bluuebunny/crossref_metadata_2025_split huggingface dataset:
WE’RE NEVER TALKING ABOUT IT: POLICY AND PRACTICE ABOUT END OF LIFE IN ASSISTED LIVING
Authors: Bender Alexis A , Vandenberg Ann E , Kemp Candace L , Burgess Elisabeth O , Perkins Molly M 
Published: November 2019

Abstract
Increasing numbers of people are aging in place and dying in assisted living (AL) and AL is increasingly becoming a site of end-of-life care in the US. Consequently, AL staff frequently experience death and decline of the residents they care for. Using data from ethnographic observations and in-depth qualitative interviews with 14 direct care workers and 16 administrators participating in a 5-year NIA-funded study (R01AG047048) examining end-of-life care in four diverse ALs, we used thematic analysis to examine how AL administrators and staff implement and understand policies and norms around death and dying (e.g., training or use of advance care directives). We found there is limited training regarding death and bereavement and limited formal grief support for staff. These findings identify gaps in communication between administrators and direct care workers with implications for increasing communication about death and dying and improving support for direct care workers experiencing grief and bereavement.
SENSORY LOSS AND THE HEALTH CARE SYSTEM
Authors: Reed Nicholas , Yeh Charlotte 
Published: November 2019

Abstract
Communication is fundamental to patient-centered care. However, sensory impairment may limit communication among older adults. Specifically, hearing impairment strains communication via degraded auditory encoding while vision impairment distresses ability to read and interpret visual cues. The presence of dual sensory impairment, defined as concurrent hearing and vision impairment, may exacerbate these effects. The potential consequences of age-related sensory loss on health care interactions and outcomes are beginning to surface in epidemiologic studies demonstrating poorer patient-provider communication, higher incurred health care costs, increased risk of 30-day readmission, and longer length of stay when compared to individuals without sensory loss. Importantly, these associations may be amenable to intervention via sensory aids; however, uptake to sensory care is low. Notably, less than 20% of persons with hearing impairment have hearing aids and over 55% of Medicare Beneficiaries with reported vision problems have not had an eye examination in the prior year. Affordability and access may contribute to lack of sensory care uptake as Medicare explicitly excludes coverage of vision and hearing services. In this symposium, we will review current and new evidence for whether sensory loss affects health care outcomes, including satisfaction with care and medical costs, and present data on how persons with sensory loss interact with the health care system based on the need and reasons for accompaniment to care visits. Further, we will discuss and provide evidence for how sensory care may mitigate these associations. Lastly, we will place these results within the context of quality care and policy initiatives.
EXPLORING THE POWER OF COMBINATORIAL HEALTH TECHNOLOGIES TO SUPPORT SELF-MANAGEMENT OF COPD AMONG OLDER PEOPLE
Authors: Varey Sandra , Dixon Mandy , Hernandez Alejandra , Mateus Ceu , Palmer Tom , Milligan Christine 
Published: November 2019

Abstract
Ways to address the increasing healthcare needs of older people are a priority for the National Health Service (NHS) in England. The NHS England Test Bed programme was designed to trial new models of care that are supported by digital health technologies. This paper reports on findings from one Test Bed programme, the Lancashire and Cumbria Innovation Alliance (LCIA) – a partnership between NHS England, industry and Lancaster University, which ran from 2016 to 2018. A key aim of the LCIA Test Bed was to explore the extent to which supported self-care telehealth technology helped older people with long-term conditions to better self-manage their own care, promoting independence and enabling them to remain at home for longer. Each patient received a combination of health technologies over a six-month period. This paper presents results from the qualitative data that formed part of a large-scale mixed-methods evaluation. Specifically it draws on the analysis of 34 observational interviews with 17 participants with chronic obstructive pulmonary disease (COPD) to understand the role of these technologies in the self-management of their care. The data revealed that the majority of participants felt more confident about self-managing COPD as a result of their participation in the programme. These increases in confidence were the result of participants’ increased knowledge and skills in managing their COPD. The paper demonstrates how patients learned to better manage their respiratory condition, the impact of this learning on their daily lives and that of their family carers, and the implications for healthcare practice.
EAST MEETS WEST: BUILDING DEMENTIA-FRIENDLY COMMUNITIES: REFLECTIONS ON GLOBAL EXPERIENCES
Authors: Sun Fei , Hooyman Nancy 
Published: November 2019

Abstract
The emergence and rapid development of dementia friendly initiatives (DFIs) represents growing global awareness of needs of persons living with dementia (PWD). Policy and practice efforts across regions and countries made to make physical and social environments more friendly, inclusive, and capable for PWD vary. When designing, implementing and evaluating DFIs, countries at different socioeconomic development stages need to set priorities based upon their local needs and cultural norms. This East Meets West symposium aims to understand the variability and progress of the DFI in the global context, highlighting experiences from two countries: U.S.A. and China, where about one third of the world’s total estimated 47 million PWD live. The first study from Shanghai emphasizes efforts by local health care professionals to promote dementia screening and improve diagnosis, with the ultimate goal to improve dementia literacy and build a dementia friendly city. The second paper describes a community-based participatory approach to develop dementia friendly communities in Beijing, highlighting the significance of non-governmental and governmental collaboration. The DFI in Florida underscores the partnership among multiple sectors with an emphasis of the involvement of PWD, while the DFI in rural Michigan stresses care system coordination. The last paper based upon an online survey of DFI stakeholders from six WHO regions echoes successful features of DFIs (i.e., involvement of PWD, multi-sectorial partnership) identified in Chinese and U.S. examples, and identifies variations in strategies used to modify physical and social environments across countries. Invited panelists from different sectors will share comments in the end.
INVOLVING COMMUNITY GOVERNMENTAL ORGANIZATIONS IN THE ESTABLISHMENT OF DEMENTIA-FRIENDLY COMMUNITIES IN BEIJING
Authors: Liu Yu , Zhao Hexin , Guo Hong 
Published: November 2019

Abstract
China has about 20% of the world’s total dementia population. Since most elders with dementia are living at home with care by family members, communities are fundamental support resources for families as well as patients. Dementia-friendly community initiatives aim to empower families with dementia and increase their social inclusion. Within the Chinese political context, the community level governmental organization called Ju-wei-hui has played a key role in community engagement. Within this context, a Community Based Participatory Action Research (CBPAR) process is utilized to increase public awareness on dementia and caring strategies. Our team collaborated with 15 Ju-wei-hui offices across Beijing to design a series of courses and teaching modules together. Five hundred community residents participated and positively evaluated the project. A major finding is that CBPAR could be an effective strategy to develop dementia-friendly communities across China.
PAIN, PAIN MANAGEMENT, AND CONSEQUENCES OF PAIN AMONG HOSPITALIZED PERSONS WITH DEMENTIA
Authors: Arendacs Rachel , Boltz Marie , Kuzmik Ashley , Resnick Barbara 
Published: November 2019

Abstract
The purpose of this study was to describe the incidence, management and impact of pain on behavior and delirium in hospitalized older adults living with dementia. This was a descriptive study using baseline data from patients in the first cohort of the Fam-FFC study which evaluates the impact of a family-engaged function-focused care intervention in hospitalized patients with dementia. The majority of the sample was female (70%) and black (80%) with a mean age of 82.5 (SD=8.9). Pain (PAINAD) was reported by 36% of the patients; 42% of those demonstrating pain were prescribed analgesics. Controlling for age, gender and baseline cognition, pain was significantly associated with behavioral and psychiatric symptoms of dementia ( t =2.1, p= .034) and delirium severity (t = 4.9, p&lt;.0001). Results suggest the need for pain assessment and individualized treatment plans to promote comfort and decrease behavioral and delirium symptoms in hospitalized persons with dementia.
GERIATRICS MICU CO-MANAGEMENT: INTEGRATING GERIATRIC ASSESSMENTS FOR CRITICALLY ILL PATIENTS
Authors: Gnanasekaran Gowrishankar , Mireles-Cabodevila Eduardo 
Published: November 2019

Abstract
Programs like orthogeriatrics, geriatric cardiology have shown to improve outcomes in hospitalized geriatric patients. Our Geriatrics MICU Co-management program is a quality improvement initiative that instigates a partnership approach with critical care medicine in integrating geriatric assessments and build foundation for interdisciplinary care of critically ill patients. MICU (Medical Intensive Care Unit) protocols do not have standard geriatrics assessments integrated in clinical care. An electronic dash-board identifies high risk elderly (HRE) patients admitted at a MICU in a large teaching hospital in Northeast Ohio based on nursing specific screening triggers. A geriatrics co-management team engages in a comprehensive geriatric assessments and care transition. 386 patient were identified using HRE screening triggers in a period of 100 days. 33 % (n=131) were generated as consults for co-management. A pilot review on 131 HRE patients was conducted. 70% (n=93) patients had incident frailty. 93% (n=87) of patients with frailty were diagnosed with incident delirium. 56% (n=74) of patients were newly diagnosed with cognitive impairment. 56 % (N=74) of patients had a medication reduction. An average of 1.23 medication was changed. 85% (n =112) of patients had a warm hand off to the next level of provider on discharge. 90% (n=119) of patients notified improved self-management skills and better understanding of discharge process. The Geri-MICU program demonstrates a patient -centered approach in integrating geriatric assessments for critically ill patients and build foundation of a geriatrics-critical care task force. The program would be a mile stone in optimizing elderly care in critical care units.
THE PRICE OF DEMENTIA: POLICY STRATEGIES TO NARROW HEALTH DISPARITY GAPS, REDUCE COSTS, AND IMPROVE QUALITY OF LIFE
Authors: Super Nora , Ahuja Rajiv , Proff Kevin 
Published: November 2019

Abstract
Historically, a diagnosis of Alzheimer’s disease and related dementias (ADRDs) created a sense of hopelessness among those diagnosed, their families, and physicians. The misperception that there is no available medical treatment or interventions inhibited patients from receiving cognitive assessments or exploring home- and community-based interventions that could improve quality of life. Today, researchers have developed evidence-based pathways to improve brain health, reduce dementia risk, and enhance lifelong cognitive function. This report highlights recent scientific advancements focused on medical and lifestyle interventions that reduce the risk of ADRDs and slow the disease progression. To improve the current system and reduce the risk of dementia and improve brain health, the following policy areas are recommended: 1) promote brain health strategies to delay onset and reduce the stigma associated with cognitive decline; 2) increase early detection and cognitive screening efforts; 3) build a dementia-capable workforce; 4) create seamless transitions from health systems to community-based services to better support those with dementia; 5) improve caregiver training and support; and 6) increase funding for research related to ADRDs. Understanding that ADRDs disproportionately impact certain populations, these policy recommendations include strategies to narrow health disparities. Previous Milken Institute research highlighted the disproportionate health impacts of dementia on women, which costs the economy trillions of dollars. This report expands on that analyses and stratifies the data by race and income as well. Ensuring that these policy recommendations address disproportionately impacted groups will benefit the broader healthcare system and alleviate the burden felt by all patients and families.
A PILOT STUDY TO TEST METHODS FOR DATA COLLECTION ON NURSES CARING FOR RESIDENTS WITH DEMENTIA IN THE NURSING HOME
Authors: Perkins Rebekah , Cashdan Elizabeth , Supiano Katherine 
Published: November 2019

Abstract
Nurses draw from their experiences and intuition to detect changes in patient condition, patterns of patient behaviors, and evidence of distress. In the nursing home setting, nurses care for residents with dementia and manage challenging behavioral and psychological symptoms of dementia (BPSD), and may rely on informed intuition to assess and capably respond to such behaviors. To date, no observational method has been developed to discern nurse-resident interactions that identify expert nurses who effectively address BPSD. It is not known if or how nurses in this setting use intuition to make clinical judgments and decisions to manage BPSD events. Using an ethogram approach, we developed an observational tool and spot interview method to discern BPSD events, background and proximal factors and nurse responses to BPSD. Pilot observations took place over three nursing shifts to identify nurse-resident interactions during BPSD events using the observation tool. Nurse-resident interactions were followed by spot interviews with each nurse to clarify their responses to BPSD. Semi-structured interviews were conducted with nurse participants to further develop an interview guide and identify elements of nurse intuition. The pilot study affirmed the feasibility of gaining access to facilities with residents with BPSD, of nurse comfort with field observation and interviews, and established preliminary construct validity of the “expert nurse.” Verification of the utility of this observation and interview method permit further examination of effective nurse engagement with nursing home residents with BPSD, informs our understanding of nurse intuition and permits further exploration of the broader context of BPSD.
MOVING PICTURES: RAISING AWARENESS OF DEMENTIA IN CALD COMMUNITIES THROUGH MULTIMEDIA
Authors: Brijnath Bianca , Antoniades Josefine , Adams Jon , Browning Collette , Goeman Dianne , Ellis Katie , Kent Mike 
Published: November 2019

Abstract
Limited awareness of dementia in people from culturally and linguistically diverse (CALD) backgrounds often results in delayed diagnosis, poorer prognosis, and a higher burden of care on families and health systems. Given the rapidly ageing and multicultural populations in migrant-receiving countries such as Australia and the United States, this disparity needs to be addressed urgently. This project aimed to inform and educate people from five linguistically diverse backgrounds – Hindi, Tamil, Mandarin, Cantonese, and Arabic – about dementia. A mixed methods, multimedia design comprising video-interviews with 76 participants including carers from the five language groups and key service providers was employed. Data were gathered nationally across Australia in 2018 and thematically analysed. Data were used to co-produce 15 short films, comics, and a mobile-optimised website from which data analytics were measured. The films and comics focused on dementia detection and timely diagnosis, how to navigate the aged care system, and the importance of self-care. Analytics data is currently being collected online and via community forums. In conclusion, co-production methods in tandem with digital multimedia are fundamental to developing culturally salient interventions to address dementia disparities in CALD populations in Australia and internationally.
SKILLS AND STRATEGIES OF FACILITATORS WHO CO-CREATE DIGITAL STORIES WITH PERSONS WITH DEMENTIA
Authors: Daum Christine H , Liu Lili , Hollinda Kara , Kaufman David , Astell Arlene 
Published: November 2019

Abstract
Digital storytelling combines storytelling and digital tools to create brief video clips in which narrative, images, and music are embedded, in order to share personal stories. Digital storytelling facilitators can be health and social care providers as well as care partners who collaborate with persons living with dementia to co-create their stories. These facilitators elicit people’s stories and use the technology to create the digital story. Despite their important role, there is a paucity of information on facilitators’ specific skills and strategies used in working with persons living with dementia. The purpose of this project was to examine skills and strategies used by facilitators who co-create digital stories with persons living with mild dementia. Audio recordings of 70 digital storytelling co-creation sessions conducted in three Canadian cities (Edmonton, Vancouver, Toronto) were transcribed and subjected to qualitative content analysis. Regardless of their disciplinary background, facilitators acted as weavers, bringing together narrative threads to co-construct a digital story with participants. Essential communication skills and strategies included active listening, strategic questioning, being comfortable with silence, and therapeutic responding. Building relationships and collaboration were achieved through flexibility, empathy, and encouraging autonomy. To be an effective facilitator of the digital storytelling process with older adults living with dementia, facilitators must adapt their communication strategies and relational skills to the strengths and needs of the older adults with whom they are collaborating.
ATTITUDES TOWARDS AGING PERCEPTIONS OF AGING AND HEALTH OF OLDER ADULT SPOUSES
Authors: Smith Jennifer L , Bihary Joseph G , O’Connor Dugan , Basic Ajla , O'Brien Cate 
Published: November 2019

Abstract
Evidence suggests that negative perceptions of aging are associated with worse health outcomes. Research also shows that marital partners can mutually influence each other’s health; however, limited research has explored perceptions of aging within couples. The purpose of the current study was to examine the association between self and partner perceptions of aging and health among married older adult couples. Both members of 452 couples (average age: wives = 80.6 years, husbands = 82.7 years) completed a survey that measured perceptions of aging and health (i.e., self-reported health, healthy diet, physical functioning, stress, and physical activity). Data were analyzed using actor-partner interdependence models, and analyses were conducted separately for positive and negative perceptions of aging, controlling for self and partner’s age, depression, and chronic health conditions as well as gender and income. Consistent with previous research, analyses revealed that one’s own positive perceptions of aging were related to better health across all measures, and the opposite pattern was found for negative perceptions of aging. An examination of partner effects revealed that people reported better physical functioning and greater physical activity when their spouses had more positive perceptions of aging. Similarly, husbands reported less stress when wives had more positive perceptions of aging, but there was not a partner effect for wives. In contrast, people reported lower subjective health and less healthy diets when their spouses had more negative perceptions of aging. These findings suggest that health-promotion efforts should consider partners’ perceptions of aging as a potential resource or risk factor.
BOSTON AGING TOGETHER STUDY: ATTITUDES TOWARD OWN AGING AMONG OLDEST-OLD PARENTS AND CHILDREN
Authors: Kim Yijung K , Boerner Kathrin , Kim Kyungmin , Jopp Daniela 
Published: November 2019

Abstract
One consequence of modern longevity is the growing number of older adults with very old parents. While family members are often interdependent in their development and aging, less is known about how intergenerational relationships may influence individuals’ attitudes toward their own aging in later life. Using 70 dyads of oldest-old parents (Mage = 93) and their children (Mage = 67) from the Boston Aging Together Study, we examined the dyadic concordance in positive attitudes toward own aging, and how perceptions of giving and receiving care are associated with attitudes toward own aging for parents and children. On average, parents reported more negative attitudes toward own aging than did children. In less than half of all dyads (46%), both parents and children reported positive (i.e., score three or higher on a scale that ranged from one to five) attitudes toward own aging. T-test results showed that the dyads with positive attitudes toward own aging had more within-dyad age difference, better average self-rated health, fewer depressive symptoms and less loneliness than others. For children, higher level of caregiver’s burden was associated with more negative attitudes toward own aging. For parents, perception of received support was not associated with their attitudes toward own aging. This study sheds light on how both individual and family characteristics may influence individuals’ aging perceptions. Findings suggest the context of parent-child ties may particularly be relevant to those older adults who may have to deal with their own aging- related challenges as well as those of their parents.
COGNITIVE HEALTH STATUS AND GENDER DIFFERENCES IN ATTITUDES AND EMOTIONS TOWARD OLDER ADULTS
Authors: Caskie Grace , Voelkner Abigail R , Bashian Hannah M 
Published: November 2019

Abstract
The health and gender of older adults can elicit differing attitudes and emotions within young and middle-aged adults (Bergman & Bodner, 2015); one’s own gender may also influence these differences (Bergman & Cohen-Fridel, 2012). In this study, 287 participants (173 males, 114 females), aged 19-55 years (M=32.8), were randomly assigned to read one description of an older adult that varied cognitive health status (healthy/Alzheimer’s) and gender (male/female). Factorial MANOVAs examined differences by gender, health, and participant gender for participants’ (a) emotions about the older adult (compassion and emotional distance) and (b) negative perceptions about aging (ageist attitudes and aging anxiety). The first MANOVA found a significant main effect for health status; participants expressed more compassion (p=.013) and less emotional distance (p&lt;.001) for the older adult with Alzheimer’s than for the healthy older adult. Also, the Target Gender X Participant Gender interaction was significant for emotional distance (p=.032), but not for compassion (p=.616); men reported more emotional distance than women for the female older adult, regardless of target health status, but men and women’s emotional distance were very similar for the male older adult. The second MANOVA showed only a significant health status main effect; ageist attitudes (p=.021), but not aging anxiety (p=.062), differed by health status of the older adult, with more ageist attitudes expressed for the healthy older adult than the older adult with Alzheimer’s. Overall, these results show that individual factors can influence young and middle-aged adults’ negative attitudes and emotions towards older adults. Implications will be discussed.