bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helping Caregivers to be Ready, Willing, Able, and Healthy
Authors: Golden Robyn , Rompala Vikki , Carbonell Ellen 
Published: December 2020

Abstract
Given extended life expectancy, family caregivers are needed to provide care for older adults at home. Research has documented the deleterious effects of caregiving on mental and physical health for many. The Caregiver Health and Well-Being Initiative is a systems approach to support family caregivers of older adults by standardizing processes for identifying caregivers in ambulatory and inpatient settings, assessing caregivers’ needs, and providing relevant services and resources, including caregiver health services, a Teach Back clinic for skills development, and extended goals of care conversations. N=104 caregivers have completed assessments. Participants reported the following at baseline: depressive symptoms (54%); anxiety symptoms (69%); health being affected by the care situation (59%); financial situation decreasing (58%); feeling torn between demands of their family and demands of care (63%); and some feelings of burden from caregiving (97%). Intervention components will be discussed along with a larger systems change framework for implementation.
Older African Immigrants’ Experiences of Discrimination in the United States
Authors: Nkimbeng Manka , Taylor Janiece , Roberts Laken , Winch Peter , Commodore-Mensah Yvonne , Thorpe Roland , Han Hae-Ra , Szanton Sarah 
Published: December 2020

Abstract
Discrimination is implicated in the disproportionate burden of disease and health disparities in racial/ethnic minorities. This qualitative descriptive study explored the experiences of discrimination and its impact on the health of older African immigrants. Semi-structured interviews were conducted with 15 participants. Three main themes and six sub-themes were identified. These included: 1) types of discrimination: a) accent-based, b) unfair treatment during routine activities, c) experience with police and other systems; 2) costs of discrimination; 3) surviving and thriving with discrimination: a) “blind eye to it”, b) reacting to it, c) avoiding it. These themes describe common forms of discrimination that these older adults have experienced, current strategies used to deal with discrimination, and the impact of discrimination on the wellbeing of this sample. To improve the emotional and mental health of older African immigrants, providers serving them should assess for perceived discrimination, and refer participants with any concerns for treatment.
Homeownership Among Older Adults: Source of Stability or Stress?
Authors: Molinsky Jennifer , Herbert Christopher 
Published: December 2020

Abstract
For older adults, homeownership can be an important source of housing stability and personal wealth that can be tapped in later life, including for long-term care. Nonetheless, owning a home is not without physical and financial challenges for aging households, and many owners are reluctant to take advantage of housing equity later in life. This paper reviews the conditions of older homeowners to assess the degree to which owning a home is—or is not—associated with financial security and housing stability. We review trends in homeowning among older adults, including differences by race/ethnicity and income. We then describe the extent of housing affordability challenges among homeowners, the degree of mortgage indebtedness, and the extent and use of housing equity. Finally, we examine issues related to housing quality and accessibility. The paper concludes with a discussion of policy implications.
Older Persons’ Use of Social Media for Communication During Hurricane Matthew
Authors: Gibson Allison , Kusmaul Nancy , Engelhardt Ethan 
Published: December 2020

Abstract
Older persons are frequently identified as more vulnerable during natural disasters due to age-related changes and chronic conditions. Over the last decade, the use of social media has grown, even among the older adult population. While many communities and organizations have utilized social media as a platform to communicate news and information about natural disasters among the public, little is known regarding how older adults utilize social media to plan, evacuate, and recovery from natural disaster events. This study examined the experiences of 23 older adults (n=23) use of social media following Hurricane Matthew. Individuals were able to speak about what they perceived as helpful in the information communicated, and recommendations they had for how such communications could be improved. The presentation will conclude with recommendations on how individuals helping with evacuation and recovery can utilize social media as a communication resource for older adults during disasters. Part of a symposium sponsored by Disasters and Older Adults Interest Group.
Elder Abuse Multidisciplinary Teams: Describing and Classifying a Key Collaborative Resource for APS Workers
Authors: Gassoumis Zachary , Galdamez Gerson , Rowan Julia , Wilber Kathleen 
Published: December 2020

Abstract
Elder abuse multidisciplinary teams (MDTs) are a key resource when APS workers address their most complex cases. MDTs promote coordination and information sharing, and provide access to highly specialized input and problem-solving from legal, health, social service, and financial fields. This paper characterizes the range of elder abuse MDTs across the U.S. We identified 324 MDTs in the U.S., which most frequently addressed cases of financial exploitation (90.8%), physical abuse (83.6%) and neglect (81.6%). Based on a follow-up survey, latent class analysis was used to determine closeness of a subset (n=91) to the elder abuse forensic center model, which has received much evaluation and policy attention. Twenty-six showed strong similarity to forensic centers, with 24 others showing partial similarity. Coupled with observations from site visits to 4 teams, findings can guide the development and evaluation of elder abuse MDTs to foster better interdisciplinary collaboration for APS workers. Part of a symposium sponsored by Abuse, Neglect and Exploitation of Elderly People Interest Group.
Lessons Learned in Research to Address Wicked Problems Facing the Care of Older Adults Across the Care Continuum
Authors: Dobbs Debra , Zimmerman Sheryl 
Published: December 2020

Abstract
A wicked problem, by definition, has innumerable causes, is tough to describe, and doesn’t necessarily have a right answer. This describes today’s health care for older adults across the long-term care continuum. Our interdisciplinary group has almost as many years (n=70) of experience as GSA conducting research in community-based groups across the continuum of care from skilled nursing facilities, assisted living communities, adult day care, to independent living. In this symposium we will discuss lessons learned in recruitment, intervention delivery, and unexpected outcomes. Peterson will discuss lessons learned in using large data sets to derive actionable information on staff license mix and SNF complaints. Dobbs will discuss the utility of using hospice nurses to train ALC nurses in delivering palliative care. Lee will discuss lessons in engaging direct care workers in their need for sleep. Meng will discuss learning to embrace an unexpected finding that friendships developed in a dementia family caregiver music and mindfulness intervention were as meaningful as positive health outcomes. Buck will discuss lessons learned in recruiting a hidden group – informal caregivers with complicated grief. Finally, Zimmerman, as expert long-term services and support discussant, will pull the pieces together across the studies to facilitate discussion. Enrich your future research related to addressing wicked problems in health care for older adults by learning from our experiences.
Brief Mindfulness Intervention for Family Caregivers of Persons With Dementia: A Pilot Study
Authors: Meng Hongdao , Dobbs Debra , Peterson Lindsay , Risal Punam , Veal Britney , Monaco William 
Published: December 2020

Abstract
Family caregivers (FCGs) play a crucial role in helping persons with dementia age-in-place. This pilot study is designed to test a group-based mindfulness intervention for FCGs to reduce stress and enhance wellbeing. We recruited two groups of FCGs (n=7), one from an assisted living community and another from an adult day service center. We used a mixed-methods pre-post study design. Quantitative outcome measures included stress, sleep quality, and quality of life. We conducted focus group interviews to gain an in-depth understanding of the intervention acceptability. Participants reported that they benefited from participating in the intervention sessions, and were more aware of their reactions to stressors. FCGs indicated that the mindfulness practice assignments were acceptable and feasible. An unexpected finding was that the majority of the participants intended to continue with informal meetings after the pilot study. Implications of the intervention benefits for FCGs in the community will be discussed.
Older Adult Fatality Reviews: A Powerful Tool to Improve Policies, Protections, and Services
Authors: Wilson Janet , Jackson Kimethria 
Published: December 2020

Abstract
Older adult maltreatment is a serious problem that can hasten mortality and cause fatality. Child and Domestic Violence Fatality Review teams have made a major impact to improve protections, services, and system responses for victims. There are over 1300 child fatality review teams in 50 US states and 200 domestic violence fatality teams in 45 states. Older adult fatality reviews, in contrast, have not proliferated across the country, missing opportunities to bring interdisciplinary expertise together to resolve policy, protection, and services needed to prevent older adult premature deaths due to violence and abuse. Method: A mini mock review of a fatality of an older adult woman will demonstrate the possibilities of beginning Older Adult Fatality Review Board as recommended by the American Bar Association. Conclusion: Interdisciplinary older adult fatality review teams have been an underutilized tool to make changes in older adult mistreatment protection services and systems.
Abuse of Vulnerable Older Adults by Designated Surrogate Decision Makers
Authors: Bolkan Cory , Teaster Pamela , Ramsey-Klawsnik Holly , Gerow Kenneth 
Published: December 2020

Abstract
Abuse perpetrated by designated surrogates has become highly visible nationally, yet no reliable data exist on its nature or extent. Because vulnerable older adults needing surrogate decision makers typically rely upon others for care, they may be unable to advocate for themselves and are susceptible to abuse. We prospectively gathered Adult Protective Services (APS) data from six geographically diverse counties on over 400 substantiated cases of abuse by perpetrators (53% non-surrogates; 47% documented or claimed surrogate) of vulnerable adults 65+ living in community settings. Most perpetrators (85%) were designated power of attorney, while approximately 8% were guardians, and 7% were representative payees; most perpetrators were family members. Polyabuse occurred frequently. Almost 25% of cases involved a prior substantiated APS report. This presentation highlights how surrogates perpetuate abuse and outcomes on older adult victims. Our findings inform practice and policy for better prevention, detection, investigation, and intervention in these challenging cases.
Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care
Authors: Young Yuchi , Chen Ye-Mei , Chung Kuo-Piao , Schumacher Patrick , Chen Hsiu-Hsi , Yeh Yen-Po 
Published: December 2020

Abstract
The concept of person-centered health care (PCHC) shifts from the individual’s diagnosis to the holistic health and individual social needs. PCHC is defined by WHO as “empowering people to take charge of their own health rather than being passive recipients of services.” This care strategy is based on the belief that if an individual is an equal partner in care planning and care decision making process, and that his/her view, input, and experiences can help improve overall health outcomes. PCHC requires a reconfiguration of the health care system. A vertical or/and horizontal integration of a variety of healthcare settings is necessary. A proposed 5-year PCHC pilot study in Taiwan’s Changhua county aims to reduce unnecessary hospitalizations by 15% in 4 years. Year one will focus on alignment of health care providers, baseline data collection, and assessment plans development. PCHC intervention will start in years two to five. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.
Promoting Aging in Place in Social Housing
Authors: Sheppard Christine , Perry Tam , Austen Andrea , Hitzig Sander 
Published: December 2020

Abstract
As cities around the globe plan for current and future older cohorts, there is a need to explore innovative housing models to help older adults age in place. This paper presents findings from an action-research academic/community partnership on a new service model at Toronto Community Housing, the second largest social housing landlord in North America and home to 27,000 older adults. As Toronto works to improve delivery of housing/support services, more knowledge was needed to understand the inadequate and inconsistent delivery of services to tenants. Interviews/focus groups with older tenants and service providers (N=116) identified challenges related to unit condition (e.g., pest control) and tenancy management (e.g., arrears), and that the fragmentation of housing and health services negatively impacts older tenants’ abilities to access supports and age in place. The presentation will conclude with discussion of planning and policy decision making approaches relevant to both Canadian and American contexts.
Integration and Implementation Challenges of State-Based Long-Term Services and Supports Financing Programs
Authors: Tell Eiileen , Cohen Marc , Veghte Ben , Bradley Alexandra 
Published: December 2020

Abstract
Several states are in the process of developing or implementing programs that use a social insurance approach to financing long-term services and supports (LTSS). The National Academy of Social Insurance developed a roadmap that highlights key design parameters for states to consider in crafting a program. It also outlines a range of vetted approaches states could adopt, and describes the building blocks and tradeoffs associated with a range of options. States that establish a new LTSS program will need to make decisions about the integration of the program with other payers and benefit programs as well as address concrete implementation challenges. This presentation summarizes these issues including coordination of benefits with other payers, Federal Medicaid funding issues, integration of LTSS and medical care, and challenges around program startup, administration and monitoring as well as evaluation and modification. Addressing such issues is critical to the success of these type of programs.
The 2019 National Nursing Home Social Services Directors Study
Authors: Bern-Klug Mercedes , Bonifas Robin 
Published: December 2020

Abstract
Psychosocial and emotional needs of nursing home (NH) residents can take the back seat to physical needs in NHs that do not employ staff with the appropriate educational and experience level to anticipate, identify and address these important issues. When present, professional licensed social workers can enhance the NH’s ability to address psychosocial issues. However, federal guidelines do not require licensed social workers in NHs, nor does it collect data that would reveal the extent to which licensed social workers are present. With financial support from the RRF Foundation for Aging the NNHSSD Study was undertaken in 2019 to build understanding of departmental staffing characteristics and involvement of the department in key activities and processes. The 924 respondents from around the country also answered questions about training needs, barriers to addressing resident needs, compensation, and job satisfaction. Findings reveal that about half of the nation’s NH social services directors have earned a bachelors or master’s degree in social work, and about half are licensed (although not all degreed social workers are licensed and not all licensed social workers have earned a social work degree). Half of all social services departments employ only one staff member, one-third have two staff members, and 9% have three staff. About 90% report enjoying their job, with over half reporting they are thriving (not just surviving) in their job. Respondents provided feedback that can be used to strengthen the role of the department and its ability to identity and address resident psychosocial needs.
The Experience of Working Family Caregivers: Implications for a National Paid Leave Policy
Authors: Washington Tiffany , Feinberg Lynn Friss 
Published: December 2020

Abstract
Family caregivers provide the bulk of unpaid care to older adults. The typical family caregiver is a 49-year-old woman who works full time and simultaneously provides an average of 24 hours of care per week for an older relative. Unfortunately, their caregiving duties places them at risk for lost wages and termination due to frequent interruptions at work, especially in the absence of a national paid family leave policy. It is possible that such a policy could mitigate these risks; however, the United States is the only developed nation that lacks a national paid family leave policy for all workers. This symposium will highlight the psychosocial, economic, and health issues experienced by working caregivers, and conclude by linking presenters’ findings to implications for a national paid leave policy. To start, presenter one will describe findings from a scoping review on workplace experiences of female family caregivers. Next, presenter two will describe findings from a systematic review to explore predictors of the adoption and implementation of state-level paid family leave policies. Presenter three’s study examines interest in supportive services among working and non-working Black caregivers in the Deep South. Presenter four will describe factors associated with healthcare utilization of working caregivers using data from the Regional Healthcare Partnership – Region 17 Health Assessment Survey. The final presenter, HHS Advisory Council to Support Grandparents Raising Grandchildren co-chair, will describe development of policy initiatives to identify, coordinate, and promote information, resources, and best practices for working grandparents raising grandchildren.
Beyond FMLA: Making the Case for State-Level Paid Family Leave, the Path to Policy Adoption
Authors: Stephenson Eugenie 
Published: December 2020

Abstract
The Family Medical Leave Act (FMLA) was established in 1993, and while limited in scope, it is the only national policy in place to support individuals that need to take time away from work to care for a sick family member. Paid Family Leave, a state-level mechanism of FMLA, creates a safety net to support these workers. Despite its potential impact, such programs currently exist in only 6 states and the District of Columbia. Further, even within these states, individuals are often unaware of the policy's existence. A systematic review of peer reviewed literature from 1994-2019 explores the predictors of the adoption and implementation of state-level Paid Family Leave and public awareness of Paid Family Leave programs in these states. This presentation will explore these findings and their implications on future state level adoption, implementation and awareness of Paid Family Leave.
Reframing Aging: A Generation's Work
Authors: D'Antonio Patricia 
Published: December 2020

Abstract
The Reframing Aging initiative, led by GSA on behalf of the Leaders of Aging Organizations, is a long-term, grant-funded social change endeavor designed to improve – or “reframe” the public's understanding of what aging means and the many contributions older people bring to society. Using evidence-based research, the initiative seeks to teach advocates how to tell an effective story about aging that will promote positive perceptions of aging and reduce ageism. This session will explore GSA's efforts to address ageism through Reframing Aging and the policy implications of this important initiative and will include lessons learned from experts who are utilizing reframing aging in their teaching and practice.
Negotiating the Gerontological Uncanny and Passing Tactics for Aging in Place
Authors: Yeh Jarmin , Fox Pat , Vlahov David , Pinderhughes Howard 
Published: December 2020

Abstract
Insisting people are equally worthy of aging in place is a radical but challenging idea. Scenes of homelessness texture the contemporary city, manifesting broader issues of inequality. This qualitative study explored material with twenty-two housed and unhoused San Franciscans born in 1950 or earlier, who participated in semi-structured in-depth interviews and chronicled their everyday lives using disposable cameras. Theoretical work on social and spatial practices was drawn upon to help understand their aging in place experiences. In interpreting themes, informants elucidated a moving tension between the daily interiority of identity and the negotiation of a changing environment that produces a sensation characterized as the uncanny. The vicissitudes of life and precariousness of their positionalities exposed tactics for “passing” as creative forms of resistance to their expulsion from society. Utilizing visual methods helped reveal assumptions and contributed to gerontological discourse and critical theorizations about aging in place inequalities. Part of a symposium sponsored by the Qualitative Research Interest Group.
Vulnerable Older Adults in Disasters: Effects of Hurricane Irma on Nursing Homes and Assisted Living
Authors: Peterson Lindsay , Dosa David , D’Antonio Patricia 
Published: December 2020

Abstract
Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders from small and large ALCs concerning the hurricane experiences of residents, including those with dementia. This symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.