bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systems-Wide Approach for Early Detection and Management of Dementia in Primary Care
Authors: Fitzpatrick Annette , Belza Basia 
Published: December 2021

Abstract
Dementia is frequently unrecognized and under-reported by health care providers. The needs of an aging population increase the burden on an already over-worked primary care system that is often without the appropriate training, resources, and reimbursement to address the growing number of people with cognitive decline in the US. In this symposium we present a systems-wide approach within University of Washington (UW) Primary Care to increase awareness of early signs and symptoms, detection of cognitive impairment, and support of providers, patients and caregivers that will ultimately improve outcomes of care. This quality improvement (QI) program integrates stakeholder-selected components of the GSA KAER (Kickstart-Assess-Evaluate and Refer) Model and Toolkit (2020 Edition), developed by the Gerontological Society of America (GSA), into primary care practice. We describe content and logistics of a continuing education intervention for primary care providers and clinical staff to increase skills for evaluation and management of dementia. Working with UW clinic managers and information technology (IT), we have developed a pragmatic system for streamlining operations and documenting care utilizing newly developed interdisciplinary workflows and electronic health record order sets. Using input from our Community Advisory Board, we explain development of a web-based resource directory to be used in-clinic and at home to support providers, staff, patients, families, and caregivers across cognitive changes. Strategies presented here are aimed to help other health care systems initiate steps to integrate KAER and other tools into a practical QI program for improving detection and management of dementia through support of primary care.
What Do Israeli Gerontology Students Think About Medical Marijuana Use for Alzheimer’s and Parkinson’s Disease?
Authors: Edelstein Offer , Isralowitz Richard , Wacht Oren , Reznik Alexander , Bachner Yaacov 
Published: December 2021

Abstract
Aims: The aims of the current study were as follows: 1) to assess gerontology graduate students’ beliefs about medical marijuana’s (MMJ) effectiveness for two common age-related conditions - Alzheimer’s (AD) and Parkinson’s disease (PD); 2) to assess students’ beliefs and attitudes toward MMJ; 3) to explore associations linking background characteristics, MMJ-related attitudes and beliefs, and beliefs about the MMJ effectiveness for AD and PD. Method: A sample of 104 (84 women and 20 men) gerontology graduate students voluntarily participated in an anonymous online survey. Results: The vast majority (95%) of the participants indicated they had no formal education about MMJ and reported being unprepared to answer clients’ MMJ-related questions (84.6%). Most of the participants believed that MMJ is effective for use with AD (70.2%) and PD (80.8%) patients. Participants reported favorable beliefs about MMJ benefits, concerns about risks, the need for training, and positive attitudes toward recreational marijuana use legalization. Prior marijuana use (e.g., self-use, friends or family) was found to be associated with more positive beliefs about MMJ benefits, risks, and its legalization for recreational purposes. Prior marijuana use was the only factor associated with the belief that MMJ is an effective therapy for use with individuals diagnosed with AD or PD. Conclusions: The study findings stress the need for students’ MMJ education in order to provide future gerontology service providers with the necessary knowledge and ability to address clients’ questions about MMJ use. Efforts to develop curricula and training programs need to be promoted.
Health, Quality of Life, and Economic Impacts of Home Care Vouchers for Middle-Income Adults
Authors: Spetz Joanne , Wagner Laura , Miller Jacqueline , Chapman Susan , Kwong Connie 
Published: December 2021

Abstract
The Support at Home pilot program provided financial support for home care services by middle-income adults with disabilities in San Francisco to support aging in place. This presentation reports the results of the mixed-methods evaluation of the program, which incorporated administrative records, surveys of clients and comparison group members, surveys of informal caregivers of clients, surveys of the care providers hired by clients, and focus groups with clients and with informal caregivers. Outcome measures included the Older People’s Quality of Life Questionnaire, Patient Health Questionnaire-2, an adapted Burden Scale for Family Caregivers, and self-reported falls, emergency department visits, and hospitalizations. Analyses included pre-post chi-squared and t-test comparisons and comparisons of changes between the client and comparison groups. Multivariate regression analyses were conducted to control for demographic differences between the groups. An economic analysis was conducted to learn whether changes in costs associated with medical appointments, emergency department visits, and hospitalizations were greater than the costs of the program, including both voucher and administrative costs. Results indicated statistically significant positive changes in personal stress and financial stress, but not in the composite quality of life score. There also were statistically significant reductions in attendance at medical appointments, falls, emergency department visits, and hospitalizations. The focus group data supported the findings regarding personal and financial stress, and also indicated that clients and their caregivers perceived positive quality of life benefits. The economic analysis indicated substantial cost savings from the program due to reduced use of medical services.
Whom Can I Rely on? The Impact of China's Public Pension Program Expansion on the Expectations for Old-Age Support
Authors: Zhang Qian 
Published: December 2021

Abstract
Aging is a global trend and China is no exception. Older people in China mostly rely on their adult children for old-age support. This traditional provision pattern of old-age support, however, is challenged by hundreds of millions of internal migrant workers. They relocate from rural to urban regions for better employment and are no longer able to provide old-age support to their older parents in rural areas. The aim of this study was to determine the impacts of China’s public pension program expansion in rural areas on older people’s expectations for old-age support. Utilizing the natural experiment of program expansion, this study identified an instrumental variable as the county adoption of the pension program. In addition, the study analyzed a nationally representative longitudinal dataset CHARLS with fixed effects model. Results from the statistical model showed that given the participation in the pension program, older adults reported more reliance on pension for old-age support financially and less reliance on children. Heterogeneous effects were found for older adults living together with children and older adults living independently. These important findings suggest that the government partially assumes the responsibility for the old-age support of adult children in the traditional sense. The potential benefits of this study provide a policy implication for developing countries to alleviate old-age support problems and enable internal migration for economic development.
Perceptions of Healthy Aging Among Community-Dwelling Older Persons in an Urban Slum in Ibadan, Nigeria
Authors: Omobowale Olubukola 
Published: December 2021

Abstract
Background: Healthy Ageing is the process of the development and maintenance of functional capacity which allows well-being at an older age. This understanding is comprehensive and relevant for all older persons. Despite the global attention being given to healthy ageing, there is limited information on the perceptions of this concept among older persons in low resource settings like Nigeria, hence the need for this study. Methods: In depth interviews were conducted among older persons aged 60 years and above residing in Idikan Community, an urban slum area in Ibadan, Nigeria. Using an interview guide, perceptions of older persons on meanings of healthy ageing, factors related to healthy ageing and experience of ageing were explored. Results: A total number of 24 interviews were conducted. Slightly more than half of the respondents were females. The majority of the respondents were of the opinion that healthy ageing is about being “ strong” and able to move around, without being dependent on anyone for mobility and activities of daily living. In their opinion, healthy ageing is related to different health dimensions: biological (adoption of healthy habits and behaviors with self-responsibility, psychological (feelings of optimism and happiness), spiritual (faith and religiosity) and family and social support (healthy and well children, friends and family). Conclusion: Urban Community dwelling older persons’ perception of healthy ageing was positive and incorporating their opinions on healthy aging from the perspective of the older persons can support the activities of professionals who work with this population group.
Students’ Attitude Change: Virtual vs. In-Person Intergenerational, Arts-Based Courses
Authors: Young Meghan , Lokon Elizabeth , Li Yue 
Published: December 2021

Abstract
When higher education classes went virtual at the start of the COVID-19 pandemic, converting an in-person, arts-based, service-learning course into a meaningful, virtual experience seemed impossible. However, the Opening Minds through Art (OMA) program developed online courses where students met older adults weekly over Zoom to create and discuss art. Undergraduate and graduate students at Miami and Marian Universities (n=47) came from more than 20 different areas of study and had varying knowledge of gerontology and dementia. Pre- and post-assessments were administered at the start and end of the academic semester. Paired-samples t-tests were conducted to examine pre-post changes in students’ attitudes toward people living with dementia (PLWD) using the Dementia Attitude Scale (DAS) (O’Connor & McFadden, 2010) and the extent students actually like PLWD using the Allophilia scale (Pittinsky et al, 2011). Students in virtual OMA courses showed significant improvement in overall DAS and Allophilia scores and all subdomain scores (i.e., general knowledge about dementia, affection, social comfort level, kinship, and engagement and enthusiasm when interacting with PLWD), with moderate to high effect sizes (Cohen’s d range between 0.39 and 1.10). The magnitudes of these effect sizes for virtual OMA are comparable to previous studies examining students’ participation in face-to-face OMA sessions, where Cohen’s d on DAS and Allophilia scales ranged between 0.48 and 1.07 (Lokon et al, 2017, 2018). Overall, we found that it is possible to design virtual service-learning courses that improve students’ attitudes toward PLWD as effectively as face-to-face courses.
Associations Between Comorbidity and Depressive Symptoms During COVID-19: Variation by Social Isolation?
Authors: Cheng Jianjia , Kobayashi Lindsay 
Published: December 2021

Abstract
Adults with comorbidities are at high COVID-19 risk and may experience elevated depressive symptoms during the pandemic. We aimed to investigate the associations between comorbidity at pandemic onset and subsequent depressive symptoms and whether social isolation modified this association. Data were from monthly online questionnaires in the COVID-19 Coping Study of US adults aged ≥55 from April/May-September/October 2020 (n=4,383). Depressive symptoms were measured by the 8-item CES-D, and social isolation as “high” vs. “low” based on contact with family, friends, social organizations, and living alone. In multivariable mixed-effects models, comorbidity (≥2 vs. &lt;2 chronic conditions) was associated with greater depressive symptoms at baseline (β=0.50; 95% CI: 0.36-0.64), this association varied negligibly by social isolation. Differences in depressive symptoms by comorbidity status at pandemic onset were consistent over the six-month follow-up. This study indicates that middle-aged and older US adults with comorbidities experienced persistently elevated depressive symptoms during the COVID-19 pandemic.
Factors Influencing Resident Responsive Behaviors Toward Staff in Nursing Homes: A Systematic Review
Authors: Weeks Lori , Nassur Abubakar Mohamed , Haq Fajr , Rupasinghe Viraji , Estabrooks Carole , Song Yuting 
Published: December 2021

Abstract
When staff experience various types of resident responsive behaviors, this can lead to decreased quality of work-life and lower quality of care. We synthesized empirical quantitative and qualitative evidence on factors associated with resident responsive behaviors directed towards staff in nursing homes. We searched 12 bibliographic databases and "grey" literature with two key words: long-term care and responsive behaviors resulting in 7671 sources. Pairs of reviewers independently completed screening, data extraction, and risk of bias assessment. Based on extracted data, we developed a coding scheme of factors utilizing the ecological model as an organizational structure. We then applied the coding scheme to quantitative and qualitative articles and prepared narrative summaries for each factor. From 86 included studies (57 quantitative, 28 qualitative, 1 mixed methods), multiple factors emerged, such as staff training about responsive behaviors (individual level); staff approaches to care (interpersonal level); leadership, staffing resources, and physical environment (institutional level); and racism and patriarchy (societal level). Quantitative and qualitative results each provided key insights, such as qualitative results pertaining to leadership responses to reports of responsive behaviors, and quantitative findings on the impact of staff approaches to care on responsive behaviors. By synthesizing both quantitative and qualitative evidence, this review provides a comprehensive overview of factors associated with resident responsive behaviors towards staff. Our findings offer insights into promising factors for long-term care system and nursing home managers to address to strive to reduce responsive behaviors of residents toward staff in nursing homes.
Partnership With Families During Hospitalization of Persons With Dementia: Intervention and Measurement Strategies
Authors: Boltz Marie , Resnick Barbara , Tate Judith 
Published: December 2021

Abstract
Persons with dementia have high rates of hospitalization and are at risk for complications including psychological distress, and functional and cognitive decline. In turn, their family caregivers often face increased stress related to lack of preparedness to meet the complex needs of the patient during hospitalization and in the post-acute period. Hospitalization provides an opportunity to reframe the role of family caregivers from the traditional passive one to that of partners with the hospital team. The aim of the Family-centered, Function-focused Care (Fam-FFC) clinical trial is to test a nurse-family partnership model that incorporates a four step approach to optimize behavioral, functional, and cognitive outcomes in hospitalized persons with dementia and increase preparedness of caregivers to continue to optimize these outcomes in in the acute and post-acute recovery period. In this symposium we provide a description of the intervention with regard to theoretical support, four step process, and cultural appropriateness of the process. Two presentations describe, among Black and white dyads, evidence to support the psychometric properties of major outcome measures, caregiving preparedness and neuropsychiatric symptoms, in hospitalized dyads living with dementia. The final presentation describes a strategy to engage the dyad in goal development and evaluation, and its effect upon hospital readmissions. Findings from this symposium will help to identify intervention and measurement resources for those working with hospitalized persons with dementia and their family caregivers, and guide ongoing research needs in this area. Our discussant will synthesize the research findings and discuss implication for research, policy, and practice.
Effects of the COVID-19 Pandemic on Place in End-of-Life Care: Insights From a Homeless Mobile Palliative Care Team
Authors: Johnson Ian 
Published: December 2021

Abstract
The effects of the COVID-19 pandemic on both those experiencing homelessness (Tsai & Wilson, 2020) and those with life-limiting illnesses (Abbott et al., 2020) is of great public health concern. This presentation details the findings from an organizational case study (Yin, 2014) aimed at investigating COVID-related changes to the service environments in which unhoused palliative care patients receive care. Through ethnographic field observation (Phillippi & Lauderdale, 2017) and interviews with a homeless palliative care team and their community partners (Turner, 2005), findings included 1) decreased staff capacity due to de-congregated care; 2) efforts to extend care in community settings due to relocation barriers; 3) conflict between reducing viral risk and honoring unique population needs; and 4) provider perceptions of COVID-19 as an “equalizer.” Findings illustrate the impact of emergency response within housing and healthcare systems on unhoused patients’ care and offer potential pathways to quality end-of-life care for homeless populations.
Get In and Get Out: The Impact of COVID-19 on the Emotional Health of Home Care Workers
Authors: Janssen Leah 
Published: December 2021

Abstract
This research explores the emotional health of home care workers (HCWs) during the coronavirus pandemic. In-depth, qualitative interviews were conducted with 17 home care workers in the fall of 2020. Thematic analysis revealed important connections between emotional health and success on the job. Perception of time and appreciation emerged as key elements that impacted emotional health. HCWs expressed the pressure to perform as usual while simultaneously taking on extra tasks as distracting from direct client care and reinforcing a task-oriented care approach. As a result of these tensions, HCWs experienced a loss of appreciation by the client, who prioritized personal safety and a “get in and get out” attitude, leaving the HCW feeling less fulfilled in their work. Implications of this research highlight the importance of HCW emotional health needs when retaining HCWs as valuable members of the long-term care workforce is paramount.
Older Adults as Co-Creators in the Research Process: An Overview of Concepts, Methods, and Approaches
Authors: Wanka Anna 
Published: December 2021

Abstract
Participatory approaches have a long-standing tradition in the social sciences and approaches have diversified across multiple research domains. Also in ageing, there is a growing interest in involving older adults, particularly in fields like gerontechnology development, environmental gerontology or patient involvement. In this contribution, ask what participatory approaches and co-creation means in the context of ageing research. What are the benefits and challenges of involving older adults in different research domains, stages of the research process and deploying various participatory methods and approaches? To approach this question, we present preliminary results of a comprehensive scoping review of the literature and provide examples of how older adults can be involved in developing research questions together with researchers, collecting and analysing the data, as well as validating and disseminating study results.
Relational Approaches in Patient-Oriented Research During the COVID-19 Pandemic
Authors: Hung Lillian 
Published: December 2021

Abstract
The COVID-19 pandemic has exposed the fragile state of patient involvement in research. The involvement of the most vulnerable population (older people with dementia) in research was even more challenging. This presentation outlines challenges my research team encountered in patient-led projects (older people with dementia) and describes how we found creative strategies to set up and complete research during the time of pandemic. I will describe how the team applied collaborative participatory principles to engage a team with diverse backgrounds in the lockdown time to maintain research progress. Patient partners in my research team actively led recruitment, research planning and decision-making, team analysis and knowledge exchange. University students in our research team helped to make technology easy to use for our patient partners. The friendly, flexible and accessible exchange between students and patient partners reinforced the importance of a respectful relational approach in patient-oriented research.
A Longitudinal Study of Older Adults’ Acceptance of Robot Companions and Their Effects on Well-Being
Authors: Rebola Claudia , Malle Bertram 
Published: December 2021

Abstract
Robotic animal-like companions for older adults are promising technologies that have shown to have health benefits, especially for individuals with dementia, and good adoption rates in some previous studies. Our project, Affordable Robotic Intelligence for Elderly Support, aims to design new capabilities for companionship and smart care, but at high affordability. In a 6-month longitudinal study of baseline acceptance and well-being, we assessed the impact of an Ageless Innovation Joy for All™ robotic pet on user acceptance and emotional well-being (depression, loneliness, positive emotions). Nineteen participants from independent and assisted living facilities completed three standardized in-person surveys, each 3 months apart, including the CES-D, measures of Loneliness, Emotions, Attitude towards Technology (ATI), and various measures of evaluation of and engagement with robotic technology. The measures showed modest to very good reliability and meaningful construct validity. Participants in this sample showed little depression or loneliness, and these levels did not further decrease over the six months. People welcomed the pet and expressed positive evaluations of it, and these sentiments were stable over time. Attitudes toward technology varied but were unrelated to well-being measures and to robot evaluations. Our current conclusion, on the basis of a small sample, is that the selected robotic pet companion is appreciated and seen as beneficial, and for adults who are already low in depression and loneliness, the robot companion helps maintain the adult’s emotional well-being but does not further increase it.