bluuebunny/crossref_metadata_2025_split huggingface dataset:
UTILITY OF SIX-MONTH PROGNOSIS TO PREDICT SURVIVAL AMONG NEWLY ADMITTED NURSING HOME RESIDENTS WITH CANCER
Authors: Vu Long , Warner David , Schiltz Nicholas , Rose Johnie , Cullen Jennifer , Owusu Cynthia , Sajatovic Martha , Douglas Sara 
Published: December 2022

Abstract
A prognosis of less than 6 months life expectancy has potential to be useful in planning and evaluating end-of-life care; however, its agreement with actual survival data has not been assessed. Here, we measured the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the nursing home (NH) Minimum Data Set (MDS) 6-month prognosis indicator among individuals diagnosed with incident breast (female), colorectal, lung, pancreatic, or prostate cancer during the years 2004-2017 and admitted to a NH between 2012-2017 (n=254,183). Cancer patients were identified from the linked Surveillance, Epidemiology, and End Results (SEER) Registry. The median age was 80 years, 52.6% were women, and 15.15% were non-White. Only 7,541 (2.97%) of patients were deemed by a physician to have a life expectancy of less than 6 months as recorded in their first comprehensive MDS assessment; of those, 83.0% died within 6 months, and 12.3% died after 6 months. Sensitivity and specificity were 7.8% and 99.3%, respectively, for the prognosis indicator predicting mortality within 6 months; PPV was 83.0% and NPV was 69.9%. In conclusion, although very few patients had received a physician designation of their 6-month prognosis, a high percentage actually died within 6 months. Conversely, among those without a 6-month prognosis, nearly one-third died within 6 months. A terminal diagnosis appears reasonably predictive of death — when made. However, its low sensitivity demonstrates that a vast majority of terminal patients are not properly captured, calling into question its greater application.
THE LINGERING EFFECTS OF LOSS: WIDOWHOOD AND SUBSTANCE USE IN THE LGBT POPULATION
Authors: Barrett Anne , Noblitt Jessica 
Published: December 2022

Abstract
The immense stress of widowhood can lead to unhealthy coping strategies, including substance use. Relatively little is known, however, about widowhood’s effects on substance use among sexual minorities. Of the few studies examining LGB widowhood, none employ large, nationally representative samples or consider whether effects depend on current partner status. We address these issues using a sample of 2,258 respondents aged 50 and older who participated in the 2010 Aging with Pride: National Health, Ageing, and Sexuality/Gender Study. Multivariate regression analyses reveal that widowhood is associated with higher odds of being a current smoker and of using drugs in the past year. These results are found for individuals who are currently partnered, as well as those who are not. This observation suggests that widowhood’s negative effects on use of these substances are not attenuated by the potentially protective effect of current partnership. In contrast, the effects of widowhood on alcohol use do appear to be diminished by current partnership. Among those who have experienced widowhood, those with a current partner are less likely than those without a partner to report problematic drinking. Our results suggest that current partnership may protect against problematic use of more socially acceptable substances like alcohol, but it may not prevent less acceptable behaviors like smoking or drug use. In sum, our study suggests that current partnership may not completely counter the lingering effects of partner loss in the LGB population.
LATER-LIFE TRAJECTORIES OF MARITAL QUALITY FOR WOMEN AND MEN
Authors: Bulanda Jennifer , Yamashita Takashi , Brown J Scott 
Published: December 2022

Abstract
It is essential to better understand older adults’ marital dynamics, as marital quality is consequential for older adults’ physical and mental health, relationships with other social network members, and risk of divorce. Although numerous studies examine marital quality during the early life course, much less is known about later life trajectories. Earlier work suggested marital quality followed a U-shaped curve, characterized by a later-life upswing, but more recent research finds patterns of stability or decline over time. Gender differences in marital quality are well established, but it is less clear whether older men and women experience different marital quality trajectories during later life. We use nationally-representative data from a sample of continuously-married adults over age 50 in the Health and Retirement Study (n=2,175) with measures of both positive and negative marital quality at three time points (2006, 2010, and 2014). Latent growth mixture models in Mplus estimate trajectories of marital quality over the eight-year time period. Results show small declines in both positive (b = -0.016, p &lt; 0.05) and negative (b = -0.028, p &lt; 0.05) marital quality over the observation period, but the declines in positive marital quality are limited to those in remarriages. Women have lower initial positive marital quality and higher initial negative marital quality than men, but there are no significant gender differences in change over time. Results support the stability and continuous-decline patterns of marital quality over the life course rather than a U-shaped curve, and suggest persistence of gender differences over time.
DO OPPOSITES ATTRACT OR AGGRAVATE? THE IMPACT OF INTERGENERATIONAL SOLIDARITY ON WELL-BEING
Authors: Scott Rachel , Lopez Acacia , Olson Marin , Nadorff Danielle 
Published: December 2022

Abstract
Family Systems Theory states that values are transmitted between generations within families and, while many of these values are similar between immediate generations, there may be more differentiation in values between generation gaps. Ideological differences between generations may potentially cause subsequent tension and fluctuations in well-being. The current study sought to examine the moderating effect of ideological differences (religious and political) on the relation between how emotionally close grandparents perceive themselves being with younger generations and grandparental well-being. Participants included 419 grandparents (age: M = 76, SD = 5.33), 716 adult children (age: M = 53, SD = 4.16), and 638 adult grandchildren (age: M = 29, SD = 5.52) from the 8th wave of the Longitudinal Study of Generations (LSOG) data set. Well-being in grandparents was positively correlated with perceived emotional closeness among both of the intergenerational dyads. Religious ideological differences between grandparents and grandchildren were found to negatively influence grandparental well-being; this relation was also found to be significantly different from political ideological differences within the same intergenerational dyad. While moderation was not achieved for either dyad, the overall model fit was found to be excellent, suggesting its utility for further research into the relation between the study variables. These findings indicate that there is a complex relation between perceived emotional closeness, ideological beliefs, and the well-being of grandparents that warrant additional attention within the literature and may inform interventions related to intergenerational communication and well-being. Further implications for these findings will be discussed.
WHAT CAUSES OLDER PARENT–ADULT CHILD ESTRANGEMENT?: A QUALITATIVE INTERVIEW STUDY
Authors: Nolte Julia , Cope Marie , Pillemer Karl 
Published: December 2022

Abstract
The life-course perspective’s emphasis on “linked lives” highlights the importance of positive parent-child relationships for adults’ well-being in mid-life and beyond. However, one in ten Americans experiences parent-child estrangement, defined as ending all contact and communication for a period of time. Despite the prevalence, the reasons underlying family estrangements are poorly understood. In this study, we conducted in-depth, qualitative interviews with 43 middle-aged and older adults (age range = 46-81, M = 65.05 years) who are or were estranged from an adult child (estrangement range = 1-26, mean = 6.53 years). On the basis of a jointly developed codebook, independent coding from the first and second author revealed 22 estrangement reasons across eight categories, with parents citing reasons from across four categories on average. Estrangement was most often attributed to the behavior, issues, or traits of the child (79%), problems surrounding a difficult in-law/ partner (72%), or disagreements about beliefs and values (67%). To a lesser degree, estrangements were linked to separation or divorce (49%), financial problems and conflicts (42%), adverse childhood experiences of the estranged child (30%), and interference from someone other than a partner (16%). More than half of the parents (58%) also endorsed other reasons, including their own traits and behaviors, communication issues, a family history of estrangement, and passive loss of contact. Older parent–adult child estrangements are perceived as multi-causal, with four out of five parents describing the estranged child as difficult or troubled. Implications of the findings for professionals working with older adults are discussed.
SUPPORTING DEMENTIA CAREGIVERS IN HEALTHCARE DELIVERY: RECOMMENDATIONS FROM A NATIONAL CONSENSUS CONFERENCE
Authors: Riffin Catherine , Griffin Joan , Bangerter Lauren , Brody Lilla , Falzarano Francesca , Pillemer Karl , Czaja Sara , Adelman Ronald 
Published: December 2022

Abstract
More than 6 million adults in the United States are affected by Alzheimer’s Disease and related dementias (ADRD), the majority of whom rely on assistance from an unpaid caregiver (family, friends). The goal of the 2021 Conference on Engaging Family and Other Unpaid Caregivers of Persons with Dementia in Healthcare Delivery, funded by the National Institute on Aging, was to establish a policy- and practice-aligned research agenda for enhancing ADRD caregiver engagement and support in healthcare settings. The Conference convened multidisciplinary thought leaders from across the United States to establish a set of actionable recommendations to advance the field. Recommendations centered on five key topics: 1) Identification and assessment of ADRD caregivers, 2) Reimbursement and financing for provider time spent on ADRD caregiver, identification, assessment, and support, 3) ADRD caregiver training and support, 4) Healthcare provider education, and 5) Technology. To support future work in each of the five priority areas, conference participants highlighted the importance of leveraging lessons from implementation science and models of equity and inclusion. Recommendations are intended to inform federal agencies and foundations about high-priority areas and motivate multidisciplinary collaborations to design care delivery systems that effectively engage and support ADRD caregivers.
FACTORS PREDICTING FAMILY MEMBER PROVISION OF ASSISTANCE WITH ACTIVITIES OF DAILY LIVING FOR SENIORS
Authors: Spetz Joanne , Ross Leslie 
Published: December 2022

Abstract
The aging of the U.S. population is leading to greater demand for assistance with activities of daily living. Much of this support is provided by family members, but changing family sizes and locations have raised concern that those needing support will be increasingly reliant on non-family assistance. This study examined patterns of provision of family, non-family, and paid caregiving to those 65 years and older who need assistance with activities of daily living, focusing on the impact of geographic location. We used the National Health and Aging Trends Study Restricted Metro-Nonmetro round five data file. We identified individuals who needed assistance with activities of daily living and/or instrumental activities of daily living. We merged information about the primary survey respondent (subject person, or SP) with data on “other people” (OP) in their supportive network, excluding spouses living with the respondents because nearly all spouses provided support. The final analytic data file consisted of 5,234 unique SPs. We used weighted and unweighted bivariate analyses as well as weighted multivariate logistic regression models to examine the association of family or non-family support and geographical location. We found that SPs who never were unmarried were more likely to have a non-spouse family helper compared to those married or living with a partner. Family who lived near the SP had a greater likelihood of providing help. SPs who were Black, non-Hispanic, multi-racial, and other non-Hispanic had more than twice the likelihood of having a family member helping them compared to White non-Hispanic SPs.
AN EXPLORATORY DESCRIPTIVE STUDY OF CARE PARTNERS’ PREFERENCES AND SKILL TRAINING NEEDS DURING HOSPITAL CARE
Authors: Vanias Kaitlyn , Yahr Andrea , Fields Beth 
Published: December 2022

Abstract
Care partners play a critical role in caring for an increasingly complex, aging population in the United States after hospital discharge. However, care partners’ preferences and needs are often not formally assessed during their loved one’s hospitalization. The Care Partner Hospital Assessment Tool (CHAT) is a standardized decision-support tool that facilitates the inclusion and training of care partners during hospital care. The purpose of this exploratory descriptive study was to understand the preferences and needs of 12 care partners of older adult patients admitted to a large academic hospital utilizing the CHAT. The majority (8 of 12) of care partners surveyed were spouses while the remainder were adult children of the patients. All care partners provided comparable support including physical and social support as well as healthcare management. Despite providing similar support, there were differences in the care preferences and needs of spouses compared to adult children. A greater proportion of spouses preferred to be present for care in the hospital and requested information on adaptive equipment and community services. All adult children desired access to the electronic medical record while there was a mixed response among spouses. The most common needs across care partners included training on mobility assistance and medical devices. Findings from this study demonstrate that care partners have varying preferences and training needs during hospital care and suggest differences across care partner relationships. Further investigation is necessary to better understand these patterns and improve hospital care for patients and their care partners.
CULTURALLY CONCORDANT CARE: CLINICIAN PERSPECTIVES ON PROVIDING CANCER CARE TO SOUTH ASIANS
Authors: Singh Nainwant , Manja Veena , Pukhraj Ambri , Risbud Rashmi , Desai Shreya , Schapira Lidia , Lorenz Karl , Trivedi Ranak 
Published: December 2022

Abstract
In many South Asian (SA) cultures, cancer is stigmatized, and family members are expected to become primary caregivers. Clinicians need to be familiar with these SA needs and values to provide culturally concordant care. The South Asian Family Approaches to Disease (SAFAD) study aims to understand cultural needs of SAs managing breast cancer. We conducted semi-structured qualitative interviews with multidisciplinary clinicians at a major academic medical center about caregiver interactions, cultural dynamics affecting clinical practice, unmet patient needs, and perceptions of culturally concordant care. Participants included physicians(8), a nurse practitioner(1), a social worker(1), and a physician assistant(1) with experience in palliative care(5), hematology/oncology(4), breast cancer(3), critical care(2), and radiation oncology(1) with one to 42 years in practice. Participants identified as Caucasian/White(6), South Asian(3), African American/Black(1), and Chinese(1). Clinicians noted the following: 1)SAs have greater family involvement in care and may defer treatment decisions to family members; 2)SAs seek clinician support with cancer management and nutrition; 3)SA emotions and hesitation around sensitive topics may result in non-disclosure; 4)SAs have diverse caregiver roles; and 5)individual SA needs cannot be generalized within the diaspora. “There’s still some stigma… with breast cancer… [it] may lead a patient to not want to share their diagnosis… then set up a patient for having less support… [We can] help them feel more comfortable opening up selectively.” Understanding such cultural needs is essential to cultivating trust and providing person-centered care. Interventions and resources to promote culturally concordant cancer care can target education in these areas.
PERCEPTIONS OF DEMENTIA CARE AMONG AFRICAN IMMIGRANTS IN MINNESOTA: INSIGHTS FROM COMMUNITY CONVERSATIONS
Authors: Yam Hawking , Nkimbeng Manka , Rosebush Christina , Russel Wynfred , Shippee Tetyana , Gaugler Joseph 
Published: December 2022

Abstract
Immigrants and persons from diverse racial and ethnic backgrounds have a higher prevalence of dementia compared with their U.S.-born counterparts, yet the estimates of dementia prevalence, perceptions, and needs among African immigrants are not fully understood. This qualitative study examined African immigrants’ perceptions of dementia and dementia care. Specifically, it explored the community’s attitudes, care practices, and barriers toward dementia care. Community conversations (focus groups) were conducted with 24 African immigrants residing in the Northwest Minneapolis suburbs. Conversation transcripts were analyzed using thematic analysis in Nvivo. The majority of participants were women, 79% from Liberia, 43% were over the age of 65 years, and 65% held a bachelor’s degree or higher. Three themes were identified: 1) Perceptions of and attitudes toward mental health and dementia, which indicated that cultural issues limit awareness of dementia, but 2) Family care of a person living with dementia, meaning care happens in the home, and receiving care in a facility is the last resort; 3) Facilitators and barriers to dementia care, including distrust of health systems, immigrant status, and limited finances. This project offers unique insights on the dementia care and caregiving beliefs and attitudes among African immigrants that can inform policy and intervention efforts aimed at decreasing dementia care barriers in the African immigrant community.
SERIOUS MENTAL ILLNESS IN MINNESOTA NURSING HOMES: THE ROLE OF RESIDENT AND FACILITY CHARACTERISTICS
Authors: Shippee Tetyana , Bucy Taylor , Ng Weiwen , Woodhouse Mark , Fashaw-Walters Shekinah , Bowblis John 
Published: December 2022

Abstract
Multiple studies have shown an increasing prevalence of adults with serious mental illness (SMI) in nursing homes. As adults with SMI age, the reality of care needs that span physical, medical, and psychosocial services necessitates further consideration of the role of comprehensive, ancillary mental health services in nursing homes (NH). Yet, little work examines characteristics of those with SMI, their care needs & the role of facility structural factors. Using the 2011-2017 Minimum Dataset (MDS) assessment data for Minnesota, we examined resident-level demographic characteristics of NH residents with and without SMI, and facility-level characteristics including quality of life (QoL), quality of care (QoC), and state recertification survey scores. We defined SMI as a diagnosis of bipolar disorder, schizophrenia or schizoaffective disorder, or psychotic conditions other than schizophrenia present on the reference assessment. Individuals admitted with SMI were younger, had better physical health, were more likely to be racial/ethnic minorities, and more likely to be admitted to a facility with a higher proportion of racial/ethnic minority residents. SMI-only admissions were concentrated in larger, for-profit facilities with a high-reliance on Medicaid. Lastly, SMI-only admissions were more likely to occur in facilities with lower QoL, QoC, and inspection scores. There is a growing need for behavioral health services in NHs, yet access to services is inadequate and lacks equity based on geography, race/ethnicity and other system-level disparities.
NURSING HOME PALLIATIVE CARE DURING THE PANDEMIC: DIRECTIONS FOR THE FUTURE
Authors: Ninteau Kacy , Bishop Christine 
Published: December 2022

Abstract
For this qualitative, pilot study, seven Massachusetts nursing home Directors of Nursing (DONs) were interviewed remotely about palliative care provision before and during the COVID-19 pandemic. Interview data were analyzed using thematic analysis. Palliative care addresses physical, emotional, psychological, and spiritual suffering that accompanies serious illness. Symptom management and goals of care is especially valuable for seriously ill nursing home residents. We investigated the solutions nursing home staff developed to provide palliative care during the COVID-19 pandemic despite restrictions on external resources. Before the pandemic, palliative care was delivered primarily by nursing home staff depending on formal and informal consultations from palliative care specialists affiliated with hospice providers. When COVID-19 lockdowns precluded these consultations, nursing staff did their best to provide palliative care, but were often overwhelmed by shortfalls in resources, resident decline brought on by isolation and COVID-19 itself, and a sense that their expertise was lacking. Advance care planning conversations focused on hospitalization status and options for care given COVID-19 resource constraints. Nevertheless, nursing staff discovered previously untapped capacity to provide palliative care on-site as part of standard care, building trust of residents and families. Nursing staff rose to the palliative care challenge during the COVID-19 pandemic, albeit with great effort nursing home payment and quality standards should support development of in-house staff capacity to deliver palliative care while expanding access to the formal consultations and family involvement that were restricted by the pandemic.
EXPERIENCES OF DISTRICT NURSES WITH MAKING DECISIONS ABOUT THE USAGE OF INVOLUNTARY TREATMENT
Authors: Moermans Vincent , Bleijlevens Michel , Verbeek Hilde , de Casterlé Bernadette Dierckx , Milisen Koen , Hamers Jan 
Published: December 2022

Abstract
District nurses play a key role in care of older Persons Living with Dementia (PLWD) who still live in their own home environment. Studies show that they often have to deal with decision-making about and the usage of involuntary treatment. Involuntary treatment is care provided that they resist to and/or have not given consent to, such physical restraints, psychotropic medication. This study aimed to describe district nurses’ experiences regarding the decision-making processes about and the usage of involuntary treatment among PLWD. A qualitative study design with a grounded theory approach was used. During semi-structured interviews, 16 district nurses shared experiences in 31 different cases of involuntary treatment use among PLWD. Results show that district nurses were often not involved in the decision-making process. In most cases, family caregivers decided solely to use involuntary treatment, and district nurses were asked to do also. District nurses experienced these situations as difficult to deal with. They felt that they were torn between providing “good care”, wishes of PLWD, and meeting the expectations of family caregivers. Their experiences were negatively affected if PLWD verbally rejected the care provided, they were unable to enter into a dialogue with the caregivers about the care provided, and if they did not have sufficient knowledge about how to deal with PLWD. These findings indicate the importance, of proactive case management in dementia care at home. District nurses can facilitate this by going into dialogue between PLWD and his caregivers, in order to provide person-centered dementia care at home.