bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spiritual Experience in Dementia From the Health Care Provider Perspective: Implications for Intervention
Authors: Palmer Jennifer , Hilgeman Michelle , Balboni Tracy , Paasche-Orlow Sara , Sullivan Jennifer 
Published: December 2021

Abstract
Spiritual care seeks to counter negative outcomes from spiritual distress and is notably needed in dementia. Such care needs disease-appropriate customization. Employing “cognitive apprenticeship” theory’s focus on learning from contrast, we explored spiritual needs salient within dementia as related to other disease states; we aimed to inform future dementia-focused spiritual care design. Accordingly, we conducted semi-structured qualitative interviews with 24 providers who serve older adults inclusive of persons with dementia. We sampled participants purposively by discipline (chaplains, nursing staff, social workers, activities professionals) and religious tradition (for chaplains). Our interview guide inquired about the nature of spiritual needs in dementia and stakeholders’ roles in addressing them. Hybrid inductive/deductive thematic analysis was employed. A thematic structure emerged with two themes: 1) spiritual experience in dementia compared to other medical conditions (sub-themes: the salience of (a) fear; (b) loss of self; (c) dementia’s progressive and incurable nature; (d) dementia’s impact on accessing faith); and 2) the need for spiritual intervention at the mild stage of dementia (sub-themes: (a) awareness in mild dementia and its influence on spiritual distress; (b) a window of opportunity). These findings pointed to possibilities for the “what” of spiritual needs and the “who” and “when” of implementing spiritual care. Implications included the imperative for dementia-specific spiritual assessment tools, interventions targeting fear and loss early in the disease, and stakeholder training. Researchers should study the “how” of dementia-appropriate spiritual care given recipients’ cognitive and linguistic challenges. Conjointly, these efforts could promote the spiritual well-being of persons with dementia worldwide.
Telehealth as a Resource for Continuity of Care in the Face of Disaster
Authors: Boot Walter , Phillips Judith Robertson 
Published: December 2021

Abstract
This symposium co-sponsored by the Disasters and Older Adults and the Technology and Aging special interest groups of GSA aims to highlight the promise of, and barriers to, the use of telehealth to support continuity of care in the face of disasters and crises, such as the ongoing COVID-19 pandemic. M. Mattos will showcase a home-based medical care (HBPC) program to address chronically ill and homebound persons living with dementia and caregivers’ needs during the pandemic. T. Wyte-Lake will present the results of a national survey on how changes were made to the Department of Veterans Affairs (VA) HBPC programs in response to the pandemic. G. Demiris describes a large caregiver study in which problem solving therapy and positive appraisal theory interventions designed specifically to support family caregivers of hospice patients during the COVID-19 pandemic were implemented via telehealth. D. Lindeman will specifically discuss challenges and implementation strategies for telehealth solutions applied to low-income older adults living in affordable housing communities. Finally, H. Xu will present the results of an analysis examining the effectiveness of telehealth in reducing readmissions among heart failure patients during the COVID-19 pandemic. While the COVID-19 pandemic has especially impacted older adults and those who care for them, these talks highlight the potential of telehealth services and interventions to provide support and facilitate the continuity of care during times of crisis.
Telemedicine Use Among Older Adults During the COVID-19 Pandemic
Authors: Szerszen Anita , Kogan Yulia , Burns Edith 
Published: December 2021

Abstract
Objective: Although technology adoption among older adults is improving, ethnic minorities and those with socioeconomic disadvantages may have lower utilization of telemedicine. Here, we evaluate telemedicine uptake amongst community-based older adults. Materials and Methods: Using a retrospective cohort design, we examined electronic medical records (EMR) for documentation of telemedicine use among patients &gt; 65 years old at Geriatric practices in the New York metropolitan area from January-November 2020. Demographic details and insurance payer were captured for telemedicine visits and compared to in-person encounters. Multivariable regression was used to evaluate the association of demographic, socioeconomic factors and visit type. Results: A total of 712 patients (32.3%) engaged in 1,085 telemedicine visits. Telemedicine represented 80% and 66% of all encounters during April and May, respectively and averaged 11.8% between June and November. Use was similar across age groups, gender, race and insurance payer status between telemedicine versus in-person encounters. Patients with greater number of comorbidities were more likely to use telemedicine-. Medicaid recipients had preference for video visits. 47.5% of patients who engaged in video visits had another person/family member present during an encounter. Conclusions: Telemedicine augmented access to health care for older individuals during the peak of the COVID pandemic and continues to be utilized to improve access to care for older Americans. Given the distinct preference for video visits among patients with multiple medical conditions and those who have Medicaid, telemedicine has potential to serve as a tool to reduce enduring health care disparities beyond the pandemic.
Sex-Specific 25-Hydroxyvitamin D Threshold Concentrations for Functional Outcomes in Older Adults
Authors: Shardell Michelle , Guralnik Jack , Simonsick Eleanor , Kritchevsky Stephen , Cawthon Peggy 
Published: December 2021

Abstract
25-Hydroxyvitamin D [25(OH)D] has extra-skeletal effects, but it is not known whether the minimum sufficient serum levels for such targets, like muscle, differ from those for bone health (typically recommended at 20 or 30 ng/dL). Therefore, we derived and validated sex-specific thresholds for serum 25(OH)D predictive of poor physical function using 5 cohorts comprising 16,388 community-dwelling older adults (60.9% women). Using a cohort-stratified random two-thirds sample, we found incident slow gait was best discriminated by 25(OH)D&lt;24.0 versus 25(OH)D&gt;=24.0 ng/mL among women (Relative Risk=1.29; 95% CI 1.10-1.50) and 25(OH)D&lt;21.0 versus 25(OH)D &gt;=21.0 ng/mL among men (RR=1.43; 95% CI 1.01-2.02). Estimates from the remaining one-third validation sample were similar. Empirically identified and validated sex-specific 25(OH)D thresholds from multiple well-characterized cohorts of older adults may yield more biologically meaningful definitions in important sub-populations. Such thresholds may serve as candidate reference concentrations or inform design of vitamin D intervention trials in older adults.
Well-Being Among Aging Women: Observations From the Women’s Health Initiative Study (WHI)
Authors: Cochrane Barbara , Cochrane Barbara 
Published: December 2021

Abstract
Previous efforts to assess well-being in relation to health have relied on descriptive analyses of hedonic or eudaemonic well-being indicators. Factor scores from principal components analysis offer a summary measure of well-being, but limited interpretability in epidemiologic analyses, e.g. estimated risk ratios. Use of latent class analysis to identify groups differing by levels of both hedonic and eudaemonic indicators preserves information about both dimensions while supporting interpretation of well-being effects on health indicators important for studying older women’s health. For this symposium, we report on analyses to: (1) Develop a multidimensional profile of well-being that would preserve the individual dimensions of well-being (hedonic, eudaemonic) using latent class analysis; and (2) Support epidemiologic analyses of well-being as both an outcome and a predictor of health outcomes, enhancing interpretability of levels of well-being across various dimensions. Data on well-being in over 80,000 older women in the Women’s Health Initiative Study were obtained in 2011-2012, along with their baseline demographic characteristics in 1993-1998. All-cause mortality included death from any cause occurring from 2012-2020. Four classes of well-being were identified: (1) lowest hedonic and eudaemonic well-being scores; (2) higher hedonic/lower eudaemonic scores; (3) lower hedonic/higher eudaemonic scores; and (4) highest hedonic and eudaemonic scores. Results will be presented in three papers addressing the development of the well-being profile; relationships of the profile with predictors of well-being; and the relationship of the profile to all-cause mortality. The discussion will focus on future research questions, such as likely factors mediating well-being and health outcomes.
Cancer and Caregiving Among Older Black Americans and Families
Authors: Ellis Katrina 
Published: December 2021

Abstract
Cancer disproportionately affects Black Americans and consequently, their families. In addition, cancer is often just one of the significant health concerns facing Black families at any one time. Research on family support after an adult cancer diagnosis overwhelmingly focuses on a single (i.e., primary) caregiver and spousal family caregivers, limiting understanding of the complexity of caregiving within family systems facing multiple health challenges. This presentation presents a framework for a broader focus on the role of family systems in providing cancer care, highlighting both the unique strengths and challenges facing Black families who provide care. A family comorbidity lens is used to underscore the need to better understand the nature and impact of concurrent health challenges within families. Ultimately, this perspective reflects the lived experiences of older Black adults and their families after a cancer diagnosis and has implications for future research and interventions to address health issues interdependently.
Inhibitory Control in Age-Related Hearing Loss
Authors: Shende Shraddha , Nguyen Lydia , Rochford Grace , Mudar Raksha 
Published: December 2021

Abstract
Inhibitory control involves suppression of goal irrelevant information and responses. Emerging evidence suggests alterations in inhibitory control in individuals with age-related hearing loss (ARHL), however, few have specifically studied individuals with mild ARHL. We examined behavioral and event related potential (ERP) differences between 14 older adults with mild ARHL (mean age: 69.43 ± 7.73 years) and 14 age- and education-matched normal hearing (NH, mean age: 66.57 ± 5.70 years) controls on two Go/NoGo tasks: a simpler, basic categorization task (Single Car; SC) and a more difficult, superordinate categorization task (Object Animal; OA). The SC task consisted of exemplars of a single car and dog, and the OA task consisted of exemplars of multiple objects and animals. Participants were required to respond to Go trials (e.g., cars in SC) with a button press, and withhold responses on NoGo trials (e.g., dogs in SC task). Behavioral results revealed that ARHL group had worse accuracy on NoGo trials on the OA task, but not on the SC task. ARHL group had longer N2 latency for NoGo compared to Go trials in the simpler SC Task, but no differences were observed on the OA task between Go and NoGo trials. These findings suggest that more prolonged neural effort in the ARHL group on the SC task NoGo trials may have contributed to their ability to successfully suppress false alarms comparable to the NH group. Overall, these findings provide evidence for behavioral and neural changes in inhibitory control in ARHL.
Carer Café in Taiwan: An Innovative Model Providing Caregiver Support for Older Adults
Authors: Hou Su-I , Kuo Tsuann 
Published: December 2021

Abstract
Physical places and environments play critical roles in shaping how people interact. This paper introduces an innovative Carer Café model in Taiwan with social infrastructure support and services for family caregivers caring for older adults. Carer cafés are community-based initiatives of Taiwan Association of Family Caregivers (TAFC), aiming to help carers recognizing their own needs and increase awareness of long-term care resources available. Through partnerships with local coffee shops, respite-focused services are provided. The “free coffee for two” campaign encourages family members and friends taking a caregiver out for a “respite coffee”. Carer Café has also become an important “third place” hosting respite programs and the “a shop within a shop” style creating designated space to build a sense of community. Pilot survey (n=375) showed 77% perceived reduced stress, 83% appreciated services provided, and 250% increased referrals within one year. Implications on impact and future opportunities will be discussed.
Community-Based Brain Health Promotion During the COVID-19 Pandemic: Efforts of AARP in the USA
Authors: Lock Sarah , Chura Lindsay , Lazarus Rachel 
Published: December 2021

Abstract
The pandemic has created new barriers for the delivery of healthcare resources and information, as well as in-person delivery of health care, caregiving, and social engagement. AARP created trainings designed for volunteer-led community-based brain health promotion. Due to the COVID, we have had to convert them to virtual presentations, distributed through technology. Staying Sharp is AARP’s online platform that educates users about integrated, holistic, lifestyle-based approaches for maintaining brain health as we age. This platform was created for convenience and scalability – we currently have over 800,000 users. During a period of necessary isolation, this platform has performed as an ideal way to get helpful information about maintaining brain health to our consumers, who are now stuck at home without access to in-person (e.g., community-based) alternatives. We will discuss lessons learned from these two different approaches along with preliminary data on behavior change based on these engagements.
Discrimination in Long-Term Care Facilities: Legal Consciousness and Problem-Solving Among Staff
Authors: Perone Angela 
Published: December 2021

Abstract
Over half of direct care workers in long-term care facilities are women of color. Building on legal consciousness theory–which explains how individuals invoke legal principles to define everyday experiences–this study examines how staff understand and resolve discrimination between residents and staff and among staff. This study employs a multi-method qualitative extended comparative case approach. Data includes in-depth semi-structured interviews (n=80) and participant and non-participant observation (n=8 months) at two facilities that vary in staff racial composition. Findings reveal rampant unreported instances of race and sex discrimination toward Black staff by white staff and residents. Black staff at all levels did not invoke rights or discrimination rhetoric when they experienced overt race discrimination by residents but engaged in significant emotional labor to respond to race discrimination by residents. Black staff, however, perceived microaggressions and unequal treatment by white staff as discrimination. At both facilities, floor staff and management adopted diverse team approaches across race and staff hierarchy for responding to race discrimination by residents toward Black female staff. These findings suggest the need for new and targeted policy and practice approaches that recognize extensive emotional labor expended by staff of color when addressing discrimination by residents and challenges from white staff when addressing race discrimination by staff. These findings have theoretical implications by extending legal consciousness theory to multi-level staff understandings of discrimination. Findings also provide useful tools and case examples for policymakers and practitioners interested in racial justice, particularly given how COVID has exacerbated racial inequities in long-term care.
The Effects of Assets and Debt on the Depression Trajectory of Low-Income Older Adults in South Korea
Authors: Woo Jihee , Choi Hyojin 
Published: December 2021

Abstract
Evidence suggests that assets and debt are among the most significant factors affecting older adults’ mental health. This study focuses specifically on South Korea, where the poverty rate of older adults is the highest among all OECD countries. Given that low-income older adults with fewer assets and more debt may be at greater risk for depression, we investigated how assets and debt affected the depression trajectory of low-income older adults in South Korea. We used the six most recent waves of data from the Korean Welfare Panel Study (2014-2019) to estimate the longitudinal effects of assets and debt on depression in low-income older adults. Our sample was restricted to low-income Korean heads of household aged 55 and above (N=2,832). Using latent growth curve modeling, the unconditional model revealed decreasing trends in depression over time, while the conditional model, controlling for sociodemographic variables (i.e., age, gender, education, general health, marital status, employment status, income), suggested that assets and debt had contrasting impacts on depression. Specifically, although it did not impact the depression trajectory, debt did have a positive impact on depression at baseline. Most notably, assets negatively affected both depression at baseline (B=-1.911, SE=0.284, p&lt;.001) and its trajectory (B=-0.235, SE=0.081, p&lt;.01). These findings highlight the importance of holding assets over time as a protective factor against depression and thus the need for interventions such as savings programs and financial education for low-income older adults.
Hmong Older Adults’ End-of-Life Care Preferences: Physical, Psychosocial, Cultural, Religious, and Spiritual
Authors: Her-Xiong Youhung 
Published: December 2021

Abstract
As the Hmong community continues to grow and age in the United States (US), mainstream healthcare providers may encounter Hmong older adults who prefer their cultural end-of-life (EOL) care. The challenge for these providers is to offer culturally sensitive EOL care to Hmong older adults within the realm of the Western healthcare system. One factor contributing to this challenge may be the lack of knowledge regarding Hmong older adults’ EOL care preferences. Another is Hmong EOL care is interwoven with care from domains such as culture, religion, and spirituality. The purpose of this study is to garner an understanding of the care preferences of Hmong older adults during the dying process. A qualitative study using inductive content analysis was conducted. Thirty Hmong older adults who reside in Wisconsin participated in semi-structured interviews that were audio recorded and transcribed. Data was analyzed using inductive content analysis by Elo & Kyngäs (2008). The findings revealed that participants preferred care at EOL in the domains: physical, psychosocial, cultural, religious, and spiritual. Physical care included ADL’s while psychosocial care related to communication and companionship. Cultural care included children as caregivers and decision-makers. Religious and spiritual care surrounded Animism and Christian beliefs such as soul calling and prayers. Findings also suggest Hmong older adults’ care preferences as heterogenous and holistic. The findings have implications for the Hmong community and formal care services to collaborate on how culturally sensitive care can be provided to Hmong older adults at end of life.
Establishing a Dementia-Inclusive Community: The Evaluation of Dementia Friends in Cleveland Heights
Authors: Bibbo Jessica , Cardellini Jennifer , Nicolay Sarah 
Published: December 2021

Abstract
Cleveland Heights, in northeast Ohio, is currently working towards becoming a member of the Dementia Friendly America National Network. Utilizing the Dementia Friends curriculum to raise community members’ awareness of issues related to dementia is a key component of this initiative. Our initial efforts toward this goal targeted two sectors, namely community member and libraries. Participants completed on-line surveys at the beginning and end of each session. The surveys include the Brief Tool for Dementia-Friendly Education and Training Sessions developed by the Administration for Community Living. Of the 22 participants, nine had not previously attended a Dementia Friends session and completed both pre- and post-session surveys. Results indicated participants felt more confident interacting with people living with dementia at post-session compared to pre-session (t = -2.83, p=.022). Changes at the individual level may create more inclusive communities for people living with dementia and those who care for and about them.
Improving Staff-Family End-of-Life Communication at Israeli Geriatric Facilities by Using a Mobile App
Authors: Cohen Rinat , Maydan Gal , Brill Shai , Cohen-Mansfield Jiska 
Published: December 2021

Abstract
Family caregivers (FCs) of persons institutionalized at geriatric facilities present significant unmet communication needs regarding receiving regular updates about their loved one’s condition and having available healthcare professionals (HPs) to approach when needed. We developed and tested a mobile-app for staff-family communication with both parties having active roles in app planning to tailor it to their needs and abilities. The app includes a daily-update module for FCs and a chat option for FCs and HPs. App use was piloted at one geriatric-medical-center for 15 months (unit-level randomization resulted in one complex-care and one assisted-ventilation unit in each group- intervention and control) and one single-unit nursing-home for three months. Personal interviews were conducted with 55 FCs (28 from intervention-group and 27 FCs from control-group) before-and-after app use (with mean duration of use 1.6[S.D.=.6] months. Most participants were women and the children of the patients; their mean age was 55.9 years (S.D.=12.4). Repeated-measures Analysis-of-Variance for the end-of-life communication sub-scale on the Quality-of-communication questionnaire yielded a main effect for time (F(1,53)=8.31, p=.006) with both groups’ ratings increasing over time and an interaction effect (F(1,53)=4.78, p=.033) with a greater increase for intervention-group compared to control-group. Intervention-group participants rated the app as convenient to use. Qualitative data revealed that FCs perceived app use as improving quality of communication with the HPs who used it and improving their own well-being. The app offers a feasible and an effective mode of communication that incorporates technology in daily communication between FCs and HPs while addressing FCs’ unmet needs.