bluuebunny/crossref_metadata_2025_split huggingface dataset:
WOMEN SUPPORTING WOMEN: PEER SUPPORT GROUP FOR OLDER WOMEN WITH METASTATIC BREAST CANCER IN NIGERIA
Authors: Chidebe Runcie , Agha Agha A , Nwakanma-Akanno Onyedikachi , akwiwu Chika Okem , Nwakasi Candidus , Aruah Simeon , Esiaka Darlingtina , Cummins Phyllis 
Published: December 2023

Abstract
Metastatic breast cancer (mBC) is incurable and devastating to all cancer patients. In Nigeria, the proportion of patients with stage III or IV/metastatic breast cancer at diagnosis is 98%. Although many younger mBC patients live for years, older mBC patients have poorer prognosis, more physical symptoms, poorer access to palliative care, and experience higher social isolation. Also, most older Nigerian women diagnosed with mBC experience psychological challenges during and after their treatment, with higher possibility of abscondment from treatment. While peer support groups (PSG) have become increasingly beneficial for improving the quality of life (QoL) of these older women, there is paucity of literature exploring the benefit of these groups and how they provide support to cancer patients in Nigeria. Using a qualitative research approach and interpretative phenomenological analysis, we explored the experiences of older Nigerian women (n=8) living with mBC who belong to a PSG. Our finding shows that for older women living with mBC, seeing peers with similar lived experiences inspire them to keep living, being hopeful, and experience a reduction in death anxiety. PSG provides a culture of love, peer support, socialization and strengthened connections. In addition to pain and inability to walk (mBC linked disabilities) being recurring physiological challenges for many older women with mBC, forced retirement/inability to work, death anxiety, financial burden, and limited access to cancer care are some of the socio-psychological challenges they face. Therefore, the establishment of PSG in cancer treatment centers in Nigeria would improve QoL and reduce abscondment from treatment.
CARE JUSTICE FOR UNPAID AND UNDERPAID CARE WORKERS
Authors: Hooyman Nancy 
Published: December 2023

Abstract
Scholarship on older women, family caregiving, feminist gerontology, community-based services and policy change intersected throughout my career. As a social worker, care of older adults has always been a matter of social justice. My focus now is on care justice for those who perform the critical work of long-term services and supports: unpaid family caregivers and underpaid home care workers. This lecture will examine the interrelationships among both types of care laborers, who often face structural constraints on their decision to care and whose work is devalued, marginalized and invisible. Inequities for care workers by race, immigrant status, and sexual orientation are rooted in systemic racism, sexism, xenophobia, and homophobia. This lecture presents the components of a care justice framework, informed by feminism, intersectionality, and care theory, of fundamental structural changes to value collectively the essential work of care, ensure meaningful choice to care, and reduce inequities in care labor.
UNIVERSITY KENAN DISTINGUISHED PROFESSOR AND CO-DIRECTOR, PROGRAM ON AGING, DISABILITY, AND LONG-TERM CARE
Authors: Zimmerman Sheryl 
Published: December 2023

Abstract
The concept of person-centeredness -- simply stated, knowing the person in a holistic perspective and meeting the individual’s needs and preferences -- has become so ubiquitous in health and supportive care that it borders on being a cliché. More so, it is often not reflected in national surveys and databases; considered in relation to the capacity of varying systems of care; forward-thinking in terms of emerging realities; or dissected in reference to some of the nuanced and implicit issues responsible for bringing it to the forefront of national attention. This Kleemeier Award lecture will reconstruct the concept of person-centeredness based on literature review, questionnaires, interviews, forums, and think tank meetings with diverse experts. It is supported by National Institute of Aging through a grant to the Alzheimer’s Association’s LINC-AD.
STATE GENEROSITY IN HOME- AND COMMUNITY-BASED SERVICES (HCBS): VARIATIONS AND IMPACT ON DEMENTIA OUTCOMES
Authors: Cheng Zijing (Flora) , Li Yue 
Published: December 2023

Abstract
To meet the needs of community-living older adults and reduce overall medical spending, home- and community-based services (HCBS) provide assistance and care for persons with significant physical and cognitive limitations. Together, Medicaid long-term services and supports (LTSS) coverage and the Title III program under the Older Americans Act (OAA) of 1965 support the majority of the HCBS for older adults living in the U.S. with low-income and/or disabilities. We evaluated state variations in generosity of supporting HCBS in recent years and how these variations affect the healthcare outcomes of community-living older adults and socio-economic and racial disparities in dementia outcomes. State HCBS generosity from the perspectives of program participation and intensity of services was defined by the exploratory and the confirmatory factor analysis with data from multiple sources, including state reports from the National Association of State Budget Officers. State data was linked to a nationally representative sample of older adults who enrolled in the Health and Retirement Study in 2020. Analyses revealed that overall state supports for HCBS increased over time in recent years while state Medicaid expenditures for institutional long-term care remained largely stable. State supports through both Medicaid and the OAA programs for HCBS varied substantially and persisted in recent years. Discussion will focus on instrumental variable analyses that determine the causal impact of state variations in HCBS generosity on health outcomes (i.e., unmet need; hospitalization) for persons living with dementia persons.
ASSOCIATIONS BETWEEN NEIGHBORHOOD SOCIAL DESTINATIONS AND GPS-DERIVED COMMUNITY MOBILITY OF OLDER ADULTS
Authors: Moored Kyle , Crane Breanna , Dunlap Pamela , Carlson Michelle , Rosso Andrea 
Published: December 2023

Abstract
Neighborhood social destinations may encourage greater out-of-home travel (i.e., community mobility) and support independent functioning in later life. We examined associations between quantity of destinations that promote social interactions (e.g., arts/recreation, restaurants, stores, civic/religious institutions) and objective, GPS-derived community mobility. Participants were 146 adults ≥65 years old (Mean=77.0±6.5 years, 68% women) at baseline of a randomized trial to improve walking coordination. Participants carried a GPS device that passively collected real-time location data for 5-7 days. Spatial extent of community mobility was quantified using median standard deviational ellipse area (SDEa, km2) and maximum distance from home (mDOH, km). Duration of community mobility was characterized using percentage of time spent out-of-home (pTOH). Community mobility measures were stratified into tertiles due to positive skew. We used National Establishment Time Series (NETS) classifications to derive a total social destination count at the Census tract-level (Mean=48.9±35.7 social destinations per tract). Ordinal logistic regressions were adjusted for demographics (age, gender, race, education), device, season, and number of comorbidities and were clustered on Census tract. Each 1-SD greater destination count was associated with 46% greater odds of being in a higher tertile of pTOH (OR=1.46, 95% CI: 1.08-1.97, p=.014). Number of social destinations was not associated with SDEa or mDOH (all p’s&gt;.05). Nearby social destinations may encourage greater duration, but not necessarily spatial extent, of community travel. Future work utilizing GPS can objectively measure activity in community social spaces to assess its benefits for cognitive and mental health in later life.
ROLE CAPTIVITY, DAILY SOCIAL ISOLATION, AND THE MENTAL HEALTH OF DEMENTIA CAREGIVERS
Authors: Puga Frank , Wang Danny , Bibriescas Natashia , Poe Abigail , Alvarez Loreli , Jablonski Rita , Vance David 
Published: December 2023

Abstract
Family members providing informal care to individuals living with Alzheimer’s disease and related dementias (ADRDs) have an increased risk of poor mental and cognitive health. Social connection has been proposed as an intervention target to support the health and well-being of ADRD caregivers; however, little is known about daily variation in social connection, contextual factors that impact social connection, and its association with caregiver mental health experiences. Thus, the purpose of this study was to examine the relationship between role captivity and daily social isolation (i.e., lack of social connection) among dementia caregivers, as well as associations between social isolation and depression and anxiety-related symptoms. A sample of community-dwelling ADRD caregivers (N=30) completed a baseline survey followed by 14 days of daily diaries (n=323 data points). Participants were asked about role captivity, social isolation, and daily depression and anxiety-related symptoms. Data were analyzed using mixed-level modeling. Role captivity reported at baseline was significantly associated with daily social isolation (B=0.82, 95% CI [0.68, 0.96], p &lt;0.001). Further, daily social isolation was significantly associated with both depression (B=0.69, 95% CI [0.61, 0.77], p &lt;0.001) and anxiety (B=0.55, 95% CI [0.48, 0.62], p &lt;0.001) related symptoms reported on a given day. The findings from this study contribute knowledge on ecologically valid interventions that target daily experiences of social isolation and support the mental health of dementia caregivers. Such interventions are critically important given the proposed links between mental health, social isolation, and cognitive health in later life.
PUBLIC SECTOR INVOLVEMENT IN AGE-FRIENDLY CITIES AND COMMUNITIES: A SCOPING REVIEW
Authors: Greenfield Emily , Pope Natalie , Keyes Laura , Russell Elizabeth 
Published: December 2023

Abstract
The global age-friendly cities and communities (AFCC) movement has long centered the involvement of the public sector, calling on high-ranking authorities to commit to improving the built, social, and service environments of their localities. However, there is little understanding of how the public sector is involved in actual practice. To address this gap, we conducted a scoping review of peer-reviewed articles published since 2010, with a focus on studies in Canada and the United States, to synthesize the evidence on the ways in which the public sector has been involved with AFCC work. Our review identified four primary themes. The first theme describes the variety across studies in descriptions of the overall positioning of the public sector in AFCC efforts, with public sector actors ranging from leaders to partners to targets for advocacy. The second theme addresses activities that are initiated by a public administration that targets age-friendly improvements for that administration. The third theme encompasses activities that help to connect a public administration with, as well as influence, outside actors, primarily the private sector and government administrations at other systems levels. The final theme elucidates the various ways in which the public sector is involved with AFCC assessment, evaluation, and research. We discuss the implications of our findings for practice, policy, and continued empirical research. We also discuss theoretical implications for AFCC efforts in terms of distinguishing “whole of government” from “whole of society,” grassroots, and planning-specific approaches.
ADVANCING AGING EQUITY AMONG OLDER BOSTONIANS
Authors: Hernandez Adriana , Coyle Caitlin 
Published: December 2023

Abstract
More than five years after the City of Boston started its journey towards becoming an Age and Dementia Friendly community, the initiative and its collaborators have been working to ensure that the initiative and its many contributions are equally realized by all Bostonians. Drawing on the concept of aging equity--that all older adults, despite their life course histories, have equitable access to programs and services that help them age well. To achieve this means removing obstacles to accessing community features that support healthy aging, establishing social and civic engagement opportunities, ensuring safe environments, establishing access to healthcare, and disseminating knowledge of available supports and services. This presentation will describe the research and community engagement that led to the development of an aging equity conceptual framework and examples of how it is being operationalized in the City of Boston. For example, we will share the ways in which outreach and communication strategies have been altered to more equitable practices including efforts to build trust, engage in cultural translation of programs and services, and consider new channels of information sharing.
EAST MEETS WEST: INTERVENTIONS, PRACTICE MODELS, AND POLICIES TO SUPPORT FAMILY CAREGIVERS IN DIVERSE CULTURES
Authors: Sun Fei , Sun Juanjuan , Lu Jiehua , Harrison Tracie 
Published: December 2023

Abstract
This East Meets West symposium consists of six studies that examined innovative interventions, practice models and policies designed to support family caregivers of older adults in the U.S., Taiwan, and mainland China. The first two papers both used case management interventions to assist family caregivers with a focus on caregiver depression. The paper from the U.S. found that more difficulties of performing caregiving tasks and less caregiver preparation contributed to higher levels of depression, and the paper from Taiwan found that caregivers who received the case management service reduced depression at four-month and six-month follow-up assessments. The third paper discussed a “time travel” paradigm developed to guide service design and delivery for persons with dementia at different stages. The fourth paper used the state of Michigan as a case to examine service gaps in the current aging service network, and identifies an urgent need for statewide policy renovations to support family caregivers. The fifth and sixth papers both used large secondary data analyses to examine the effects of piloted policy and practice efforts on family caregiver outcomes. One study found that the long-term care insurance programs have resulted in positive caregiver outcomes including reduced caregiving financial cost, time, and physical and psychological burden. The other study found the use of home-based care services reduced adult children caregiver burden and did not affect the relationship between older adults and adult children caregivers. After individual presentations are done, two discussants will summarize shared themes in these papers and provide critical feedback.
A CRITICAL EXAMINATION OF AAA SERVICES AND SUPPORTS FOR CAREGIVERS IN MICHIGAN: POLICY AND PRACTICE IMPLICATIONS
Authors: Ilardo Joan , Zell Angela 
Published: December 2023

Abstract
To identify the service gaps for family caregivers in Michigan, this study examined the perceptions of stakeholders from the 16 area agencies on aging (AAA). An online questionnaire was administered to assess a point-in-time picture of current caregiver assessments and services in 2020. Fifteen AAAs responded to see definitely or probably an increase in the number of caregivers in their catchment areas. Fifteen AAAs currently purchase or contract for respite care services. Fourteen provide some type of direct caregiving resources. Twelve utilize staff to develop and monitor care plans. While some provided caregiver training, none directly provided supportive services. AAAs anticipated rapidly increasing needs for caregiver supports and services. While each provided a different array of services, they anticipated that demand would continue to increase given a rising aging population in Michigan. Results were used to craft a proposal to establish a network of regional caregiver resource centers. Recommendations in the study include creating a task force of stakeholders to identify standardized service definitions, measures and reporting requirements; create a no-wrong-door, multi-prong approach for caregivers to access programs; provide respite care through contracts and referrals to community-based organizations; create a network of trainers to disseminate evidence-based best practices to AAAs and contractors; use untapped resources such as AARP and Alzheimer’s Association; explore forming local healthcare systems and provider collaborations to identify caregivers and triage them. Next steps are to pursue funding from the legislature and other sources to create regional caregiver resource centers across the state.
PARTNERING TO IMPROVE CARE: STRENGTHENING THE FAMILY CAREGIVER AND HOME CARE WORKER RELATIONSHIP
Authors: Scales Kezia , King Jessica , Dieppa Emily 
Published: December 2023

Abstract
Family caregivers and home care workers provide essential daily care for millions of older adults and individuals with disabilities across the United States—and together they constitute the backbone of home and community-based services (HCBS). In many cases, these unpaid and paid caregivers work closely together and share common knowledge, skills, experiences, and challenges. Yet the overlap and relationship between them remains relatively understudied. This session will describe the importance of strengthening the family caregiver/home care worker dyad and discuss promising developments in research, policy, and practice. We will then highlight a pilot training intervention designed to improve the shared knowledge and interpersonal competencies of family caregivers and home care workers. The intervention— Partnering to Improve Care: Direct Care Workers and Families—was developed by PHI (a national nonprofit research, public education, and consulting organization) in partnership with the Florida Pioneer Network, Home Instead, and Florida State University through the North and Central Florida Geriatrics Workforce Enhancement Partnership (GWEP). Informed by the PHI Coaching Approach®, the intervention consists of five parallel online training modules for family caregivers and for home care workers that utilize adult learner-centered teaching methods and reflect input from home care stakeholders. The modules portray common scenarios that family caregivers and home care workers face and aim to build communication and relationship skills that facilitate collaborative problem-solving and the provision of person-centered care. We will present key findings on the feasibility and acceptability of this intervention, discuss next steps in this research, and highlight broader policy and practice recommendations.
PRAGMATIC IMPLEMENTATION OF AN ADVANCE CARE PLANNING INTERVENTION: FINDINGS FROM SHARING CHOICES
Authors: Scerpella Daniel , Wolff Jennifer , Gaugler Joseph 
Published: December 2023

Abstract
Advance care planning (ACP) is defined as a key task in ambulatory care for patients to share values, goals, and preferences for future medical care. Ideally ACP is revisited throughout the course of serious illness and engages family in discussions with clinicians. Most interventions, however, have not targeted primary care as a setting for ACP but have instead targeted a specific illness, conversation or setting such as the inpatient hospital or nursing home. Additionally, family is often not included in ACP discussions. This symposium will discuss critical components of the SHARING Choices cluster-randomized pragmatic trial, including the setup, monitoring, and analysis of this intervention within two primary care health systems located in the Baltimore-Washington DC metropolitan corridor. Each presenter will discuss key efforts conducted during the trial that highlight challenges, lessons learned, and novel approaches of embedding an evidence-based intervention within usual care settings targeting older adults 65 years of age and older. Preliminary analyses indicate that the ACP intervention was highly effective for increasing the likelihood of having advance directives in the patients’ electronic health records within 1-year of intervention initiation (odds ratio = 2.88, p &lt; 0.001). Attendees of this symposium will take away relevant insights for implementing effective ACP and communication interventions within primary care settings as well as supporting outcome data. Our discussant will provide thoughts on the implications of these results for current primary care organizations and in the field of ACP and communication for older adults including those with dementia.
PERCEIVED WORKPLACE AGEISM AND OLDER WORKERS’ LABOR FORCE TRANSITIONS DURING THE GREAT RECESSION
Authors: Sahin Duygu Basaran 
Published: December 2023

Abstract
Previous research suggests that workplace ageism increased during the Great Recession (GR). During the GR, despite having lower unemployment rates compared to younger workers, older workers took considerably longer to find jobs once they were unemployed. Yet, no study has investigated the potential role of workplace ageism in older workers’ labor force outcomes. This study examines the role of perceived workplace ageism in older workers’ labor force transitions during the GR using longitudinal data from the Health and Retirement study. I conduct a multi-period analysis and compare how the association of perceived workplace ageism with labor force transitions changed during the GR compared to pre and post-recession periods. Results from multivariate logistic regressions show that only in the GR period, both measures of perceived workplace ageism – pressure to retire before age 65 and preference for young in promotions – were associated with a higher likelihood of employment instability (b= 0.336 p&lt; 0.05 and b= 0.340 p&lt; 0.05), net of demographic, socioeconomic, financial, job-related and health-related factors. Moreover, older workers perceiving workplace were less likely to retire and thereby more likely to be unemployed (b= -0.667 p&lt; 0.05). In contrast, perceived workplace ageism had no association with reducing or increasing the hours worked per week. In sum, this study provided the first individual-level evidence on the impact of perceived workplace ageism on older adults’ labor force transitions during the GR. Findings can be used to motivate additional studies on older workers’ experience during the Covid19 crisis.
THE SYNERGISTIC EFFECT OF STRESSORS AND UPLIFTS FOR DAILY SUBJECTIVE AGING IN THE US
Authors: Neupert Shevaun 
Published: December 2023

Abstract
Exposure to daily stressors is consistently associated with reduced health and well-being, including feeling subjectively older. Experiencing uplifts, however, are typically associated with increased health and well-being, but have not yet been examined with respect to subjective aging. The current study tested daily stressors and uplifts as unique as well as interactive effects for daily subjective age and daily ageist attitudes. A sample of 440 U.S. adults aged 50-85 participated in a 14-day daily diary study, reporting on their subjective age, ageist attitudes, daily stressors, and daily uplifts each day. All variables demonstrated significant within-person variability, with ICCs ranging from .68 (uplifts) to .75 (subjective age). Daily stressors and daily uplifts were each uniquely predictive of daily ageist attitudes, where daily stressors were positively associated and daily uplifts were negatively associated with daily ageist attitudes. For daily subjective age, there was a synergistic effect of daily stressors and daily uplifts. On days with no stressors, daily uplifts were not associated with daily subjective age. However, on days with stressors, increases in daily uplifts were associated with significant decreases in subjective age. These findings underscore the multidimensionality of subjective age constructs and will be situated within cross-cultural comparisons.