bluuebunny/crossref_metadata_2025_split huggingface dataset:
COUPLES LIVING WITH ADVANCED CANCER: RAMIFICATIONS OF SOCIAL ISOLATION AND BENEFITS OF AN EMBEDDED SOCIAL NETWORK
Authors: Raveis Victoria H , Pretter Sheindy , Carrero-Tagle Monique , Karus Daniel G , Shah Avani 
Published: November 2019

Abstract
Cancer remains a leading cause of death, especially among older adults. While spouses are commonly involved in the provision of emotional and practical assistance to their ill spouse, their caregiving is not without cost. Although knowledge of an impending death permits preparation for the loss, a long and protracted illness, or one marked by intense caregiving demands, can deplete the well spouse’s personal resources, increasing the risk of morbid bereavement outcomes. Well spouses (n=138), aged 50 and older (mean age 63.6), 41% male, providing 8+ hours of caregiving to a spouse with advanced cancer and a life expectancy of 6 months or less were followed over the terminal illness period. Caregiving spouses’ anticipatory grief, depression and anxiety were all significantly, inversely correlated with sufficiency of social support, specifically tangible, informational and emotional support (p&lt;.05). At 2-3 months post-death (widowed subsample, n=82), the surviving spouses’ grief was inversely correlated with informational support (p&lt;.01) and their social re-engagement post-death was directly correlated with sufficient tangible support (p&lt;.05). Their narrative accounts about the illness and post-death period reveal various demands and negative social encounters they experienced with family members and others during this period, as well as, documenting support received. Spousal death presents a significant adaptive challenge, particularly to older adults who must adjust to the dissolution of longstanding bonds and altered life circumstances. Awareness of these complex relationship issues, i.e. problematic network relationships, will enable clinicians to attend to the needs and preferences of bereaved spouses during this period of heightened vulnerability.
A LIFE MORE ORDINARY: CREATING DEMENTIA-FRIENDLY SPACES THROUGH THE PERFORMATIVE ARTS
Authors: Milligan Christine 
Published: November 2019

Abstract
The concept of dementia friendly communities emerged from the ‘age-friendly’ movement that has been supported by the WHO for some time. This recognizes that like most older people, those with dementia desire to remain in their own homes, and their own communities, for as long as possible. But it also recognizes the significant socio-environmental challenges this can present. Transforming attitudes to dementia, supporting family and friend caregivers, and promoting meaningful participation for all in the community are essential to the success of any such movement. This paper draws on a qualitative evaluation of one such programme that has sought to develop innovative dementia friendly spaces through the arts and arts performance. Focusing on the Dukes Theatre in Lancaster, UK and its partner theatres and cinemas, I discuss how these venues have, over a three year period, developed spaces in which both people with dementia and their family carers can continue to meaningfully participate in ordinary everyday activities that can be crucial to maintaining the sense of belonging and partnership that is often lost as the dementia journey progresses. Whilst efforts to implement change at the city and community level are laudable, I suggest that it is perhaps at the micro-scale of individual places that we are most likely to successfully stimulate change.
HARNESSING THE POWER OF NETWORKS TO ADDRESS SOCIAL ISOLATION, LONELINESS, DEPRESSION, AND ELDER ABUSE
Authors: Abramson Tobi A , Jacquelin Berman , Sirey Jo Anne 
Published: November 2019

Abstract
Challenges to aging and risks to physical health and mortality arise when older adults have untreated mental health needs, experiences social isolation, loneliness, or is a victim of elder abuse. This symposium presents three innovative models that harness the power of networks and collaboration between aging services and an academic medical center to meet the needs of ethnically diverse community seniors. These model programs include: embedded mental health services on-site in community senior centers; Friendly Visiting to homebound seniors; and PROTECT intervention to treat elder abuse victims’ mental health needs. Research from these innovative, collaborative programs indicate that over 50% of senior center members screened positive for depression and anxiety (higher than the national average of 3-20%), social isolation, loneliness, and elder abuse. Of the 75% who engage in treatment, 37.3% and 41% showed a 3-month improvement of depression and anxiety, respectively. For seniors who have a friendly visitor, one-third also suffer from depression and/or anxiety. Three months after being visited by a friendly visitor, 42% and 53% see improvement in loneliness and social isolation, respectively. Among victims of elder mistreatment, 33% screened positive for depression or anxiety and 16% reported suicidal ideation. Clients receiving the PROTECT intervention had a greater decrease in depression, felt services were more useful, and reported greater improvement in the abuse. To find and build strength in age, it is essential that programs and policy be developed to support collaboration and provide the opportunities for building and utilizing networks across different domains of aging.
INTEREST GROUP SESSION—ABUSE, NEGLECT AND EXPLOITATION OF ELDERLY PEOPLE: DAILY REFLECTIONS OF DEMENTIA CAREGIVERS: MICRO-LONGITUDINAL APPROACHES TO UNDERSTANDING ELDER ABUSE AND NEGLECT
Authors: Pickering Carolyn E , Gassoumis Zach 
Published: November 2019

Abstract
Studies with clinic samples have found approximately 50% of family caregivers self-report engaging in abusive and neglectful acts towards the person with dementia whom they assist. Despite this, interventions to reduce and prevent elder abuse and neglect in dementia caregiving are lacking. To develop targeted interventions, the field still has much to learn about what happens during single incidents of elder abuse and neglect including (1) the types of tactics used (2) contextually-based risk/protective factors and (3) circumstances surrounding acts. This symposium will advance discussions on these topics through presentation of pilot data from a micro-longitudinal study on abuse and neglect within dementia family caregiving. Micro-longitudinal methods, such as daily diary studies, rely on intensive longitudinal measures over shorter periods of time. This approach can better ascertain ecologically-valid factors and identify temporal patterning between variables than traditional longitudinal and cross-sectional methods. First, we will provide an overview of the pilot project with family caregivers (N=50) completing diaries for 21 days. The second presenter will discuss data on the co-occurrence of different types of elder abuse and neglect as they manifest in daily lives of family caregivers, and lead discussion on measurement considerations. The next presenter will discuss data on contextually-based risk and protective factors for abuse and neglect that occur during daily caregiving activities. The final presentation will discuss findings on caregivers’ perceptions of the circumstances surrounding abusive and neglectful behaviors. Discussion will focus on how these findings, and methods, can be used to advance intervention development for the field.
RISK AND PROTECTIVE FACTORS FOR ABUSE AND NEGLECT IN DAILY CAREGIVING
Authors: Yefimova Maria , Pickering Carolyn , Maxwell Christopher , Puga Frank , Sullivan Tami 
Published: November 2019

Abstract
The stress-process model suggests a variety of factors related to the stress-experience as important in the formation of outcomes including elder abuse and neglect (EAN). Multi-level modeling with days (n=831) nested within caregivers (N=50) was used to evaluate relationships between theoretically-based risk and protective factors and odds of EAN. Disruptions in the daily routine are a significant risk factor for abuse and neglect. Participating in a meaningful activity at least twice a day with the care recipient is a significant protective factor for neglect (OR=0.19; CI=0.06-0.64; p=0.01), but not abuse. Hypotheses that spending the full day together would increase the risk of EAN, and receipt of instrumental support and caregiver participation in self-care would decrease risk, were not supported. Findings demonstrate that the risk of EAN varies from day-to-day in the presence and absence of contextual factors. Moreover, abuse and neglect may have different etiologic pathways.
TWELVE YEARS OF CHANGES IN STATES’ ASSISTED LIVING REQUIREMENTS FOR DEMENTIA-SPECIFIC STAFF TRAINING
Authors: Carder Paula , Smith Lindsey , Taylor Seamus , Kaskie Brian , Thomas Kali S 
Published: November 2019

Abstract
We describe two categories of dementia-specific AL requirements: staff training and admission/discharge criteria. We reviewed current requirements for all states and the District of Columbia, and amendments made over 12 years. Current and historic regulations were collected and analyzed using policy surveillance and qualitative coding. Twenty-three states currently require dementia-specific training, and 22 require continuing education. Nearly all states (49) require administrators to complete dementia-specific training. Of these, 13 states specified 7 to 120 hours of dementia care training. Some states added pre-admission screening for cognitive impairment; a few require a dementia diagnosis for admission. We describe state variation longitudinally in direct care staff training requirements, including: number of training hours, training content, and use of examinations or other tests of knowledge, skills and abilities. In addition, we categorize changes in admission/discharge criteria over time, including the use of medical versus behavioral health symptoms.
RESULTS FROM A 2019 SURVEY OF STATE AGENTS ON ASSISTED LIVING REGULATIONS AND TRENDS
Authors: Kaskie Brian P , Cornell Portia , Carder Paula , Thomas Kali 
Published: November 2019

Abstract
AL is regulated at the state level. Yet, little is known about the structure and function of state agencies that license and monitor AL. We fielded a 21-question survey among state agents with responsibility for AL in all 50 states. While licensure definitions of AL vary, state efforts appear uniform in regard to administrative alignment with departments of health as well as roles with facility licensing, renewal, and monitoring. However, we observed variability in the approaches used to monitor AL. While 80% of agents reported being able to issue fines for failures to meet regulatory standards, only 40% of states collected information concerning individual resident status. Only 20% issue separate licenses for providing care to persons with dementia, whereas 30% of state agents affirmed that non-licensed AL facilities were operating within their state. We consider how these varied regulatory approaches may shape facility operations and impact resident outcomes.
REFLECTIVE THINKING OF THE CSMP APP CO-DESIGN AND ALPHA-TESTING PROCESS
Authors: Yu Kexin , Wu Shinyi , Liu Mandong , Jiang Haojun , Chi Iris 
Published: November 2019

Abstract
Time and transportation barriers prevented caregivers with busy schedules to attend the CSMP. Developing a CSMP mobile application (app) and testing its feasibility was hypothesized to increase the accessibility of the CSMP to caregivers. Applying a user-participatory approach, seven caregivers who attended the CSMP in-person intervention participated in a 2-hour co-design session. A CSMP app prototype was developed based on the co-design interview results. The same seven caregivers and another five caregivers who were naïve to the CSMP intervention participated in a 2-hour alpha testing interview to provide feedback to the app prototype. Compared to co-design, participants were able to provide more constructive suggestions regarding app design when the app prototype was shown. The user participatory approach is a dialogue between researchers’ knowledge framework and users’ lived experience. Both agreement and disagreement regarding app design were identified, yet how to address the discrepancy has not been discussed in the literature.
INTEREST GROUP SESSION—ECONOMICS OF AGING: EVOLVING CARE SYSTEMS FOR OLDER ADULTS: UTILIZATION IMPACTS OF MEDICARE AND MEDICAID PAYMENT TRENDS
Authors: Bishop Christine E 
Published: November 2019

Abstract
With the promise of better care coordination, better member outcomes, and lower costs, Medicare and state Medicaid programs are implementing population-based payment systems for older adults. Medicare Advantage (MA) plans are responsible for Medicare services for their members, Medicaid managed long-term services and supports (MLTSS) programs cover a broad span of Medicaid benefits, and some state initiatives enroll beneficiaries dually eligible for both Medicaid and Medicare and integrate benefits from the two programs. Simultaneously, Medicaid programs are attempting to shift LTSS utilization away from nursing homes and toward home and community based services (HCBS). The presentations for this symposium address aspects of this changing landscape using Medicare and Medicaid claims and other data and causal econometric models. The first paper considers the effect of MA utilization on SNF staffing, quality, and financial health. The second paper compares medical care utilization outcomes, specifically risk of hospitalization, for Medicaid nursing home residents to outcomes for similar Medicaid members receiving HCBS. The third paper presents an MLTSS initiative in one state in the context of national developments and considers the challenges of evaluating its impact. The fourth paper compares hospitalization rates for MLTSS populations to rates for dually eligible-beneficiaries not enrolled in MLTSS. The discussion will bring findings together to assess early gains and costs as these systems of care evolve.
LONG-TERM EFFECTS OF CHILDHOOD SEXUAL ASSAULT AMONG OLDER PEOPLE WITH HIV
Authors: Brennan-Ing Mark , Seidel Liz , Erenrich Rebecca , Karpiak Stephen E 
Published: November 2019

Abstract
Research finds high rates of childhood sexual assault (CSA) among people with HIV (PWH). CSA is related to depression, post-traumatic stress disorder, substance abuse, and poor health. PWH age 50 and older account for the majority of this population in the U.S., but we have little information on the impact of CSA on these older adults. Data were obtained from the San Francisco arm of the Research on Older Adults with HIV 2.0 study (n=197). Fifty percent reported CSA. Cisgender women and transgender people were more likely to report CSA compared to other groups. PWH reporting CSA were more likely to meet the diagnostic criteria for PTSD (42% vs. 27%), and had higher mean PHQ-9 depression scores (9.3 vs. 6.8). Those reporting CSA had significantly more comorbid health conditions compared to their peers. Implications for using a trauma-informed care model with older adults living with HIV will be discussed.
TRAIT AND STATE SUBJECTIVE AGING INTERACT TO PREDICT DAILY CONTROL BELIEFS
Authors: Zhang Shenghao , Neupert Shevaun D 
Published: November 2019

Abstract
We examine trait and state subjective aging as antecedents of control beliefs in older adults with a daily diary design. Adults (n=116) ranging in age from 60 to 90 (M=64.71) completed a nine-day daily diary study online. Participants reported trait aging attitudes (Attitudes Towards Own Aging; ATOA) on Day 1 and daily Awareness of Age-Related Change (AARC) of loss and gain experiences and control beliefs (Locus of Control and Perceived Competence) on Days 2-9. Controlling for demographics and known antecedents of control beliefs (health, stressors, emotional well-being, and cognition), daily increases in AARC gain were associated with increases in both Locus of Control and Perceived Competence, and a cross-level interaction revealed that Locus of Control decreased for those with more positive ATOA on days when they reported more AARC losses. Discussion will focus on interpreting the interaction between trait and state subjective aging.
MAKING IT WORK: PEAK 2.0 PROGRAM EVALUATION RESEARCH
Authors: Syme Maggie , Doll Gayle , Cornelison Laci , Kaup Migette 
Published: November 2019

Abstract
Research opportunities from our organizational partnerships allow us to pursue answers to questions about PCC outcomes that have largely been out of reach for the field. Our program evaluation research agenda includes groundbreaking, short-term clinical outcomes from older Kansans living in nursing facilities implementing increasingly levels of PCC, including a 49% lower prevalence of depression for residents in strong PCC adopting homes (Hermer et al., 2017; Hermer et al., 2018). Yet there have been several challenges to achieving these goals that are atypical to the common academic research process. This presentation will further highlight the clinical outcomes association with PEAK 2.0, our continued research partnership with the state, and highlight some of the unique opportunities and challenges large-scale research with a state organization presents.
LONG-DISTANCE CAREGIVING: MENTAL HEALTH CONSEQUENCES AND USE OF RESOURCES
Authors: Cimarolli Verena R , Horowitz Amy , Pruchno Rachel 
Published: November 2019

Abstract
Long-distance caregiving (LDC) is a growing phenomenon and common experience for caregivers of frail older adults. In fact, 11% of family caregivers in the US live more than two hours distance from the care recipient (CR). Unfortunately, there is a paucity of research on unique experiences of LDCs and the impact of LDC on the mental health of LDCs. This symposium presents findings from the NIA funded Fordham Long-Distance Caregiving Study (R21AG050018) analyzing data of 304 long-distance caregivers (LDCs). The overall study goal was to better understand how LDCs deal with the structural constraint of distance, and to examine LDC consequences and resources. First, Horowitz presents the study background, characteristics of the sample, and provides a description of the unique experiences of LDCs. Next, Cimarolli concentrates on the Sociocultural Stress Process Model applied to LDC. Her study tested the impact of LDC on mental health and investigated resources (e.g., coping skills) which could mediate the association between caregiving stressors and mental health outcomes. The third paper (Falzarano) presents data related to satisfaction with formal service providers for four subgroups of LDCs based on CR residence and dementia status. Finally, Jimenez focuses on the characteristics of LDCs’ network of other informal caregivers (IC) providing assistance to the CR and factors are associated with more help received from other ICs. Dr. Pruchno, an expert in caregiving research, will discuss study findings. The symposium provides insights into unique experiences of LDCs, the impact of LDC on mental health, and resource use among LDCs.
BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA: DOES GENDER MATTER?
Authors: Galik Elizabeth , Boltz Marie , Resnick Barbara , Kolanowski Ann , Haitsma Kimberly Van 
Published: November 2019

Abstract
Regardless of presenting symptoms, there are concerns that BPSD is more often identified in males versus females and males are more likely to be treated with pharmacologic and non-pharmacologic interventions than females. In part this is due to the behaviors in men, specifically aggression, being more distressing for staff and more difficult to manage. The purpose of this study was to test for gender differences in identification and management of BPSD. This was a secondary data analysis using data from the EIT-4-BPSD study including 357 residents, 114 males and 243 females. Men had more aggressive behavior (p=.03) and women more refusal of care (p=.05) and repetitive verbal behavior (p=.03). Men received more mood stabilizers (p=.02) than women. Ongoing research is needed to evaluate if aggression in females may not be recognized or treated as aggressive women are less distressing for staff than these same behaviors in males.
PRESIDENTIAL SYMPOSIUM: MULTIDISCIPLINARY EMERGING PERSPECTIVES ON BUILDING AND MAINTAINING NETWORKS IN AGING.
Authors: Petrovsky Darina V , Justice Jamie N 
Published: November 2019

Abstract
This ESPO Presidential Symposium features a multidisciplinary perspective and recent scientific advances made by early career researchers from each of the GSA scientific sections. They will provide examples of how their work is addressing ways to build and maintain networks in aging and gerontological workforce. These talks will span research on the age-associated transcriptional networks (Biological Sciences, Kulkarni), enhancing care for persons with dementia using a professional healthcare network (Health Sciences, Kovaleva), ways to maintain care networks in nursing home residents (Behavioral and Social Sciences, Kennedy), exploring the impact of social isolation in older adults on the Autism Spectrum (Social Research, Policy, and Practice, Waldron) and reflections on a project that linked aging education and student involvement within the aging network at the state level (Academy for Gerontology in Higher Education, Stephenson). These talks will demonstrate the diversity of aims, strategies, methodologies, and tools employed across disciplines. In addition, these early career researchers will share how they use networks in their own disciplines to advance their science with the goal of building an independent program of research. We will conclude with a discussion on ways to identify synergies across different fields and promote strategies for successful cross-discipline collaboration.
AGING ON THE AUTISM SPECTRUM: AN EXPLORATION OF SOCIAL NETWORKS AND IMPLICATIONS
Authors: Waldron Danielle , Coyle Caitlin , Kramer John 
Published: November 2019

Abstract
Social isolation is associated with poor health and well-being in older adults. Little is known about isolation in persons aging on the Autism Spectrum (AS), a group with varied physical and mental health comorbidities. The purpose of this study was to explore social networks of adults aging on the AS. We conducted in-depth interviews (N=30) with adults on the AS (age 50+) and analyzed findings using a constant comparative method. Findings suggest that older adults on the AS struggle to build and maintain social networks over the life course, in large part, because of challenges with communication and trust. Implications of isolation include challenges with community supports and employment. We propose several social convoy models and intervention mechanisms to support this population--as their social networks narrow over time, and they face aging-related challenges without the buffer of strong social relations.