bluuebunny/crossref_metadata_2025_split huggingface dataset:
SLEEP CHARACTERISTIC OF AN OLDER END OF LIFE (EOL) CAREGIVER: A SINGLE CASE STUDY
Authors: Park Hyeyoung , Lee Sunghoon , Bailey Amelia , Liu Yunda , Jacelon Cynthia 
Published: December 2022

Abstract

Background
Extensive caregiving work, psychological distress, and caregiving burdens put end of life (EOL) caregivers at great risk of sleep disturbances.

Methods
A single case mixed method design was used to explore older EOL caregivers’ sleep characteristics. Multi-dimensional data was collected through a series of methods including questionnaires (caregiver and care recipient demographics, care recipient symptom severity, caregiver caregiving strain, depressive symptoms, and sleep quality), 14 days of National Sleep Foundation (NSF) sleep diary, 28 days of daily sleep and activity measured by wearable personal sleep monitoring devices (Garmin vivofit 4), and a semi-structured interview. Data was analyzed using thematic content analysis. Findings: A 60 year old female taking care of her 85 years old mother with dementia, kidney cancer, and several other illnesses was recruited for this case study. She showed overall poor sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI, total score: 8), and she slept 6.73 (±1.27) hours per day on average with 52.96% of deep sleep, 41.63% of light sleep, and 5.41% awake times. The caregiver reported that her daily sleep quality depended on her care recipient’s health condition each night. She also described others supporting for her caregiving work as a “double-edged sword,” because she needed to trade some privacy for the additional help.

Conclusion
Further study is needed for EOL caregivers’ poor sleep quality considering external factors and sleep intervention for EOL caregivers should be developed considering these external caregiving contexts.
URBAN ENVIRONMENT AND AFFECTIVE STATES IN REAL TIME: AN ECOLOGICAL MOMENTARY ASSESSMENT STUDY OF OLDER ADULTS
Authors: Liang Peichao , Guo Yingqi , Chan On Fung , Chui Cheryl Hiu-Kwan , Liu Yuqi , Lu Shiyu , Lum Terry 
Published: December 2022

Abstract
Older adults are more dependent on their surrounding environment. Extensive research has demonstrated beneficial effects of both nature and built environment on mental health of older people. However, most previous research used cross-sectional designs failed to test the intraindividual variability between environment, behavior, and mental wellness in daily life. We used ecological momentary assessment (EMA), activity sensors, and GPS tracking to examine the association between real-time environment, mobility and activity, and momentary affect among older adults in Hong Kong. Data collection and data processing was conducted from December 2021 to May 2022. 168 older adults aged 65 to 84 received seven EMA prompts per day during a fifteen-day period, and completed a total of 17,345 momentary assessments of affective states, mobility, and activities. A set of GPS-derived indicators were used to measure the real-time environment. To disaggregate the between- and within-person effects, we used multilevel models to estimate three dimensions of affect, i.e., valence, calmness, and energetic arousal, in EMA observations, nested within individual participants. Preliminary results indicate significant concurrent associations between environmental attributes and momentary affect at the within-person level, while the between-person differences appear to be either null or modest. Being out of home is associated with higher valence ratings (b=0.04, p=0.0427), while exposure to green is associated with a lower level of energetic arousal (b=-0.03, p=0.0163). Greater walkability is consistently associated with higher momentary affect ratings in three dimensions, but these associations are not statistically significant. Implications of these findings for promoting healthy aging will be discussed.
THE RECIPROCAL RELATIONSHIP OF SELF-RATED HEALTH AND INSTRUMENTAL HELP FROM CHILDREN: EVIDENCE FROM GERMANY
Authors: Jessee Lisa 
Published: December 2022

Abstract
Prior research suggests that receiving support from children may promote health among ageing parents. Poor health, however, often precedes the need for support. Yet, research linking instrumental support and self-rated health (SRH) has been deficient in two regards: First, little research has addressed the relationship between instrumental support and SRH simultaneously using longitudinal data. Second, only few studies, have accounted for unobserved confounders (e.g. within-person effects) and potential reverse causality. Recently developed dynamic panel models with fixed effects provide an opportunity to address these methodological issues. Using four waves of the German Ageing Survey (DEAS) among 4,496 adults aged 40 years and older, the current study investigates the potential bidirectional relationship between instrumental support and SRH. I find that prior receipt of instrumental support from children is not a significant predictor of future reported poor SRH. Similarly, previous poor SRH does not significantly predict the likelihood of receiving instrumental support from children at follow-up. Independent of older adults’ SRH, however, prior receipt of instrumental support is a statistically significant predictor of receiving support at follow-up. Regardless of receiving children’s instrumental support, poor SRH in the past predicts poor SRH in the future. The results shed new light on prior bidirectional associations between SRH and instrumental support in the German context. Previous results may be partly explained by a lack of controls for unobserved individual characteristics. The findings suggest that policy interventions may not exclusively rely on older adults’ receipt of support from children in the event of health declines.
A LATENT CLASS ANALYSIS OF STRESSORS AND RESOURCES AMONG SPOUSAL CAREGIVERS TO OLDER ADULTS IN THE UNITED STATES
Authors: Liu Ruotong , Chi Iris , Wu Shinyi 
Published: December 2022

Abstract
Spousal caregivers to older adults experience differing intensities of co-occurring caregiving stressors and resources. Analyzing their heterogeneous profiles can improve recognition of spousal caregivers needing support and caregiving impact on their health. This study aims to identify latent classes among spousal caregivers to older adults and to explore the associated background characteristics and health outcomes. Using pooled data from Round 5 and Round 7 of National Study of Caregiving and the linked National Health and Aging Trends Study, eight indicators for stressors and three indicators for resources are included for latent class analysis to identify distinguishable spousal caregiver subgroups. ANOVA test or Chi-square test are used to understand the different characteristics across spousal caregiver classes. Multivariate regression is conducted to examine associations between class membership and health outcomes. Three latent classes are identified among the 793 included spousal caregivers: low-stress low-support class (39%), medium-stress high-support class (36%), and high-stress medium-support class (25%). Compared to the other two classes, high-stress medium-support class includes more female than male, medium-stress high-support class has greater portions of non-Hispanic Black individuals, and caregivers in low-stress low-support class have fewer comorbidities. In addition, compared to low-stress low-support class, spousal caregivers in high-stress medium-support class reported lower (0.42 unit) level of self-rated health and higher (1.87 unit) level of depressive symptoms. These results confirmed the heterogeneity among spousal caregivers, and highlighted the elevated needs to address the physical and mental health needs among spousal caregivers whose levels of resources could not offset the caregiving stress they experience.
PREDICTING CARE-RECIPIENTS’ WELLBEING BASED ON SPOUSAL CAREGIVERS’ CO-OCCURRING STRESSORS AND RESOURCES
Authors: Liu Ruotong , Chi Iris , Wu Shinyi 
Published: December 2022

Abstract
Besides caregivers, care-recipients’ health outcomes can be impacted by caregiving as well. The aim of the current study is to explore whether care-recipients’ longitudinal health outcomes differ by caregivers’ profiles characterized by the co-occurring and relative intensities of caregiving stressors and resources. Data from Round 5 and Round 7 of National Study of Caregiving and Round 5 to Round 8 of the linked National Health and Aging Trends Study are utilized. After multiple imputation, sample characteristics are described and compared among the 639 unique care-recipients by caregivers’ latent classes. Generalized estimating equations (GEE) with first-order autoregressive covariance are estimated to examine the differences in care recipients’ health outcomes at baseline and rates of change across groups. The average self-rated health at baseline is 2.73 (SD=1.02), and the average baseline depressive symptoms are 2.65 (SD=2.76). GEE results indicate that compared to care-recipients cared by low-stress low-support spousal caregivers, those cared by medium-stress high-support and high-stress medium-support partners score 0.20 and 0.35 unit lower in self-rated health at baseline, respectively, and those cared by high-stress medium-support caregivers on average score 1.21 unit higher in depressive symptoms at baseline. No statistical differences in rate of change are detected for both self-rated health and depressive symptoms across groups. Despite different levels of health at baseline, our research does not find care-recipients’ rates of change in health different across groups over one-year. Future studies are needed to further explore the longer-term differences in rates of change and to better understand the caregiving dyads.
FACTORS ASSOCIATED WITH VOLUNTEERING AMONG FAMILY CAREGIVERS OF OLDER ADULTS
Authors: Baik Sol , Coleman Rachel , Crittenden Jennifer 
Published: December 2022

Abstract
Family caregiving has been linked to an increased risk of poor mental health, poor physical health, and higher rates of perceived social isolation among caregivers. Despite the connection between caregiving and negative outcomes, or perhaps because of this connection, caregivers seek out and enjoy other life roles and activities including formal volunteerism. To explore the connection between informal caregiving and volunteering and establish the representative prevalence of formal volunteering among caregivers, descriptive and multivariate logistic regression analyses were carried out with data from 1,745 caregivers in the National Study of Caregiving (NSOC) (2017). Utilizing social capital theory four models were constructed with salient demographic characteristics associated with volunteering (model 1), caregiving context (model 2), caregiver physical and mental health (model 3), along with participation in informal and formal social networks (model 4). About a quarter of the sample participated in volunteering (26%). The average age was 60.5 years (SD = 14.3) and more than half consisted of female caregivers (67.11%). Non-Hispanic Whites (62.9%) were the majority of the sample, followed by non-Hispanic Blacks (28%), Hispanic (6.5%), and caregivers in other racial/ethic groups (2.6%). Gender, educational achievement, caregiving for a spouse, coresiding with care recipient, caregiving for multiple care recipients, quality of relationship with care recipient, caregiver psychological well-being, having emotional/physical support, attending religious services, and group activity participation were all significant indicators for caregiver volunteerism. Findings support the importance of both human and social capital in volunteering among caregivers.
GIDDY UP! LESSONS LEARNED FROM INTRODUCING AN ONLINE, NATURE-BASED INTERVENTION TO ASSISTED LIVING
Authors: Westmore Megan , Anderson Keith , Mauldin Rebecca 
Published: December 2022

Abstract
The processes involved with developing, funding, and conducting intervention studies in long-term care present a unique set of challenges for researchers. In this presentation, we explore the experiences of researchers evaluating an online nature-based intervention in assisted living. The first challenge lies in creating or finding a novel intervention specific to the setting and population. In this case, the researchers found and tailored an existing online, interactive program that focused on ranch life in rural Montana – Days at Dunrovin. In partnership with the developer of Days at Dunrovin, a group intervention was developed specifically for long-term care settings. The second challenge is finding a facility that has the desire, environment, and staffing to support the intervention. In this case, the researchers were able to partner with an assisted living facility that had an owner who was interested in research, an environment that matched the experimental design of the study, and a staff that was eager to find new ways for residents to engage with the world, particularly during the COVID-19 pandemic. The final challenge involves selecting a funding mechanism that best fits the needs of the study. In this case, the researchers targeted a private foundation that provided ample funding along with the latitude and flexibility that allowed the study to evolve and pivot as necessary. This presentation concludes with recommendations for both budding and seasoned researchers who seek to introduce creative interventions into long-term care settings.
HOW TO ENGAGE SENIORS AS VOLUNTEERS IN SOCIAL CARE SECTORS: A CASE STUDY OF A TIMEBANK IN HONG KONG
Authors: Lu Shiyu 
Published: December 2022

Abstract

Objective
Exploring the roles of older adults as volunteers in social care settings has attracted wide attention to facilitate healthy aging. However, knowledge of engaging older adults as volunteers in social care sectors remains scant. This study explores theoretical mechanisms for promoting volunteer engagement among older adults in the social care sector.

Method
This study used a time bank program called Good Hands in Hong Kong as a case study. Good Hands was established in 2018 and engaged almost 200 older adult volunteers to provide buddying and accompany (e.g., home visits and medical escort services) to over 390 frail peers in the community. This study adopted a qualitative method. Three semi-structured focus group interviews with 18 participants, including senior volunteers and the timebank staff, were conducted in January – August 2021. The thematic analysis. Stakeholder checks were conducted in July 2022 to enhance the credibility of the findings.

Results
Three emergent themes were identified as critical components to facilitate engagement among senior volunteers: (1) strong cross-sector collaboration, (2) meaningfulness in voluntary work comprising four subthemes, including capacity optimization, care capacity enhancement, belonging cultivation, and value recognition, and (3) a co-producing environment. In addition, this study also identified the challenges related to the sustainability of the timebank program.

Conclusion
This study is the first to explore mechanisms for promoting volunteer engagement among older adults in the social care sector. The findings provide theoretical and practical implications for the roles of older adults in social welfare production for our society.
IMPACT OF AN ONLINE COURSE ON GERIATRICS AND QUALITY IMPROVEMENT SKILLS FOR NURSES IN LONG-TERM SERVICES AND SUPPORTS
Authors: Telonidis Jacqueline , Savage Kirstie , McLeskey Nanci , Edelman Linda 
Published: December 2022

Abstract
Nurses working in long-term services and supports (LTSS) settings need training in geriatrics and quality improvement (QI). Our Geriatric Workforce Enhancement Program (GWEP) created an online Nurse Residency Program for nurses from other LTSS settings. Nurses (n=7) who completed the program showed statistically significant improvements in confidence in performing geriatrics skills (t = -3.12, df = 6, p = 0.01), attitudes about community-centeredness (t = -2.14, df = 6, p = 0.04), self-efficacy to engage in the treatment and assessment of depression (t = -3.06, df = 6, p = 0.01), and dementia (t = -2.04, df = 6, p = 0.04). Open-ended, satisfaction responses revealed improved self-efficacy with conducting a QI project. Empowering nurses in LTSS settings may improve quality of care, and decrease burnout and turnover. Future revisions will make the course both asynchronous and applicable to other professions in order to build stronger interprofessional LTSS teams.
AMPLIFYING COMMUNITY ENGAGEMENT TO INCREASE REPRESENTATION AND APPLICABILITY OF CAREGIVING RESEARCH
Authors: Williams Ishan , Jones Randy , Brown-Hughes Travonia 
Published: December 2022

Abstract
Alzheimer’s disease and related diseases (ADRD) disproportionately affect persons of African American ethnicity, yet persons who identify as Black/African American are consistently and markedly underrepresented in Alzheimer’s research. Prior research suggests that a complex array of factors, from mistrust in medical research to non-inclusive recruitment approaches, have led to the disparity. With the growing rates of ADRD among racial/ethnic groups in the US, it is imperative that research scientists develop interventions and clinical research that are culturally informed and meaningful to the lives of diverse caregivers. The goal of our research is to demonstrate the importance of community engagement and culturally informed interventions, and to offer best practices to advance the science of caregiver recruitment, which may ultimately improve overall representation across racial/ethnic caregiver groups. Research findings will highlight the variety of recruitment strategies used to build trust and more sustainable relationships with diverse communities often underrepresented in research.
ASSOCIATION OF MID UPPER ARM CIRCUMFERENCE AND COGNITION: A POPULATION-BASED COHORT STUDY
Authors: Lynch David , Howard Annie Green , Tien Hsiao-Chuan , Du Shufa , Zhang Bing , Wang Huijun , Gordon-Larsen Penny , Batsis John 
Published: December 2022

Abstract

Introduction
Evidence suggests a positive association between muscle mass and cognitive impairment exists. Mid-upper arm muscle circumference (MUMC) is a simple measure that may provide prognostic information on cognitive status.

Methods
We included adults aged ≥55 years from the China Health and Nutrition Survey 1997-2018 with MUAC and triceps skinfold (TSF) measurements at each visit. Cognition was estimated based on a subset of the modified Telephone Interview for Cognitive Status (TICS, 0─27). Sex-stratified linear mixed-effects models accounting for within-individual and within-community correlation assessed the association between MUAC and the ratio of MUAC:TSF with TICS across age. We tested whether the rate of cognitive decline by age differed by quartiles of MUAC and MUAC:TSF in separate models. In cases of no statistical differences in cognitive declines by age, we tested whether overall cognitive function was associated with quartiles of MUAC and MUAC:TSF across all ages.

Results
Of 5,964 adults (53% female, age 62.4±6.4), mean MUAC was 26.6±3.74 and 26.2±3.9 cm, mean MUAC:TSF ratio was 2.9±1.6 and 1.94±1.1, and baseline TICS was 15.4±6.1 and 13.2±6.4 for men and women, respectively. MUAC was not associated with the rate of cognitive decline. Lower MUAC was associated with higher overall cognitive function scores for men (p=0.01) and women (p=0.05). For men and women there was no association between MUAC:TSF ratio and either cognitive decline or overall function.

Conclusion
MUMC can be a marker to predict overall cognitive function across this period in the lifecycle, suggesting that declining MUAC may help predict lower overall cognitive function
SWISS NURSING HOMES’ ENGAGEMENT IN QUALITY IMPROVEMENT: A MULTICENTER CROSS-SECTIONAL STUDY
Authors: Favez Lauriane , Simon Michael , Serdaly Christine , Zúñiga Franziska 
Published: December 2022

Abstract
Many publications have focused on quality improvement interventions in nursing homes but the self-initiated daily involvement of nursing homes in quality improvement activities has rarely been investigated (e.g., conducting surveys, using data to set quality aims and track quality of care over time, conducting quality improvement projects). Such activities can be carried out by nurses in expanded roles with competences beyond those of regular registered nurses (e.g., advanced studies, Bachelor/Master’s degree), but evidence is lacking. We aimed to described the involvement of nursing homes and of nurses working in expanded roles in quality improvement activities in Swiss nursing homes. A cross-sectional multi-center study (2018-2019) using survey data from a convenience sample of 115 Swiss nursing homes and 104 nurses in expanded roles was used and descriptive statistics applied. Most nursing homes reported carrying several quality improvement activities (median = 8 activities out of 10 surveyed). The group of nursing homes working with a nurse in an expanded role (n = 83) were more engaged in quality improvement than the other group (median = 8 versus 6.5) Higher-educated nurses participated more in a majority of quality improvement activities than lower-educated nurses (Bachelor/Master-educated nurses: median of 13 out of 17 activities surveyed, versus diploma-educated nurses: 10), except for clinical teaching. This study provides insights into nursing homes’ involvement in daily quality improvement and suggests that, depending on the targeted quality improvement needs, nursing homes use different profiles and education levels of nurses in expanded roles.
NATIONWIDE ALIVIADO CHAMPION TRAINING: KNOWLEDGE IMPROVEMENT, CHAMPION TURNOVER, AND LESSONS LEARNED
Authors: Sadarangani Tina , Durga Aditi , Ford Ariel , McCabe Donna , Jones Tessa , Convery Kimberly , Lin Shih-Yin 
Published: December 2022

Abstract
Aliviado Champions are hospice employees selected by their agency to lead the local implementation of the Aliviado program. Accordingly, training and retention of champions are critical to hospices’ success (or failure) of program implementation. As of February 2022, we have trained 308 champions across 19 agencies; 94% of the champions agreed all learning objectives were met. A total of 144 champions (97 nurses, 27 social workers, 16 chaplains, and 5 providers) completed pre- and post-training dementia knowledge surveys, demonstrating significant improvements in dementia knowledge, attitudes, and confidences in 7 out of 10 domains post training (p&lt;0.005). The champion turnover rate during COVID-19 (March 2020-Feb 2022) was 11%. In addition, we share our experience adapting the originally 2 full-day, in-person Aliviado Champion Training into a Zoom-based format in response to COVID-19 including strategies to prevent Zoom fatigue. We also discuss strategies to address turnover and rapidly onboard new champions during COVID-19.
INTERDISCIPLINARY DEMENTIA CARE WORKFORCE TRAINING DURING COVID-19 AND TWO HOSPICE CASE STUDIES
Authors: Lassell Rebecca , Durga Aditi , Lin Shih-Yin , Jones Tessa , Ford Ariel , Brody Abraham 
Published: December 2022

Abstract
Hospice is a care model characterized by interdisciplinary team-based, person and family-centered care. To optimize agency-wide interdisciplinary team-based hospice dementia care, at least two levels of tailoring of the dementia care workforce training are imperative, first, by discipline, and second, by hospices’ local culture and needs. As of February 2022, a thousand and one skilled hospice interdisciplinary team members (not counting champions) across 18 hospice agencies have completed their discipline-specific Aliviado dementia care training, including 56 providers, 763 nurses, 129 social workers, and 53 chaplains. In this presentation, we describe how we tailored dementia workforce training for skilled interdisciplinary team members (first level tailoring), as well as provide two case studies elucidating how we performed further tailoring of the program for two large hospice agencies (average daily census: 354 and 868, respectively) in two different states to meet their local needs (second level tailoring), and lessons learned.