bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTERDISCIPLINARY DEMENTIA CARE WORKFORCE TRAINING AND QI IMPLEMENTATION: LEARNINGS FROM 25 HOSPICES
Authors: Brody Abraham , Gaugler Joseph 
Published: December 2022

Abstract
To build and sustain a dementia-capable clinical workforce and care delivery organizations, it is essential to systematically disseminate evidence-based, interdisciplinary dementia care programs. The outbreak of COVID-19, clinical staff shortages, and competing priorities experienced by healthcare organizations including staff vaccination and other regulatory requirements, pose significant challenges to the continuation of agency-wide, interdisciplinary dementia care workforce training and quality improvement. In this symposium, we present our experience Implementing Aliviado Dementia Care, a comprehensive, interdisciplinary dementia care workforce training and quality improvement program amid COVID-19 across 25 U.S. hospice agencies, as part of an embedded pragmatic clinical trial. Aliviado Dementia Care consists of interdisciplinary dementia care workforce training, treatment algorithms, assessments, care plans, caregiver education, and clinical workflow changes. The symposium begins with a discussion of the training, knowledge improvement, turnover, and replenishing strategies of hospice champions during COVID-19. We then discuss how we tailored dementia care training for each of the skilled hospice disciplines (i.e., medicine, nursing, social work, spiritual care) and provide two case studies elucidating how additional tailoring was performed to fit local agency culture and needs during COVID-19. Furthermore, we discuss how we developed and iterated training for home health/hospice aides, the usability and training results, and specific considerations for training aides during COVID-19. Lastly, we conclude the symposium with a discussion of salient strategies and technologies that help sustain our nationwide implementation despite the ongoing COVID-19. Throughout each of these abstracts we also discuss how COVID-19 affected, and created differential implementation of components of the intervention.
THIS TOO SHALL PASS: WEATHERING THE STORM AS OLDER FEMALE FAMILY CAREGIVERS FOR THOSE WITH AD/ADRD DURING COVID-19
Authors: Harrington Candace , Witt Dean 
Published: December 2022

Abstract

Background
Older female caregivers of persons with AD/ADRD are under-represented, under-reported, and understudied. Purpose: This qualitative study aimed to understand how COVID-19 affects older female caregivers' lived experience, ongoing capacity, and willingness to provide care for their loved one(s) with AD/ADRD. Specific Aims: Aim 1: Explicate older female caregivers' lived experience in the context of caring for family members with AD/ADRD during COVID-19. Aim 2: Elucidate how COVID-19 affected older female caregivers' relationships with their family members with AD/ADRD. Method: 172 units of meaning were extracted from 327 pages of transcripts and 972 minutes of interviews with urban (n = 10) and rural caregivers (n = 10). Thematic analysis was then conducted.

Results
Respondents, recruited with purposive and snowball sampling, saw hastened AD/ADRD progression in their family member(s) attributed to social isolation. For many, long-term placement was not an option for financial reasons. Respondents providing full-time caregiving depended heavily on their care recipients' financial resources for basic living expenses, reporting placement in long-term care would leave them at risk of homelessness. Black caregivers expressed an "unspoken" cultural taboo about placement. For all, caregiver disability was the only impetus for placement. Respondents in rural communities more often reported faith-based gratefulness, moments of joy, relational harmony resulting from "being stuck together", and less availability of resources allowing virtual support. Urban caregivers reported more social isolation, less awareness of resources, more intentional family member distancing, and higher pandemic-related distress. Implications: These findings have broad economic, social, policy, research, and practice implications.
APPLICATION OF QUALITATIVE METHODS IN THE DEVELOPMENT OF AN INFORMANT-REPORTED MEASURE OF LUCIDITY
Authors: Ramirez Mildred , Teresi Jeanne , Ellis Julie , Gonzalez-Lopez Paloma , Silver Stephanie , Bhatti Usama , Devanand Davangere , Luchsinger Jose 
Published: December 2022

Abstract
The aim was a qualitative evaluation of a lucidity measure for front-line staff or family informants. A sequential approach to item development and evaluation was followed: refinement of the operationalization of the construct; review of seminal items, modification, and purification; confirmation of the feasibility of reporting methodology. Modified focus groups were conducted with 20 staff and 10 family members who participated using a web-based survey. Sample themes included: reaction when hearing the term; words that come to mind; description of and first reaction to referenced or observed “lucidity” events. Data were extracted from Qualtrics for analysis using NVivo. Semi-structured cognitive interviews were conducted with10 health professionals working with older adults with cognitive impairment. An external advisory board reviewed the clarity, breadth, and scope of the conceptual definition and item content. Suggestions for item modification derived from the focus groups and cognitive interviews resulted in the final lucidity measure.
POSITIVE SELF-PERCEPTIONS OF AGING AS PREDICTORS OF COVID-RELATED PREVENTIVE BEHAVIOR AND RESILIENCE
Authors: Giasson Hannah , Chopik William , Carrillo Alejandro 
Published: December 2022

Abstract
Individuals have faced extraordinary challenges throughout the COVID-19 pandemic. Psychosocial strengths may promote individuals’ resilience during this time. Positive self-perceptions of aging (SPA) have been found to predict a variety of health and well-being indicators. We examined SPA as a predictor of COVID-19-related behavior, adaptation, and resilience in a sample of 3,620 adults (Mage=65.88; 61.1% women; 65.4% white) from the 2016 and 2020 waves of the Health and Retirement Study. Linear regression results revealed that more positive SPA in 2016 was associated with more preventative health behavior (β=.03, p=.04), a higher likelihood of staying at home (β=.07, p&lt;.001), less worry (β=-.27, p&lt;.001), less stress (β=-.24, p&lt;.001), less loneliness (β=-.27, p&lt;.001), and greater resilience (β=.20, p&lt;.001) during the first year of the pandemic (2020). Associations held after controlling for demographic covariates. Findings support SPA theories, suggesting linkages between SPA and adaptive behaviors and outcomes in the face of external challenges.
THE FAMILY-CENTERED FUNCTION-FOCUSED CARE INTERVENTION: IMPLEMENTATION AND MEASUREMENT CONSIDERATIONS
Authors: Boltz Marie , Flanagan Jane 
Published: December 2022

Abstract
Family care partners can play an important role in promoting the functional recovery of hospitalized older adults living with dementia. Family-centered function-focused care (Fam-FFC) aims to create an “enabling” milieu for the person with dementia through, staff education, unit-based champions, environmental and policy assessment/modification, and individualized goal setting. In this patient/family-centered care approach, nurses purposefully engage family care partners in the assessment, decision-making, care delivery and evaluation of function-focused care during hospitalization and the 60-day post-acute period. Staff are provided with techniques to support positive interaction with patients and families and respect the role of care partners as advocates. The goal is to promote functional recovery and well-being in the patient, and prevent unnecessary long-term care admissions, while improving care partners’ preparation for caregiving and well-being. Fam-FFC was developed with the input of patients, families, nurses, and rehab therapists. This symposium focuses on key factors associated with the implementation of Fam-FFC, and relevant measures. After an introductory overview of Fam-FFC, the nature of staff/patient interaction during hospitalization, including the influence of gender, will be discussed in the first presentation. Two presentations will address the planning for transition to the post- acute setting, including the intrinsic factors associated with preparation for caregiving, in contrast to the decision to seek long-term care. The final presentation will describe the approach to promoting fidelity to the Fam-FFC intervention, within the context imposed by COVID-19 restrictions. Our symposium will conclude with a discussion of future direction for policy, practice, and research.
ADDRESSING THE MENTAL HEALTH NEEDS OF HOMEBOUND OLDER ADULTS IN AGING SERVICE SETTINGS
Authors: Choi Namkee 
Published: December 2022

Abstract
Despite significant and urgent mental health needs among low-income homebound older adults, the existing mental health service systems’ reach for these older adults is almost nonexistent. Given the current and projected geriatric mental health workforce shortages, innovative approaches are needed to better serve these underserved older adults. This presentation will focus on a series of randomized clinical trials that tested acceptable and feasible mental health service delivery models for homebound older adults who are served by aging service network agencies that provide hot meals and case management. Findings from the real-world effectiveness trials of tele-delivered behavioral activation treatment for depression and loneliness by bachelor’s-level lay counselors who are embedded in aging service agencies will be shared. Ways to promote a wider adoption of scalable and sustainable mental health service delivery models for homebound older adults will be discussed.
HUMAN AGING INTERVENTIONS
Authors: Parker Daniel 
Published: December 2022

Abstract
Biological aging is the greatest risk factor for multiple non-communicable diseases affecting multiple organ systems. Evidence from animal studies suggest that the rate of biological aging is modifiable and that slowing the rate of biological aging may decrease the incidence of age-related morbidity and mortality. Based on these findings, several approaches are currently being studied to slow the rate of biological aging in humans. This symposium features internationally renowned aging research scientists whose work focuses on clinical interventions to modify biological aging in humans. We will hear from Rajagopal Sekhar from the Baylor College of Medicine who will present his research on “Improving oxidative stress, mitochondrial dysfunction, inflammaging, aging hallmarks and muscle strength in older adults: the novel role of GlyNAC and the 'Power of 3'”; Jamie Justice from the Wake Forest School of Medicine will present her work on “Response to dietary restriction interventions in older adults: biomarkers of cellular senescence and biological aging”; Reem Waziry from the Columbia University Mailman School of Public Health will present her work “Does Caloric Restriction Slow the Process of Biological Aging in Non-Obese Healthy Adults? Evidence from the CALERIE™ Trial”; and Daniel Parker from the Duke University School of Medicine will present his work “Does APOE genotype moderate the impact of diet modification and exercise training on age-related outcomes?”. Attendees will learn about recent advances in interventions targeting human aging.
OLDER ADULTS' PERCEPTIONS OF CANNABIS AND OPIOIDS USE
Authors: Bobitt Julie 
Published: December 2022

Abstract
Older adults in the U.S. are increasingly using cannabis as a method to manage pain. Some studies have linked increased cannabis use with an increase in prescription opioid use while others have suggested that older adults may be using cannabis as a way reduce/replace opioids. From April 2018 - January 2019 we conducted 12 focus groups throughout Illinois with 82 cannabis users aged 60+. To examine the relationship between cannabis and opioid use we used an inductive thematic analysis to code and theme the focus group transcripts. We found three themes 1) medical culture around opioids influences cannabis use; 2) past negative experiences with opioids influences cannabis use, and 3) aversion to ever trying opioids out of fear of an anticipated harm that may be brought about by opioid use such as overdose. In this session we present these findings and discuss cannabis use relative to opioids by older adults.
MEDICAL MARIJUANA LAWS AND OUT OF POCKET EXPENSES AT END OF LIFE
Authors: Bhagianadh Divya , Arora Kanika 
Published: December 2022

Abstract
Resource intensive and costly End-of-Life (EOL) care is a significant healthcare policy concern in the U.S. In addition to the high Medicare spending, out of pocket (OOP) expenses are also high during EOL adding considerable stress during terminal days. The Medical Marijuana Laws (MMLs) is a significant policy in this context. Previous studies have shown increased use of MM among older adults, better pain management, influence on site of death as well as evidence of reduction in Medicare expenditure on drugs in states with MMLs. In this study, we explore the association between MML and OOP expenses during EOL using data from the Health and Retirement Study exit and core interviews from 1995 to 2018. We use a difference in differences (DD) and event study models to examine this question. We find evidence of increased OOP expenses on drugs and doctor visits with the effects concentrated among the early implementing states, among decedents who are White and among cancer patients. Despite its growing acceptance in palliative medicine, affordability of MM could pose a significant hurdle to terminally ill patients especially since MM and related costs are not covered by insurance.
A DUTY TO CARE: MALE PERSPECTIVES ON THE CAREGIVER ROLE FOR PERSONS WITH ALZHEIMER’S OR RELATED DEMENTIA
Authors: Bueno Michael , Chase Jo-Ana 
Published: December 2022

Abstract
The population of family caregivers (FCGs) of persons with Alzheimer's Disease and related Dementias (ADRD) is growing, as is the proportion of males taking on this traditionally female role. Most caregiving research has mainly focused on females. Although female caregivers have reported more negative outcomes, men still report significant levels of burden. With the aging population and increased need for caregivers, there is a gap in knowledge exploring the male caregiving experience. Understanding male caregiving experiences can inform clinicians on developing future strategies to tailor support for this underrepresented group. The purpose of this qualitative descriptive study was to explore the experiences of male FCGs of people with ADRD. The Caregiver Identity Theory (CIT) was used to guide the study exploring participants’ perception of self-identity within their caregiving relationship and self-identity as a male. Eleven male caregivers, recruited through social media and community resources, were interviewed by telephone or Zoom. Interviews were recorded, transcribed, and analyzed using thematic analysis. Four major themes emerged highlighting males’ struggles with the unfamiliar caregiving role and changing identity; their acknowledgement of personal growth and discovery through caregiving, challenges in finding the “right” kind of support, and perceived reshaping of masculinity through the caregiving role. Male caregivers express unique experiences as FCGs suggesting future research is needed to explain gender differences in caregiving and identify additional factors that influence male caregivers’ experiences. Furthermore, findings indicate clinicians should tailor support strategies for male FCGs’ as they fulfill this potentially unfamiliar role.
DISCRIMINATION TRAJECTORIES, RESILIENCE CHARACTERISTICS, AND MULTIMORBIDITY AMONG MIDDLE-AGED AND OLDER BLACKS
Authors: White Kellee , Robinson-Ector Kaitlynn , Wei Melissa , Ma Tianzhou , Bell Bethany , Quinones Ana 
Published: December 2022

Abstract
Discrimination is a chronic psychosocial stressor that can accelerate aging. While strong empirical evidence demonstrating linkages between discrimination and adverse health outcomes, the role of discrimination in multimorbidity burden has received less attention. Prior research on discrimination and health largely uses a single, static, cross-sectional measure to predict health at a second time point, that may mask significant heterogeneity in the dynamic nature of repeated exposures to discrimination. Characterizing longitudinal patterns of discrimination may be a better predictor of health risk and provide insight on resilience processes that influence aging-related outcomes such as multimorbidity. However, this relationship is not well understood. We investigate the association between discrimination trajectories, resilience characteristics, and multimorbidity burden among a sample of middle-aged and older black adults. Specifying discrimination trajectories and resilience characteristics that differentially predict multimorbidity burden may inform the design of culturally-relevant interventions to delay the development and progression of multimorbidity.
ALASKA NATIVES AND GENERATIVITY: BENEFITS AND CHALLENGES OF GENERATIVITY IN A RAPIDLY CHANGING ARCTIC
Authors: Lewis Jordan 
Published: December 2022

Abstract
Generativity is not often associated with successful aging, but aligns with the cultural values and practices of Alaska Native Elders. This study explored the concept of generativity, why elders share their knowledge, how it makes them feel, and what they want everyone to know. This study interviewed 108 Alaska Native Elders across Alaska, ages ranging from 48 - 93 years old, and willing to share their knowledge of successful aging. Employing content analysis, we explored themes related to each research question on generativity. Elders felt motivated, happy, and good about sharing their knowledge, but only when others listened. Their motivations were to teach the real history of Alaska, leave a community or family legacy, and help youth engage in healthy behaviors. Knowing cultural values, your history, practical skills, and how to listen to your Elders were things they want to share with youth and fellow Elders. Participants also shared the challenges to being generative, including technology, lack of interest by others, and age differences in experiences and knowledge sought. We learned the importance of addressing the generative mismatch between generations and to improve quality of life for Elders and help youth age successfully, we need to create culturally meaningful activities to bring all generations together. Programs to teach youth to be healthy and develop a healthy identity through cultural practices and values, and provide Elders outlets to share and improve their quality of life will ensure cultural survival and foster and strengthen the cultural practice of Indigenous cultural generativity.
NEIGHBORHOOD QUALITY AS IT RELATES TO HEALTH AND WELL-BEING IN OLDER AFRICAN AMERICANS
Authors: Wright Regina , Gamaldo Alyssa , Lee Anna 
Published: December 2022

Abstract
With the burgeoning older adult population, there will be an increased demand for neighborhood environments that are conducive to successful aging. For example, the need for affordable and usable housing developments for older adults that provide greater opportunities for social engagement, social services, and convenience to neighborhood resources (e.g., grocery stores, healthcare) will continue to rise. Several initiatives have sought to develop age-friendly neighborhoods, which focused on improving accessibility and affordability of community resources. However, limited effort has focused on the health and cognitive effects of neighborhood-level socioeconomic disadvantage, with respect to neighborhood income, education, employment, and housing quality. This symposium will include presentations from two studies that explored how neighborhood disadvantage (measured by the Area Deprivation Index) relates to health and cognition. The objectives of the proposed symposium are the following: (1) discuss how neighborhood disadvantage relates to subjective and objective measures of physical health; and (2) discuss how neighborhood disadvantage relates to cognitive functioning. Allan and colleagues explored the association between neighborhood disadvantage as it relates to changes in self-reported health and objective measures (i.e., blood pressure) of health among older Black adults. Wright and colleagues explored the association between neighborhood disadvantage and measures of subclinical cardiovascular disease in older Black and White adults. Aiken-Morgan and colleagues examined associations between neighborhood disadvantage and cognitive functioning among Black older adults. Lastly, McCain and colleagues explored associations between neighborhood disadvantage and mobility among Black older adults.
DYADIC LONELINESS AND COGNITIVE HEALTH AMONG OLDER MARRIED COUPLES: LONGITUDINAL EVIDENCE FROM THE HRS
Authors: Stokes Jeffrey , Prasad Anyah , Barooah Adrita 
Published: December 2022

Abstract
Loneliness is associated with numerous poor health outcomes, including mortality. Additionally, loneliness is not merely an isolated individual’s experience; rather, loneliness occurs regularly even among the married, and can affect both spouses’ health. We analyze 3-wave dyadic data from the Health and Retirement Study (2008-2018; N = 7,907 dyads) to determine (a) whether loneliness is associated with participants’ own and/or their partner’s verbal fluency and episodic memory over a nearly decade-long period, and (b) whether these measures of cognitive health predict older spouses’ own or their partner’s loneliness over the same period. Results indicated that (1) loneliness, episodic memory, and verbal fluency were all “contagious” within couples, such that baseline levels of each predicted participants’ own and their partner’s values at follow-up; (2) participants’ own loneliness was associated with poorer verbal fluency and episodic memory at follow-up; and (3) neither participants’ own nor their partner’s cognitive functioning predicted future loneliness.
RELATIONSHIP QUALITY AND OLDER PARENTS' COGNITIVE TRAJECTORIES: A NATIONAL LONGITUDINAL STUDY IN THE UNITED STATES
Authors: Zhang Yan , Liu Hui 
Published: December 2022

Abstract
This study aims to assess the impact of the relationship quality between parents and children on parents’ cognitive function in later life, with an additional focus on variation by parents’ gender. We analyze data from a nationally representative longitudinal panel survey of participants age 50 and older. We employ latent growth curve models (LGCM) to estimate how changes in parent-child relationship quality are related to cognitive trajectories over time. Maintaining frequent contact with children and receiving more support from children are associated with a slower rate of cognitive decline for older parents whereas experiencing relationship strain with children is associated with a faster rate of cognitive decline for older parents. These associations are stronger for mothers than fathers. This study highlights the importance of the “linked lives” of aging parents and their children. The findings have implications for the development of interventions and strategies to protect cognitive function in later life.