bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ROLE OF PAID CAREGIVERS IN HOME-BASED DEMENTIA CARE: FAMILY, PAID CAREGIVER, AND GERIATRICIAN PERSPECTIVES
Authors: Watman Deborah , Reckrey Jennifer 
Published: December 2022

Abstract
Paid caregivers (e.g., personal care aides, home health aides, other direct care workers) provide essential care that allows people with dementia to remain living at home, yet little is known about the lived experience of this care. This project uses multiple perspective, qualitative longitudinal interviews to explore paid caregiver role in home-based dementia care. We conducted one-on-one interviews via telephone or zoom with the family caregiver, paid caregiver, and geriatrician of an individual person with moderate or severe dementia (n=9) living at home in New York City. After an initial interview, up to 2 additional interviews (at 3 and 6 month intervals) were also conducted for a total of 75 interviews with 29 unique respondents. Interviews were audio-recorded, transcribed, and analyzed using the framework method of analysis. Interviews revealed nuanced care arrangements, but paid caregiver role in care remained largely stable over time. Key findings include: (1) Family caregivers played a primary role in determining overall paid caregiver role in care, (2) Paid caregivers describe the emotional components of caregiving (e.g. being “like family”, having patience) more frequently than families or doctors, and (3) Doctors rarely engage with paid caregivers unless family involvement is limited. The unique structure of each triad emphasizes the importance of person-centered dementia home care. Formal care plans may not reflect the nuances of care arrangements and responsibilities. Rather than prescriptive standards for home care, improved communication and clear expectation setting may help meet the complex needs of people with dementia and their families.
GLOBAL CLINICIAN PERSPECTIVES ON NON-OPERATIVE HIP FRACTURE MANAGEMENT DURING COVID-19
Authors: Xiang Lucille , Singh Mriganka , McNicoll Lynn , Moppett Iain 
Published: December 2022

Abstract
There are currently no guidelines regarding clinician decision making in the type of hip fracture management among older adults. Cultural, social, structural and economic differences between global healthcare systems may result in differing approaches. This study’s objectives were to identify possible factors influencing clinicians’ decision to undertake a non-operative hip fracture management approach among older adults, and to determine whether there is global heterogeneity regarding these factors between high income countries (HIC), and low- and middle-income countries (LMIC) clinicians. A SurveyMonkey questionnaire was distributed to clinicians through the Fragility Fracture Network’s Perioperative Special Interest Group and clinicians’ personal networks between May 24 and July 25, 2021. 406 respondents from 51 countries returned the questionnaire, of which 225 respondents came from HIC and 180 from LMIC. Clinicians from HIC reported a greater median [IQR] estimated proportion of admitted patients with hip fracture undergoing surgery (96% [95–99]) than those from LMIC (85% [75–95]) of mean (SD) at 94% (8) compared to 81% (16) among LMIC clinicians (p=2.94e-23). Several factors seemed to influence the clinician hip fracture management decision making process. Global heterogeneity seems to exist between HIC and LMIC clinicians regarding factors such as anticipated life expectancy, ability to pay, treatment costs, insufficient resources, and perception of risk in hip fracture management decision-making. This is the first international sampling of clinician perspectives regarding hip fracture management. Further research is necessary for the development of best practice guidelines to improve hip fracture management decision-making and quality of hip fracture care among older adults.
BARRIERS AND STRATEGIES TO ENGAGE AND RETAIN DIVERSE RURAL DYADS IN PSYCHOSOCIAL INTERVENTIONS
Authors: McCarthy Michael , Garcia Y Evie , Cassady Mara , Mall Neshay , Bosch Pamela , Barger Steven 
Published: December 2022

Abstract
It is often challenging to engage and retain rural Latinx and Native Americans in psychosocial interventions after stroke, despite the fact that these populations tend to experience poorer health outcomes. Although strategies for effective patient-provider communication exist, few studies focus on the cultural aspects of engagement and retention of diverse dyads in a rural context. The aim of this study is to describe barriers to engagement and retention of diverse rural dyads in post-stroke psychosocial interventions, as well as to elucidate specific strategies to address these barriers. Semi-structured interviews were conducted with Nf14 clinical providers with extensive experience serving diverse rural couples and families. Qualitative data were analyzed using interpretive description methods. Seven key barriers were identified, grouped broadly into: 1. Those presented by providers (1a. Lack of time and attention given to dyads “telling their story”; 1b. Lack of culturally appropriate interpersonal skills; 1c. Incongruence between provider-patient values) and 2. Those existing within dyads themselves (2a. Low priority given to interpersonal and emotional issues; 2b. Concern about confidentiality in small communities and mistrust of those in power due to current or historical experiences with dominant cultures; 2c. Perception of stigma surrounding interpersonal and emotional issues; 2d. Tendency to be polite, accommodating, or feign investment). Providers offered specific culturally-informed strategies to overcome barriers which in turn may increase engagement and minimize attrition. Providers and researchers may benefit from these insights as they work to communicate with, build trust, and meet the unique needs of these populations.
EDUCATION AND PERCEIVED FUTURE NEED FOR ADL HELP
Authors: Finan Julia 
Published: December 2022

Abstract
Extant literature suggests that adults with higher education are more likely to avoid poor health outcomes and to rate their health as better than individuals with less education. The current study builds on prior research by analyzing the association between educational attainment and the perceived need for future help with activities of daily living (ADLs), often measuring disability in the literature. 2011-2014 National Health Interview Survey (NHIS) data for adults in the United States age 40 to 65 (N=55,166) were analyzed using multivariate regression analysis. Among non-Hispanic Whites, increased years of education predicted stronger anticipation of the need for future ADL assistance. For non-Hispanic Blacks, this relationship was reversed at the some-college level. Education was not predictive of perceived future ADL assistance need for all other racial-ethnic groups. Results of this study suggest education has a unique impact on anticipation of future need for ADL assistance among non-Hispanic Whites.
USING STORYTELLING TO ASSESS NURSE’S KNOWLEDGE IN CARING FOR OLDER ADULTS
Authors: Murphy-Boucher Michele , Woods Diana Lynn 
Published: December 2022

Abstract
Continuing education, knowledge acquisition, and competence is required of all professional Registered Nurses. Remaining current in care delivery trends based on evidence practice is the responsibility of nurses supported by professional development specialists and educators. This project was conducted as a quality improvement project, using the evidence-based teaching modality of storytelling to educate practitioners in caring for older adults. This project addresses the question: For leaders of professional development and education focused on acute care and ambulatory practice, who have not had specialty geriatric training, how does using case-based/story-telling education for the care of patients 65 years and older affect confidence levels of the 4 M’s (mentation, mobility, what matters and medication) of elder care? A convenience sample of 12 Directors of Professional Development participated, and a validated comparison of responses to the Gerontological Nursing Competence Questionnaire (GNCQ) and the Facts on Aging (2015 version) (FAQ) were used for collecting data of pre intervention and post intervention. An eight-minute video was the educational intervention. GNCQ responses for confidence in knowledge and confidence in teaching were statistically significant. Although an increase in the mean score for interest in additional training, it was not statistically significant. The FAQ showed no statistical significance for the pre and post results. Findings indicate that storytelling is a viable teaching modality for increasing nurse’s knowledge of caring for older adults based on the concepts of the 4 Ms of age-friendly care. Keywords: storytelling, case studies, nurse education, professional development, narratives, and adult learning.
INTEGRATED FAITH BASED CURRICULUM FOR COMMUNITY-BASED OUTREACH WORKERS: ADDRESSING INEQUITIES AMONG OLDER ADULTS
Authors: Bullock Karen , Stansbury Kim , Ruth Terrance 
Published: December 2022

Abstract
Older Latino and Black Americans experience health inequities and a lack of culturally competent clinician may influence this outcome. Community-Based Outreach (CBO) has proven to be effective in addressing such challenges. CBO is an effective approach to engaging communities that have been historically marginalized and are less likely to utilize hospice and palliative than other racial/ethnic groups. Yet, few models and modules for training are available in the literature to prepare CBO workers. This presentation describes the development, coordination, content and implementation of an Interprofessional Educational (IPE) training and curricular innovation to meet needs of diverse older adults diagnosed with a serious illness.
Methods: A community-based outreach approach that integrated faith-based/spiritual care curriculum to train African American and Latino outreach workers to support older adults with serious illnesses, with a focus on advanced care planning (ACP) that explored potential barriers to equitable care. A collaboration with faith-based community representatives to design the intervention research protocol was essential.
Results: The curriculum consisted of three parts: (1) a 36-hour classroom component delivered in three modules organized around eight themes: what is hospice and palliative care, spirituality and the meaning of death, understanding the dying process and decision making, goals of care, culturally responsive care; (2) weekly visits; and (3) field education/workforce development. At the end of the training, learners were able to: (a) express knowledge about culture differences; (b) demonstrate skills – listening, identifying meaning in the decision making, convey health information using patient-centered language; (c) understand cultural influencing decision making.
WHAT DO FAMILY CAREGIVERS WANT? PAYMENT FOR PROVIDING CARE
Authors: Nadash Pamela 
Published: December 2022

Abstract
Although the primary goal of self-directed programs providing long term services and supports (LTSS) is to maximize choice and control for service recipients, such programs may also benefit family caregivers by compensating them for providing supportive services. This study draws on qualitative data from research supporting the RAISE Family Caregiver Advisory Council, finding that family caregivers themselves see the expansion of self-directed programs as a policy priority due to their need for financial security. The request for compensation was the strongest finding, with respondents highlighting the incompatibility of work with caregiving and their inability to rely on the existing paid workforce due to supply and quality issues; the consequences of this loss of earned income were reported as severe. Ultimately, respondents saw payment for providing care as an issue of fairness. This evidence supports the policy case for expanding access to self-directed programs that permit the employment of family caregivers.
IMPACT OF GENDER ON ASSOCIATION BETWEEN RACE AND DISABILITY: THE CALIFORNIA HEALTH INTERVIEW SURVEY (CHIS)
Authors: Quach Lien , Vu Christine , Tran Isabelle , Peeri Noah , Nguyen Uyen-Sa 
Published: December 2022

Abstract
Women generally have higher prevalence of disability than men in later life. Moreover, Blacks and Hispanics usually have higher prevalence of disability than Whites. Little is known about the impact of gender on the association between race and disability. We used 2015-2016 CHIS data, restricted to adults ≥ 65 years old (n=15,044). Disability was classified as present or absent based on responses on questions related to “to physical, mental, and emotional conditions.” Race was classified as: White, Black, Hispanic, Asian, and Other. We estimated sex- and race-specific proportions and 95% confidence intervals (CI) and used sex-specific multivariable logistic regression to examine the associations between race and disability adjusting for age, education, marital status, cigarette smoking, arthritis, hypertension, and diabetes, mental distress, and walking for work or pleasure. All analyses accounted for complex sampling weights. Approximately 52% of women and 47% of men had disability, while 48% of White, 48% of Black, 60% of Hispanic, 43% of Asian, and 50% of Other race responded as having disability. Adjusting for covariates, Hispanic women had 67% higher odds of having disability compared with White women (OR= 1.67, 95% CI= 1.07–2.60), but there were no differences in male counterparts (OR=1.03, 95% CI=0.68-1.56). Compared with White men, men of Asian or Other race had lower odds for disability, while associations were in the opposite direction in female counterparts; however, associations were not statistically significant. Further research is needed to understand higher prevalence of disability among older minority women compared with White women.
BIOLOGICAL RISK FACTORS FOR DEMENTIA AND COGNITIVE FUNCTION AMONG OLDER INDIANS: FINDINGS FROM LASIDAD
Authors: Wu Qiao , Crimmins Eileen , Farina Mateo , Kim Jung Ki , Zhang Xinyao 
Published: December 2022

Abstract
A number of clinical and exam-generated biomarkers have been associated with dementia. We assess the relative importance of 41 biomarkers using a novel dataset from an understudied population – a national sample of older Indians. The value of our data includes the biomarker extensiveness, the validated classification of dementia, and the relatively lower average education of the population. We use both traditional social science methods based on biological theories and agnostic machine learning algorithms to examine how biomarkers explain variance in dementia diagnosis and cognitive functioning. Comparing different approaches shows how to best characterize the influence of biology and how to trim and combine biomarkers. The six approaches used in our study include: (1) 41 individual biomarkers; (2) identification of subsets of biomarkers with elastic net; (3) support vector machine learning; (4) factor analysis; (5) principal component analysis; and (6) factor classification based on a theoretical approach. Preliminary results show that all the biomarkers or a reduced set of biomarkers identified by elastic net do the best job at explaining variability in dementia outcome, but the biomarkers chosen as most important by elastic net do not match well our understanding of biological mechanisms. Traditional social science approaches (e.g. factor analysis and principal components approach) provide better understanding and interpretation of the relative importance of biological systems as well as the association between biomarkers and cognition. These results are informative for others collecting and analyzing biomarker data in population samples.
STRATEGIES AND TECHNOLOGIES TO SUSTAIN NATIONWIDE IMPLEMENTATION OF ALIVIADO DEMENTIA CARE
Authors: Brody Abraham , Durga Aditi , Ford Ariel , Lassell Rebecca , Lin Shih-Yin 
Published: December 2022

Abstract
It is well documented that knowledge improvement alone is not sufficient to sustain systems level changes. Through supporting dementia care workforce training and the embedding of Aliviado program tools (treatment algorithms, assessments, care plans, and caregiver education materials) into hospices’ clinical workflow across the U.S., we learned that both technologies and human support strategies are essential for lasting changes. In this presentation, we first discuss our experience leveraging a powerful customer relationship management software (Salesforce) to assign, manage, and encourage completion of the interprofessional Aliviado Dementia Care training for thousands of active users across the nation. We then share how we provide additional human support and implementation tools in the face of COVID-19, which can inform implementation of similar trials, including office hours, training reports, Plan-Do-Study-Act worksheets, symptom management cheat sheets, champion calls, and electronic health records integration meetings with each agency to locally tailor and embed Aliviado tools.
CHANGE IN EPISODIC MEMORY AND EXECUTIVE FUNCTIONING PREDICTS MORTALITY RISK
Authors: Odd Kaleena , Boron Julie , Alderson Jacob , Lachman Margie , Turiano Nicholas 
Published: December 2022

Abstract
The current study explored whether the Brief Test of Adult Cognition via Telephone (BTACT) assessment could be used to predict longevity in a national sample of adults from the Midlife Development in the United States (MIDUS) study. Specifically, we examined whether 9-year changes in episodic memory (EM) and executive functioning (EF) predicted all-cause mortality risk (2004-2018). The sample included 2,643 participants (MAge=45.87; 92.23% white; 107 deceased) who completed the BTACT twice: between 2004-06 and between 2013-2017. Using change scores, decreases in EM (HR= 1.45 [1.09-1.93], p=.01) and EF (HR=1.585 [1.17-2.14], p&lt;.001) increased the hazard of dying (controlling for age, gender, race, education, and self-rated health). Results suggest the BTACT is sensitive enough to detect health-consequential decreases in EM/EF. Future research should consider the BTACT as a viable assessment tool for older adults who may not have easy access to cognitive screenings.
WITHIN-PERSON RELATIONSHIP BETWEEN MINDFULNESS AND COGNITION IS MEDIATED BY SUBJECTIVE AGE
Authors: Graham Lyndsey , Neupert Shevaun 
Published: December 2022

Abstract
Cognitive functioning fluctuates daily throughout adulthood. Lapses in mindfulness can have cognitive consequences, which may be impacted by how old a person feels each day. Subjective age was examined as a mediator in the within-person relationship between mindfulness and cognition. 107 younger adults (aged 18-36, M = 19.96) and 116 older adults (aged 60-90, M = 64.71) completed reports of mindfulness and subjective age and tests of inductive reasoning and episodic memory for 8 consecutive days. Within-person multilevel mediation models indicated that daily subjective age mediated the relationship between daily mindfulness lapses and both indicators of daily cognition across ages. However, the mediation effect was stronger for younger adults on inductive reasoning but was stronger for older adults on episodic memory. These results show that daily changes in subjective aging are an important mechanism for daily cognition, with differential impact based on age and cognitive component.
USE OF DIGITAL TECHNOLOGY SOLUTIONS TO SUPPORT CAREGIVING BY FAMILY CAREGIVERS OF OLDER ADULTS
Authors: Malhotra Rahul , Azman Nur Diyana , Goh Veronica Shimin , Visaria Abhijit 
Published: December 2022

Abstract
Caregiving-relevant information and services are increasingly available online. Greater understanding of the extent and purpose of their use by family caregivers of older adults and specific caregiver sub-groups that are more or less likely to use them can inform both policies related to and the content of such solutions. We investigated the extent to which family caregivers of older persons in Singapore use digital technology solutions such as the internet and apps, and the purposes for which they use them. Information on digital device use was collected from 278 caregivers. Of them, 139 caregivers gave detailed information on how they had used the internet or apps to support caregiving in the last six months. Most (89%) caregivers used digital devices regularly (mostly smartphones (87%)). Digital device use was associated with caregiver age, ethnicity and education. Common generic online activities included sending instant messages (77%) and surfing websites (64%). While 54% had used the internet to support caregiving (most common purpose: search for information on care-recipient’s health conditions), 43% had used apps to do so (most common purpose: coordinate care with family members or other caregivers). Such use was associated with caregiver age, education and care-recipient health. While use of digital devices and generic online activities are common among caregivers, their use of the internet or apps to support caregiving is less common. Information-seeking and coordination are indicative of avenues in which digital technology solutions can complement ‘physical’ channels of communication and support with and for caregivers, and be further expanded.
LUCIDITY IN DEMENTIA: EMERGING CONCEPTS AND DATA
Authors: Gilmore-Bykovskyi Andrea , Eldadah Basil 
Published: December 2022

Abstract
Episodes of lucidity among people with advanced Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD), reportedly evidenced by an unexpected return of meaningful communication or connection, are an area of growing interest. Event transient recovery of abilities in the setting of advanced AD/ADRD are potentially significant for caregivers and the person living with dementia; as well as for shaping our understanding of AD/ADRD more broadly. Despite the potential significance of these events, existing evidence is largely comprised of anecdotal reports and retrospective/case reports. Recently, the National Institute on Aging funded six studies to advance empiric studies on episodes of lucidity in advanced AD/ADRD. This symposium will provide an update on progress and findings across these funded studies. The first presentation focuses on acceptability and feasibility of a prospective observation study focused on characterizing potential observable indicators of episodes of lucidity in individuals with advanced AD/ADRD near end of life encompassing audiovisual observation, informant field interviews and case reviews. The second presentation will provide an overview of a 3-phase mixed methods study focused on development of preliminary types of lucid episodes. Collectively, presentations demonstrate a variety of approaches to investigating episodes of lucidity and shed light on emergent methods for operationalizing these events. Implications of various conceptualizations for EL and conceptual decisions across studies will be reviewed.
IS THERE A DIFFERENCE BETWEEN TERMINAL LUCIDITY AND PARADOXICAL LUCIDITY?
Authors: Peterson Andrew , Clapp Justin , Harkins Kristin , Kleid Melanie , Largent Emily , Stites Shana , Karlawish Jason 
Published: December 2022

Abstract
Recent arguments in aging and dementia research suggest that “terminal lucidity”—defined as unexpected communication or connectedness occurring shortly before death—is distinct from “paradoxical lucidity”—defined as an episode of communication or connectedness in a person who is assumed to have lost these capacities due to progressive neurodegeneration. We disagree with this distinction and argue that terminal lucidity is a special subtype of paradoxical lucidity. We suggest that specifying the relationship between terminal and paradoxical lucidity is important for investigating the underlying mechanism of lucidity in dementia.