bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older Adults Walking the Camino de Santiago Pilgrimage: Motivations, Transformations, and Spiritual Perspectives
Authors: Nelson-Becker Holly , Pickard Joe , Aitch Gina , Buettner Alyssa 
Published: December 2020

Abstract
This mixed-method study describes reasons that older people chose to complete the Camino de Santiago pilgrimage route in Spain and their assessment of how they were changed by the experience. The study is framed in Maslow’s (1988) self-actualization and Tornstam’s (2005) concept of gerotranscendence. We analyzed a subset of 121 participants age 65 and over who completed an online survey. Motivation included five themes: gratitude and transitions, cultural or historical curiosity. relationships, challenge and adventure, and spirituality. Transformations since their return involved greater strength, self-understanding, peace, desire to live lightly and to integrate their experience. Older individuals who walked the Camino have done so for a variety of reasons. Spiritual reasons may be more difficult to disclose. Half responded in the open-ended question, but a later spirituality question added many more respondents. Older people envision many forms of benefit to walking the pilgrimage and find growth in the experience.
Culture Change and Quality Star Ratings in High Medicaid Nursing Homes: Does Time of Adoption Make a Difference?
Authors: Chisholm Latarsha , Ghiasi Akbar , Lord Justin , Weech-Maldonado Robert 
Published: December 2020

Abstract
Racial/ethnic disparities have been well documented in long-term care literature. Culture change is a movement to transition nursing homes to more home-like environments to improve the quality of care for all residents. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid facilities. The final model consisted of an ordinal logistic regression. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.
Three Trends Shaping the Politics of Aging in America
Authors: Super Nora 
Published: December 2020

Abstract
The demographic bulge created by the baby boom generation has shaped American politics since they came of age in the 1960s. Over the next decade, aging issues will become more relevant as the oldest boomers reach 84 and the youngest boomers will be eligible for Medicare. This paper highlights three converging trends that will shape United States politics; including increased spending on “entitlement” programs like Social Security and Medicare, growing mismatch in caregiving need and supply, and the heightened concentration of older adults in certain geographic areas. The next decade will see not only extraordinary demographic change but also unprecedented advances in technology and medicine, and cultural and societal shifts that were once unimaginable.
Challenges for Elder Abuse Prevention Law
Authors: Tsukada Noriko , Katsumata Asako 
Published: December 2020

Abstract
This paper compares components of four abuse prevention laws in Japan, including elder abuse, child abuse and domestic abuse, and abuse for people with disabilities and delineates major strengths and weaknesses of the Elder Abuse Prevention Law in comparison to the other three. Based on this analysis, this paper recommends improvements　in the elder abuse prevention law given the success of the related abuse laws. Despite the requirement of re-evaluation every 3 years, no amendments have been made to the elder abuse prevention law, while amendments have been made to the child abuse and domestic abuse prevention laws, based on outcome data and implementation experience. Identified needed revisions include provisions of protection orders and temporary shelters to protect elder victims from abusers at the time abuse is reported.
Policy Series: ESPO/ Social Research, Policy, and Practice Section Symposium: Connecting Aging Research to Policy: Insights and Strategies for Early-Career Researchers
Authors: Pendergrast Claire , May Jennifer 
Published: December 2020

Abstract
A wide range of policy issues, from healthcare to transportation to social insurance, influence health and wellbeing for older adults. Gerontologists have the opportunity to get involved with policy at any scale, from the organizational or community level to local, state, or federal policy. This symposium brings together a diverse panel of emerging and established academics to discuss strategies for early career researchers to understand and participate in aging policy activities. Panelists will discuss opportunities for researchers to contribute their expertise to policy discussions, and will share their own experiences and perspectives on participating in the policy process. Specific topics covered will include aging policy internship opportunities for graduate students, academic involvement with advocacy efforts to promote healthcare access to older adults, strategies for designing and conducting impactful and policy research, approaches to collaboration with diverse stakeholders to connect research to policy, and strategies for communicating policy-relevant research findings to general public and policy audiences. This symposium will reflect the SRPP’s strong commitment to connecting research to policy and practice, and will provide early career scholars with strategies to connect their own research to policy in order to inform decision-making and improve health and quality of life for older adults.
Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare
Authors: Emery-Tiburcio Erin , Snyder Rani 
Published: December 2020

Abstract
As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.
Embedding Patient Priorities Care in an Age-Friendly Health System
Authors: Naik Aanand , Kiefer Lea , Catic Angela , Dindo Lillian 
Published: December 2020

Abstract
Background: Patient Priorities Care (PPC) is an innovative approach to improving care for older adults with multiple morbidities. We developed a PPC training program for healthcare professionals and describe preliminary results. Methods: We implemented PPC in a geriatrics clinic. 20 staff and trainees participated on 1) how to identify patient priorities, 2) documentation in the electronic health record (EHR), and 3) strategies to align care with priorities; and received case-based audit and feedback. Results: 250 patients participated in PPC encounters. The EHR template was subsequently integrated within an Age Friendly Health System (AFHS) note. Clinicians have integrated this AFHS template for all encounters. Conclusion: PPC is a feasible approach to the care of older adults with multiple morbidities following a structured clinician training program. PPC can be effectively incorporated into the “Matter Most” component of AFHS.
Housing, Affordability, and Community-Based Aging
Authors: Scheckler Samara 
Published: December 2020

Abstract
The house acts as both an environment of care and a vehicle to financially potentiate long-term community-based support. While housing can empower a diverse set of options for a person-centered aging process, inadequate housing can also impede healthy aging in the community. This symposium teases out the nodes where housing acts to benefit or limit safe community-based aging. The first paper in this symposium, Homeownership Among Older Adults, describes typologies of older adult homeownership and sensitively highlights trends, disparities and important considerations of homeownership in later life. The next two papers take these older adults and explores situations where their housing acts as an asset or as a burden. Identifying Cost Burdened Older Adults acknowledges that housing cost burdens look different for older adults than younger cohorts. A more precise definition of older adult housing cost burden is proposed to help researchers and policymakers better synthesize the complex relationships between older adult housing and their long-term care decisions. The Long-Term Care Financing Challenge then explores the role of home equity in expanding the community-based long-term care choice set for older adults. This paper demonstrates benefits (both realized and unrealized) in home equity and suggests policy implications moving forward. Finally, Cardiometabolic Risk Among Older Renters and Homeowners disentangles the relationship between housing and health by demonstrating health disparities that are associated with housing tenure, conditions and affordability. Taken together, this symposium explores the complex and multidirectional relationships between housing, long-term care and older adult health.
The Long-Term Care Financing Challenge: What Role for Home Equity?
Authors: Tavares Jane , Cohen Marc , Popham Lauren 
Published: December 2020

Abstract
With increasing longevity comes the need for support in activities of daily living. This growing demand for long-term services and supports (LTSS) threatens older adult financial security. About 25 million adults aged 65 and older will have a significant LTSS need that will cost up to $140,000 out-of-pocket plus an estimated $120,000 from public payers like Medicaid; the total public and private costs of care exceeding $250,000. Home equity, the most valuable financial asset owned by Americans, offers one solution to this financing challenge. While seniors boast $7 trillion in collective home equity, opportunities to annuitize this asset vary and the distributions of home ownership and value are highly skewed. Using the 2016 wave of the HRS, this paper explores the relationship between socio-demographic/health characteristics and the annuitized home value. We determine which individuals with LTSS needs might benefit from the annuitization of home equity and to what extent.
Creating Stories Using TimeSlips With People Living With Dementia
Authors: Ihara Emily , Barrett Kendall , Tompkins Catherine , Inoue Megumi , Hanson Kari 
Published: December 2020

Abstract
TimeSlips is an award-winning, non-pharmacologic, creative storytelling intervention designed specifically for individuals living with dementia by Anne Basting. As part of the NextGen pilot program, George Mason University implemented TimeSlips at a dementia-specific adult day health care center with undergraduate and graduate students trained as facilitators. They worked with two different populations living with ADRD – an early-stage group and a moderate- to late-stage group. Students who participated reflected upon their experiences and noted that they learned so much about the importance of open-ended questions and accepting even one-word answers. One student stated: “This makes so much sense, as I have noticed participants take these open-ended questions and deliver beautifully unexpected and clever responses.” The implementation was different for these two groups, and our analysis of the content and process indicate that consistency and person-centeredness are key to participants’ expression of pride and joy in their accomplishments.
Disaster Literacy
Authors: Brown Lisa , Peterson Lindsay 
Published: December 2020

Abstract
People who plan ahead typically fare better during the response and recovery phases of a disaster. However, problems arise when the needs, wants, abilities, and resources of vulnerable people are not adequately considered. The lack of alignment between the literacy demands of existing materials and the literacy skills of many vulnerable subgroups limits their ability to understand and effectively use potentially life-saving information. Existing health literacy models that have demonstrated effectiveness in changing health behaviors and improving outcomes is a first step to reducing disaster-related morbidity and mortality in low resource and low literacy areas. This presentation will 1) describe how interdisciplinary collaborations can be used to address this public health issue, 2) explain how health literacy techniques can be applied when developing disaster materials, and 3) present research data on a social marketing campaign to improved disaster preparedness of older adults. Part of a symposium sponsored by Disasters and Older Adults Interest Group.
Interprofessional Collaboration to Address Elder Abuse, Neglect, and Exploitation With Adult Protective Services
Authors: Liu Pi-Ju , Penhale Bridget 
Published: December 2020

Abstract
Adult Protective Services (APS) is responsible for investigating reports of abuse, exploitation, and neglect among vulnerable adults. Additionally, APS also refers or provides needed services to victims. Though APS also takes the lead position in investigation and service planning, determining harm and designing person-centered remedies often require other professionals to be prepared to address these elder justice issues with APS. Afterall, adult safeguarding is everybody’s business. This symposium includes four presentations on researchers’ findings working with APS and other professionals. Dr. Burnes will compare outcomes on usual APS care (APS only) versus enhanced APS care (APS plus advocate who are case managers). Dr. Pi-Ju (Marian) Liu will examine nurses’ role in working in and with APS, focusing on how their job responsibilities are different from other nurses and APS social workers. Dr. Jason Burnett will present an innovative referral portal linking banks and other financial firms directly to APS. Lastly, Dr. Zachary Gassoumis will appraise the multidisciplinary teams across the country, including professionals involved, and provide input on what makes a team work well together. Following the four presentations, Dr. Bridget Penhale will open up the discussion regarding protective agencies’ operations and collaboration with other agencies, focusing on the comparison between protective agencies in the United States and European countries. Abuse, Neglect and Exploitation of Elderly People Interest Group Sponsored Symposium.
Home Health Registered Nurses’ Experiences With Financial Exploitation of Older Women With Cognitive Impairment
Authors: Rogers Carol , DeSpain Lisa , Wilson Janet 
Published: December 2020

Abstract
Older adults diagnosed with cognitive impairment (CI) who live at home are at high risk for FE due to dependence on caregivers and diminishing cognitive and financial capacities. Health care providers are mandated reporters for elder abuse, that includes financial exploitation (FE), one of the seven types of older adult maltreatments. Twenty Home Health Care Nurses (HHRN) of older adults in Oklahoma were interviewed to discover their understanding and experiences with FE. Transcripts were analyzed by conventional content analysis. Line-by-line codes were generated inductively and codes were grouped into categories and themes until data saturation was reached. Five themes emerged: Red Flags, Familiar Offenders, Dire Consequences, Barriers/Facilitators, Doing Better. Conclusions: HHRNs are an untapped resource to provide suggestions for improvements of FE detection/reporting of older adults with CI and to help formulate policies, procedures, strategies to improve coordination and communication among healthcare, law enforcement, and social service systems.
Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care
Authors: Young Yuchi , Resnick Barbara 
Published: December 2020

Abstract
The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture.
This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.
Off-Label Antipsychotic Prescribing for Persons With Dementia in Assisted Living
Authors: Wretman Christopher , Zimmerman Sheryl , Sloane Philip , Preisser John 
Published: December 2020

Abstract
Off-label antipsychotic use is contra-indicated for persons with dementia due to lack of efficacy and FDA black box warnings. Yet, residents in assisted living (AL), including those with dementia, are frequently prescribed such medications. If distinct typologies of AL communities exist based on prescribing rates, it might be possible to reduce use. Toward that end, data from 247 AL communities in seven states were analyzed to discern potential unobserved latent classes that differentiate prescribing levels. Results using finite mixture modeling determined a 5-class solution best fit the data, with class-level prescribing rates ranging from 16.9% of residents with dementia to 27.4% (Mean = 18.9%). Bivariate tests found differences across classes by variables related to community structure, medication processes, and resident-case mix (e.g., frequent formal pharmacy review was more likely in communities with higher prescribing). Typologies are useful to identify differences and care and may be useful for quality improvement.
Advancing the Concept of Resilience for Older People Who Are Experiencing Homelessness
Authors: Wada Mineko , Canham Sarah , Fang Mei Lan 
Published: December 2020

Abstract
Current conceptualizations of resilience have overlooked the lived expertise of older people experiencing homelessness (OPEH) – individuals who have much insight to offer in terms of progressing notions on how people ‘stand up’ to adversity and ‘bounce back’ to a state of physical and psychological homeostasis across the life course. Drawing from extant literature and data from a community-engaged research project, which interviewed 40 participants and examined the health supports needed for individuals experiencing homelessness upon hospital discharge, we provide a comparison of resilience among homeless individuals generally and resilience among OPEH. Based on narratives of significant adversity experienced by OPEH in Vancouver, Canada, we offer a critical analysis of ‘resilience in ecological context’ that identifies unique characteristics of resilience at micro, meso, exo, and macro system levels. We discuss how our conceptual model of resilience pertinent to OPEH can be used to shape research, policy, and practice. Part of a symposium sponsored by the Environmental Gerontology Interest Group.
Can the Nation’s Housing Support a Population Seeking to Age in Place?
Authors: Molinsky Jennifer 
Published: December 2020

Abstract
While surveys report that most older adults wish to “age in place,” the nation’s current housing and neighborhoods fall short on several dimensions needed to support independence and health in later life. Drawing from national data (including the American Housing Survey, American Community Survey, Health and Retirement Survey, and Survey of Consumer Finances), we describe the current housing and living situations of older adults and key challenges they face in securing affordable, accessible housing while also securing supportive services. We identify three challenges: the unaffordability of housing, which causes budgetary tradeoffs in healthcare spending; a lack of accessibility features in homes and neighborhoods, which can limit independence and safety, and the low-density location of much of the US housing stock (including that inhabited by older adults), where service delivery is difficult and the potential for isolation is high. We conclude with an overview of the policy implications of these challenges.
Older Women Causing a Ruckus: Gentrification, Displacement, and Tenant Advocacy
Authors: Versey H Shellae 
Published: December 2020

Abstract
Gentrification is a process through which lower-income neighborhoods experience large-scale investments and an influx of wealthier residents, often displacing lower-income residents. The restructuring of neighborhoods for newer, wealthier residents can compromise belonging, place attachment, and security for existing residents. This study explores resistance to displacement through tenant advocacy and organizing in New York City. This research specifically focuses on the efforts of older, lower-income, African American women, who are most at risk for eviction and housing stability, and yet are at the center of advocacy efforts to preserve affordable, low-income housing. In three case studies, we interview key stakeholders invested in anti-displacement housing preservation, eviction resistance, and public housing organizing to highlight the often invisible work taking place from within socially vulnerable communities. Implications for policy and future directions for applied research are discussed.