bluuebunny/crossref_metadata_2025_split huggingface dataset:
MANDATORY MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS IN PENNSYLVANIA: EVALUATING POLICY CHANGE
Authors: Degenholtz Howard 
Published: November 2019

Abstract
The Commonwealth of Pennsylvania is implementing a mandatory Medicaid managed Long-Term Services and Supports (LTSS) program that covers people age 21 and older who are fully eligibly for both Medicare and Medicaid, living in a nursing facility paid for by Medicaid, or in an aged or physical disability home and community based services (HCBS) waiver. The overall program goals are to: Enhance Opportunities for Community Living; Improve Service Coordination; Enhance Quality and Accountability; Advance Program and Innovation; and Increase Efficiency. The program will be administered by 3 managed care organizations (MCOs) that are obligated to coordinate with Medicare Advantage and D-SNP plans. This major policy change affects the traditional roles and responsibilities of the aging network by shifting the locus of control to insurance companies. This presentation will describe the policy change, the implications for the aging network, and the multi-method evaluation designed to assess the implementation and outcomes.
ROLE OF COPING STYLES AND NEGATIVE LIFE EVENTS ON HIGHER PERCEIVED MENTAL FATIGABILITY IN OLDER ADULTS
Authors: Gmelin Theresa , Andersen Stacy L , Boudreau Robert M , Christensen Kaare , Wojczynski Mary K , Cosentino Stephanie , Glynn Nancy W 
Published: November 2019

Abstract
Older adults are vulnerable to negative recent life events (RLE) which deplete attentional resources and leads to cognitive exhaustion. Adaptive coping styles reduce perceived stress severity but their role on cognitive tiredness is unknown. We examined RLE and coping styles on perceived mental fatigability (Pittsburgh Fatigability Scale (PFS), 0-50pts, higher=greater fatigability) in the Long Life Family Study (N=1464, age=74.7±12.6, female=57.7%, 43.9% ≥1 major RLE past 6 months, 27.8% higher mental fatigability≥13). All analyses adjusted for family structure, field center, age, and sex. PFS mental scores correlated with all NEO-FFI (60-item, 5-domain) personality traits representing maladaptive (neuroticism r=0.25 p&lt;.0001) and adaptive (conscientiousness r=-0.18, extraversion r=-0.24, p&lt;.00001) coping. Having ≥1RLE was associated with higher mental fatigability (OR=1.4, 95% CI:1.2,1.8, p=.0004); adjustment for neuroticism (OR=1.3, 95% CI:0.9,1.7, p=.06) attenuated the association. Education on adaptive coping may be a modifiable skill that allows older adults to maintain lower perceived mental fatigability despite stressful events.
STRESS-BUFFERING EFFECTS OF VOLUNTEERING ON DAILY WELL-BEING: RESULTS FROM THE NATIONAL STUDY OF DAILY EXPERIENCES
Authors: Han Saehwang , Kim Kyungmin , Burr Jeffrey 
Published: November 2019

Abstract
Based on theory and empirical evidence linking volunteering and health, we investigated the associations between daily engagements in formal volunteering, stressors, and negative affective well-being, focusing on the stress-buffering effect of volunteering. Using eight days of daily diary data from the second wave of the National Study of Daily Experiences (participants, N = 1,320; participant-day observations, N = 8,277), we estimated a series of multilevel models to assess the within-person associations between daily volunteering, stressors, and affect. Results indicated there were no direct associations between daily volunteering and negative affect. However, we found the association between daily stressors and negative affect (but not positive affect) was weaker on days when volunteering was performed compared to days volunteering was not performed. Taken together, our findings suggested that short-term health benefits associated with daily volunteering were largely based on the stress-buffering effects of helping others, rather than through a direct effect.
PAIN, PAIN MANAGEMENT, AND CONSEQUENCES OF PAIN AMONG AL RESIDENTS
Authors: Resnick Barbara 
Published: November 2019

Abstract
The purpose of this study was to describe the incidence, management and impact of pain on function, agitation, and resistance to care. This was a descriptive study using baseline data from 260 residents in the second cohort of the FFC-AL-EIT study. The majority of the sample was female (71%) and white (96%) with a mean age of 87 (SD=7). Fifty-two residents (20%) reported pain based on objective (PAINAD) or subjective (verbal descriptive scale, VDS) pain assessments. A total of 75 residents (29%) received pain medication and 22 (42%) individuals reporting pain were not getting pain medication. Controlling for age, gender and cognition, PAINAD was significantly associated with agitation, function, and resistance to care and the VDS was only associated with function. Pain assessments should include objective and subjective measures and management of pain should be considered as it may help to optimize function and decrease behavioral symptoms among AL residents.
THE EXAMINATION OF DETERMINANTS AND BARRIERS TO END-OF-LIFE DECISION MAKING AND PLANNING
Authors: Gaines Brittany E , Dobbs Debra J 
Published: November 2019

Abstract
As individuals are living longer, in many cases with chronic diseases, there is an increased focus on end-of-life (EOL) planning and decision making. This includes a broad spectrum of choices including advance care planning (ACP) and turning to palliative care or hospice care. Although there has been an increase in palliative and hospice care enrollment and ACP engagement over the past decade, participation remains low for certain subgroups of the population. The purpose of this symposium is to offer insight into reasons for these varying rates of engagement by exploring determinants and barriers to EOL decision making and planning and by examining caregiver knowledge of EOL decision making and planning from the service provider perspective. The first three studies examine various types of influences in EOL decision making and planning. Inoue and colleagues explore factors associated with the length of hospice stay, and Gaines and colleagues examine the impact of environmental characteristics in ACP. Ornstein and colleagues use Denmark registry data to assess the role of kinlessness at the time of death in EOL decision making and healthcare utilization. The final presentation by Noh and colleagues examines how service providers in rural areas perceive community residents’ knowledge of ACP and palliative care. The discussion following these presentations will compare findings across different forms of EOL decision making and planning, consider the impact of the varying methodological approaches used, and highlight implications of these works for potential interventions and policies related to EOL decision making and planning.
A PRACTICE FRAMEWORK FOR CONSIDERATION OF GENDER IN ETHICAL DECISION-MAKING
Authors: Bowland Sharon , Halaas Beth 
Published: November 2019

Abstract
Gender role stereotypes, social norms and social policies negatively influence health and well-being for marginalized groups. These inequalities are embedded in the fabric of our society and are often unquestioned and hidden. Practitioners frequently use an ethical lens that does not consider the influence of gender on life course decision-making. We developed the Practice Framework for Older Persons (PFOP) to assess past and current realities that take gendered experiences into consideration. By contextualizing means and opportunities, a more complete picture can be drawn about a person’s unique gender experiences. Subsequently, we can better understand their decision-making processes, wants, needs, and desires. This type of assessment may be particularly beneficial for women and transgender persons given ethical demands for practice paradigms which consider gender fluidity and development of a sense of personal agency.
INTEREST GROUP SESSION—COMMUNITY COLLEGE: THE ROLE OF COMMUNITY COLLEGES IN WORKFORCE DEVELOPMENT AND TRANSFER WITHIN GERONTOLOGY
Authors: Abushakrah Jan , Faber Michael A 
Published: November 2019

Abstract
This symposium will highlight how innovative and often non-traditional Community College Gerontology students are motivated to seek career shifts and intentional training and comprehensive education. Understanding and applying this approach allows students to build on their prior skills, especially caregiving experience, to advance to more professional roles in the field of Gerontology. During this symposium we will focus on the Applied Gerontology aspect of Community College programs, including short-term certificates and other approaches related to and informed by the rapidly evolving workforce development in the field of aging. Selected Community College and University representatives, who understand and are leaders in the field of Applied Gerontology, will highlight models of existing Community College and University partnerships/collaboration that work, as well as provide models of other applied approaches. In addition, there will be an opportunity for robust dialog between Community Colleges and four-year Colleges and Universities – both on developing other effective Applied Gerontology approaches, and on creating even better partnerships and collaboration. This symposium will appeal to professionals working in both two and four-year systems of higher education. Colleges and Universities desiring to develop or enhance relationships with area Community Colleges will find this session especially helpful.
FACILITATORS OF DEPENDENCY IN THE VERY OLD: RESULTS FROM THE NEWCASTLE 85+ STUDY
Authors: Kingston A , Robinson Louise A , Duncan Rachel , Jagger Carol 
Published: November 2019

Abstract
In order for governments to plan health and social care strategies to help people maintain independence, evidence is required to show how risk factors are associated with progression in dependency. We use a transparent measure of dependency, based on help needed with activities of daily living, incontinence and cognitive impairment, categorised as: high (24-hour care); medium (daily care); low (less than daily) and independent, then characterise changes over ten years (age 85-95) using the Newcastle 85+ Study while exploring how eight disease groups, multimorbidity and impairments interact to increase care needs. Stroke and diabetes confer an increased risk of low-level dependency. Complex multimorbidity, or three or more falls engendered the greatest risk of transitions to substantial dependency. There should be a focus on prevention of, and appropriate and efficient service provision for those with complex multimorbidity with emphasis on stroke, diabetes and falls, to maintain the independence of older people
RELATIONSHIP BETWEEN CARE HOME STAFFING AND QUALITY OF CARE: A MIXED-METHODS APPROACH
Authors: Spilsbury Karen , Charlwood Andy , Valizade Danat , Haunch Kirsty 
Published: November 2019

Abstract
Beyond broad recognition that ‘staff influence quality’, little is known about the care home workforce and its relationship to quality. Our study examines this relationship for the first time in the UK. Quality is a complex, contested and dynamic concept: we have operationalised this concept using data collected at national and organisational levels to measure quality, as well as considering the views of quality of different stakeholders. We will present interim findings from this study’s work packages (due to complete in July 2020), including: (1) our review which has developed theoretical explanations of how, why and in what circumstances staffing promotes quality for residents and relatives; and (2) our observational study using routine administrative data sets at national and provider level. Key findings include the importance of experience and stability of care hoe staff, as well as how care is delivered (individual commitment, team reciprocity and organisational mandate).
USING ACCESSIBLE TECHNOLOGY TO SUPPORT CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Maslow Katie , Trudeau Scott A , Czaja Sara J 
Published: November 2019

Abstract
There is widespread enthusiasm about the potential of technology in general to support persons living with dementia and their families and other caregivers. At the same time, recommendations from the 2017 National Research Summit on Care, Services, and Supports for Persons with Dementia and their Caregivers emphasize the need for research to develop, evaluate, and disseminate specific technologies that can achieve meaningful benefits for well-defined subgroups of persons living with dementia and their caregivers, including individuals from diverse populations and individuals who live and receive care in various settings. This symposium focuses on specific home-based technologies to help family caregivers of community-living persons with dementia. Our three speakers will talk about research results for three different technology-related interventions, including: use of home video telehealth visits to help family caregivers provide effective dementia care and provide medical management; use of home video assessments by occupational therapists to help family caregivers increase home safety for community-living persons with dementia; and approaches for making a self-paced Home Safety Toolkit available to family caregivers of community-living veterans with dementia. Each speaker will report both positive outcomes, including family caregiver satisfaction, and barriers encountered in delivering the interventions. Such barriers include difficulties with the technologies as well as caregiver reluctance to change and costs that were not covered by health care insurance or health systems. Our discussant will respond to the presentations and solicit audience questions and discussion.
CAREGIVER EXPERIENCE OF TELEHEALTH-DELIVERED HOME SAFETY EVALUATIONS
Authors: Gately Megan 
Published: November 2019

Abstract
People with dementia are living in the community, necessitating in-home supports for their day-to-day needs. Given geriatrics work force shortages, innovative strategies that increase the reach of extant providers while maintaining quality are needed. Home-based video telehealth may increase access to specialty care such as a dementia-focused home safety evaluation by an occupational therapist; however, little is known about the technological demands and caregiver experience of a home safety evaluation delivered by telehealth. Our study employed video telehealth to deliver a dementia-focused home safety evaluation compared to in-person evaluation for caregivers (n=10) of veterans with dementia. Most video visits encountered technological problems. Caregiver experience between the video and in-person evaluations differed. Our findings reflect the highly dynamic, complex nature of in-home video telehealth which requires maximal collaboration with caregivers. By explicating the resource demands and potential burden of video telehealth for caregivers, development of effective in-home telehealth evaluation is enhanced
CORRELATES OF BREAST CANCER SCREENING BEHAVIORS AMONG INDIGENOUS WOMEN
Authors: Roh Soonhee , Lee Yeon-Shim , Lee Kyoung Hag , Jun Jung Sim 
Published: November 2019

Abstract
Cervical cancer remains a significant cause of morbidity and mortality among women globally; yet cancer burden is unevenly distributed among racial/ethnic groups. With 12,820 new cases in 2017 in the U.S., cervical cancer is the top cause of death among Indigenous women. Indeed, cervical cancer mortality rates among AI women in South Dakota are five times the national average and 79% higher compared to Whites in that region. This study examined predictive models of utilization of mammograms among Indigenous women adapting Andersen’s behavioral model. Using a sample of 285 Indigenous women residing in South Dakota, nested logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years, whereas 21.0% never had a mammogram test. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. The results provide important implications for intervention strategies aimed at improving breast cancer screening and service use among Indigenous women. Educating health professionals and Indigenous community members about the importance of breast cancer screening is highly needed. It is critical to assess a woman’s level of traditional beliefs and practices and its possible influence on screening participation and future screening intention.
META-SYNTHESIS: OLDER ADULT SURVIVORS’ RESILIENCE
Authors: Greene Roberta R , Cohen Harriet , Greene Nancy A , Hantman Shira 
Published: November 2019

Abstract
This paper presents the results of a meta synthesis of 8 qualitative studies that examined resilience among 270 older adult survivors following potentially traumatic adverse events (Bonanno, 2004). The primary data involved information about survivors’ critical events during the Holocaust , the Cambodian genocide, and the discriminatory practices of the Jim Crow U.S. South. A narrative approach to gerontology was used to collect and analyze the original data. known as a constant comparison data analysis ( Glaser & Strauss, 2009; Miles & Huberman, 1994). This allowed for the understanding of risks such as such as discrimination, imprisonment, genocide, and possible loss of life and the development of themes of resilience at the personal, interpersonal, sociocultural, and societal levels (Kenyon & Randall, 2001) The meta synthesis of secondary data involved coding the original findings, grouping them into descriptive themes, and generating new overarching analytical themes (Thomas & Harden, 2008). The most prevailing theme at the personal-level (internal feelings) was overcoming the grief of losing a loved one. Interpersonal-level themes (relationships between people) were related to staying connected to family. Sociocultural-level themes (the beliefs and mores of the time) centered on making meaning of a critical event within its historical context Societal themes (government and institutions) themes were indicative of being able to contribute or influence one’s current community. Implications for clinical practice and policy formation are provided.
LIFE SPACE MOBILITY AND NEIGHBORHOODS: HOW HOME MODIFICATIONS IMPACT AGING IN PLACE
Authors: DeLaTorre Alan , García Ivis , Reno Julianne , Kim Ja Young , Moore Keith Diaz 
Published: November 2019

Abstract
This presentation details a mixed methods study funded by the National Institute for Transportation and Communities that was conducted with 50 older adults aged 65 and older who lived in Portland, Oregon (n=25) and Salt Lake County, Utah (n=25). The purpose of the study was to improve understanding of how home modifications affect older adults’ mobility in different life-spaces (e.g., one’s bedroom, neighborhood), their understanding of aging in place and neighborhood, and their ability to age in place. During each home visit, a series of research protocols (i.e., surveys, interviews, mapping exercises) were carried out with each participant. The study found that home modifications (e.g., grab bars, replacing showers with bathtubs, and adding raised toilets) were reported to increase in-home mobility and, for some, their independence; however, for certain participants, those same modifications were less useful, especially to those with the need for caregiver supports. Life-space mobility outside the home was impacted by home modification such as ramps and railings on stairs; for some, those modifications bolstered social connections and access to services. Overall, home modification were seen as enabling both mobility and aging in place. Furthermore, respondents’ understanding and description of their neighborhoods varied greatly and were influenced by mobility barriers (e.g., presence of sidewalks and crosswalks) and available amenities.
AGING IN COMMUNITY: A LEGAL MAPPING ANALYSIS OF MASSACHUSETTS MUNICIPAL ACCESSORY DWELLING UNIT ZONING BYLAWS
Authors: Gagen Travis M 
Published: November 2019

Abstract
Accessory-dwelling units (ADUs) are one alternative housing arrangement that enable older adults to remain in the home despite functional decline. Functional decline increases with age making older adults more susceptible to loosing independent housing. Involuntary relocation to institutional care can result in a decline of functional health, reduced life satisfaction, impairment of psychological well-being and increased mortality rate. The majority of older Americans (93%) wish to remain in their home for as long as possible. ADUs function to maintain, stimulate and support an older adult as a means to prevent relocation to an institution. The modified environment coupled with adaptable features maintains and supports activities of daily living (ADL) within a familiar place. Under Massachusetts law MGL c. 40A, the state gives authority to cities and towns to adopt ordinances and bylaws to regulate the use of land, buildings and structures. Restrictive zoning laws limit the ability to construct health-promoting built-environments to age-in-community. All 351 Massachusetts municipalities Accessory Dwelling Unit (ADU) zoning bylaws were coded using the ADU Friendliness Score. Once scored, the 351 municipalities were placed into four categories based off their ADU score; the four categories are poor (0-24), fair (25-49), good (50-74), and excellent (75-100). Eighty-nine municipalities (25%) are in the poor category; thirty municipalities (8.5%) are in the fair category; one hundred and eighty-five municipalities (53%) are in the good category; forty-seven municipalities (13.5%) are in the excellent category. These findings contributed to a model ADU bylaw specific for aging Americans for municipalities to adopt.