bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Nurse Aide Retention on Ohio's Nursing Home Resident Care Experience Scores: A Facility-Level Analysis
Authors: Kennedy Katherine 
Published: December 2021

Abstract
The objective of the study was to analyze whether higher nurse aide retention was related to better resident care experiences using an overall score and seven domain scores among a sample of Ohio nursing homes. The 2017 Ohio Biennial Survey of Long-Term Care Facilities was used in combination with the 2017 Ohio Nursing Home Resident Satisfaction Survey. These data were merged with the Ohio Medicaid Cost Report, Certification and Survey Provider Enhanced Reports, LTC Focus, Area Health Resource File, Rural Urban Commuting Area data, and Payroll-based Journal Public Use Files. The analytic sample (N=690) represents freestanding facilities with a full-year cost report. The analysis included means and frequencies, ANOVAs with Tukey adjustments, and linear regressions that controlled for heteroskedasticity. Quartiles of the CNA retention rate were used to define four groups: low, medium, high, and extremely high. After controlling for facility and county characteristics, facilities with high CNA retention (61-72%) had significantly higher overall resident care experience scores by 1.27 percentage points and better environment scores by 1.35 percentage points compared to those with low CNA retention (0-48%). Medium retention (49-60%) also had significantly better environment scores than low retention. Compared to the high retention group, facilities with extremely high retention (73%+) had significantly lower scores for the overall resident care experience, facility culture, caregivers, and spending time. Maintaining a high retention rate of CNAs is important, but there were surprising negative effects from having extremely high retention potentially due to high burnout or poor person-job fit.
Visualizing Person-centered Long-term Care: An Exploratory Scoping Review and Evidence Mapping
Authors: Ciolfi Mary Lou , Coastlines Rocky , Taylor Catherine , Thompson Kayla , Crittenden Jennifer , Kaye Lenard , Hunt Angela , Nebenzahl Paul 
Published: December 2021

Abstract
Despite decades of professional, academic, and policy interest in person-centered long-term care (LTC), the field continues to be challenged by the absence of a comprehensive depiction of the concept and a lack of consistency reflected across studies and measures. In response, a participatory action, research-focused, partnership between an institution of higher education and an LTC community (the University of Maine Center on Aging and The Cedars), with funding from The Mayer-Rothschild Foundation, is identifying and mapping the landscape of person-centered LTC in nursing homes and assisted living communities. A collaborative, ongoing, exploratory scoping literature review and evidence mapping has compiled a database of 663 academic and 115 grey literature articles through 65 systematic searches reviewing over 4,296 articles. An iterative process from both the resident and organizational perspectives revealed nine core domains (e.g. dining, resident care, environment, quality improvement, identity and personhood, etc.) and two substantive research gaps (the intersection of person-centered long term care with diversity, equity, and inclusion issues, and pandemic considerations). For mapping purposes, domain content was analyzed categorically based on concept, information revealed about resident, family, and staff experience, and operations applicability. The identified person-centered LTC domains, categorical analysis, identified gaps, and visual representation via mapping will contribute to generating research ideas, supporting the development of effective operationalization for LTC settings, and contributing to an understanding of the theoretical scope and concrete elements of a person-centered care model that aims to improve the wellbeing and quality of life of older adults in long-term residential settings.
Better Brain Health through Equity: Addressing Health and Economic Disparities in Dementia
Authors: Ahuja Rajiv , Levy Cara 
Published: December 2021

Abstract
Dementia disproportionately impacts the health and financial security of women and certain minority groups. Long-standing inequities create distrust of the medical system, fewer treatment options, and reduced access to care. Research predicts that from 2020 to 2060, the number of African Americans and Latinx living with dementia will grow by nearly 200 percent and 440 percent, respectively, while prevalence among non-Hispanic Whites will increase by 69 percent. As the prevalence of dementia rises, so will the costs associated with dementia care. African Americans bear 1/3 of the costs associated with dementia. And the costs for Latinx living with Alzheimer’s disease are expected to exceed $100 billion by 2060. To mitigate these growing health and economic concerns, efforts to improve dementia care must put equity front and center. This presentation highlights five actionable recommendations to build health equity by reducing disparities in dementia prevention, detection, diagnosis, and care. These recommendations center around two overarching themes: (1) Strengthening the infrastructure among health-care, long-term care, and community-based organizations to achieve greater health equity for people living with dementia and their caregivers and (2) Expanding dementia-friendly networks and workplaces in racially and ethnically diverse communities. The recommendations discussed in this presentation will offer guidance for policymakers, health services researchers, businesses, health systems, and communities to reduce the inequitable impact of dementia on African Americans and Latinx, which is even more vital amid demographic trends showing a population growing older and more racially and ethnically diverse.
Butterfly Garden Connects Community Living Center Residents, Family, and Staff During the COVID-19 Pandemic
Authors: Rodriguez-Gonzalez Maribel , Miller Maura , Pratt Gelda , Silverman Micheal A , DiScala Sandra 
Published: December 2021

Abstract
The COVID-19 Pandemic has led to significant morbidity and mortality in older residents of long-term care facilities. In addition, the stringent restrictions on visitation of family and loved ones has further socially isolated residents leading to an increase in depression, loneliness, and spiritual distress. The Community Living Center (CLC) staff at West Palm Beach VA Medical Center wanted to address this dilemma and created a unique “Butterfly Garden” (BG) visitation space. This space is a therapeutic garden adjacent to the CLC that can be accessed by families without having to enter the facility. Participants in the BG reported feelings of peace, undisturbed reflection, and tranquility as they observed and experienced nature’s life cycle. This show of nature’s beauty promotes visual, tactile, and olfactory sensory stimulation while attracting hummingbirds, bees, butterflies, and peace to this calm garden space. The BG visitations offers residents, family, and staff opportunities to experience the health benefits of nature during their visits under strict CDC social contact guidelines. From September through December 2020 and from January through March 2021 there were 67 and 184 visits respectively as families became more involved. The feedback from residents, families, and staff indicated that the spirits of all participants were raised by the BG visits despite the difficult challenges of social distancing and limited CLC visitations. This BG concept could serve as a model for other long-term care facilities to allow socially distant family visits to loved ones in a safe nature-based environment of care with or without a pandemic.
Changes in Daily Life Conditions among Korean Older Adults after COVID-19 Outbreak
Authors: Lyu Jiyoung , Kim Young Bum , Lim Yeon Ok 
Published: December 2021

Abstract
The pandemic of COVID-19 has had a significant impact on peoples’ daily life conditions. Therefore, it is worth understanding changes in daily life conditions among older adults after COVID-19 outbreak. This study was aimed to explore the impact of the pandemic on daily life conditions among Korean older adults. To achieve this aim, an online survey was conducted during April, 2021 to include 184 Korean adults aged 60 years or older nationwide. The results are as follows. First, about 54.9% older Koreans reported that their daily life has stopped since COVID-19. Second, the top 3 increased daily life conditions were spending time at home (77.2%), using internet (60.3%), and shopping online (51.6%). Third, the top 3 decreased daily life conditions were traveling (90.2%), meeting with friends (90.2%), and meeting with family members (80.4%). Fourth, the top 3 daily life conditions with no change were sleeping time (72.3%), eating instant food (58.2%), and household income (53.8%). These findings suggest that several daily life conditions changed after COVID-19 outbreak. Further study is needed to examine the impact of these changes on physical and mental health among older adults.
Cross-National Analysis of Bereavement From COVID-19 and Depressive Symptoms Among Older Adults in Europe
Authors: Wang Haowei , Verdery Ashton , Margolis Rachel , Smith-Greenaway Emily 
Published: December 2021

Abstract
The COVID-19 pandemic has left older adults around the globe grieving the sudden death of relatives and friends. We examine if COVID-19 bereavement corresponds with older adults’ depressive symptoms in 27 countries, and test for variation by gender and country context. We analyzed the Survey of Health, Ageing and Retirement in Europe (SHARE) COVID-19 data collected from N=51,383 older adults (age 50–104) living in 27 countries between June-August 2020, of whom 1,363 reported the death of a relative or friend from COVID-19. We estimated pooled-multilevel logistic regression models to examine if COVID-19 bereavement was associated with depressive symptoms and worsening depressive symptoms for older men and women, and we tested whether the national COVID-19 mortality rate in their country had an additive, or multiplicative, influence. COVID-19 bereavement from the death of a relative or friend is associated with significantly higher odds of reporting depressive symptoms, and reporting that these symptoms have recently worsened since the outbreak of COVID-19. Net of personal loss, living in a country with the highest COVID-19 mortality rate corresponds further with women’s depressive symptoms; however, living in the midst of more COVID-19 deaths does not alter the implications of personal loss for depressive symptoms. COVID-19 deaths have lingering mental health implications for surviving older adults. Even as the collective toll of the crisis is apparent, bereaved older adults are in particular need of mental health support.
Intergenerational connections to improve social well-being of older adults with ADRD: A research protocol
Authors: Xu Ling , Fields Noelle , Daniel Kathryn , Troutman Brooke , Cipher Daisha 
Published: December 2021

Abstract
There is growing concern about social isolation, loneliness, and diminished emotional well-being among persons with ADRD who live in the community. Research suggests that reminiscence strategies, especially with the production of a digital story book, combined with an intergenerational approach may yield significant benefits for older adults. Reminiscence approaches are typically implemented by trained professionals. However, the use of trained volunteers is of growing interest due to the costs associated with reminiscence programs. This research protocol describes the development and testing of an intergenerational, telephone-based reminiscence program offered by trained, young adult volunteers that includes the use of digital storytelling (DST). Specifically, the study addresses three aims: 1) Quantitatively test the effectiveness in improving social and emotional well-being of older adults with ADRD; 2) Quantitatively test attitudes towards aging and knowledge and awareness of ADRD disease among the young adults; and (3) Qualitatively evaluate the usefulness of this intervention from perspectives of the dyads. A randomized control trial is used to assess the effects of the intervention using an explanatory sequential mixed methods design. The older and younger participants (n = 92 dyads) are randomly assigned to intervention (reminiscence) or sham (social visit) group, and then randomly matched. Data are collected at baseline, mid-intervention, post- intervention, 3 months-post intervention and through qualitative interviews (selected dyads). The proposed evaluation activities will allow us to determine the applicability of intergenerational reminiscence with DST as an effective intervention for supporting the social and emotional needs of persons with ADRD.
Financial Hardship and the Pain of Social Disconnection During the COVID-19 Pandemic in the United States
Authors: Bhatta Tirth , Lekhak Nirmala , Goler Timothy , Kahana Eva , Maheshwari Sfurti 
Published: December 2021

Abstract
Considerable scholarly attention has been directed at increasing social isolation and loneliness during the COVID-19 pandemic, and their adverse impact on later life psychological well-being. Notably absent is the focus on financial hardship in the context of overlapping unprecedented economic and public health crisis. It is unclear whether loneliness continues to differ across different levels of financial hardship even amidst immense uncertainty, social isolation, and anxiety induced by the pandemic. Based on our nationwide web-based survey of adults aged 50 years and older (n=1861), we used ordinal logistic regression to examine the influence of financial hardship on loneliness and assessed the role of socioeconomic status (SES), emotional support, and health status in contributing to such influence. We found significantly higher odds of greater loneliness (β = .28, p &lt; .001) among individuals who reported experiencing greater financial hardship. Among two measures of SES, only household income contributed substantially to the influence of financial hardship on loneliness. We documented significantly lower emotional support and greater health disadvantage among individuals experiencing greater financial hardship. Consideration of emotional support and health status explained the remaining influence of financial hardship, due to their association with both financial hardship and loneliness. Despite a sense of shared vulnerability and social isolation across the general population, our findings suggest that SES inequalities in later life loneliness are maintained even in the midst of the pandemic.
Physical Indicators of Aging are Related to Cellular Senescence Signal P16INK4a in Midlife Adults
Authors: Rentscher Kelly , Seeman Teresa , Cole Steve , Carroll Judith 
Published: December 2021

Abstract
Cellular senescence signal p16INK4a has been identified as a biomarker of aging that accumulates with chronological age across several tissues in mice and humans and may be potentially modifiable by interventions. This study examined whether physical indicators of aging were associated with p16INK4a and other markers of the aging process in midlife adults. Participants were 543 adults aged 26–78 years (Mage=54.0; 50.5% female) in the Midlife in the United States Refresher cohort. Interviews, questionnaires, and performance tests measured physical indicators of aging, including the Fried frailty index, limitations in daily activities, and age-related comorbidities. RNA sequencing of whole blood assessed biomarkers of aging: p16INK4a (CDKN2A), the DNA damage response (DDR), and the senescence-associated secretory phenotype (SASP). Older age was associated with enhanced p16INK4a (r=.11, p=.01), DDR (r=.34, p&lt;.001), and SASP (r=.38, p&lt;.001) expression. Multiple regression models that adjusted for age, sex, race/ethnicity, BMI, comorbidities, and time between assessments revealed that frailty (pre-frail/frail vs. non-frail) was associated with greater p16INK4a (B=0.13, p=.048) and marginally greater DDR (B=0.06, p=.06) expression. Limitations in daily activities were also associated with p16INK4a (B=0.12, p=.045). History of heart disease, stroke, arthritis, and cancer were associated with DDR and SASP expression in unadjusted models only (ps&lt;.05). In summary, senescence indicator p16INK4a was elevated in whole blood samples from middle-aged adults who showed signs of frailty and limitations in daily activities. Findings suggest that whole blood p16INK4a expression might potentially be used to detect early signs of aging and target interventions to reduce biological aging and frailty.
Precarious Aging: A Working Definition
Authors: Grenier Amanda , Phillipson Christopher , Martin Grace , Karalasingam Abiraa , Kobayashi Karen , Marier Patrik , Laliberte-Rudman Debbie 
Published: December 2021

Abstract
Until recently, studies of precarity have overlooked aging and late life. This poster presents a snapshot of conceptual work in progress on a Canadian Social Sciences and Humanities Research Council (SSHRC) Insight Grant on precarity and aging. The poster outlines existing definitions and theoretical perspectives, key results, a current evolving conceptual model, and a working definition of Precarious Aging. It situates existing knowledge and definitions of precarity, highlights crucial intersectional locations of gender, im/migration and (dis)ability, and clarifies the concept of precarity in later life. Results at this point in the study are based on conceptual reviews, reviews of literature on precarity and aging, and the consideration of allied concepts. In conclusion, the concept of precarity offers a promising lens to guide research in the field of social and critical gerontology, providing a foundation for an enhanced understanding of the lives and realities of older people with regards to aging, disadvantage, and inequality.
Project ECHO-Age Friendly Community Care: Applying the ECHO® Model with Area Agency on Aging Staff
Authors: Bennett Katherine , O'Leary Mary Pat , Phelan Elizabeth 
Published: December 2021

Abstract
The Extension for Community Healthcare Outcomes (ECHO®) model originated at the University of New Mexico to improve access to specialty care in underserved communities via telehealth and has spread worldwide. It has been utilized to improve geriatrics care with interprofessional participants but not specifically to train community case managers in Age-Friendly care and community initiatives. This is a program evaluation of an ECHO developed exclusively for Area Agency on Aging (AAA) case managers via a community-campus partnership. Twenty-eight AAA staff (including 15 case managers) participated in a 6-session series (March through April 2021) focused on the 4Ms of Age-Friendly care (What Matters, Medication, Mentation, and Mobility). Each one-hour session included a mini-didactic and at least one case presented by participants utilizing a novel age-friendly case form. Participants completed pre and post surveys to assess self-efficacy in applying Age-Friendly principles on 5-point scales. Surveys were anonymous and analyzed comparing pre-post using Mann-Whitney U tests. Of the 28 participants, 86% completed pre and 65% post-surveys. Self-efficacy for providing Age-Friendly care improved from 2.58 pre to 4.5 post (p&lt;0.001) and for providing recommendations to colleagues on Age-Friendly care from 3.4 pre- to 4.5 post (p&lt;0.001). Participants showed significantly increased self-efficacy (p&lt;0.05) pre vs. post on 14/15 Age-Friendly care items. One hundred percent would recommend this ECHO program to a colleague. This pilot utilizing Project ECHO with AAA staff increased their self-efficacy for providing Age-Friendly care and suggests this may be an effective tool to bridge the Age-Friendly Health Systems and Age-Friendly Community initiatives.
Stereotypes of Older Adults, Older Men, and Male Leaders Predict Expectations, Stance, and Voting Intentions
Authors: Monahan Caitlin , Lytle Ashley , Inman Elizabeth , Apriceno Marybeth , Macdonald Jamie , Levy Sheri 
Published: December 2021

Abstract
The 2020 U.S. Presidential Election offered a unique opportunity to examine how stereotypes of older adults, older men, and male leaders impact expectations of candidate job performance and intentions to vote for Biden or Trump. This online study involved 500 college students from two universities from September 30th until November 3 (Election Day). A Biden and Trump model were tested for the relationships among (a) stereotypes from public discourse with (b) expectations of candidates/ presidential performance with (c) voting stance (pro- and anti-Biden vs pro- and anti-Trump) and (d) intentions to vote for Biden/Trump. As expected, for the Biden model, endorsement of older adult (lesser endorsement of senile, unhealthy), male leadership (greater endorsement of assertive and collaborative, lesser endorsement of uncaring), and older male stereotypes (greater endorsement of elder statesman and family-focused) predicted greater expectations of Biden’s performance, which predicted pro-Biden and anti-Trump stances and ultimately voting intentions for Biden. As expected, for the Trump model, endorsement of older adult (lesser endorsement of senile), male leadership (greater endorsement of assertive, collaborative, lesser endorsement of immoral and uncaring), and older male stereotypes (greater endorsement of elder statesman) predicted greater expectations of Trump’s performance, which predicted pro-Trump and anti-Biden stances and ultimately voting intentions for Trump. Taken together, these results suggest examining relevant categories of stereotypes associated with candidates and voting stances provides a fuller picture of voting behavior toward multiple candidates vying for office in addition to political ideology and voting intentions.
Acceptability of a Newly Developed Financial Program for Caregivers of Individuals Living with a Chronic Illness
Authors: Grant Claire , Fazio Sam , Moreno Monica , Kallmyer Beth , Lanigan Kerry , Judge Katherine 
Published: December 2021

Abstract
Over 40 million informal caregivers provide care to adults aged 50 or older with a chronic illness. In addition to the negative health and well-being impact, caregivers experience financial difficulties including lost income, retirement benefits, future earnings, and unanticipated out-of-pocket costs. Few evidence-informed programs exist to assist caregivers in understanding and managing these financial tasks. This poster presents preliminary acceptability data from 71 caregivers who completed the newly developed Managing Money: A Caregiver’s Guide to Finances program. The 60-minute program was delivered online by trained community educators and addressed caregiving costs/impacts; future planning; initiating conversations; avoiding financial abuse/fraud; and identifying needs. Participants (Mage = 59.45, SD = 11.31) were 87.32% female with 77.46% self-identified as White, 9.86%, as Black, and 8.45% as Hispanic/Latino. Using a Likert scale (1=strongly disagree to 5=strongly agree), participants indicated the program: 1) identified financial challenges (M= 4.11 ; SD = 0.73); 2) provided information for managing money (M = 3.99; SD = 0.64); 3) content was easy to read/understand (M = 4.49; SD = 0.61); 4) program length was appropriate (M = 4.18; SD= 0.68); and 5) activities were helpful (M = 4.13; SD = 0.69). Participants rated the program as very important (M = 4.54; SD = 0.82) and would highly recommend (M = 4.52; SD = 0.53). Results indicated the program was well-received by participants and highly acceptable. Discussion will highlight key program features designed to promote acceptability along with the importance of measuring acceptability for large-scale implementation along with next research steps.