bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Professionals' Knowledge of how to Report a Missing Person With Dementia: A National Survey
Authors: MacAndrew Margaret , Beattie Elizabeth , Taylor Dubhglas , Whitehead Jim , Quinn John 
Published: December 2020

Abstract
In Australia one in five land searches conducted by Police involve a person with dementia. Over a third of these people go missing from a health care service and 15% are not found alive. Delays in commencing a specialised search for the missing person with dementia contributes to the risk of death. Delays in Police searching may result from ambiguity in current policies about how to report a missing patient/client. This study aimed to explore health professional’s knowledge about how to report a missing person with dementia and reasons for delayed reports to Police. 246 Australian health professionals completed an online survey. Most were registered nurses (n=124), allied health professionals (n=69) and medical practitioners (n=22) who worked in a range of settings including acute care (n=111), community care (n=59) and residential aged care (n=44). Over a third (n=81) did not know their care service policy for reporting a missing patient/client and did not know if their health service had a policy specific to reporting a missing person with dementia. 20% did not know how long they needed to wait before reporting a missing person to Police and fear of calling Police too soon or wasting their time were common reasons for delaying a report. These findings confirm a degree of misunderstanding about current policy and procedures for reporting a missing person with dementia. Addressing knowledge deficits and standardising approaches to reporting a missing person with dementia in Australia would be recommended as a step toward improving their health outcomes.
A Qualitative Analysis of the Relationship Between Older Adults’ Daily Lives and Life Outlook
Authors: Bouklas Isabella , Pasquini Giancarlo , Gilbert Renee , Bergeman Cindy , Scott Stacey 
Published: December 2020

Abstract
Leading theories of adult development suggest age-related changes in one’s life perspective and changes in one’s priorities are reflected in daily behavior. The present study explored how older adults understand their current lives through a qualitative study of midwestern Americans. Twenty-four participants (Mage= 69.53 years; age range=63-78 years) from the Notre Dame Study of Health & Well-Being (Whitehead & Bergeman, 2014) completed semi-structured interviews in which they were asked about turning points across their lives. Inductive analysis using the constant comparative method (Maykut & Morehouse, 1994) resulted in 10 life-domains based on common descriptions across participants. These domains represented the ways in which participants understood their identities over the course of their lives, as well as their organization and use of time and space in daily life. Participants’ descriptions of both general life outlook and daily life informed one another, revealing the dialectical relationship between micro-level behaviors and macro-level attitudes.
The Dynamics of Control: Investigating the Effect of Control Diversity on Subjective Well-Being in Later Life
Authors: Mann Ajit , Nakamura Jeanne 
Published: December 2020

Abstract
Recent advancements in research on control beliefs have enabled the assessment of inter-individual differences in its intra-individual variability via a measure of control diversity. However, past research has focused on control diversity in relation to daily stressors. Among a sample of prosocial exemplars, this experience sampling study investigates control diversity across general daily activities and explores its relationship with subjective well-being. Participants indicated the activity they were primarily involved in, the extent to which they felt in control over the situation, and levels of positive and negative affect each time they were signaled; satisfaction with life was measured using a one-time survey at the end of the study. Results from multilevel structural equation modeling suggested that control diversity did not significantly predict positive or negative affect, or satisfaction with life. The study points toward the lack of association between control diversity and subjective well-being and highlights future directions for research.
Adult Day Services as a Platform for Innovation: Moving Beyond Simply Attendance
Authors: Anderson Keith 
Published: December 2020

Abstract
At the most basic level, adult day services (ADS) provide a congregate environment for participants and respite for caregivers. Researchers often evaluate the impact of ADS on participants and caregivers in terms of attendance; however, what happens in ADS (e.g., specific programs and interventions) may be equally or even more important than simply attendance. In this presentation, we review four recent innovative studies conducted in the ADS setting with participants: (a) a board game intervention to improve cognitive functioning; (b) a cognitive behavioral intervention to improve sleep; (c) an aromatherapy intervention to address behavioral issues; and (d) a dance and movement intervention to stimulate physical activity. While these interventions had varying levels of effectiveness, they do support a growing body of evidence that ADS can serve as a platform for innovation and suggest that attendance may be simply one facet of the overall ADS experience.
Life Employment Histories in Middle Age and Their Association With Health Outcomes in Later Life: A Sequence Analysis
Authors: Shin Oejin , Kim BoRin , Park Sojung , Kang JiYoung , Kwon Ilan , Ahn Seoyeon 
Published: December 2020

Abstract
Despite consistent evidence on the negative effect of precarious employment on health, little is known about the dynamic pattern of employment over the life course on later year health. Using the longitudinal data (1-18 waves) from the Korean Labor & Income Panel Study (KLIPS) (n=1,705), this study aimed to (1) identify long term change patterns of employment in two middle-age groups (early middle-aged: 40-49 / late middle-aged: 50-59), (2) examine the association between the patterns and self-rated health in old age. We apply sequence analysis with 18 years of working status and conducted regression health outcomes in the 18th wave. The result of sequence analysis found the differential employment patterns: among the early middle-aged, five patterns were identified consistently full-time, consistently not- working, transit to self-employed, mixed pattern, retired. Among the late middle-aged, five patterns were identified: consistently full time, mixed pattern, consistently retired, transit to not- working, consistently not working. Regression results indicated a negative association between precarious employment history and health in later years: Among the early middle-aged, members in the “consistently full-time” were likely to have better health compared to “transit to self-employed”. Among the later middle-aged, “retired” and “transit to not –working” were likely to have better health compared to “mixed pattern group”. The findings suggest the importance of employment history in middle age to predict the health outcome in later life. Policies to support experiencing precarious or self-employment are needed to prevent health disparity in later life.
Optimizing Physical Activity and Decreasing Care-Resistant Behaviors Among Nursing Home Residents With Dementia
Authors: Galik Elizabeth , Resnick Barbara , Vigne Erin , Holmes Sarah 
Published: December 2020

Abstract
The purpose of this study was to test the effectiveness of the Function and Behavior Focused Care (FBFC) intervention on function, physical activity and behavioral symptoms among nursing home residents with dementia. This study was a clustered, randomized controlled trial with a repeated measures design in 12 nursing homes. The participants (N=336) were 82.6 (SD=10.1) years of age, mostly female and were moderate to severely cognitively impaired (MMSE of 7.8, SD=5.1). There were a statistically significant improvements in time spent in light, moderate and overall physical activity based on actigraphy and a decrease in resistiveness to care at 4 months among participants in the treatment group. There was no change in mood, agitation, and the use of psychotropic medications. This study provides some support for the use of the FBFC intervention to increase time spent in physical activity and decrease resistive behaviors during care among nursing home residents with dementia. Part of a symposium sponsored by Nursing Care of Older Adults Interest Group.
Peers in Primary Care: How Peer Specialists Support Aging Veterans
Authors: Peeples Amanda , Muralidharan Anjana , Kuykendall Lorrianne , Goldberg Richard , Chinman Matthew 
Published: December 2020

Abstract
Most of the more than 1,100 peer specialists (“peers”) in the Veterans Health Administration (VHA) work in mental healthcare settings. These peers provide a variety of services to Veterans such as facilitating groups, teaching recovery and coping skills, connecting Veterans with VHA and community services, and helping Veterans navigate VHA care. In 2014 the White House issued an Executive Action mandating the reassignment of peers from mental health to primary care settings in 25 VHA locations nationwide. This paper presents qualitative findings from a mixed-methods study evaluating this implementation of peers in VHA primary care. We found that peers assisted aging Veterans in primary care through activities such as providing health coaching, facilitating health education groups, connecting Veterans with services, and providing general peer support. Findings are drawn from semi-structured interviews with 27 peers, 25 supervisors, and 10 Veterans who received services from the peers in primary care.
Older Peer-Delivered and Smartphone-Supported Integrated Medical and Psychiatric Self-Management Intervention
Authors: Fortuna Karen 
Published: December 2020

Abstract
PeerTECH is older peer-delivered and technology-support integrated medical and psychiatric self-management intervention developed by older adult peer support specialists. Older adult peer support specialists are older adults with a lived experience of a mental health condition, who are trained and accredited to provide support services to others with similar conditions. A pre/post trial by our group has shown PeerTECH is associated with statistically significant improvements in self-efficacy for managing chronic disease and psychiatric self-management skills. This presentation will discuss the feasibility and potential effectiveness of a 3-month pre/post study with older adults with SMI. We will discuss the potential effectiveness of PeerTECH with older adults with SMI related to loneliness, distress, and medical and psychiatric self-management. in conclusion, we will discuss the main and interactive effects of loneliness and factors linked to mortality.
Trends in the Receipt of Consistent Hospice Professional Visits at the End of Life and Ratings of Hospice Care Quality
Authors: Christian Thomas , Teno Joan , Cobb Kyle , Galantowicz Sara , Levitt Alan , Massuda Cindy 
Published: December 2020

Abstract
Caregivers have identified consistent visits by professional hospice staff at the end of life as positively affecting experiences of care quality. Little is known about the prevalence of such visits. Using 100% Medicare hospice claims with discharge dates in Federal Fiscal Year 2018, we identified the rates of providing skilled nurse or social worker visits to hospice beneficiaries in at least two of the last three days of life and compared these rates to percentages of caregivers indicating they would “definitely” recommend the hospice and caregivers rating the hospice a 9 or 10 on a 10-scale from CAHPS Hospice scores. Among our analytic cohort of 762,238 hospice discharges, 509,585 individuals (66.9%) were visited by a nurse or social worker in at least two of the last three days of life. Beneficiaries lacking these visits were more likely to be black (black 39.6% vs. white 32.2%; AOR 1.32 95% CI 1.29-1.34) or resided in a nursing facility (nursing facility 37.7% vs. patient’s home 32.1%, AOR 1.39 95% CI 1.36-1.40). The mean hospice-level score for achieving these visits was 64.8% (median 70.2%; IQF 53.0%-80.9%). The Pearson’s correlation coefficients between hospice-level rates of visits at the end of life and the caregiver percentages for “definitely” recommending the hospice was 0.2418 and for rating the hospice a 9 or 10 on a 10-scale was 0.2587. These findings demonstrate significant variability across hospice providers and signal a positive correlation with caregivers’ quality ratings. Future work is needed to monitor the provision of these visits.
What Is Important at the End of Life? Perspectives From Experienced Home Care Workers
Authors: Tsui Emma , Franzosa Emily , Boerner Kathrin 
Published: December 2020

Abstract
Home care workers (HCWs) make up a large and rapidly growing sector of the American health care workforce serving older adults. This study focuses on a common but understudied feature of home care labor: workers’ thoughts around what makes a "good" or "bad" patient death. While researchers have investigated patients’, families’, physicians’, and other care providers’ perspectives on this issue, the perspectives of HCWs, who contribute substantially to home-based care at the end of life, have yet to be explored. We conducted 40 in-depth interviews with HCWs in New York City on their experiences with and reflections on patient death. We used a inductive, iterative approach to analyze data on what HCWs believe is important for dying patients. HCWs described EOL values that align well with the views held in common by patients, families, and other care providers, like the importance of not being alone when dying and being physically comfortable (not in pain and not suffering). In particular, HCWs conceptualized a detailed role for themselves when providing EOL care near the time of death. HCWs’ sustained presence and relationships with patients may uniquely position them to assist in the attainment of patients’ EOL goals, particularly when HCWs understand what these goals are. HCWs’ potential for playing this role, however, is jeopardized by a lack of training in EOL care and by the limited information they receive about a patient’s health status.
An Exploration of Learning Results and Curricula Gaps Within an Online Grandfamilies Certificate Program
Authors: Crittenden Jennifer 
Published: December 2020

Abstract
Professionals who work with grandparents raising grandchildren have cross-cutting training needs that span content in gerontology, social services, child welfare and program development. To address these needs, a unique, asynchronous, online continuing education program was launched by the UMaine Center on Aging. To-date the program has 177 individual program completers with learners from across the U.S. and Hong Kong that are affiliated with a diverse set of organizations and perform a wide range of professional and lay functions. Participant data indicate that the program has appealed to a wide variety of learners including participants who serve caregivers generally (60.8%) and grandparents raising grandchildren specifically (81%). A small majority (55.6%) of the agency-based learners reported serving, on average, more than 40 grandfamilies annually. Self-reported learning levels were notable ranging from a mean low of 3.46 out of 4 points (N = 157, SD = 0.59) for the volunteer recruitment and mentorship programming module to a mean high of 3.79 (N = 167 ,SD = 0.45) for the caregiver self-care module. Evaluation results from the first seven learner cohorts underscore the efficacy of program content as well as the utility of performing an initial program needs assessment to guide curriculum development. Practice implications for future continuing education efforts targeting grandfamilies professionals and lay leaders include: the need for easily accessible online education in combination with supplemental training opportunities addressing topics such as the long-term impact of substance use disorder and trauma combined with locally relevant content on grandfamilies and legal resources.
Barriers and Challenges Faced by Social Workers Caring for Dementia Patients in Acute Care Settings
Authors: Dunkle Ruth , Cavagnini Katherine , Cho Joonyoung , Sutherland Laura , Kales Helen , Connell Cathleen , Leggett Amanda 
Published: December 2020

Abstract
The nature of dementia care provided by social workers across various hospital settings is unexplored. This study utilized the “rigorous and accelerated data reduction” (RADaR) qualitative analysis technique to explore the process of care among social workers for persons with dementia (PWDs) across a Midwestern tertiary care system with two aims: 1) to identify environmental barriers and supports to quality dementia care in two hospital settings (medical and psychiatric emergency departments (ED), and the main inpatient hospital (IP)), and 2) to identify existing strengths and challenges to high quality social work dementia care within these settings. Twelve qualitative interviews were conducted with a purposive, snowball sample of social workers in dementia care in a large, academic health care system in 2016. Results identify environmental barriers in both settings (physical space design, patient-environment interactions, safety, and discharge disposition). Environmental aspects that promote quality care include supportive staff and family in the patient environment in the IP and ED hospital sections while the discharge disposition is more relevant in the IP. While there are some areas of social work involvement (discharge, psycho-social needs, treatment/management issues) that promote quality of care across locales, the pattern of performing roles varied, e.g. there is more focus on discharge planning and less management of competing demands in the IP than in the ED. Also, social workers were more involved in the diagnosis of dementia in the ED than other settings. We offer policy and practice recommendations to improve care for PWDs in academic hospital settings.
Leveraging Novel Label Design to Improve Older Consumers' Use of Medications
Authors: Harben Alyssa , Nathan Andrew , Anderson Kaitlin , Kashy Deborah , Bix Laura , Becker Mark 
Published: December 2020

Abstract
Over-the-counter (OTC) medication is a convenient, affordable way for older adults to treat a variety of conditions; older consumers use more OTCs per capita than other people for varied reasons. As with any medication, OTCs carry risks. Because the labels of OTCs are frequently the only information accessed by consumers, labels designed to communicate safety information are paramount for these products. Yet, available studies suggest that consumers do not regularly access the comprehensive information in the Drug Facts Label (DFL) when making purchase or use decisions, tending to rely on information found on the front of the package. Herein, we evaluate how four OTC label formats (standard; standard/highlight; critical warnings on front/highlighted; critical warnings on front not highlighted) affect how aging participants attend to critical information. Sixty-eight participants (65+) engaged a computer-based task answering yes/no questions that required use of labeling information about the warnings or active ingredients (AI). Results indicate that AI information is found accurately and relatively quickly compared to warning information and highlighting and placement on the front of the package had little effect. By contrast, warning information was found slowly and with low accuracy with the standard label, and highlighting and front of pack placement both significantly improved performance. These results suggest that novel labelling strategies could result in more effective, safer use of OTC medicines among older consumers and provide insights that could be used by regulators as they work to improve policy focused on improving mandates for OTC labeling.
Effects of Nurse Staffing, Work Environment, Education on Adverse Events in Nursing Homes
Authors: Choi Seonhwa , Cho Eunhee , Kim Eunkyo , Lee Kyoungeun , Chang Soo Jung 
Published: December 2020

Abstract
This study examined the effect of registered nurse (RN) staffing level, work environment, and education on adverse events experienced by residents in nursing homes. A cross-sectional study was conducted with 216 RNs working in nursing homes who were selected using random stratified sampling by location and bed size. Self-reported questionnaires regarding staffing level, work environment, education level, adverse events, and nurse characteristics were administered. Data from the National Health Insurance Service were used to describe nursing home characteristics. Both multiple and multinomial logistic regressions were used to control for the characteristics of nurses and nursing homes, and investigate the effects of nursing staffing level (number of older adults assigned to a nurse), work environment (Practice Environment Scale of the Nursing Working Index), and level of nursing education on the adverse events experienced by residents. An increase of one resident per RN was significantly associated with a higher incidence of pressure ulcers (OR= 1.019, 95% CI=1.004-1.035). Poor work environment increased the incidence of adverse events such as pressure ulcers (OR= 3.732, 95% CI=1.155-12.056) and sepsis (OR=3.871, 95%CI=1.086-13.800). Compared to RNs with a baccalaureate or higher, RNs with diplomas reported increased incidence rates of pressure ulcers (OR=2.772, 95%CI= 1.173-6.549). RN staffing, work environment, and education level affect the incidence of pressure ulcers, and the work environment affects the incidence of sepsis among residents in nursing homes. Policy-wise, improving the level of nurse staffing, nursing work environment, and nursing education will improve health outcomes of residents.
Stakeholder Perspectives on Reducing Hospitalizations Among Nursing Home Residents
Authors: Tyler Denise , Kordomenos Cleanthe , Ingber Melvin 
Published: December 2020

Abstract
Organizations in seven states have been participating in the Center for Medicare and Medicaid Innovation (CMMI) initiative aimed at reducing potentially avoidable hospitalizations among long-stay nursing home (NH) residents. The purpose of this study was to identify market and policy factors that may have affected the initiative in those states. Forty-seven interviews were conducted with key stakeholders in the seven states (e.g., representatives from state departments of health, state Medicaid offices, and nursing, hospital and nursing home associations) and qualitatively analyzed to identify themes across states. Few policies or programs were found that may have affected the initiative; only New York (NY) was found to have state policies or programs specifically aimed at reducing hospitalizations. Market pressures reported in most states were similar. For example, stakeholders reported that the increased availability of home and community-based services and the growing presence of managed care are contributing to higher acuity among both long and short stay residents and that reimbursement rates and staffing have not kept up. Stakeholders suggested greater presence of physicians and nurse practitioners in NHs, better training around behavioral health issues for frontline staff, and more advance care planning and education of families about end of life may help further reduce NH hospitalizations. We also found that all states, except NY, had regional coalitions of health care related organizations focused on improving some aspect of care, such as reducing hospital readmissions. These coalitions may suggest ways that organizations can work together to reduce hospitalizations among NH residents.