bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXPLORING THE HEALTH BURDEN AND SOCIOECONOMIC COSTS OF DEPENDENT ELDERLY CARE IN NSUKKA, NIGERIA
Authors: Ezeah Peter C 
Published: November 2019

Abstract
It is projected that by 2030, 6 percent of Nigeria’s present population of 180 million will be 60 years and above. However, the extent to which the traditional systems of family support and security can manage the care of the increasing number of older people in the country is not clear as limited studies are available in the country regarding the health burden and Socioeconomic costs of caring for dependent older people. This study is therefore aimed at assessing the health burden and costs of caring for dependent older people in Nsukka, Nigeria. This cross sectional survey involved 1030 randomly selected elderly persons in Nsukka, Nigeria (Mage=70.15, SD=12.23). Structured questionnaire and Focus Group Discussion Guide (FGD) provided the data for the study. The qualitative data were analyzed with descriptive statistics, while regression analysis formed the basis for predicting effects of the variables in the study. The qualitative data from the FGD were analyzed thematically. The findings show that the Nigeria government was largely uninvolved in the care and support for older dependent people; leaving families to negotiate a ‘journey without maps’. Families carried the health burden of care for the elderly with attendant socioeconomic costs. The traditional role of female relatives as caregivers was beginning to give way to paid caregivers. An innovative policy frame work targeted at the needs of older persons in health care, social protection and other forms of intergenerational support is required to supplement inputs from families of the aged in Nigeria.
WORK-RELATED OPPORTUNITY COSTS OF PROVIDING UNPAID FAMILY CARE
Authors: Mudrazija Stipica 
Published: November 2019

Abstract
Older Americans living in the community who need help with basic activities of daily living overwhelmingly rely on unpaid care provided most commonly by working-age family members. Because unpaid family care limits the demand for nursing facilities and reduces expenses paid by Medicaid and other government programs, previous estimates of its economic value have mostly focused on estimating the benefits of unpaid family care. However, to assess accurately the overall economic value of unpaid family care and define better the scope for policy intervention, it is also important to account for the costs of such care, yet our knowledge of their magnitude remains limited. This study assesses the impact of unpaid family caregiving on the likelihood of working and hours worked for caregivers, and calculates the related cost of forgone earnings today and in 2050. To do so, it matches family caregivers from the National Study of Caregiving with non-caregivers from the Panel Study of Income Dynamics, and uses projections from the Urban Institute’s DYNASIM microsimulation model to inform calculations of future costs of foregone earnings. Results suggest that the cost of foregone earnings attributable to caregiving is currently about $67 billion. By mid-century, it will likely more than double, outpacing the growth of disabled older population as the share of better-educated caregivers with higher earning capacity increases. Policymakers can use these results to inform their current and future policy efforts aimed at assisting family caregivers who are facing the challenge of balancing work and caregiving responsibilities.
PLACE MATTERS: HOW LOCATION AT DEATH INFLUENCES CAREGIVER WELL-BEING IN BEREAVEMENT
Authors: Waldrop Deborah P , McGinley Jacqueline M 
Published: November 2019

Abstract
Most older adults express the preference to die at home, but the desire for home death may go unfulfilled when the dying process become burdensome. Little is known about the congruence between older adults’ and their caregivers’ desired locations at death. The purpose of this study was to explore how the congruence between caregiver-care recipients desired and actual location at death influenced well-being in bereavement. This exploratory study utilized simultaneous qualitative and quantitative methods. Interviews were conducted with 108 bereaved caregivers about 4 months after the care recipient died while receiving hospice care. Care recipients’ ages ranged from 43-101 (M=79.6); caregivers from 32-88 (M=61.5). Quantitative data included categorical variables about demographics, advance care planning and location at death. The Core Bereavement Items and CDC HRQOL–14 "Healthy Days Measure" scales were used. Qualitative data involved open-ended questions about the illness trajectory, desired location and perceptions of care at life’s end. Quantitative analysis included comparison of group differences using both Independent Samples t-tests and One-way ANOVA. Of the 92 care recipients who had an advance directive, N=49 (45%) were in the location they desired and for N=49 (45%) there was caregiver/care recipient congruence about location. Caregivers who experienced incongruence reported poorer physical and emotional well-being and higher, more intense bereavement symptoms. Three overarching themes illuminated caregivers’ experiences: (1) Caregiver-recipient congruence; (2) Caregiver-recipient incongruence; (3) Incongruence-influenced bereavement. Results suggest that incongruence between desired and actual location of death affects well-being in bereavement. Implications: Communication about location at death is an essential consideration.
HOUSE CALLS AND BEHAVIORAL HEALTH INTEGRATION: ADDRESSING MENTAL HEALTH LITERACY AND DEPRESSION CARE
Authors: Perweiler Elyse , Bodenheimer Lisa , Belfer Gail , DeGennaro Jennifer , Chopra Anita , Meyers Marla 
Published: November 2019

Abstract
The House Calls and Behavioral Health Integration project was an inter-agency collaboration to address depression in the older adult population by increasing knowledge and awareness of the condition and providing better access to care. Rowan Medicine, New Jersey Institute for Successful Aging (NJISA) and Jewish Family and Children Services (JFCS) partnered to deliver a comprehensive education, screening and referral program for residents of 3 senior housing facilities serving an estimated 300 elderly and disadvantaged residents. The goal of this year long project was to provide depression education for both housing residents and staff; offer on-going access to free depression screens (using PHQ-9) for residents; and refer residents to an appropriate resource (counseling/case management/house calls) depending on depression screen outcome. Depression education was provided to 15 housing staff and 78 older adult residents. A total of 34 depression screens were completed (82% female, average age=82 years); further evaluation of symptoms was indicated for 59% (n=20) of those screened. Seventeen of the 20 residents accepted a recommendation for a referral to supportive counseling; 3 declined. The average PHQ-9 score was 8.45 (SD=4.42; Range 1-24). Referrals to case management and house calls (n=4) were also made. Feedback from both housing residents and staff was positive and the project team learned valuable lessons about serving older adults in congregate living settings which has informed other programming. The project was successful in providing education, screening and referrals to residents who might not otherwise have access to specialized geriatric behavioral health interventions.
BARRIERS TO CARE FOR OLDER ADULTS IN MEDICATION-ASSISTED TREATMENT FOR OPIOID USE DISORDER
Authors: Bender Alexis A , Robert Maggi N , Quan Nathan S , Klein Emma M , Perkins Molly M 
Published: November 2019

Abstract
Over the last decade, the number of older adults (people over the age of 50) who misuse opioids doubled and continues to increase. People over the age of 50 also represent one of the fastest growing groups entering into and sustaining medication assisted treatment (MAT) (i.e., methadone and buprenorphine) for opioid use disorder (OUD). Despite increasing awareness of this growing at-risk population, significant knowledge gaps regarding their support and care needs persist. To begin to address these gaps, we conducted interviews with 20 treatment staff, focus groups with 18 patients and surveys with 100 patients over the age of 50 at eight diverse Opioid Treatment Programs (OTPs) participating in a 1-year pilot study (Bender, PI) funded by the Georgia Clinical and Translation Science Alliance supported by the National Center Advancing Translational Sciences. Patients in this study do not always disclose their use of MAT to non-OTP providers. When they do, participants reported numerous negative experiences with non-OTP providers, including perceived discrimination, stigma, and misunderstanding by providers about MAT. These negative experiences potentially contribute to an over reliance on OTP providers to manage age-related health conditions (e.g., COPD, hypertension). Providers report minimal training about aging and varied levels of confidence to manage these conditions. We present the experiences of patients and providers with suggestions for improving care coordination. We conclude with recommendations to improve communication among providers working with older adults in recovery from OUD.
GENDER DIFFERENCES IN HEALTH-RELATED BEHAVIORS OF RETIRED PEOPLE IN TAIWAN
Authors: Huang Nuan-Ching , Hu Susan C , Wang Ying-Wei 
Published: November 2019

Abstract
Many studies have indicated that lifestyles and health behaviors are important factors associated with elderly health. However, few studies have focused on such issues in Taiwan. The purposes of this study were to examine the gender differences in health-related behaviors of retired people in Taiwan. We used face-to-face interviews to collect 20 health-related behaviors among retired people aged 50-74 in Taiwan. A total of 3131 retired sample was collected including 1754 male (56.0%) and 1377 female (44.0%). The health behaviors were designed as binary variables. If the retirees executed exactly on the behavior within a month, they got 5 scores, otherwise, they got 0 scores. Then, we used factor analysis with Varimax Rotation to detect factors associated with the 20 health behaviors. Results showed that six factors were related to these 20 behaviors after conducting factor analysis. These six factors were named as 1) No tobacco, alcohol and betel nut, 2) Periodic health examination, 3) Correct medication, 4) Good habits, 5) Normal sleep and no pressure, (6) No high-fat and pickled foods. Gender differences were found in three factors: 1, 5 and 6. More female practiced every behavior in factor 1 and factor 6 than male (68.7%, 55.5% vs. 43.6%, 50.3%, p&lt;.001, respectively). However, the male had better behaviors in factor 5 than female (54.0% vs. 47.3%, p&lt;.001). We hope these findings could help design different health promotion programs for retirees of different genders.
HEALTH PROMOTION A NEW APPROACH TO DEVELOP GERONTOLOGICAL NURSING CARE QUALITY INDICATORS
Authors: Kitamura Satomi , Igarashi Ayumi , Inagaki Asa , Takaoka Manami , Noguchi-Watanabe Maiko , Sakka Mariko , Naruse Takashi , Yamamoto-Mitani Noriko 
Published: November 2019

Abstract
While the inter-RAI, a comprehensive geriatric assessment tool, contains standardized system for assessing quality of care, there are limitations for its everyday use. Limitations include large number of items, lack of apparent process indicators, and limited symptoms and disease-related information. A new approach was introduced to develop gerontological nursing quality indicators that were targeted at long-term care. We plan to develop staff-friendly indicators, which can be extracted from regular routine client records. A group of nurse researchers discussed essential domains of elderly persons’ life quality, based on nursing theory literature, that nurses strive to maintain. Several outcome indicators were derived out of the domains, and process quality indicators were developed based on literature review. We identified nine domains based on Gordon’s functional health patterns: 1) minimizing symptoms and disease deterioration, 2) maintaining nutritional status, 3) controlling bowel movements, 4) encouraging physical activities, 5) promoting sound sleep, 6) minimizing dementia symptoms, 7) maintaining dignity, and 8) reducing family stress. We then developed 17 outcome indicators; each domain included one to four outcome indicators (e.g., maintaining nutritional status has three indicators: no aspiration, no weight loss by 3% or more, and no dehydration). Process indicators that covered regular assessment (e.g., swallowing evaluation), preventive interventions (e.g., adjusting body positions during a meal), and interventions for the problems (e.g., food texture modification) were determined. These indicators may be useful to assess gerontological nursing quality. We are planning to conduct expert panel and individual client surveys to assess its usability.
THE BURDEN OF ENGAGING IN VOLUNTEER ATTENUATE THE RELATIONSHIP BETWEEN VOLUNTEER ENGAGEMENT AND HEALTH OUTCOMES
Authors: Nemoto Yuta , Sakurai Ryota , Hasebe Masami , Nonaka Kumiko , Mtsunaga Hiroko , Fujiwara Yoshinori 
Published: November 2019

Abstract
This study examined the interaction of participating in volunteer activity and its burden on health outcomes. A community-based cross-sectional study was conducted in 2018. Of 8426 older adults aged 65 and over, 5232 individuals were included in the analyses (response rate: 62.1%). Health outcomes included self-rated health (SRH), mental health (The World Health Organization Five Well-Being Index: WHO-5), and Instrumental Activities of Daily Living (Tokyo Metropolitan Institute of Gerontology Index of Competence: TMIG-IC) as dependent variables. Independent variables included engagement in volunteer activity and its burden. These variables were combined and classified into three groups: non-participants; participants with burden; and participants without burden. Covariates included age, gender, educational attainments, economic status, and living arrangement. Logistic regression analysis and analysis of covariates were conducted to examine the interaction of volunteer activity and its burden on health outcomes. Of 5232 older adults, 76.3% of subjects were non-participants, 3.4% were participants with burden, and 20.3% were participants without burden. Multivariate analysis showed that non-participants were more likely to have poor health outcomes compared with participants with burden. Moreover, participants without burden were more likely to have better health outcomes (SRH: Odds Ratio [OR] = 1.92, 95% Confidence Interval [CI] = 1.70 to 2.17, WHO-5: OR = 1.69, 95% CI = 1.51 to 1.88, TMIG-IC: Coefficient = 0.36, 95% CI = 0.10 to 0.62). Our findings suggest that volunteer activity is related to better health regardless of their burden. However, burden of volunteer engagement might attenuate the relationships between volunteer activity and health outcomes.
LIFE SATISFACTION AND SELF-PERCEPTION OF AGING IN CONTRIBUTING TO SUCCESSFUL AGING IN A CHINESE CONTEXT
Authors: Chan Sunny H W , Pan Yao , Xu Yuebin , Yeung Ka Ching 
Published: November 2019

Abstract
Research indicated that life satisfaction and a positive self-perception of aging are vital during the aging process which contribute significantly to successful aging. Discovering the underlying determinants should provide a novel insight into the mechanism involved in achieving successful aging. A representative random sample of 2161 Chinese older people aged 60 years or above was surveyed by face-to-face interview. Sociodemographic factors were measured by age and educational level. Physical functioning was identified in terms of self-perceived health, basic and instrumental activities of daily living, and number of chronic illnesses. Social functioning was characterized in terms of number of people living together, social support network, and sense of loneliness. Hierarchical multiple linear regressions were performed to identify significant determinants of life satisfaction and self-perception of aging. Results showed that people in older age with lower educational level had a higher level of life satisfaction; whereas people in younger age with higher educational level had a more positive self-perception of aging. Moreover, social functioning took precedence over physical functioning in contributing to life satisfaction. In contrast, physical functioning outweighed social functioning in promoting a positive self-perception of aging. A sense of companionship and a supportive social network are imperative in enhancing life satisfaction, whereas perceived physical health and functional independence are essential in facilitating a positive self-perception of aging. This study provides empirical support to improve understanding of the primary mechanism of achieving successful aging. It also lays important groundwork for future tailored-made interventions for promoting successful aging in a Chinese context.
INDIRECT EFFECT OF PARTICIPATION ON THE ASSOCIATION BETWEEN FUNCTIONAL VISION AND SELF-RATED HEALTH OF OLDER ADULTS
Authors: Steinman Bernard A , Mittlieder Casandra 
Published: November 2019

Abstract
Older adults with visual impairments experience barriers to participation that could impact their own health and wellbeing. Participation limitations that are associated with poor vision and unsupportive environments have been associated with objective health outcomes, including chronic disease and secondary outcomes such as fall injuries. In this study, we assessed the association between functional vision impairment and self-rated health (SRH). We also tested the mediating role of participation in that relationship. We conducted analysis with covariates representing six domains included in the International Classification of Functioning, Disability, and Health (ICF). We computed ordinal logistic regression models using two waves (2011 and 2016) of the National Health and Aging Trends Study (NHATS). Vision status was assessed via self-reported measures of visual functioning (e.g., ability to recognize someone across the street). “Participation” was operationalized using 6 items that assessed participation in social and community-based activities (e.g., visiting friends, participating in classes). SRH (measured in 2016) was assessed using a single item asking participants to rate their health on a scale ranging from excellent to poor. We assessed key relationships while holding ICF’s other health dimensions constant. Functional vision status was statistically associated with SRH in models containing all covariates. Participation variables reduced but did not eliminate the effects of vision, suggesting a partial mediating effect—that is, part of the association between vision and SRH was explained by participation factors. These results point to the importance of developing community support and reducing barriers to participation by older adults with functional vision impairments.
DEVELOPMENT AND IMPLEMENTATION OF AN INTERDISCIPLINARY HONORS COURSE ON AGING
Authors: DiBartolo Mary C 
Published: November 2019

Abstract
With the aging of Baby Boomers, 2030 will mark the first time in U.S. history that those aged 65 and older will outnumber children. This population shift is expected to place unprecedented demands on the healthcare system in terms of both volume and complexity of care. Given these population shifts and emphasis on an interdisciplinary approach to care, a 4-credit Honors aging course was developed for Honors students in nursing and other health-related majors. Aging Reexamined, Reimagined is offered in a discussion/seminar format with limited enrollment to allow for deep reflective discourse about pertinent issues affecting older adults. Topics include physical/cognitive changes, ageism, Alzheimer’s disease, sexuality, aging in place, polypharmacy, addiction, depression, caregiving, elder justice, and end-of-life care. Guest speakers share their expertise on selected issues, otherwise students alternate leading discussions on remaining topics. There are three focused reflections on assigned experiences which include conducting a videotaped interview with a retired community-based older adult, attending a support group or senior center activity, and visiting a center to view various physical/technological adaptive aids that maintain mobility and independence in the home. There is also a culminating research paper on an issue of their choice. Student evaluations are overwhelmingly positive; comments include gaining in-depth knowledge about the unique needs of this population and the importance of healthy aging with an emphasis on a positive, inter-professional approach to care. It is incumbent upon educators to better prepare students to recognize ageist attitudes, as well as address the significant impact of this “longevity revolution”.
PREPARING FUTURE AGING PROFESSIONALS FOR A RACIALLY, INTERDISCIPLINARY, AND INTERGENERATIONALLY DIVERSE WORKFORCE
Authors: Donorfio Laura K , Elliott Kathryn , Greenberg Phyllis A , Karasik Rona J , Kishimoto Kyoko 
Published: November 2019

Abstract
Workforce development is a growing concern for educators and agencies serving older adults as both workers and aging clientele become more diverse (Obhi, et al., 2017; Spetz et al., 2015). Teaching courses on aging to traditionally-aged college students brings to light ageism, the continued need for cultural competence, and intergenerational experience. Typical pedagogical approaches of lecture and discussion only prepare future aging professionals for what Bloom (1956) calls the “cognitive domain”. Absent is the “affective domain” - how students interpret aging, the lifespan, and diversity in all its forms. For example, issues of power in the aging experience need to be analyzed to understand root causes of racial disparities, as well as the impact of past, current, and future policies. Preparing students for an intergenerational workforce is also essential, as there can be upwards to five generations working in paid positions together. With each generation comes differences in workplace expectations, modes of interacting (e.g., communicating, pace), and the impact of societal policies (e.g., institutional racism, ageism). Drawing upon the multiple disciplinary perspectives of its authors, this poster outlines the most prevalent differences among and between workforce generations, and identifies methods of pedagogy, andragogy, and geragogy needed to prepare future generations of aging professionals. Successful strategies and tools are highlighted including various experiential learning techniques (e.g., service-learning, simulations, vignettes, and anti-racist pedagogy).