bluuebunny/crossref_metadata_2025_split huggingface dataset:
TEACHING SEX AND AGING TO PRE-PROFESSIONALS: EXPERIENTIAL LEARNING OF A TABOO TOPIC
Authors: Naar Jill Juris , Weaver Raven H , Sonnier-Netto Libbie 
Published: November 2019

Abstract
Myths and stereotypes of sex in late life prevail (e.g., sex becomes unimportant or irrelevant; sex gets worse as individuals age; older adults are asexual). Unless the workforce is adequately prepared and knowledgeable to address the sexual health needs of older adults, it is difficult to disrupt ageism that contribute to discrimination against older adults. Methods: We evaluated a two-day experiential workshop designed for students to develop factual community resources and educational materials related to sex and aging. Results: Using content analysis, we examined open-ended responses from 41 students. We identified three themes that depicted the value of experiential learning, specifically for this taboo topic. Students (1) increased awareness of late life sexual health and behaviors, (2) demonstrated comfort and creative strategies to discuss sex, and (3) appreciated the opportunity for transferable pre-professional skill development. Discussion: Providing pre-professional training helped close the knowledge gap about basic gerontological issues and issues specific to sexual health and sexual behaviors in late life. Students perceived the flipped classroom and collaborative structure of this experiential workshop as beneficial and practical for their learning and professional preparation. They developed skills for translating knowledge into practical resources that likely will transcend professions. Emphasizing the potentially uncomfortable topic of sex and aging provided students an opportunity to increase their comfort when addressing issues they will experience in their various professions. It is critical for gerontology educators to identify strategies to deliver sex and aging education among professionals to enhance interactions with older adults.
2019 GSA FELLOWS SYMPOSIUM: STRENGTH IN AGE: HARNESSING THE POWER OF NETWORKS
Authors: Martin Peter 
Published: November 2019

Abstract
The 2019 GSA Fellows Symposium includes GSA members who were recently granted GSA Fellow status. They represent each of the GSA sections: Biological Sciences (BS), Health Sciences (HS), Behavioral & Social Sciences (BSS), Social Research, Policy & Practice (SRPP), and the Academy for Gerontology in Higher Education (AGHE). The theme of the 2019 GSA Fellows Symposium is focusing on the power of networks and will highlight the importance of neuroendocrine networks (Christian Sell), the role of social support for refugees in Canada (Esme Fuller-Thomson), the importance of professional partnerships to promote health (Heather Young), aging-friendly communities (Emily Greenfield), and the role of networks in teaching gerontology (Tina Kruger). The importance of networks across disciplinary boundaries will be discussed.
CONTEXTS SURROUNDING PSYCHOLOGICAL MISTREATMENT AND NEGLECT BY CAREGIVERS TO PEOPLE WITH DEMENTIA
Authors: Meyer Kylie , Lee Kyungmi , Yefimova Maria , Pickering Carolyn 
Published: November 2019

Abstract
This presentation examines the individual experiences of caregivers using psychological mistreatment and neglect. When a caregiver indicated psychological mistreatment (e.g., yelling) or neglect (e.g., skipping necessary care) occurred on their daily diary, they were asked what they were doing and how they felt when the event occurred. Text responses were analyzed using content analysis. When psychological mistreatment occurred, there was often a triggering event. For example, 43.8% of caregivers reported they were responding to a behavioral symptom, and 28% indicated something inconvenient occurred. Caregivers were mostly frustrated/angry (68.8%) and annoyed (21.9%) when they used psychological mistreatment. When the caregiver neglected the recipient, 43.5% of caregivers reported the recipient refused to receive care and 30% reported prioritizing other care activities. In cases of neglect, caregivers were frustrated/angry (39.1%) and worried/anxious (30.4%). Findings indicate psychological mistreatment and neglect occur in unique contexts; prevention of these behaviors likely will require distinct intervention strategies.
INTEREST GROUP SESSION—ASSISTED LIVING: DEMENTIA IN ASSISTED LIVING: STATE VARIABILITY IN REGULATIONS, OVERSIGHT, AND RESIDENT OUTCOMES
Authors: Thomas Kali S , Schwartz Lindsay 
Published: November 2019

Abstract
Approximately one million individuals, an estimated 40% with a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care provided in AL. Unlike other forms of long-term care (LTC), the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their regulatory approaches. The overall objective of this symposium is to examine states’ AL regulatory environments and understand if and how the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. Presenters will highlight the state variability in the regulation, oversight, resident composition, and outcomes of AL residents with ADRD. The first presentation will describe states’ different regulatory requirements for staffing and admission/discharge criteria as it relates to residents with ADRD and how those have changed over the last decade. The second presentation will report results from a national survey of state agents regarding their oversight and enforcement activities in AL. The third presentation will characterize differences in the resident composition and healthcare utilization among residents with ADRD across states. The fourth presenter will report on the effect of residing in an AL licensed to provide specialized dementia care versus a standard-licensed AL on ADRD residents’ outcomes. The discussant will contextualize findings as they relate to the current state of the AL industry. Results will ultimately inform policy-makers, organizational leaders, and clinicians as they seek the most effective ways to ensure optimal outcomes vulnerable residents with ADRD.
DOES MEMORY CARE MATTER? EXAMINING THE EFFECT OF DEMENTIA-LICENSED CARE ON RESIDENTS’ OUTCOMES
Authors: Cornell Portia Y , Rahman Momotazur , Zhang Wenhan , Thomas Kali 
Published: November 2019

Abstract
The objective of this study is to estimate the effect of receiving care in a dementia-care licensed (DCL) assisted living community, versus a standard AL, on outcomes of residents with ADRD. In four states that issue a license for specialized dementia care (AL, CO, MS, and NY), we identify a cohort of 5,720 Medicare fee-for-services beneficiaries with ADRD who moved to an AL in 2014. To control for unobserved factors that contribute to a patient’s selection of AL type, we use the difference in the log-distances from an individual’s home address to the nearest DCL and standard AL as an instrumental variable. We will report the effect of residence in a DCL AL on mortality, inpatient hospital days, emergency department utilization, and hospice use, showing how the use the distance instrument offers differing estimates from unadjusted or multiple-regression methods.
STATE VARIABILITY IN HEALTHCARE UTILIZATION AMONG ASSISTED LIVING RESIDENTS WITH DEMENTIA
Authors: Thomas Kali S , Cornell Portia , Zhang Wenhan , Rahman Momotazur , Dosa David , Kaskie Brian , Carder Paula 
Published: November 2019

Abstract
The objectives of this study are to describe the state variability in the prevalence of ADRD among AL residents and in this group’s healthcare utilization. Using 2014 Medicare enrollment data, Medicare claims, and the Minimum Data Set for a sample of 493,867 Medicare fee-for-service beneficiaries in AL (178,787 with ADRD), we present their rates of hospital and emergency department (ED) use, by state, adjusting for age, sex, race, and dual-eligibility status. States varied in their unadjusted percent of residents with ADRD from 25% in MN to 48% in WV. In 2014, 40% of AL residents with an ADRD diagnosis were hospitalized during the year, ranging from 30% in UT to 47% in FL. Forty-two percent of residents with ADRD used an ED in 2014, ranging from 36% in MD to 56% in NC. The potential influence of state regulations, enforcement, and market factors will be discussed.
INTEREST GROUP SESSION—CHINESE GERONTOLOGY STUDIES: DEVELOPING A BODY-MIND-SPIRIT CAREGIVER SELF-MANAGEMENT PROGRAM AND A MOBILE APPLICATION FOR CHINESE AMERICANS
Authors: Chi Iris , Boot Walter 
Published: November 2019

Abstract
Caregivers of older adults are at risk for poor physical and mental health outcomes. Chinese American caregivers, especially those who are recent immigrants, are at risks for developing health symptoms while less likely to seek outside help and utilize caregiver resources due to cultural barriers, low health literacy, and limited-English proficiency. This symposium will introduce the Caregiver Self-Management Program (CSMP), a training program based on the Body-Mind-Spirit model to equip Chinese immigrant caregivers with self-care knowledge, skills, and self-efficacy. We designed the in-person training to be four 3-hour sessions and pilot tested it among 11 Chinese caregivers. The training was well-received by participants; however, the caregivers’ duties and their working status, compounded with transportation barriers, leave them little time to participate in the intervention. To address these challenges, we further employed a user participatory approach to design, prototype, and pilot-test a CSMP mobile application (app) to meet the needs of Chinese immigrant caregivers. App functions included interactive multi-media lessons and practice, scheduling of coaching sessions for problem solving, extended readings, community resources, etc. We co-designed the app with seven caregiver co-designers, alpha-tested the app prototype with 12 caregivers, and beta-tested the app in real-life settings with 20 caregivers. Four presentations in the symposium will discuss the CSMP in-person training design and evaluation, influence of Chinese culture on caregiving and impacts of CSMP, user-participatory approach used in co-design and alpha-testing of the app prototype, and preliminary results from the beta-testing to assess external user acceptance and feasibility of the CSMP app.
A BODY-MIND-SPIRIT CAREGIVER SELF-MANAGEMENT PROGRAM FOR CHINESE AMERICANS: PROGRAM DESIGN
Authors: Liu Mandong , Wu Jinli , Zhang Geng , Chi Iris 
Published: November 2019

Abstract
The aging society presents a growing demand for formal and informal caregivers. Literature review reveals that cultural practices and immigration challenges compound the caregiving burden in Chinese American caregivers. The team designed a culturally sensitive and linguistically appropriate training program targeting the overall well-being of Chinese caregivers. The intervention pivots on the Body-Mind-Sprit model, a health model rooted in Chinese traditional philosophies and integrating three components into an inseparable unity. We designed the in-person training to be four 3-hour sessions and incorporated modalities, which include mini lectures, skill training, discussion, exercise videos, homework activities, and a website. We pilot tested the intervention among 11 Chinese caregivers, followed by two focus group discussions and formative evaluation. Participants provided positive feedback in program evaluation survey, while analysis of focus group revealed three major topics: program benefits, barriers to receiving training and applying its content, and suggestions.
BETA-TESTING OF A CSMP APP: AN ASSESSMENT OF USABILITY, UTILITIES, AND CHALLENGES
Authors: Wu Shinyi , Yu Kexin , Liu Mandong , Jiang Haojun , Chi Iris 
Published: November 2019

Abstract
A beta-version of a CSMP app was designed to empower Chinese caregivers with the knowledge, skills, and self-efficacy needed for holistic health self-care at the convenience of using their mobile phone. The key app functions included interactive multi-media lessons and practice, scheduling of coaching sessions for problem solving, and extended readings. Four groups of 5 caregivers (totaling 20) sequentially participated in one-hour lab and one-week in-home testing of the app to identify usability, utilities and challenges of using the app. They also were invited to join a social media group chat to enable peer-to-peer communication for support and sharing. Using post-lab interviews and exit survey, the beta-testing allowed the research team to assess external user acceptance and feasibility of using the CSMP app in real-world settings, and helped the team explore the perceived training requirements, values, challenges, and improvement priorities to materialize learning CSMP curriculum in a mobile environment.
MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS: POLICY INNOVATION AND EVIDENCE GENERATION
Authors: Degenholtz Howard 
Published: November 2019

Abstract
Twenty-two states have turned to managed care organizations to finance and deliver long-term services and supports (LTSS) as a way to control costs, improve quality and shift the locus of care away from institutional settings. These programs, referred to as Managed Long-Term Services and Supports (MLTSS) have been undertaken under several CMS authorities, and vary in terms of the program design and populations covered. Some programs such as the financial alignment demonstration, have integrated Medicaid and Medicare financing, while others have used waiver authority and three-party agreements to achieve coordination. However, all efforts share the same goal of improving the linkage between LTSS and both physical and behavioral health care. This presentation will provide conceptual framework for understanding and assessing program impact using the example of the multi-method evaluation of the $4 billion Pennsylvania Community HealthChoices program, one of the largest transitions in Medicaid policy to date.
INTEREST GROUP SESSION—HIV, AIDS AND OLDER ADULTS: HIV AND AGING: IMPROVING BIOPSYCHOSOCIAL HEALTH AND FUNCTIONAL WELLNESS
Authors: Brown Monique J , Perkins Molly M 
Published: November 2019

Abstract
People living with HIV/AIDS (PLWH) are living longer due to the success of antiretroviral therapy. In 2016, approximately 50% of PLWH in the U.S. were age 50 and older and 17% of new infections were among this age group. One key factor that contributes to the HIV prevalence and incidence among older adults is the lack of sexual health discussion during healthcare visits. Among older (50+) PLWH, most are exhibiting signs of accelerated aging and declines in functional (physical, cognitive and psychosocial) wellness and little is known about the lasting impact of childhood sexual abuse (CSA). In this symposium, we present new research assessing the biopsychosocial challenges faced by older PLWH and older adults at risk for HIV. Dr. Robinson will present findings on the frequency, content and barriers and facilitators in provider communication with older patients on sexual health and HIV. Dr. Brennan-Ing will examine the association between CSA and psychosocial health among older PLWH. Dr. Schrack will assess the impact of energy utilization on physical activity and function among older HIV+ and HIV- men. Dr. Taylor will assess predictors of physical, cognitive and psychosocial wellness among older men with and without HIV. Dr. Sekhar will present findings from a trial on the impact of glycine and N-acetylcysteine supplementation on accelerated aging among older PLWH. Dr. Perkins, will discuss the public health implications of the presented research for HIV prevention and wellness interventions among older adults, and suggest future areas of inquiry to improve clinical outcomes for this population.
EXPLORING SEXUAL HEALTH AND HIV COMMUNICATION BETWEEN HEALTHCARE PROVIDERS AND OLDER PATIENTS
Authors: Robinson Erin L , Washington Karla , Park Geuhye , Conner Laneshia , Lusby Tara 
Published: November 2019

Abstract
While HIV and aging is a complex issue, healthcare providers can play a vital role in education and screening among older patients. Therefore, this study aimed to better understand the frequency, content, and barriers/facilitators of provider communication with older patients around sexual health and HIV. One-on-one interviews were conducted with healthcare providers (N=18) and analyzed using Nvivo12. Providers reported that approximately 1-30% of their older patients show risk factors for STI’s. The majority of providers tailor their communication to older patients regarding sex/HIV, however they were divided in who initiates such conversations (themselves or the patient). Providers stated that standardized/routine health assessments help facilitate those conversations. Results indicate several barriers to conversations, such as age/gender differentials and time. Additional results will be discussed. Study findings can help guide provider education and screening of older adults regarding sexual health/HIV.
FUNCTIONAL WELLNESS AND OLDER MEN WITH HIV
Authors: Taylor Tonya N , Weedon Jeremy , Silk Tarik 
Published: November 2019

Abstract
Aging-related stressors, such as changing physical function, poorly managed multimorbidity, increasing pill burden and social losses can diminish for some older adults with HIV the capacity for self-care. These challenges, however, can be improved by maintaining physical, cognitive and social function, or functional wellness. Using cross-sectional data from a men’s health study with younger and older men with and without HIV, we conducted general linear models to identify individual and clinical predictors for physical, cognitive, social and role function, as measured by the Medical Outcomes Study HIV Health Survey. We found that older HIV+ men had lower burdens of functional deficits compared to older HIV- men and younger HIV+ men and that across all models, depression, followed by diabetes, housing, and employment were predictive of functional wellness. Functional wellness for older HIV+ men is a multidimensional construct that includes optimizing internal and external resources to maintain healthy living and wellness.
HOME IS WHERE THE HEART IS: OPTIMIZING AND TAILORING HOME AND COMMUNITY-BASED SUPPORT FOR DEMENTIA CAREGIVERS
Authors: Samus Quincy M , Hodgson Nancy , Gaugler Joseph E 
Published: November 2019

Abstract
Family caregivers, often “de facto” members of the care team for persons with dementia, play a central role in ensuring safety, support, quality of life, and continuity of care. Most often, they provide this care for loved ones at home and over a long period of time, as the illness progresses and care need intensifies. This session will provide a unique understanding of potential ways to optimize support for family caregivers in provision of day-to-day care in the home by examining often-overlooked factors influential in the health and wellbeing for both caregiver and persons with dementia. Presentations will draw from three large community-based trials testing interventions to support dementia caregivers. Drs. Samus and Sloan will present on common unmet needs identified by family caregivers and explore how needs differ by disease stage and race. Dr. Fortinsky will present baseline caregiver care-related challenges in a diverse cohort of caregivers and the effects of a caregiver intervention designed to mitigate these challenges. Dr. Hodgson will present the common symptoms clusters among home-dwelling persons with dementia patients and how these are associated with caregiver distress. Dr. Jutkowitz will discuss factors influencing dementia caregiver’s willingness to pay for help at home. Findings from this session will help elucidate care needs that matter most to family caregivers in diverse community-living cohorts and how we might optimize and tailor supportive home-based interventions to target these needs and challenges.
COMMON UNMET NEEDS OF DEMENTIA CAREGIVERS AND HOW THESE DIFFER BY DISEASE STAGE AND RACE
Authors: Samus Quincy M , Sloan Danetta , Leoutsakos Jeannie-Marie , Black Betty , Johnston Deirdre 
Published: November 2019

Abstract
This presentation (co-presentation Samus and Sloan) will use combined cross-sectional, baseline data from two intervention studies (n=-642) conducted in Maryland evaluating the impact of dementia care coordination model (MIND at home) to provide a detailed description of common modifiable unmet care needs of family caregivers of community-living persons with dementia (PWD), explore how care needs may differ by the disease stage of the PWD, and presence of racial disparities in care needs. Unmet caregiver needs were identified based on comprehensive in-home assessments using a standardized tool (JHDCNA 2.0) with 6 care domains and 18 items covering caregiver needs. Family caregivers were 77% women; 63 years old (mean); 60% White; and 52% adult children. The most prevalent needs were for education/resources (98%), legal (74%), mental health (44%), and informal support (43%). Needs varied based on dementia severity. African American caregivers (vs. white) had significantly more unmet caregiver needs at baseline (p&lt;.001).
EFFECTS OF AN ART GALLERY INTERVENTION IN PEOPLE LIVING WITH DEMENTIA: A PILOT STUDY
Authors: D'Cunha Nathan M , McKune Andrew J , Isbel Stephen , Georgousopoulou Ekavi N , Kellett Jane , Naumovski Nenad 
Published: November 2019

Abstract
Art gallery programs tailored to the needs of people living with dementia are becoming more popular worldwide. This study aimed to observe the effects of six consecutive weekly discussion-based small group visits to the National Gallery of Australia Art and Dementia program on the salivary cortisol (SC) diurnal rhythm, salivary interleukin-6, quality of life (QoL), depressive symptoms, and cognitive function. Twenty-five participants (17 female; mean age 84.6 ± 7.27 years) completed the study with data collection at baseline, post-intervention, and at a six-week follow-up. Statistical methods were selected based on data distribution. The waking to evening (WE) SC ratio was altered (p = 0.016) (Baseline: 1.35 (1.19, 1.64), Post-intervention: 1.72 (1.54, 1.96), Follow-up: 1.44 (1.22, 1.79)) in the 22 participants who provided viable saliva samples. The WE SC ratio was higher post-intervention compared with baseline (p = 0.011), indicating a more dynamic SC rhythm, but returned to baseline levels at follow-up (p = 0.020). Interleukin-6 levels were unchanged (p = 0.664). In the total sample, no improvements in QoL (Proxy) (p = 0.165) were observed. However, self-reported depressive symptoms differed (p = 0.006), decreasing post-intervention (2.00 (1.00, 2.00)) compared with baseline (3.00 (2.00, 4.50)) (p = 0.015), and verbal fluency was affected (p = 0.027), improving from baseline (2.00 (0.00, 3.00)) to post-intervention (2.00 (0.50, 4.00)) (p = 0.027). Art and Dementia programs appear to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a longer controlled trial inclusive of physiological outcomes.
APPLICATIONS OF QUALITATIVE RESEARCH IN DESCRIBING PCC ENVIRONMENTS: THE STORY BEHIND THE STATISTIC
Authors: Kaup Migette , Poey Judith , Doll Gayle , Cornelison Laci 
Published: November 2019

Abstract
The goal of PCC is to enhance quality and bring meaning to the lived experience in long-term care. This requires attention to patterns of life, and the creation of residential experiences within the environment. Ten case studies of homes participating in a pay-for-performance PCC program in the Midwest reveals how environmental affordances may be critical in the implementation and sustainability of PCC. Data collected through an in-depth environmental assessment revealed multiple strategies and attributes related to organizational, operational, and environmental practices. This presentation will demonstrate a diagrammatic and empirical comparison of the environments of those early in the process and those who have fully implemented and sustained PCC practices. Specific features will be highlighted and patterns discussed.