bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPROVING GERIATRIC CARE OF INTERPROFESSIONAL PRACTICING PROVIDERS
Authors: Powers Becky , Ross Jeanette 
Published: November 2019

Abstract
Practicing providers often struggle with the care of older adults due to knowledge, skill, and attitude barriers. In an attempt to improve employee engagement in the care of older adults, the Geri-EMPOWER (Empowering Medical Providers and Older adults With strategies to Escape Readmission) program was initiated. In this program, case managers and visiting VA rural geriatric scholars participated in a two days of intensive educational sessions including lectures, shadowing inpatient teams and clinic providers, a dementia simulation learning exercise, and an Observed Structured Clinical Exam (OSCE) with standardized patient encounters. The 15 initial participating trainees came from a variety of medical backgrounds including physicians, nurse practitioners, nurses, social workers, and psychologists. A 10 item knowledge based pretest and posttest was constructed using the learning objectives of the course. Skills of attendees were directly observed during 4 OSCE stations. Attitudes towards older adults were measured before and after the intervention using the Caroline Opinions on Care of Older Adults (COCOA) scale. Geriatric and palliative care knowledge improved with average knowledge test scores improving from 63% to 86% before and after the course. Participants obtained all minimum competencies during their OSCE exam, and rated this session very highly in their course feedback. Attitudes towards older adults were also found to improve with an average COCOA score increase of 9 points before and after the educational sessions. This innovative course based in adult-learning theory demonstrates that employed interprofessional providers can quickly improve knowledge, skills, and attitudes towards older adults.
HOUSING AFFORDABILITY AND INTER-REGIONAL MOVES AMONG OLDER ADULTS
Authors: Mawhorter Sarah , Ailshire Jennifer A 
Published: November 2019

Abstract
Housing prices have risen in urban areas across the US since 2000, with only a brief interruption after the housing crisis of 2008. At the same time, prosperous urban areas have pulled away from declining urban and rural areas. Older adults are more likely to be affected by both increases and divergence of housing prices: owners may not be able to afford rising property taxes (though they benefit from increasing home equity), and renters are especially vulnerable. Housing affordability constraints may also affect the places where older adults can afford to move. In this paper, we compare the residential mobility patterns of adults aged 50+ living in high-cost, mid-cost, and low-cost areas from 2000-2014, using data from the Health and Retirement Study with county-level US Census and American Community Survey contextual data, as well as the Zillow Home Value Index. We find that both homeowners and renters living in high-cost areas remain in place at higher rates compared with those living in mid-cost and low-cost areas. Among those who move, older adults living in high-cost regions move towards mid-cost and low-cost regions more often than the reverse. The differences are particularly pronounced for renters. The overall outcome is a net movement of older adults away from high-cost areas towards mid-cost and low-cost areas. These shifts have consequences for the well-being of older adults facing budget constraints that may limit the areas where they can afford to live or move, and broader implications for the future of urban areas.
THE PHYSICAL AND SOCIAL ENVIRONMENTS, SOCIAL ACTIVITIES, AND SUBJECTIVE WELL-BEING: FINDINGS FROM THE K2 STUDY
Authors: Takayama Midori , Ishioka Yoshiko , Sugawara Ikuko 
Published: November 2019

Abstract
It has been pointed that the environments effect subjective well-being(SWB). However, it is still not clear what aspects of environments effect SWB among older adults and if degree on physical condition of older adults cause the difference on relations between and environments and SWB. In this study, firstly, we examined the relationship between the physical and social environments, social activities, and SWB in a sample of older Japanese. Secondly, we examined the differences on the effects of environments on SWB between older adults with lower physical functions and those with higher physical functions. We used data from locally representative longitudinal study of older adults 75±1, 80±1, and 85±1 years of age (at baseline) , which was conducted in Japan (The Keio-Kawasaki Aging Study(K2 study) ; N = 1388). Concerning the environments, we assessed the physical environments (public spaces and buildings, and accessibility) and the social environments (culture and recreation programs, and inclusive social environment). Results from covariance structure analyses showed that the accessible physical environment and the social environments were significant predictors of SWB, and showed that accessibility and the social environments influenced SWB via participation of social activities, too. Moreover, results from multiple group structural equation modeling showed that accessibility was a stronger predictor of SWB among older adults with lower physical functions, while accessibility was not a predictor among older adults with higher physical functions. The potential benefits of this approach provide a basic developing compensation model of SWB for this population of older adults.
DEVELOPING A QUALITY-OF-RELATIONSHIP INTERVENTION FOR STROKE-SURVIVOR FAMILY CAREGIVER DYADS
Authors: McCarthy Michael J , Lyons Karen , Dunn Dorothy , Garcia Yolanda , Bakas Tamilyn 
Published: November 2019

Abstract
A strong interpersonal relationship after stroke is important for the well-being of survivors and family caregivers. At present, few interventions are specifically designed to strengthen the relationship between members of the care dyad. The aim of this study is to develop, validate, and pilot test a quality of relationship intervention for stroke dyads. This poster presents findings from the content validity phase of the study and includes “tips” that dyads offered for maintaining a strong relationship. Semi-structured interviews were conducted with N=19 dyads to solicit information about relationship problems and tips. These data were used to develop a 17-item relationship assessment questionnaire with 17 “tip sheets” corresponding to each item. A Delphi process was used to obtain feedback from a 10-member expert panel about the degree to which the questionnaire and each tip sheet was (1) relevant; (2) clear; (3) accurate, and; (4) useful. Expert agreement ranged for 80% to 100%. The final materials included tips for dealing with issues that arise when one or both partners experience communication, mobility, cognitive, or emotional issues; reaching agreement about different aspects of recovery; working together to meet each partners’ needs; adjusting to new roles after stroke; dealing with relationship problems that predated stroke, and; getting support from other family members, friends, peers, and professionals. Findings highlight areas to consider in promoting strong relationships in care dyads. Future research is needed to examine whether these materials can help to reduce stressful interactions for care dyads, promote dyadic coping, and improve overall relationship quality.
AN INTERGENERATIONAL DYADIC APPROACH TO UNDERSTANDING GRANDPARENT DEATH WITHIN A FAMILY SYSTEM
Authors: Manoogian Margaret M , Igarashi Heidi , Leinenweber Maggie 
Published: November 2019

Abstract
Due to increased longevity and generational location, grandparent death creates new contexts for identity, family culture, and intergenerational relationships. To explore this loss from two perspectives, we conducted intensive interviews with young adults and their mothers (N = 16) who experienced a recent grandparent (parent) death. Guided by the life course perspective, we were interested to learn how grandparent death may shape identity, meaning, and behaviors among family members, and influence their shared parent-child relationship. Findings suggest that the relationship with the grandparent, the diverse expressions of grief, the navigation of family transitions during and after death, and the curation of grandparent memories influenced individual and family outcomes. Implications suggest the need for varied supports that are sensitive to how individual family members approach grief in distinct ways reflective of their developmental positions, past experiences, and relational expectations.
SCAFFOLDING PARENTS TO ACCEPT ADULT CHILDREN’S INTERVENTION
Authors: Toyokawa Noriko , Darling Nancy , Toyokawa Teru 
Published: November 2019

Abstract
Guided by social-cognitive domain specific theory (Smetana, 1997), this study explored the issue of role reversal in the aging parent-adult child relation when parents are experiencing age-related functional limitations. Data was collected from adult children (N=16, Mage=53.06, SD=6.08) with a living parent of 70 years old or older who participated in a focus group and were analyzed by a directed analysis (Potter & Levine-Donnerstein, 1999). Participants legitimated their intervention into parents’ autonomy when they perceived a potential risk of parents’ health and safety and involvement of those and of others. Eight types of intervention emerged: (1) monitoring and talking with potential risk with parent (2) convincing parents under the name of super power or an authority figure (3) scaffolding parent’s task by teaching skills, (4) scaffolding by sharing role, (5) scaffolding by optimizing environment, (5) overriding parents’ autonomy behind parents, (6) forcefully overriding, (7) giving up parents’ behavioral modification by accepting parents’ lifestyle, and (8) giving up because of discomfort of talking about the issue (i.e., potential risks of parent’s sexual intercourse, parents’ death preparation). Thus, adult children changed their strategies of intervention from monitoring their parents’ behaviors to overriding parents’ autonomy, depending on their appraisal of potential harms of parents’ prudential and moral domains of life and of their own work/family conditions from monitoring to overriding. Adult children’s possible ways of scaffolding in helping their parents accept their children’s interventions as letting parents maintain their psychological autonomy, including communication skills to discuss uncomfortable topics is discussed.
ADVERSE CHILDHOOD EXPERIENCES REPORTED BY CUSTODIAL GRANDMOTHERS AND THEIR ADOLESCENT GRANDCHILDREN
Authors: Smith Gregory C , Infurna Frank J , Webster Britney A , Dolbin-MacNab Megan L , Crowley Max , Musil Carol M 
Published: November 2019

Abstract
The Risky Family Model postulates that adverse childhood experiences (ACE) are likely to be encountered across generations within custodial grandfamilies which, in turn, may adversely impact their overall well-being. The present study is a pioneering attempt to examine the patterns of ACEs self-reported by custodial grandmothers (CGM) and adolescent grandchildren (AGC) from the same families, and how their total ACE scores correlate with key physical and mental health outcomes. A total of 129 CGM-ACG dyads recruited for a nationwide RCT study completed separately at baseline the 10-item ACE-CDC and 4 items from the ACE-IQ, as well as various standardized measures of physical and emotional well-being. The most frequent ACEs reported by AGC were loss of a parent (60.5%), verbal abuse (58.1%), bullying by peers (46.5%), and living with someone jailed (45.0%). The predominant ACEs for CGM were bullying by peers (48.8%), verbal abuse (48.1%), living with a mentally ill person (34.1%), being touched sexually (29.5%), and loss of parent (29.5%). Only 10.1% of ACG and 15.5% of CGM reported 0 ACEs, whereas 65.1 % of ACG and 59% of CGM reported &gt; 3 ACEs. For ACG, total ACE scores correlated significantly with externalizing (r=.32) and internalizing (r=.30) difficulties, self-esteem (r= -.28), loneliness (r=.27), school problems (r=.24), and physical health (r= -.26). For CGMs, anxiety (r=.23) and depression (r=.19) only were correlated significantly with total ACEs. We conclude that although both CGM and ACG reported alarmingly high levels of ACEs, different patterns and correlates exist between the generations. [Funded by R01AG054571]
SPOUSE OR CAREGIVER? EXAMINING CORRELATES AND CONSEQUENCES OF SPOUSES BEING IDENTIFIED AS CANCER CAREGIVERS
Authors: Litzelman Kristin 
Published: November 2019

Abstract
Spouses provide critical support to cancer survivors, but are not always identified as caregivers. This study sought to understand the differences between such spouses. Using the Medical Expenditures Panel Survey 2016 Experiences with Cancer Supplement, spousal dyads in which one spouse had cancer were identified (n=670). Cancer survivors reported which family members or friends, if any, provided care during or after their cancer treatment. Survivor and spouse sociodemographic characteristics and spouse psychosocial characteristics including depression (Patient Health Questionnaire-2), distress (Kessler-6), and self-rated health were self-reported in the survey. The proportion of spouses identified as caregivers was calculated and compared with those not identified as caregivers on dyadic characteristics. Multivariable logistic regressions compared spouses’ depression, distress, and self-rated health by identification as a caregiver. All analyses employed survey weighting. Most married cancer survivors reported that their spouse was a caregiver (32%) or that they did not have a caregiver (65%); very few did not list their spouse as a caregiver (3%). Survivors who were white (non-Hispanic) or off treatment were less likely to report that their spouse was a caregiver (30% vs. 46%, p0.10; 9.6% vs 11.1%, p&gt;0.10; and 46% vs 50%, p&gt;0.10, respectively). The findings suggest that spouses’ experiences may be similar regardless of whether they are considered a caregiver, with implications for research and service delivery.
FACTORS ASSOCIATED WITH CAREGIVER REACTIONS TO PROBLEM BEHAVIORS OF PERSONS WITH ALZHEIMER’S DISEASE
Authors: Shi Junrong , Scott Cathy 
Published: November 2019

Abstract
Problem behaviors among persons with Alzheimer’s Disease (AD) can have a major impact on caregivers. However, caregiver’s subjective reactions to the problem behaviors have a stronger impact on caregivers than the objective frequency of problem behaviors (Robinson et al., 2001). This study aims to examine the factors associated with caregiver’s subjective reactions to problem behaviors. Data were collected from a sample recruited from community agencies served AD caregivers in the southeastern region of the country (N=109). The caregivers’ reactions to problem behaviors were measured by the Revised Memory and Behavior Problem Checklist (Teri et al., 1992). Three subscale scores were used to measure the reactions to the behaviors related to memory loss, depression and disruption. Multivariate regression models were conducted including gender, race, employment, living arrangement, knowledge about the disease, resilience for caregivers; and ADL and IADL functioning, and frequency of problem behaviors for care recipients. Race (B=-.162; p&lt;.05) and frequency of care-recipient problem behaviors (B= 0.733; p&lt;.001) were significantly associated with caregiver’s reaction to problem behaviors. Caregiver’s knowledge about the disease (p&lt;.01) only influence their reactions to memory loss problems but not for disruption and depression problems. African American caregivers had fewer reactions to disruption (p&lt;.01) and more reactions to depression problems (p=0.06) than white caregivers, but no difference between the two groups in their reactions to memory loss problems. Personal resilience was not associated with reactions to any problem behaviors. Intervention should be tailored to the needs of caregivers to deal with behaviors of a person with AD.
INFORMED CONSENT IN CLINICAL TRIALS FOR PERSONS WITH DEMENTIA
Authors: Carpenter Joan G 
Published: November 2019

Abstract
Informed consent is one of the most important processes during the implementation of a clinical trial; special attention must be given to meeting the needs of persons with dementia in nursing homes who have impaired decision making capacity. We overcame several challenges during enrollment and consent of potential participants in a pilot clinical trial including: (1) the consent document was designed for legally authorized representatives however some potential participants were capable of making their own decisions; (2) the written document was lengthy yet all seven pages were required by the IRB; (3) the required legal wording was difficult to understand and deterred potential participants; and (4) the primary mode of communication was via phone. We tailored assent and informed consent procedures to persons with dementia and their legally authorized representative/surrogate decision maker to avoid risking an incomplete trial and to improve generalizability of trial results to all persons with dementia.
FUTURE PLANNING AMONG OLDER CAREGIVERS OF FAMILY MEMBERS WITH INTELLECTUAL DISABILITY OR MENTAL ILLNESS
Authors: Wang Fei , Han Yangdi 
Published: November 2019

Abstract
Objectives: This study aims to examine future planning among older caregivers for family members with intellectual disability or mental illness, focusing on preferences, predictors and barriers. Method: Data were drawn from 260 caregivers (aged 50 or older) to a family member with intellectual disability or mental illness in Shanghai, China. Caregivers rated six types of future care arrangement under three circumstances: (1) the ideal situation, (2) unable to provide care due to age-related illnesses, and (3) caregivers are deceased. Socio-demographic factors associated with future planning were examined using multinomial logistic regression. Caregivers also rated twelve barriers to future planning. Results: Government-subsidized care facility is the most preferable care arrangement across the three circumstances. While continuing family care was still preferred if caregivers were to become sick or deceased, it was a less preferred option in the ideal situation. Common barriers were the cost of institutional care and the inadequate skills of the staff. Regarding the predictors of future planning, the older the caregivers were, the less likely they had no future plans. Caregivers were more likely to prefer family care over institutional care if their family members had mild impairment. Caregivers of a family member with mental illness were more likely to have no future planning than caregivers of a family member with intellectual disability. Conclusion: This study identified the needs of older caregivers for future planning specific to different circumstances. It also identified demographic profiles of future planning and the caregiver population at risk of no future planning.
ACTIONS TAKEN BY STROKE FAMILY CAREGIVERS TO POTENTIALLY PREVENT SURVIVORS’ HOSPITAL READMISSIONS IN CHINA
Authors: Yu Hairui , Perion Jennifer , Steiner Victoria , Pierce Linda 
Published: November 2019

Abstract
Stroke is a leading cause of death in China; its level of burden on the Chinese population is greater than the global average. Family caregiving plays an essential role in prevention and management of stroke. The purpose of this qualitative descriptive study was to identify actions family caregivers of stroke survivors in China take to prevent hospital readmissions. Using purposive sampling, adult family caregivers (n=10) were enrolled from Huai’an city in Jiangsu province who provided care for a survivor in community settings for six months or longer. Caregivers were asked questions in a face-to-face, semi-structured interview with content validity established by experts in the field. Audiotaped interviews were transcribed/translated into English and the narrative data analyzed using Colaizzi’s approach to content analysis. Seven female and three male caregivers with an average age of 55 years indicated actions that comprised six themes. These themes are: 1) Encouraging care recipients to be physically active, 2) Balancing a healthy diet with pleasurable foods, 3) Monitoring the physical health of care recipients and preventing injuries, 4) Developing personal and intimate strategies to motivate care recipients, 5) Providing emotional support and maintaining optimism, and 6) Gaining knowledge through relationships with doctors but desiring communication with other caregivers. Recognizing these actions taken by stroke family caregivers may improve education programs aimed at preventing hospital readmissions and be applicable throughout the world. Findings may also guide healthcare professionals who can advocate with Chinese local, provincial, and central health commissions on stroke survivors and their family caregivers’ behalf.
FEASIBILITY OF CARRES MODULES TO REDUCE POTENTIALLY AVOIDABLE HOSPITALIZATIONS IN PERSONS WITH COGNITIVE DEFICITS
Authors: Steiner Victoria , Pierce Linda , Bryan Carol 
Published: November 2019

Abstract
Family caregiving is an essential, yet understudied, factor that can hasten, delay, or prevent hospital readmissions in individuals with cognitive deficits. This 3-month feasibility study examined 18 Internet-based educational CARREs (Communicate, Assist, Recognize & Report Events) Modules for family caregivers that address care recipients’ potentially avoidable hospitalization (PAH) conditions, e.g. UTI. This study determined: 1) caregivers’ perceptions about the use of the CARREs Modules, 2) caregivers’ self-reported value of the Modules, and 3) potential outcomes for caregivers and care recipients. Community-dwelling family caregivers were recruited from local support/education programs and assigned 6-8 Modules based on their care recipients’ needs. Links to online surveys were emailed at baseline, and 30 and 90 days post-enrollment. Descriptive statistics were performed on these data. Twenty potential subjects were screened but five were ineligible and three refused to participate. The remaining 12 subjects were primarily White females caring for a husband or parent. Subjects completed all the Modules they were assigned and did not experience any difficulties answering the survey questions. Subjects reported completing the Modules at least moderately increased their knowledge (67%), not being burdened by completing the Modules (67%), and very likely to participate again (58%). Many subjects stated the Modules taught them new things about preventing hospital readmissions in their care recipient (75%) and improved their well-being as a caregiver (83%). In collaboration with a home care agency, the investigators plan to implement and test a sustainable, “real-world” educational intervention incorporating the CARREs Modules that reaches a wide audience of family caregivers.