-being for underrepresented community-dwelling older adults.
DOES PARTICIPATING IN SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM IMPROVE THE SLEEP OF OLDER ADULTS?
Authors: Chukwurah Queendaleen C , Chaparro M Pia 
Published: November 2019

Abstract
Food insecurity among lower income adults is associated with adverse health outcomes including sleep disorders. Using data from the National Health and Nutrition Examination Survey (NHANES), 2005-2008, we explored the association between participation in the Supplemental Nutrition Assistance Program (SNAP), a safety net program addressing food insecurity, and sleep outcomes among older adults. Total sleep duration (&lt;7 hours inadequate sleep, ≥7 hours adequate sleep) and sleep latency (10-20 mins normal sleep latency, ≤ 9 mins and ≥ 21mins abnormal sleep latency) were available for 805 participants 50 years and older and eligible for SNAP participation (≤130% federal poverty level). SNAP participation (yes/no) was assessed for the previous year. Sleep inadequacy was higher among SNAP participants (46.5%) compared to SNAP-eligible non-participants (36.3%), whereas the corresponding numbers for abnormal sleep latency were 71.8% and 64.1%. Binary logistic regression analysis showed no significant association between SNAP participation and inadequate sleep duration (OR=1.19, 95% CI 0.84-1.70) after adjusting for age, gender, race/ethnicity, education, and food security status. SNAP participation was also not associated with abnormal sleep latency (adjusted OR=1.49, 95% CI 1.00-2.23). SNAP participation was not protective against poor sleep outcomes among a sample of low-income, at risk of food insecurity older adults.
GERIATRICS PREVENTABLE ADMISSIONS CARE TEAM (GERIPACT): A HIGH-RISK INTENSIVE AMBULATORY GERIATRICS PROGRAM
Authors: Chow Stephanie W , Munoz Lizette , Lavayen Susana , Fani Shamsi , MacKenzie Blair , Chun Audrey 
Published: November 2019

Abstract
The Geriatrics Preventable Admissions Care Team (GERIPACT) is an inter-professional team of 2 clinicians, 1 social worker, and 1 care coordinator, dedicated to offering temporary intensive ambulatory care services to complex older patients at high-risk for incurring expensive health care (ie. frequent emergency room visits or hospitalizations). GERIPACT services include frequent office visits for medical and social work needs, frequent telephone contact, home visits, specialty visit accompaniment, and a 24/7 telephone hotline. Use of this innovative model aims to serve communities lacking in geriatrician and geriatric social work providers, with a main goal of serving the highest risk older population. We reviewed the healthcare utilization of GERIPACT enrollees 6 months prior-to-enrollment and compared with 6 months following graduation from GERIPACT from 2016 to 2018. 78 patients were evaluated, with 49 total ED visits prior to enrollment and 35 post-graduation, saving 14 ED visits for a ratio of 18 saved ED visits per 100 GERIPACT patients. There were 45 hospitalizations prior to enrollment with 29 hospitalizations post-graduation, saving 16 hospitalizations, or 20 hospitalizations per 100 GERIPACT patients. Hospital days were reduced by 237 days post-graduation. An intensive ambulatory program for high risk geriatrics patients may be shown to be an efficient model of care for targeting those older patients who potentially incur greater expenses to the health care system. This focused team may be deployed to primary care communities with complex elderly patients in need of geriatricians and geriatric social workers, and may reduce unnecessary emergency room visits and inpatient stays.