bluuebunny/crossref_metadata_2025_split huggingface dataset:
TECHNOLOGY-ENHANCED PSYCHOTHERAPY IMPROVES LIFE SATISFACTION AMONG OLDER ADULT VETERANS IN LONG-TERM CARE
Authors: Sills Jonathan , Mazzone James A , Ma Flora , Louras Peter , Alexander Erickson 
Published: November 2019

Abstract
To buffer the risk of declining life satisfaction among a Veteran cohort residing within a Veteran’s Affairs long term care facility, a new model of care called Individualized Non-Pharmacological Services Integrating Geriatric Health and Technology (INSIGHT) therapy was developed and evaluated. Consistent with the INSIGHT therapy model, traditional psychotherapy interventions including reminiscence, behavioral activation, and relaxation exercises were modified such that they could be delivered on a digital platform. A paired sample T-test was performed to identify the effects INSIGHT Therapy had on Veteran satisfaction with life. Findings indicated that Veteran life satisfaction ratings the month prior (M= 19.6522) to the initiation of INSIGHT intervention and the month following three months of INSIGHT intervention (M=22.4783) show that the satisfaction with life increased among residents (t(22)=-2.334, p=.028). Effect size = 0.489. These results suggest that INSIGHT therapy interventions help to contribute to an increase in life satisfaction among an older adult Veteran cohort residing within a Veteran’s Affairs long term care facility.
GENDER DIFFERENCES IN NURSING HOME RESIDENT QUALITY OF LIFE: WHY WOMEN DO BETTER
Authors: Davila Heather , Shippee Tetyana P , Ng Weiwen , Akosionu Odichinma C , Virnig Beth 
Published: November 2019

Abstract
Despite research documenting gender differences in numerous outcomes in later life, we know little about gender differences in quality of life (QoL) for older adults who receive institutional long-term care. To address this gap, this study examines the relationship between gender and nursing home (NH) residents’ QoL, including possible reasons for differences observed. We used a mixed methods design including surveys with a random sample of Minnesota NH residents using a multidimensional measure of QoL (n=8,870), resident clinical data, facility-level characteristics, and qualitative interviews with NH residents (n=64). We used mixed models and thematic analysis of resident interviews to examine possible differences in resident QoL based on gender. After controlling for individual and facility characteristics, women reported higher overall QoL than men, with men reporting significantly lower QoL in 4 of 8 QoL domains. In interviews, men noted being especially dissatisfied with facility activities, whereas women more frequently described having friends in the facility and relying on family for support. Some women viewed the NH as a place of respite and described wanting to stay long-term, even though their families asked them to return home. In contrast, men more often described the NH as necessary due to physical needs, but undesirable for long-term living. Our findings provide preliminary evidence that men and women experience QoL differently, with men reporting lower QoL in several domains. Tailoring more activities for men and finding ways to strengthen relationships for men within the facility may help reduce the gender disparities in QoL we observed.
INDIVIDUAL AND INTERPERSONAL INFLUENCERS OF MEALTIME EXPERIENCES: PERSPECTIVES OF NURSING ASSISTANTS
Authors: Douglas Joy W , Jung Seung Eun , Noh Hyunjin , Ellis Amy , Ferguson Christine 
Published: November 2019

Abstract
In the United States, long-term care Certified Nursing Assistants (CNAs)’s central role is to provide direct care to residents, including mealtime assistance. It has been reported that employee turnover among CNAs is nearly 75% annually. High turnover rates of CNAs can increase the workload for remaining CNAs, interrupt quality of care for residents, and require extra resources for recruiting new staff. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. Using purposive sampling, nine focus groups were conducted with a total of 53 CNAs who had at least one year of experience as a CNA working with older adults. Focus group questions were developed using the Social Ecological Model. All focus groups were audio recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. At the individual level, CNAs identified that communication skills with residents and coworkers, and the ability to accurately interpret resident behavior positively affected their ability to provide mealtime assistance. At the interpersonal level, interdisciplinary collaboration was identified as a significant facilitator. Reported barriers included negative interference from residents’ family members, unpredictable resident behaviors, and lack of support from coworkers. CNAs reported individual and interpersonal factors that may influence their ability to effectively feed residents with dementia. Our findings will inform future investigations regarding job turnover. Equally important, providing CNAs with the training and opportunity to perform their duties efficiently can ultimately benefit the residents’ mealtime experiences.
BEST INTENTIONS OR BEST PRACTICE? HOW DO STAFF PERCEIVE BEST CARE FOR PEOPLE WITH DEMENTIA IN TAIWAN?
Authors: Liou Chih-ling 
Published: November 2019

Abstract
Care of people with dementia is a global issue, and the quality of dementia care in the long-term care facility is of concern internationally. The Taiwanese government seeks to expand the availability of adult day services (ADS) to meet the needs of an aging population with dementia; however, research about care in ADS in Taiwan is limited. This study aims to investigate how ADS staff perceptions of best care affected care delivery and clients’ quality of life. A focused ethnographic method was employed to collect data through 480 hours of participant observation and 31 staff interviews at three centers. Content analysis was used to analyze the data. The findings revealed a contradiction on how staff perceived best care and what they really performed at center. Thirteen staff members who were interviewed identified that in their view the best care is to “put yourself in the shoes of the client,” and another nine staff members chose “keep clients happy” as the best care. From the observation data, however, the staff performed the “good care” by forcing the clients to follow their orders absolutely unless the clients refused violently. Staff-led activities were structured as tasks to be completed rather than activities to be enjoyed. The clients complained about the bureaucratic management that shaped their lives at centers but could only endure or accept. To support clients’ quality of life and improve the care quality, ADS staff need to be educated more with the evidence-based best care for people with dementia.
FROM BEING ACTIVATED TO SELF-ORGANIZATION IN ELDER CARE: CONCEPTS OF AGING AND THEIR IMPACT ON RESIDENTS’ AGENCY
Authors: Strasser Irene , Hopfgartner Ines , Payer Carmen 
Published: November 2019

Abstract
In a research project together with an elder care facility in Austria, we were following a participatory approach to investigate important factors and processes to increase quality of life for residents with dementia. The aim was to better understand how we can foster participation, agency and freedom of choice within a care setting. Together with care workers, residents and relatives we were working on how to identify overall strategies and aims, as well as particular processes and procedures that allow for a higher involvement of all these groups of individuals. Doing research explicitly together with care workers we also aimed to trigger reflection of individual and organizational concepts of aging. We interviewed residents, relatives and care workers, conducted research workshops, and engaged in participant observation. In the talk the focus will be on care workers’ perspectives. We wanted to better understand the multiple stressors within daily routines in care work. Particularly, we wanted to find out more about the multifaceted processes of integrating one’s experiences into everyday care work, and integrating care work into one’s life story, to make meaning of the important work they are providing under constantly stressful working conditions. Finally, together with care workers, we developed a model for participation, that is explaining a wide range of residents’ possibilities for involvement: From activity orientation to actual participation and the realization of individually meaningful activities. What helps to initialize participation, and what we identified as obstacles in supporting residents’ autonomy will also be discussed in the talk.
LONG TERM CARE FEASIBILITY OF NURSING HOME LVNS USING AN ALGORITHM-GUIDED ASSESSMENT SUPPORT TOOL
Authors: Ashcraft Alyce S , Owen Donna C , Johnson Kyle , Song Huaxin 
Published: November 2019

Abstract
Licensed Vocational Nurses (LVNs) are the frontline staff communicating with off-site physicians to manage new or unexpected symptoms in nursing home (NH) residents. Care decisions following physician-LVN conversation impact Alzheimer’s disease (AD) resident quality of care. LVN difficulties using standardized communication forms (e.g. SBAR) spurred creation of an alternative not requiring high levels of RN supervision. The aim of this study was to examine the feasibility of an algorithm guided assessment support tool (AGAST) to help LVNs collect and cluster information using a simulated clinical scenario. A descriptive, participant observation design (video-taped) was used with ten practicing LVNs. AGAST was implemented in the Simulation Center in a clinical scenario of a NH resident with AD experiencing a urinary tract infection. The algorithm was placed within an online survey and participants were directed through a series of sequenced question and answer choices to identify and collect information pertinent to describing a change in resident condition. Duration of videos, description of AGAST-linked assessment behaviors, and content analysis of post-intervention transcripts were reported. AGAST prompts were seen with LVN physical assessment behavior and followed by questions about relevant day-to-day activity/level of performance. AGAST mean completion duration was 11.20 (SD=4.67) minutes. AGAST was rated as easy or very easy (90%). Major concerns included small font size on lab screens, insufficient open text space to add more information, and direct computer input. AGAST was a feasible alternative for assessment by LVNs. Further testing is needed in a variety of conditions.
EVALUATING AN INNOVATIVE USE OF CIVIL MONETARY PENALTY FUNDS: THE MA SUPPORTIVE PLANNING AND OPERATIONS TEAM (SPOT)
Authors: Bertrand Rosanna M , Katz Gabrielle R , Mota Teresa M , Moore Terry , Pettis Jennifer , Fillo Katherine T , Saunders Katherine C , Moore Chiara S 
Published: November 2019

Abstract
The Office of the Inspector General reported in 2014, that one in three NH residents experienced an adverse event within 35 days of admissions causing lasting or temporary harm. Thus, state departments of public health (DPH) were implored to invest in improving NH quality and safety. Using Civil Monetary Penalty funds, the Massachusetts DPH, developed the SPOT Initiative to innovatively provide NH teams with technical assistance and training to enhance their federally required Quality Assurance & Performance Improvement (QAPI) programs. Selection criteria included NH Compare 5-Star and MA scorecard ratings and geographic spread. To assess program effectiveness, the SPOT Team collected a range of data in each of the three SPOT years (e.g., QAPI assessments, leadership interviews and surveys, and training evaluations). Results demonstrated the success of the Initiative. Assessment data indicated an increase in QAPI readiness in each subsequent year overall and within of the each QAPI assessment domains (Design and Scope; Governance and Leadership; Feedback, Data Systems, and Monitoring/Systematic Analysis; Performance Improvement Projects and Systematic Analysis/Systemic Action). In Year 1, the overall data collected from the assessments demonstrated that 78% of the NHs that engaged with SPOT had “Not Started” or “Just Started” (1.8/5) implementation of the key QAPI measures. By Year 3, only 13% of NH teams rated themselves in these initial categories, whereas, 57% rated themselves as “Almost There” or “Doing Great” (3.92/5). Further, feedback from most SPOT NH teams was extremely positive as evidenced by high evaluation rankings following initiative learning sessions.
FACTORS ASSOCIATED WITH RESIDENTIAL CARE COMMUNITIES THAT HAVE RESIDENTS VISITING EMERGENCY DEPARTMENTS
Authors: Melekin Amanuel , Caffrey Christine , Rome Vincent 
Published: November 2019

Abstract
Emergency department (ED) visits are an important part of healthcare utilization. However, ED visits can be costly, lead to hospitalizations, and are sometimes unnecessary. Studies characterizing ED visits among long-term care settings have been largely focused on nursing homes where the unit of analysis is typically the resident. Facility- or community-level analyses describing residential care communities (RCCs) with ED visits are limited. Using RCCs as the unit of analysis, this study examines community-level factors associated with RCCs that have residents with ED visits. Community-level factors include ownership and chain affiliation, Medicaid participation, electronic health records use, service provision, nurse staffing, U.S. census region and metropolitan status. The study uses data from the 2016 National Study of Long-Term Care Providers conducted by the National Center for Health Statistics. In 2016, about 81% of RCCs had at least one resident visiting the ED in the past 90 days and around 19% of RCCs had no residents with ED visits in the past 90 days. Bivariate analyses indicated that ED visits varied by chain affiliation, ownership status, electronic health records use, and Medicaid participation. Logistic regression modeling to examine factors associated with whether or not RCCs had any residents with ED visits in the past 90 days will also be presented. Results may benefit efforts focused on implementing practices to reduce ED visits in RCCs.
THE SOCIAL DETERMINANTS OF LATE-LIFE MIGRATION IN THE U.S.: FINDINGS FROM THE NEW AMERICANS PROJECT
Authors: Maleku Arati , Espana Megan , Karandikar Sharvari , Kagotho Njeri , Parekh Rupal , Jarrott Shannon 
Published: November 2019

Abstract
Globally, late-life migration has been a growing phenomenon. Literature on aging and migration however, has primarily focused on immigrant populations who migrated early in life. To expand our conceptualization of aging and to plan for the care of growing older immigrant populations, it is crucial to understand the compounding effects of late-life migration and aging in new spaces. Drawing on the qualitative data (N=71) from a large-scale community-based participatory research project in a mid-western U.S. region, we examined the social determinants of late-life migration on the health and well-being of older immigrants by exploring: (a) barriers and facilitators of socio-cultural adaptation, (b) patterns of human service provision in a local context, and (c) societal patterns of caring for older immigrants in places of relocation. Life course and social convoy perspectives formed the conceptual basis of the study. Using Respondent Driven Sampling method, data collection included six focus group discussions (n=48) with immigrant communities and in-depth interviews with human service providers (n=23). Data analysis followed the Rapid and Rigorous Qualitative Data Analysis technique that generated six salient themes: cultural context of aging; challenges of late-life migration; broken convoy and social isolation; gender and age intersections; human services, and community efforts and solutions. Findings suggest that late-life migration is a conglomeration of losses and gains, contingent on complex determinants such as living arrangements, language, transportation, the built environment, inter-generational relationships, socio-economic status, and social convoys. We conclude with a call to develop age-friendly, culturally responsive human services and health policies.
GEROTRANSCENDENCE OF ALASKA NATIVE ELDERS AGING SUCCESSFULLY IN THE ALEUTIAN AND PRIBILOF ISLANDS
Authors: Lewis Jordan P , Wortman Eric 
Published: November 2019

Abstract
Meeting the healthcare needs of Alaska Native (AN) Elders in remote communities is critical to support successful aging and this study allows AN Elders from the Aleutian region to share their experiences and define successful aging, supporting the limited research on AN successful aging. This study interviewed 19 Elders in two communities from the Aleutian region of Alaska. Using a 20-item questionnaire based on Kleinman’s explanatory model to explore successful aging and experiences of being an Elder. Thematic analysis was employed to identify the characteristics and activities of Elders coping and adapting to aging-related changes. This study identified 5 core elements of successful aging, 4 of which formed Lewis’s AN model of successful aging (2011): Mental and Emotional Wellbeing, Spirituality, Purposefulness, and Physical Health and Mobility, and the new element of Gerotranscendence. The unique finding of this study that expands Lewis’s model is the change in mindset Elders experience as they self-reflect. Elders describe being more intentional in their relationships and a stronger connection to traditional cultural and spiritual activities, described by Tornstam (2005) as gerotranscendence. This research will be used locally to develop community specific health promotion and prevention programs to improve Elder services. These findings can also be used by health care providers to help Elders find meaningful activities that promote health and teach individuals to cope with aging-related changes.
EXPLORING FUNCTION OVER TIME IN OLDER ADULTS WITH ADVANCED HEART FAILURE
Authors: Floegel Theresa , Schoemann Alexander , Taylor Catherine 
Published: November 2019

Abstract
Heart failure contributes to functional limitation in older adults, which is associated with rehospitalization and poorer health. However little is known about the trajectory of function after hospitalization in this population or its’ association with readmission. Objective measurement over time to assess physical function trajectory in older adults with heart failure is needed. Purpose: To explore trajectory of function in older adults with heart failure who have history of hospitalization. Methods: Exploratory longitudinal design. Bi-weekly visits were conducted over 4 months with home-dwelling, ambulatory adults with heart failure (60+ years, NYHA classification III) who had a recent acute hospitalization. Function was assessed by Short Physical Performance Battery (SPPB) test and hand-grip strength (9 time-points). Descriptive analyses across time and groups comparison were performed. Results: Participants (N=10) were 75.3±4.6 years (2 female, 5 African American), with EF(%) 39±10 and 8.2±2.9 comorbidities. Half (n=5) were re-hospitalized during the study period. Those re-hospitalized scored an average 1.3 points lower on SPPB and had 2.03 kg less hand strength over time than those not re-hospitalized. An SPPB score &lt;6 was observed across time in 51% of those re-hospitalized, compared to 31% of those remaining at home. Intra-individual function varied but did not decline over this time period. Conclusions: In a sample of older adults with heart failure, physical function ranged from some level of functional disability to functional dependence, with higher levels of disability observed in those re-hospitalized. A longer study period and larger sample may be needed to adequately assess physical function trajectory.
EFFECTS OF A SITTING REDUCTION INTERVENTION FOR OBESE OLDER ADULTS WITH DEPRESSION
Authors: Hemmady Sarita A , Rosenberg Dori , Hannon Peggy , Zhou Jing 
Published: November 2019

Abstract
Background: Little is known about the impact of sedentary behavior (SB) reduction interventions on older adults with obesity and depressed mood. An exploratory analysis examined behavioral and mental health effects of a SB reduction among participants with depressed moods. Methods: Participants were obese older adults (n=30, mean age=66, 77% female, 23% male, mean PHQ-8-Score=13.67) that were randomized to receive a sitting reduction intervention ( I-STAND); N=16) or a control condition (N=14) as part of a larger trial. Participants wore activPAL devices to assess sitting time at baseline and 12-weeks; they also completed the Patient-Health Questionnaire-8 (PHQ-8) to assess depressive symptoms. Linear regression models compared baseline and 12-week measures between groups adjusting for baseline values. A post-hoc qualitative analysis assessed ISTAND participant interview data. Results: I-STAND participants had greater reductions in sitting time than control participants by 57-minutes (p=0.04), as well as greater reductions in percent sitting time by 5.89-percent (p=0.03). Mean PHQ-8 scores were decreased by 0.14-points among the I-STAND group compared to the control (P=0.90). Qualitative themes included physical and social barriers to standing; varying perceptions of the presence of depression; physical health improvements (i.e. mood improvement) and perceptions of physical activity (i.e. feasibility to exercise). Conclusion: We found significant associations between sitting reduction and a SB intervention among older adults with obesity and depression, however this did not impact depressive symptoms. Further research should examine whether sitting reduction can improve mood or standing time among older adults with obesity and depressed mood.
THE RELATIONSHIP OF DAILY STEPS TO MOOD AND ENERGY: APPLICATION OF STEPMATE (MOBILE APP FOR TRACKING EXERCISE)
Authors: Bisson Alycia N , Sorrentino Victoria A , Lachman Margie E 
Published: November 2019

Abstract
Physical activity is one of the most promising and accessible strategies to promote healthy aging. Yet, the majority of middle-aged and older adults do not engage in the recommended amount of exercise despite awareness of its widespread benefits. Smartphone apps have the potential to be valuable tools in tracking and encouraging physical activity; however, few apps incorporate successful behavior change strategies. Drawing from interviews with older adults, we created a new smartphone app to encourage and track daily walking, StepMATE (Mobile App for Tracking Exercise). StepMATE uses behavior change strategies including action planning and social support to help users determine where, when, and with whom they will walk. The app records steps and also uses experience sampling to assess mood and energy levels twice a day. Adults ages 50 and over (N=58) participated in a one-month study where they used the app to set their own walking goals and track their daily walking. Using multilevel modeling, we found that on days in which adults take more steps than their average, they report higher mood and energy. We also found that on days in which participants achieve their step goal, they report higher mood and energy than on days when they do not achieve their goal. Discussion will center on motivational approaches to behavior change among sedentary older adults.