bluuebunny/crossref_metadata_2025_split huggingface dataset:
INCREASED SUPPORT FOR OLDER VETERANS AND THEIR CAREGIVERS USING TELEHEALTH SERVICES
Authors: Flores Bertha , Arevalo-Flechas Lyda , Jiwani Rozmin , Romo Enelda , Zaragoza Gabriela , Powers Becky , Sanchez-Reilly Sandra , Espinoza Sara 
Published: December 2023

Abstract
Five million Veterans live in rural areas in the U.S., and about half of those live in the South. Rural Veterans are more likely to be older and have a disability compared with non-rural Veterans. In Texas, Veterans comprise seven percent of the adult population with a median age of 50 years, of those 17% live in rural areas where access to care is a concern for many Veterans and their families. Technology-based services could help close this gap. The GRECC Connect program is one way to reach rural Veterans and their caregivers. GRECC Connect is a multi-disciplinary virtual geriatrics program that provides support for providers to help manage older, rural Veterans through telemedicine. Patient Tele- consultations follow the Age-Friendly Geriatrics 5 M’s framework (Medications, Mentation, Mobility, Multi-complexity, and what Matters most). As a demonstration project at the San Antonio GRECC, we partnered with the Geriatric Extended Care Services (GEC), and the Dementia Caregiver Program (DCP) to educate and support caregivers. We also partnered with the education department to conduct clinic outreach. In Fiscal year 2022, we served 72 Veterans, 66 of those had a caregiver, and the majority (51/66, 77%) were enrolled in the DCP. In Q4 (17/17, 100%) of caregivers were enrolled in the DCP. In addition, Veterans were referred to 248 additional services including palliative care and saved 5,934 miles. The GRECC Connect program decreases barriers experienced by older rural Veterans including transportation, assistance to navigate VA system and access to specialty geriatric and palliative care.
VIRTUAL COMPREHENSIVE GERIATRIC ASSESSMENT FOR VETERANS: AN INTERDISCIPLINARY QUALITY IMPROVEMENT PILOT PROJECT
Authors: Cervantes Maria , Dunlap Janette , Scott Robynn , Howell Teresa , Neal Amy , Bieber Heather , Tillmann Jacob 
Published: December 2023

Abstract
The Veterans Millennium Health Care and Benefits Act requires comprehensive geriatric assessments (CGA) to be provided to all older Veterans as part of the Veterans Medical Benefits Package. Access to a CGA may be difficult for Veterans with limited ability to travel. Currently, in the North Florida/South Georgia (NFSG) Veterans Health System, approximately 11,500 older Veterans are recognized to be at high risk for hospitalization or placement in a long-term care facility, yet only 0.09% of them have received a CGA. NFSG Geriatrics and Extended Care (GEC) developed a standardized virtual CGA process to increase access to geriatric specialty care utilizing VA Video Connect (VVC). The project design and implementation included: the development of a standard operating procedure using evidence-based screening tools, templates, clinic grids and flowcharts, communication channels, and the development of a dashboard for data collection. In addition, the VHA National CGA Template was piloted. This novel Tele-Geriatrics virtual interdisciplinary project allows older Veterans and/or caregivers to remain at their homes for all telehealth/virtual sessions completed by the CGA interdisciplinary team, including pharmacy, nursing, social work, occupational therapy, and geriatric providers. The project demonstrates increased access to comprehensive assessments, consequently closing the gap between current practice and the Veterans Millennium Health Care and Benefits Act requirements. The pilot also decreased the health disparities of rural Veterans. Furthermore, this project helped to increase Veteran knowledge of geriatric syndromes, VA resources, participation in telehealth, and access to durable medical equipment (DME) to help Veterans age in place.
AGE LOGICS IN SOCIAL WORK: THE CASE OF HARM REDUCTION FOR 50+ WITH LONG-TERM SUBSTANCE MISUSE
Authors: Jönson Håkan , Harnett Tove 
Published: December 2023

Abstract
Age is a commonly used criterion in social work: for entry and exit and in decisions on what actions being appropriate for different clients. This study introduces the concept of age logics in social work and do so by investigating the use of age in wet eldercare facilities, a type of harm reduction arrangements for older people. These settings are for people over 50 years of age with long term substance misuse. No treatment is provided, and residents can continue to consume alcohol and other substances at the facilities for the rest of their lives. Using wet eldercare facilities as a case, the aim of this article is: 1) to introduce age logics as an analytical tool for critical studies on age in social work and 2) to propose a method for how to reveal ageism embedded in locally used age logics. The empirical data consists of interviews with eleven caseworkers, 12 staff-members and 31 residents at two Swedish wet eldercare facilities. The analysis identified four age logics linking chronological age with four meanings: 1) Logic on changeability, 2) Logic on lifestyle 3) Logic on function and 4) Logic on administrative fit. Jointly these logics constructed an ideal type version of the “older addict” that justified existing arrangements. The analysis also served as a basis for a proposal of a “four-question method” that may be used to reveal and challenge ageism hidden in locally used age logics.
HOW ORGANIZATIONS CAN ADDRESS AGEISM AS PART OF THEIR DIVERSITY, EQUITY, AND INCLUSION INITIATIVES AND PROGRAMS
Authors: Perez Sasha , Javier Noelle Marie , Brown Katherine , Sanon Martine , Chow Stephanie , Andrade Allen , Goldstein Nathan 
Published: December 2023

Abstract
The Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Health System created a diverse inter-disciplinary committee to advance and promote DEI activities centered in advocating for a socially just, diverse, equitable, inclusive, and anti-racist workplace. Research shows that anti-ageism is a largely neglected component of diversity, equity, and inclusion programs. Thus, many institutions are not learning how age biases and discrimination show up in the workplace and the intersection of age across other dimensions of diversity. Ageism is a vital workplace issue as over a third (37.3%) of the U.S. workforce are aged 50 and older. We aimed to address this by incorporating the topic of anti-ageism via our various DEI initiatives available to all faculty and staff: “Humanities, Arts, and Books Initiative” on Combatting Ageism - structured workday sessions designed to provide a safe virtual space for reflection, discussion, and learning. We also held “Learning Pathway series” on Reframing Aging as well as Caring for Older Adults with HIV – structured sessions focused on knowledge building, and expert-led discussion. Attendance ranged from 40 to 60 participants at each session. Quantitative and qualitative assessment revealed a steadfast interest to address ageism and bias; appreciation of the semi-structured format for dialogue and reflection on relevant topics and finally ongoing education to create a more informed and collegial department. This type of programming can potentially serve as an additional resource for other institutions that are planning in incorporating anti-ageism activities in their DEI programs and everyday practices.
HAS YOUR SMILE BEEN CHECKED?: CHARACTERISTICS OF DENTAL CARE UTILIZATION OF MEDICARE BENEFICIARIES
Authors: Agyemang Lillian , Bakk Louanne 
Published: December 2023

Abstract

Background
An area under researched is oral health disparities in the population of older adults residing in the United States. The current dental benefits offered through health insurance plans that older adults are likely to utilize, particularly Medicare and Medicaid, are inadequate. The deficiency harms this population’s physical and mental health and well-being. Additionally, insufficient oral health care has adverse outcomes, including tooth loss, poor self-esteem, malnutrition, and cardiovascular complications. While evidence suggests race and ethnicity can be predisposing factors impacting access to dental care, it is unclear the extent to which disparities in utilization exist.

Methods
This exploratory, cross-sectional study examined the relationship between dental care utilization and Medicare beneficiary characteristics. Data from the 2018 wave of the Health and Retirement Study were used. The sample consisted of 8,357 respondents aged 65 and older enrolled in Medicare.

Results
There was an association between dental care utilization and race, ethnicity, health status, education, and age. A much lower proportion of Black and Hispanic older adults reported seeing a dentist in two years than non-Hispanic White beneficiaries (p&lt;.001). Dental care utilization was also less among respondents who were older (p&lt;.01), in poorer health (p&lt;.001), and had less education (p&lt;.001).

Conclusions and Implications
Findings suggest disparities in dental care utilization exist and disproportionally impact vulnerable Medicare beneficiaries. This is concerning, particularly given racial and ethnic differences in health. The conclusions accentuate areas such as access to dental care services, coverage, and policy implementation concerning and impacting older adults.
MENOPAUSAL SYMPTOM EXPERIENCE OF MID-LIFE WOMEN FAMILY CAREGIVERS OF PERSONS LIVING WITH ALZHEIMER’S DISEASE
Authors: Kim Hyein , Kim Heejung , Brewster Glenna , Chee Wonshik , Im Eun-Ok 
Published: December 2023

Abstract
Midlife women experience a wide range of menopausal symptoms. Such symptoms may be different in midlife women who are family caregivers of persons living with chronic disease, particularly Alzheimer’s disease. Because the cultural stigma of dementia differs among racial/ethnic minority groups, midlife minority women tend to feel burdened with family caregiving and report negative health outcomes compared with White women. This study aimed to explore the racial/ethnic differences in menopausal symptom experienced by midlife women who were family caregivers of persons living with Alzheimer’s disease (MWPLAD). A secondary data analysis was conducted using the data of a cross-sectional online survey among 172 MWPLAD. Self-report questionnaires including the Midlife Women’s Symptom Index were used to gather the data on the women’s sociodemographic characteristics, health-related information, and menopausal symptom experience. Descriptive statistics, one-way analysis of variance and multiple linear regression were adopted for the data analysis. There were significant racial/ethnic differences in midlife women’s symptoms in the total scores (total frequencies and severity scores) and individual sub-scale scores. Psychological symptoms were reported to be more prevalent in Asian MWPLAD than in other racial/ethnic groups. After controlling for race/ethnicity, several factors were associated with the menopausal symptoms experienced by MWPLAD, such as household income, history of obstetrics and gynecology diseases, underweight, and restriction to perform daily activities. Our study findings support the racial/ethnic differences in menopausal symptoms experienced by MWPLAD. More culturally competent interventions should be established considering the significant factors that differently affect the women’s menopausal symptom experience in different racial/ethnic groups.
WORK PRECARITY AND THE AGING WORKFORCE: TRENDS IN HEALTH DISPARITY AMONG OLDER SERVICE SECTOR WORKERS
Authors: Goldberg Renada , Dill Janette , Kim Jiyeon 
Published: December 2023

Abstract
Work precarity may affect workers’ physical, mental, and social well-being as navigating uncertain and insecure work conditions interacts with factors such as housing, family caretaking, and personal relationships. In particular, the service sector has long been characterized by work precarity as compared to other industries in the US, where noncollege workers are far more vulnerable to non-standard and low-wage work and Black, Indigenous, and workers of color are overrepresented. For older adults, structural and systemic inequities may exacerbate health conditions and accelerates biological aging. In this study, we measure work precarity among noncollege older workers (55-75 years old) in three large and growing service sector industries in the US: health care, retail, and food service, to access the impact of work precarity on older low-wage worker’s health outcomes, exits from the formal wage labor workforce, and linkages between work precarity and health disability.
NEIGHBORHOOD COHESION, NEIGHBORHOOD PHYSICAL DISADVANTAGE, AND END-OF-LIFE CARE: HOW NEIGHBORHOOD MATTERS
Authors: Ding Kedong , Lou Yifan 
Published: December 2023

Abstract

Background
Many studies have focused on the association between individual-level factors and end-of-life care. Yet neighborhood-level factors and end-of-life care are understudied and thus remain unclear. This study aims to examine the association between neighborhood characteristics and U.S. older adults’ end-of-life care to fulfill the existing research gaps. Method: Data were from the 2008 to 2016 Health and Retirement Study exit interview (n = 1,561) who answered left behind questionnaires. Participants included community-dwelling adults aged 55 years or older who died between waves. End-of-life care is measured from three dimensions: health service utilization, quality of life, and advance care planning; Neighborhood characteristics include neighborhood cohesion, which was assessed with 4 items to measure the extent to which respondents feel about the neighborhoods and neighbors’ trust; neighborhood physical disadvantage, which was assessed with 4 items to measure the extent to which respondents feel about the neighborhoods’ physical problems. Logistic regressions with sociodemographic and health controls were conducted.

Results
A higher level of perceived neighborhood cohesion and lower level of perceived neighborhood physical disadvantages are significantly associated with a lower likelihood of being admitted to the ICU, getting life support, and having trouble with pain. Higher neighborhood cohesion is also associated with increased odds of having a living will (OR= 1.10, p &lt; 0.05). Neighborhood characteristics are not associated with end-of-life hospitalization, use of hospice, depression, and having end-of-life care conversations.

Conclusion
This study demonstrated how neighborhood characteristics will influence end-of-life care service utilization, quality of care, and advance care planning.
SOCIAL ENGAGEMENT AMONG COMMUNITY-DWELLING OLDER ADULTS: A QUALITY-OF-LIFE ANALYSIS
Authors: Thompson Alisha , Wilks Scott , Bardales Rhonda 
Published: December 2023

Abstract
Older adults are living longer without sufficient efforts from health and social service systems to improve their quality of life (QoL). QoL is a nuanced, dynamic aspect to analyze. Literature shows that higher levels of social engagement provide a range of benefits to physical, mental, and cognitive health, all broad indicators of overall QoL. Social engagement comprises the person’s subjective experience of the richness of their relationships. The purpose of this study was to examine empirically the connection among this richness of relationships — specifically social engagement and perceived quality of relationships — and overall QoL among older adults. The study used a large sample (N=746) of non-institutionalized adults, ages 65 and older, from the nationally representative, AARP Social Engagement and Brain Health Survey. Two primary independent variables (IVs) were quantifiable measures of social engagement and perceived quality of social relationships; covariance controlled for several demographic factors (e.g., sex, ethnicity, income) and general health measures of physical, mental, and emotional health. The outcome variable was a composite score from a popular QoL measure. Analyses involved bivariate regression for the primary IVs, then multivariate OLS regression with each IV to predict quality of life. Results showed that QoL significantly regressed with predictors of social engagement (positively); each health variable (positively); unmarried status; ethnicity of Black/African American or Asian; and male gender. These results enhance our understanding of the relationship between social engagement, relationship quality, and QoL in older adults, particularly those who identify within the aforesaid demographic brackets. Implications are discussed.
WHY ARE SOCIALLY ISOLATED OLDER ADULTS UNABLE TO ACCESS SERVICES IN JAPAN? A PRELIMINARY REVIEW OF FOUR FACTORS
Authors: Ikeuchi Tomoko , Kikuchi Kazunori , Taniguchi Yu , Hayashida Cullen , Ito Kae 
Published: December 2023

Abstract
The COVID-19 pandemic has made it difficult for health and social service agencies to provide the necessary support to community-based older adults. It is believed that the number of socially isolated older adults without the necessary support has increased, but the actual situation is unclear. In this study, we conducted a self-administered mail survey targeting all local municipal governments and social welfare councils throughout Japan from September to October 2022 to examine the actual situation. The response rate was 18.7% (682/3654). Nearly 52% of respondents reported an increase in the number of socially isolated older adults during the pandemic, and 43.6% reported that providing support services to them was difficult. We specifically asked about the difficulties encountered in providing support and coded the open-ended responses (n=275). Four primary themes were identified: (1) generalized refusal by isolated older adults (n=79); (2) difficulty in locating (n=72); (3) difficulty in face-to-face communication (n=40); and (4) difficulty in supporting (n=73). Among the reasons for the difficulty in supporting isolated older adults were their diverse needs and tendency to not recognize their need for support, which may be due to mental illness or dementia. Our findings suggest that a better attempt at classifying refusals among social isolates is a first step to improving the impact of social and health services intervention. Further research is needed to clarify the reasons for refusal of the support provided and to identify the specific types of support that isolated older adults require.
LGBITQ+ INCLUSIVITY IN GERIATRIC CARE IN NORWAY: ATTITUDES AND PRACTICES AMONG HEALTH CARE PERSONNEL
Authors: Bromseth Janne 
Published: December 2023

Abstract
Person-centered care is the dominating care philosophical framework being used in geriatric care services in Norway today, as a point of departure for good practice. It implies that all care-receivers should be met from an empathic and individual perspective- and an increased focus on basic psychological needs. To be positively confirmed in relation to ones′ identities and to feel included in communities are central parts of this (Kitwood 1997). But is this also the case for older LGBTIQ+-adults? And which competence and knowledge on LGBTIQ+-adults′ life course experiences and aging conditions exist amongst health care staff working in long-term care facilities, home care services and day care activities? This paper is based on results from the interview study “Queer perspectives on geriatric care in Norway”, investigating experiences of person-centered care and inclusive practices from two perspectives; non-heterosexual care receivers and care providers in the Oslo-area. The analyzed material consists of: 1) interviews with 11 LGBQ-people between 61- 78 years old about their experiences with health care services over the life course 2) 3 focus groups and 2 individual interviews with health care staff working in a range of health and care services targeting 65+ adults. A majority of the interviewees had received training on LGBTIQ+-inclusive health care. The paper will mainly present results from the second study. What are leaders′ attitudes and knowledge regarding active work with gender and sexual diversity and equal access to care, and which experiences do they have from implementing LGBTIQ-awareness in policy and care practices?
PERSPECTIVES OF THE HOME HEALTH WORKFORCE ON TRAINING
Authors: Valdes Elise 
Published: December 2023

Abstract
As more older adults desire to age in place, home health workers are becoming a vital component of the healthcare workforce. The last large scale nationwide survey among home health workers was conducted in 2007. There has been a variety of research in this area since then; however, the majority of studies are small and qualitative in nature which may limit their generalizability. Understanding the opinions and perspectives of home health workers is vital to retaining this important part of the healthcare workforce. For the current study a broad sample of home health workers (n=1446) including home health aides, hospice health aides, personal care aides, CNAs, LVN/LPNs, and RNs completed an online self-report survey on how well their training prepared them for practice. Results indicated that most hospice health aides felt their training well prepared them for practice (80.3%), while only 56.6% of RNs reported that they felt well prepared. We also explored how prepared respondents felt on a variety of topics from patient care skills to dementia care to end of life skills. Again, hospice health aides reported the highest average scores for receiving excellent training across all topics (61.5%) and RNs reported the lowest average scores (42.6%). Feeling unprepared for a job, may lead to lower job satisfaction and higher turnover. Therefore, understanding how well-prepared home health workers feel is key to retaining this segment of the workforce. Future research should explore how to improve this training and preparation across all home health workers but particularly among RNs.
BUDDY-UP DYADIC PHYSICAL ACTIVITY (BUDPA) PROGRAM ON HEALTH OUTCOMES OF DEMENTIA CARE DYADS: A FEASIBILITY TRIAL
Authors: Yu Doris S F , Li Polly 
Published: December 2023

Abstract
Dementia is a challenging disease experience not only jeopardizes the health of the persons with the condition (PWD) and their family caregivers. In views of the health promoting effects of exercise and its high relevance to promote a meaningful encounter between the dementia care dyads, a pilot feasibility was conducted to examine the effects of a 12-week multi-component Buddy-Up Dyadic Physical Activity (BUDPA) Program. Thirty care dyads were randomized to receive the BUDPA program or wait-list control. Outcome evaluation at baseline, 6 weeks and 12 weeks showed greater improvement in most of the cognitive functional domains (Coden’s d = 0.30-0.87), neuro-psychiatric symptoms (Coden’s d = 0.22), overall mood status (Coden’s d = 0.30) and positive aspects of caregiving (Coden’s d=0.32) among the BUDPA group, though the limited statistical power did not identify significant difference. The qualitative findings from eight care dyads engaged in BUDPA program converged with the outcome evaluation, and BUDPA was described as a ‘physical-based social-cognitive training’. The PwDs were more engaging and attentive in daily life, with less irritability, delusive thoughts and repetitive behaviors. Caregivers reported feelings of vitality and enhanced mood. Converge with the 3-Phase Dyadic Adaptation Model, the care dyads felt more connected and their feeling of ‘being cared for by the PwD is very powerful to reward their effort in caregiving. This finding implies the dyadic exercise is of high fidelity, and a full-scale study is needed to evaluate its effect from a health-promoting, social-interactional and existential paradigms.