bluuebunny/crossref_metadata_2025_split huggingface dataset:
IS SOCIAL ENGAGEMENT RELATED TO FEWER HOSPITALIZATIONS IN COMMUNITY-DWELLING OLDER ADULTS?
Authors: James Bryan D , Shah Raj C , Lamar Melissa , Barnes Lisa L , Wilson Robert S , Bennett David A , Schneider Julie A 
Published: November 2019

Abstract
We tested the hypothesis that more socially engaged older adults experience fewer hospitalizations. Data came from 1,153 older adults (72.4% female, mean age 80.8, 14.6 years education at baseline), enrolled in the Rush Memory and Aging Project, with survey data linked to Medicare claims records (mean 5.0 [SD=3.1] years of Medicare coverage after study baseline). Linear regression models were fit with annual rate of hospitalization as outcome with terms for age, sex, and education. Engaging in more social activities (est=-0.16, SE=0.05, p=0.002) and larger life space (est=-0.08, SE=0.03, p=0.005) were associated with a lower rate of hospitalization, while a higher level of loneliness (est=0.18, SE=0.06, p=0.002) was associated with greater rate of hospitalization; size of social networks (est=-0.01, SE=0.01, p=0.069) was not associated with hospitalization. When examined separately by admission type, the same significant associations were found for nonelective (emergency and urgent) hospitalizations, but not for elective hospitalizations. After further adjusting for marital status, baseline levels of depressive symptoms, chronic medical conditions, physical activity, and ADL disabilities, only social activities were significantly related to hospitalization rate (total and nonelective). Adjusting for disability attenuated these associations the most, indicating that functional status may confound the relationship between social engagement and hospitalization. More research is necessary to determine if social engagement in older age can proactively help to keep older adults out of the hospital, or alternatively whether level of social engagement is a marker for functional status or other health factor that is directly related to risk of hospitalization.
STAKEHOLDER PERSPECTIVES ON DESIGN, IMPLEMENTATION, AND SUSTAINMENT OF SERVICES FOR OLDER VETERANS
Authors: Solimeo Samantha , Hicken Bret 
Published: November 2019

Abstract
A majority of United States Veterans are older adults, compelling healthcare systems such as Veterans Health Administration to attend to their unique needs when designing and implementing programs for workforce development and service delivery. In this symposium authors will present findings from four studies examining how older Veterans’ needs and preferences affect implementation and sustainment in a variety of settings. Presenters demonstrate how: 1) understanding Veterans’ perspectives and preferences for measuring functional status may inform the improvement of care coordination in the primary care setting; 2) the role of population characteristics in implementation of geriatric patient centered medical home teams (i.e., GeriPACTs); 3) the interaction of patient, provider, and delivery system information needs in limiting sustainment of diverse initiatives to improve osteoporosis screening and management for Veterans; and 4) the factors affecting transferability and sustainment of rural and geriatrics-focused quality improvement initiatives beyond local settings. Beyond their focus on how older adults’ needs are reflected or shape implementation, the studies illustrate the application of qualitative data to clinical practice and workforce development.
PERSONAL NARRATIVES OF AGING
Authors: Taylor Louise , Bailey Jan , Kingston Paul , Eost-Telling Charlotte 
Published: November 2019

Abstract
This presentation reflects on self-written narratives from respondents to a mass observation directive, focusing on the experiences of growing older. Narrative methods are theoretically and methodologically diverse, and are helpful in social research to understand events or happenings in human lives. This data presents accounts from a heterogeneous sample in the form of self-penned responses. These experience-centred narratives bring stories of personal understanding into being by means of the first person description of past, present, future or imaginary experiences. This presentation will focus on the findings with reference to physical and mental impacts, both real and anticipated. We will also explore themes arising from the data including gender differences, age-cohort effects and stigma. The data can be used to inform Health and Social Care education and practice, particularly in co-producing appropriate person-centred services with older people.
POLICY SERIES: ELDER ABUSE AND THE OPIOID EPIDEMIC IN RURAL AMERICA
Authors: Lindberg Brian W , Blancato Robert 
Published: November 2019

Abstract
Misuse of opioids is a national crisis affecting the social and economic welfare of communities throughout the U.S. and is particularly rampant in rural America. Older adults are far too frequently excluded from consideration of those who are affected by the opioid epidemic. While rural older adults may not suffer the highest per capita rate of opioid overdose deaths, they are deeply affected by the problem. In their youth and middle adulthood, many older adults used their bodies for labor. At older ages, they experience multiple chronic conditions and high rates of chronic pain for which opioids and related prescription and non-prescription drugs are often the treatment of choice. Also and far too frequently, older people become easy targets for abuse by persons needing resources to feed their addiction. This symposium focuses on elder abuse associated with opioid and related substance misuse. Zanjani’s presentation provides the context of rurality and drugs and alcohol as a precursor to elder abuse. The second paper by Teaster and colleagues examines trends in APS cases of elder abuse in which the perpetrator is a substance user and identifies perpetrator and victim characteristics predictive of different types of substantiated abuse. Using APS case notes, Roberto and colleagues characterize cases of elder abuse in rural Kentucky in which the perpetrator used opioids and related substances. Robert Blancato and Brian Lindberg will discuss presenters’ collective findings by weaving together concepts of rurality, addiction, and elder abuse and recommending strategies for prevention, intervention, and policy.
ELDER ABUSE AND THE OPIOID CRISIS: PERPETRATORS WHO ARE SUBSTANCE USERS
Authors: Roberto Karen A , Teaster Pamela B 
Published: November 2019

Abstract
Substance abuse, particularly the diversion/abuse of prescription drugs along with illicit opioid deviates by alleged perpetrators has been identified as is a risk factor for elder abuse. The purpose of this study was to characterize cases of elder abuse substantiated by APS in which the perpetrator used opioids and related substances. Guided by the Contextual Theory of Elder Abuse, we conducted a within-case/across-cases thematic analysis of Kentucky APS caseworkers’ notes on 40 substantiated cases of elder abuse. Financial exploitation was the most commonly identified type of abused associated with perpetrators who abuse opioids. Findings revealed that most cases of elder abuse occurred when the perpetrators’ substance abuse intersected with employment status, complex family relationships, and a history of altercations with the law. Findings provide new insights into a more elaborate conception of the ways in which the opioid epidemic is contributing to the perpetration of elder abuse today.
HOW CAN IMPROVING EMPLOYMENT PROSPECTS OF UNEMPLOYED OLDER WORKERS BE EXPLAINED?
Authors: Jensen Per H 
Published: November 2019

Abstract
Until recently employment prospects of older workers have been rather poor. In recent years, however, the duration of unemployment among older workers has diminished, meaning that older workers are more frequently hired by employers. Changing employment prospects of older workers are no doubt framed by a decrease in overall unemployment. The aim of this paper, however, is to shed light on the emergence of new inclusive mechanisms by answering three interrelated research questions: (1) where are the job openings for unemployed seniors? (2) How have unemployed seniors been recruited? (3) Why do companies hire older workers. Using Denmark as a test case findings show that job openings are rather frequent in branches with tight labor markets and that characteristics of companies and management are important; for instance, the older the average age of management the higher the inclination to hire unemployed older workers. Findings furthermore show that mouth-to-mouth recommendation and the internet are the most used recruitment channels, while the public employment service is less used. Finally, findings show that qualification, stability and experience are the most reported reasons as to why employers hire unemployed older workers are. The paper is based on a survey with 2,525 valid respondents, response rate: 25.
INTERSECTIONAL DIFFERENCES IN HEALTHY AGING WITH HIV
Authors: Taylor Tonya N 
Published: November 2019

Abstract
Intersecting stigmatized social identities (i.e., old, Black, gay, HIV+) and structural forms of privilege and oppression (ageism, racism, homophobia, and HIV stigma) can contribute to poor psychological wellbeing and clinical outcomes among older men with HIV (OMH). Using data from 6 focus groups and 15 interviews with 45 gay, bisexual and heterosexual OMH in Brooklyn, NY and inductive thematic analysis methods, we explored the impact of heteronormative gender roles and ideologies associated with masculinity on healthy aging with HIV. We found that changing physical and sexual function, appearance and growing financial expectations created threats to masculinity, fueling fears of perceived weakness, internalized feelings of shame, depression, anticipated loss of social status (partner loss), and loss of independence and autonomy. These findings suggest that normative gender beliefs, a key social determinant of men’s health, aging and intersectional stigma combined undermine psychosocial support and wellbeing and self-care needed to achieve healthy aging.
FEASIBILITY OF SCREENING AND MANAGING CAREGIVER BURDEN AND DEPRESSIVE SYMPTOMS DURING PATIENTS’ CLINIC VISITS
Authors: Trivedi Ranak , Risbud Rashmi , Patel Manali , Asch Steven , Lorenz Karl 
Published: November 2019

Abstract
Half of cancer caregivers experience depression, caregiver burden, or stress, yet less than a third have discussed their needs with anyone. Identifying this vulnerable population is challenging since caregivers only interact with the healthcare system in service of the patients. Our objectives were: 1) To test the feasibility of screening cancer caregivers for burden and depressive symptoms during patients’ clinic visits; and 2) To test the feasibility of a brief counseling session for caregivers who screened positive for either. Caregivers of patients with head and neck cancers were recruited from cancer clinic waiting rooms at Palo Alto VA and Stanford. Caregivers completed the PHQ-9 (depressive symptoms), and Zarit Burden Inventory-Short Form (caregiver burden). Participants screening positive for burden (&gt;16) and/or depressive symptoms (&gt;9) were provided psychoeducational resources and the choice to attend 1 brief counseling session with a clinical psychologist. Of the 50 participants who completed the surveys, 36 (72%) were women and 30 (60%) were significant others. Mean scores for depressive symptoms and caregiver burden were 6.29±5.01 and 11.02±8.62, respectively. Twenty participants screened positive for depressive symptoms (n=9) or caregiver burden (n=11); 3 screened positive for both. Of those who screened positive, only 4 indicated an interest in counseling. Main reason for refusal was lack of time, or that they were already receiving mental health care. Screening caregivers at patient visits is feasible and convenient. However, connecting those in need to mental health resources may be more challenging.
STORIES OF TRAUMA AND RECONCILIATION OF WORLD WAR II VETERANS
Authors: Ulatowska Hanna K , Santos Tricia , Walsh Diane , Lagus Jilliane , Pruett Mitchell , Aguilar Sara 
Published: November 2019

Abstract
The present qualitative study examined the reconciliation of trauma experienced by 55 World War II veterans (22 aeronautical crew members, 27 non-pilot combatants, and 6 veterans with dementia) demonstrated via testimonial language within a semi-structured interview. The research team considered themes of language coherence as they relate to veteran experiences of trauma and reconciliation. Trauma literature documents the importance of personal narratives in both identifying and reconciling traumatic experiences. This study examined morals and values of participants, traumatic experiences either lived or witnessed, and reconciliation of trauma as demonstrated by the coherence of participants’ linguistic and paralinguistic communication. Linguistic analysis included the use of evaluative and emotional language; linguistic devices such as crowding, topic maintenance, and humor; and lessons learned from trauma and the reconciliation process. Prosody was analyzed as a paralinguistic indicator of trauma and reconciliation using audio recordings of semi-structured interviews. The primary findings revealed that highly coherent language is present among participants with distinct content when comparing episodes from youth and reflections of experience in old age. The unique differences demonstrated overall strength of veterans’ narrative identity throughout their lives. Strength of identity and coherence of language indicated adequate reconciliation of traumatic events. Reconciliation of trauma was also evident in veterans’ participation in the study and generative behavior described in testimonial language.
THE 4MS IN PRIMARY CARE: THE GERIATRIC INTERPROFESSIONAL TEAM TRANSFORMATION IN PRIMARY CARE (GITT-PC) MODEL
Authors: Moran Daniel 
Published: November 2019

Abstract
GITT-PC is a Dartmouth GWEP developed program that builds on lessons learned from the original GITT program funded by the John A. Hartford Foundation in the 1990s. GITT-PC improves delivery of healthcare to older adults in primary care by training healthcare professionals in team functioning, rapid cycle QI, and evidence based geriatric practice. The program capitalizes on the role of nursing and other healthcare disciplines. To maximize sustainability, it focuses on Medicare-reimbursable visits, including: the Annual Wellness Visit (AWV), Chronic Care Management (CCM), Advance Care Planning (ACP), and Transitional Care Management (TCM). The model’s standardized approach to implementation begins with practice assessments and two trainings. Practices participate in a data-driven, virtual learning collaborative with monthly data collection and learning sessions. Since 2015, GITT-PC has been implemented in 14 sites in northern New England, 10 sites in upstate New York, and nationally through five other GWEP awardees across the country.
A CHANGING INDUSTRY IN A CHANGING WORLD: LONG-TERM SERVICES WHERE ARE YOU GOING?
Authors: Applebaum Robert A , Nelson Matt , Straker Jane , Harrington A Katherine , Bowblis John R 
Published: November 2019

Abstract
From its name to the type and setting of care provided, the world of long-term services and supports has changed dramatically in the last two decades. Using 26 years of longitudinal data from the state of Ohio this presentation describes how the long-term services system is different from the one that existed in the early 1990’s. Data come from 13 biennial surveys of Ohio nursing homes and residential care facilities (95% response rate) and comprehensive resident and home care participant data on user characteristics and utilization rates. Findings show large changes in where services are provided and who receives services. For example, Ohio, as has most other states, has changed the ratio of its older population using Medicaid long-term care, going from 91% nursing home users in 1993, to more than half using home and community-based services in 2017. At the same time the sheer number of admissions to Ohio nursing homes increased from 70,000 to more than 220,000 and Medic are admissions increasing from 30,000 to 145,000, painting a picture of today’s nursing home as a short-term care provider. These massive changes indicate an industry in transition. What will this mean for the future of the home care and nursing home industries? What will tomorrow’s system of long-term services and supports look like? Building on more than two decades of findings the presentation will tackle the question of where long-term services is going in the future.
TECHNOLOGY IN LONG-TERM CARE: DOES IT FACILITATE THE WORKFORCE OR IMPROVE SATISFACTION AND RETENTION?
Authors: Chapman Susan A , Spetz Joanne , Miller Jacqueline 
Published: November 2019

Abstract
Emerging technological advances hold potential for individuals and caregivers to help an aging population in the home or long term care settings and has the potential to alter workforce needs and potentially mitigate the rising workforce demand. The purpose of the proposed research was to research available technologies that may facilitate, replace, or enhance recruitment, training, and retention of the LTC workforce. This qualitative study included environmental scan and literature search identifying 62 companies meeting criteria for potential impact on the workforce. Categories included wearables, robots, sensors/alerts, health/social data collection and tracking, family/caregiver communication services, online care management, online worker training, and facility or home health staffing systems. Thematic analysis findings of telephone interviews with 12 national and international companies included: 1) most development focused on software rather than hardware, 2) company founders generally had a tech background and start up experience along with personal family caregiving experiences, 3) data collected in the home often did not connect directly to the health care team, 4) payment was generally out of pocket to individuals or facilities under subscription services or contracts 5) worker retention improved when system allowed better client to worker matching, more control over shift scheduling, and more efficient staffing. There was little rigorous research on the impacts for care and services or which will have the greatest potential impact on the workforce providing direct care. Reimbursement from federal and private payers is minimal to date yet demand for government payment may grow.
METHODS, THEORY, AND INNOVATION A BAYESIAN ANALYSIS OF EVIDENCE IN SUPPORT OF THE NULL HYPOTHESIS IN GERONTOLOGICAL PSYCHOLOGY (OR LACK THEREOF)
Authors: Brydges Christopher , Bielak Allison A 
Published: November 2019

Abstract
Objective: Non-significant p values derived from null hypothesis significance testing do not distinguish between true null effects or cases where the data are insensitive in distinguishing the hypotheses. This study aimed to investigate the prevalence of Bayesian analyses in gerontological psychology, a statistical technique that can distinguish between conclusive and inconclusive non-significant results, by using Bayes factors (BFs) to reanalyze non-significant results from published gerontological research. Method: Non-significant results mentioned in abstracts of articles published in 2017 volumes of ten top gerontological psychology journals were extracted (N = 409) and categorized based on whether Bayesian analyses were conducted. BFs were calculated from non-significant t-tests within this sample to determine how frequently the null hypothesis was strongly supported. Results: Non-significant results were directly tested with Bayes factors in 1.22% of studies. Bayesian reanalyses of 195 non-significant t-tests found that only 7.69% of the findings provided strong evidence in support of the null hypothesis. Conclusions: Bayesian analyses are rarely used in gerontological research, and a large proportion of null findings were deemed inconclusive when reanalyzed with BFs. Researchers are encouraged to use BFs to test the validity of non-significant results, and ensure that sufficient sample sizes are used so that the meaningfulness of null findings can be evaluated.
UNCOVERING DEEPER MEANING: APPLYING MULTIPLE METHODS OF DATA ANALYSIS IN NARRATIVE INQUIRY WITH OLDER ADULTS
Authors: Meraz Rebecca , Osteen Kathryn , McGee Jocelyn S 
Published: November 2019

Abstract
Personal narrative is at the heart of how humans share information, represent identity, and convey ideas. Using narrative inquiry, researchers may gain some insight into an individual’s personal understanding of the events in their life. Although many narrative investigations report themes from study data, there is no single, well defined approach to data analysis in narrative research. We describe how applying multiple methods of systematic evaluation to narrative data leads to a deeper and more holistic understanding of told stories about medication-taking decisions among older heart failure (HF) patients. In this paper, we share a more holistic interpretation of the decision making process by applying Riessman’s thematic, structural, and performance analysis provided a method for analyzing the data beyond the spoken words. Data was transcribed verbatim then arranged according to the essential discourse between the participant and researcher, the intact story, and the story elements needed to facilitate each method of evaluation. The data analysis process outlined in this article contributes to the academic discourse and knowledge supporting the use of multiple methods of systematic evaluation to uncover deeper meaning in narrative data. In clinical practice, care should be guided by a deeper and holistic understanding of the decisions patients make about whether to take or not take a HF medication.
EVERYDAY TECHNOLOGY: A USEFUL SERVANT BUT DANGEROUS MASTER FOR PARTICIPATION IN SOCIETY?
Authors: Gaber Sophie N , Gaber Sophie N , Nygard Louise , Brorsson Anna , Kottorp Anders , Wallcook Sarah , Charlesworth Georgina , Malinowsky Camilla 
Published: November 2019

Abstract
With an increasingly technological society comes an assumed ability to use Everyday Technologies (ET) in order to participate in activities and places in public space, e.g. operating ticket machines to access public transport. This study addresses a mismatch between a growing dependency on ET and evidence that people with dementia experience increased challenges using ET. The aim is to explore how ET-use and perceived risk relate to participation in public space, among people with and without dementia. People with dementia and without dementia, aged 55+, were interviewed using questionnaires including the Participation in ACTivities and Places OUTside the Home questionnaire, across Sweden (n=69) and the UK (n=128). The Swedish and UK findings show small but significant associations between total participation in places within public space, and i) ET-use, and ii) perceived risk in public space. Furthermore, people with dementia participated in fewer places within public space than those without dementia.