bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSYCHOMETRIC PROPERTIES OF THE NEUROPSYCHIATRIC INVENTORY QUESTIONNAIRE FOR THAI OLDER ADULTS WITH DEMENTIA
Authors: Wang Kaipeng , Hinton Ladson , Levkoff Sue , Sihapark Siranee , Chuengsatiansup Komatra , Chen Hongtu 
Published: December 2022

Abstract
Psychiatric and behavioral symptoms are highly prevalent among persons living with dementia. Clinical evaluation of those symptoms is critical for assessment of dementia progression and development of effective treatment. The Neuropsychiatric Inventory Questionnaire (NPI-Q) is a brief informant-based instrument to assess the severity of 12 types of neuropsychiatric symptoms among persons with dementia and associated caregiver distress. Although Thailand is experiencing a rapid increase in the prevalence with dementia, there is no validated instrument to assess neuropsychiatric symptoms in Thailand. This study aims to examine the psychometric properties of the NPI-Q instrument among older adults with dementia in Thailand. Data were collected from 353 participants aged 60 and over with probable dementia, at least one neuropsychiatric symptom, and an adult family caregiver willing to participate in the study. We examined the internal consistency, factorial validity, and criterion validity of the NPI-Q instrument. NPI-Q has acceptable internal consistency (Cronbach’s α=0.77). Principal component analysis yielded a five-factor solution, which accounted for 63% of the variance. The five factors included (1) agitation, anxiety, and irritability, (2) delusions, hallucinations, apathy, and disinhibition, (3) euphoria, motor disturbance, and night disturbance, (4) depression, and (5) abnormal appetite. We found that higher NPI-Q severity score was significantly associated with higher geriatric depression, associated caregiver distress, caregiver burden, and caregiver depression and lower quality of life among older adults and their caregivers, which confirmed the criterion validity of the instrument. Findings provide support for use of the NPI-Q among older adults with dementia in Thailand.
COMPLEXITY IN PSYCHOSOCIAL INTERVENTIONS: CASE STUDIES FROM A STROKE TRANSITIONS TRIAL
Authors: Chima Emmanuel , Woodward Amanda , Hughes Anne , Fritz Michele , Freddolino Paul , Swierenga Sarah , Coursaris Constantinos , Reeves Mathew 
Published: December 2022

Abstract
The Michigan Stroke Transitions Trial (MISTT) tested whether in-home social work case management (SWCM) or SWCM combined with access to a website providing stoke-related information improved outcomes relative to usual care for patients discharged home post-stroke and their caregivers. The aims of this secondary analysis are 1) to describe the actual support social work case managers (SWCM) provided to MISTT participants and 2) use select case studies to illustrate the relationship between SWCM and quantitative patient and caregiver outcomes. Data for the study were derived from SWCM case notes on 157 patients and their caregivers who received the MISTT intervention. Case notes were coded in two steps with a subset of cases coded by two researchers and reviewed for interrater reliability in each step. The first round of coding was guided by primary SWCM intervention goals. The second round of coding identified SWCM sub-themes within each primary goal. Key themes indicate SWCMs aided with understanding the post-hospitalization period, helped patients navigate a range of systems and services, identified needs and supported patient goals, provided psychosocial support, and centered support on stroke recovery and prevention. Case studies illustrate ways in which SWCM were key supports during the transition period, but that support does not cleanly align with quantitative findings from patient-reported outcomes. This study aligns with a growing body of work documenting the complexity of transitions of care and has implications for how we support patients and caregivers as they move from inpatient to outpatient care and measure outcomes.
STICK TO THE THEORY: FINDINGS FROM A COMPLEX CARE INTERVENTION FOLLOWING TRANSITION TO DIGITAL DELIVERY
Authors: Meyer Kylie , White Carole 
Published: December 2022

Abstract
Two thirds of family caregivers to persons living with dementia provide complex care tasks, including medical/nursing tasks, and nearly half worry about making a mistake. Learning Skills Together (LST) was designed to prepare caregivers to provide complex care through hands-on instruction (e.g., practice using a gait belt). Consistent with self-efficacy theory, the in-person intervention integrated behavioral modeling, strengths-based feedback, and knowledge-building. COVID-19 prompted a transition to digital delivery of LST over Zoom. Intervention content was modified to accommodate a digital approach while continuing to adhere to self-efficacy theory. Results from a pre- and post-test pilot study (N=35) indicate improvement in self-efficacy on (mean difference (MD)=1.0, SD= 1.6, p-value=0.004). Caregiver comments during qualitative interviews affirm intervention objectives were met. For example, caregivers described the importance of peer learning (modeling) during discussion. Results indicate that complex care intervention can be digitally delivered to family caregivers to improve self-efficacy surrounding complex care.
INCREASING DEMENTIA CARE MASTERY FOR RURAL CAREGIVERS: LESSONS FROM ADAPTING THE HARMONY @ HOME INTERVENTION
Authors: Gibson Allison , Henley Laura , Fairchild Vickie , Goss David , Baum Carolyn , Jicha Gregory , Rhodus Elizabeth 
Published: December 2022

Abstract
Providing care support to rural Alzheimer’s disease and related dementia (ADRD) caregivers has always been challenging, but particularly with the COVID-19 pandemic, new barriers have emerged for families in accessing care support. Delivered via telehealth, Harmony at HOME (H@H) provides dementia care mastery for caregivers of persons with ADRD in the skills of assessing and modifying the home environment to promote "person-environment fit," whereby increasing functional activity engagement and minimizing maladaptive behaviors. To enhance care supports specific to the needs of rural communities, this study reports the findings of two focus groups with rural caregivers who participated in the H@H intervention. Focus groups were aimed to identify the needs of caregivers in rural communities to guide adaptation approaches for future implementation of the H@H intervention in these underserved areas. Additional studies to assess real-world efficacy of the adaptations to H@H are needed as a next step toward implementing this intervention in clinical, home care settings.
NURSING HOME SOCIAL SERVICES DIRECTORS' ROLE AND RESPONSIBILITIES
Authors: Bern-Klug Mercedes , Galambos Colleen 
Published: December 2022

Abstract
While most of the nursing home literature focuses on residents and nurses, there is a growing literature on social services staff and family members of nursing home residents. Social services staff include social workers as well as non-social workers with responsibility for assessing and care planning for resident psychosocial issues, as well as a host of other responsibilities including working with families. This symposium presents findings from the National Nursing Home Social Services Directors Survey (NNHSSDS), a cross-sectional (2019) nationally representative study (n=924) that collected data on social services staff characteristics, departmental role responsibilities, and training needs. In this session three papers developed from these data are presented to document the extent to which social services staff are involved with family members, their interest in receiving training on how they can support other staff in understanding resident abuse and exploitation (at the hands of family, fellow residents, or staff), and neglect. As demanding as the social services role is, many holding the position of social services director report they are thriving (not just surviving) in the role. A final paper describes which variables help to distinguish those who report they are thriving versus those who do not. Implications to be discussed include what administrators could do to make the social services director’s job more attractive. The RRF Foundation for Aging provided data collection support for the NNHSSDS.
POSITIVE AFFECT IN DEMENTIA CARE DYADS
Authors: Monin Joan , Haase Claudia 
Published: December 2022

Abstract
Positive affect is important for physical health, well-being, and relationships. Yet, most studies of dementia care dyads have focused on negative outcomes, such as depression and caregiver burden. We present findings from studies that address this important research gap. The first two speakers present findings from actor partner interdependence models using secondary data from a randomized controlled trial of persons with early-stage dementia (PWD) and their spouses. Specifically, Dr. Monin will show that actor quality of life is significantly related to positive affect cross-sectionally, controlling for functional status of each partner and PWD behavioral symptoms. Ms. Piechota will present longitudinal findings demonstrating that when spouses were high in difficulty regulating emotions, the PWD’s positive affect decreased over three months, controlling for intervention arm and covariates. The second two speakers will present findings from two different studies of persons living with behavioral-variant frontotemporal dementia (bvFTD), Alzheimer’s disease (AD), and controls that engaged in laboratory conflict discussions. Dr. Brown will show that caregivers of individuals with bvFTD reported greater decreases in positive emotion across the discussion relative to caregivers of individuals with AD and language variants. She will also discuss how caregivers who reported greater decreases in positive emotion had higher levels of depressive symptoms, controlling for their partner’s diagnosis and level of cognitive impairment. Finally, Dr. Chen will provide evidence that bvFTD caregivers had lower emotional well-being according to the SF-36 than AD caregivers and controls, and this effect was fully mediated by bvFTD caregivers' lower positive emotional connections.
ASSOCIATIONS BETWEEN HEALTH AND POSITIVE AFFECT IN SPOUSAL DEMENTIA CARE DYADS
Authors: Monin Joan , Johnson Kalisha Bonds 
Published: December 2022

Abstract
Little is known about the conditions that foster greater positive affect in the daily lives of spousal dementia care dyads in the early stages of dementia. This study aimed to examine the extent to which multiple indicators of health, including activities of daily living needs, quality of life, and the person with dementia’s behavioral symptoms were associated with each partner’s positive affect in daily life. Using secondary baseline data from a randomized controlled trial testing a stress reduction intervention in 63 couples (N=126), we examined whether individuals’ multiple health indicators were associated with their own positive affect (actor effects) and their partner’s positive affect (partner effects). Actor partner interdependence model results showed that for both persons with dementia and spouses, actor quality of life was the greatest predictor of positive affect, controlling for all other actor and partner health indicators (β=.04, SE=.01, t(67.1)=3.36, p=.001).
RELIEF, REGRETS, AND REINVENTION: LIFE AFTER GRAY DIVORCE
Authors: Benson Jacquelyn , Olivia Landon , Donehower Allison , Sanner Caroline 
Published: December 2022

Abstract
“Gray divorce,” or divorce which occurs in later life, is rapidly becoming more common in the United States. The purpose of this grounded theory study was to examine the lived experience of getting divorced in mid to later life. Data address the following research questions: 1) What are the divorcees’ expectations for the process of divorce and post-divorce life? 2) How do life phase factors and family relationships shape the divorce experience? Participants included 41 heterosexual men and women who legally divorced at the age of 55 or older and between 1-7 years from the time of the interview. Participants divorced from first and higher order marital unions. They included self-identified initiators, non-initiators, and co-initiators of the divorce. Results suggest that gray divorce is a complex experience marked by shifting feelings of ambivalence and certainty that are influenced by such factors as health and social networks, especially family.
REIMAGINING ALZHEIMER’S RESEARCH: ON THE ROAD TO NEW DISCOVERIES
Authors: Andersen Stacy , Smith Lenora , Gibson Allison 
Published: December 2022

Abstract
Organized by the Alzheimer's disease and related dementias (ADRD) Interest Group, this symposium aims to highlight unique approaches to address 1) ADRD risk reductions through social and biological factors, and 2) quality of life of those with dementia. The first two presentations introduce remote communication technologies used for behavioral interventions, one for preventing social isolation and the resultant cognitive decline using video-chats by recruiting socially isolated older adults with mild cognitive impairment (MCI). The results of the recently completed randomized controlled trial provide evidence of a positive effect on cognition suggesting enhanced cognitive reserve. Another is for delivering a behavioral symptom intervention for community-dwelling persons with ADRD using telehealth. Researchers will highlight the feasibility, opportunities, and challenges of remote behavioral interventions. The third presentation focuses on micro-level communication between persons living with dementia and their family caregivers. By examining video-recorded home care observations, findings suggest caregiver education on positive interactions could facilitate more meaningful interaction with persons with ADRD. The fourth presentation explores pain among those with ADRD, a multifaceted phenomenon with health and functional consequences. Using the NHATS dataset, researchers show a continued need to detect and address pain in clinical settings particularly among persons with ADRD. The symposium concludes with a presentation using the CHARLS study to investigate correlations between inflammation or kidney-related metabolic biomarkers and cognition. Results provide longitudinal evidence of an association of kidney function and inflammation with cognitive test scores supporting the need to broaden dementia etiology research beyond the amyloid-cascade theory.
IMPLEMENTATION OF THE ELDER MISTREATMENT EMERGENCY DEPARTMENT TOOLKIT AT LYNDON B. JOHNSON HOSPITAL
Authors: Plummer Sherry , Burnett Jason , Froberg Ruthann , Campetti Randi , Dash Kim 
Published: December 2022

Abstract
Lyndon B. Johnson Hospital (LBJ) has the busiest Level III trauma and emergency department (ED) in Texas. Located in the busiest Houston zip code for Adult Protective Services reports, LBJ staff routinely assess older adults for mistreatment with no formal screening and response protocol. An ED-wide staff assessment revealed formal training needs for elder mistreatment (EM) detection, management, and reporting. Between October and December 2019, 55% of ED bedside nurses were trained along with 75% of charge nurses, and 12 clinical and nurse case managers, resulting in improved knowledge regarding EM screening and response best practices. In January 2021, LBJ staff implemented the Elder Mistreatment Screening and Response Tool (EM-SART). This resulted in 1,218 complete screens, 23 cases of suspected EM (2%), and 4 confirmed EM cases. Despite the pandemic and other challenges, LBJ staff demonstrated resilience and dedication, and reported EM training, screening, and response protocol efficacy.
IMPLEMENTATION OF THE ELDER MISTREATMENT EMERGENCY DEPARTMENT TOOLKIT AT HEYWOOD HOSPITAL
Authors: Papa Carol-Lynne , Campetti Randi , Froberg Ruthann , Haggerty Kristin Lees , Dash Kim 
Published: December 2022

Abstract
Beginning in 2016, Heywood Hospital, a 134-bed community hospital located in Central Massachusetts, partnered with the National Collaboratory to Address Elder Mistreatment to design and test a care model for identifying and responding to elder mistreatment (EM) in hospital emergency departments (ED). In February 2020, Heywood Hospital began implementing the care model known as the Elder Mistreatment Emergency Department (EMED) Toolkit as part of a five-site feasibility study. This presentation shares local results from the feasibility study and strategies for implementing the EMED Toolkit. 95% of Heywood staff participated in an online training program and, over 9 months, 4,588 (84%) of all older ED patients were screened for EM. Of these, 19 screened positive and 11 were reported to Adult Protective Services, a more than 7-fold (annualized) increase over the prior year. Most of the remaining positive cases were connected with community-based resources through Heywood’s Social Services Program.
EMERGENCY DEPARTMENT: ADULT PROTECTIVE SERVICES RELATIONSHIP IN RESPONSE TO ELDER MISTREATMENT
Authors: Sivers-Teixeira Theresa , Thayer Erin , Van Den Heever Carmen , Olsen Bonnie 
Published: December 2022

Abstract
Universal screening of older adults in emergency departments (ED) effectively improves identification of elder mistreatment (EM). To realize improved response, collaboration between ED providers and staff and local Adult Protective Services (APS) is essential. Qualitative data was derived from transcribed and coded key informant interviews with 10 APS workers and 5 ED clinical providers from 6 states. Results indicate each entity approaches EM from a different global perspective which informs key strategies to build effective response. ED providers focus on acute medical needs while APS focuses on long-term psychosocial needs. Assignment of specific individuals in both entities to be liaisons between ED and APS would support improved communication and collaboration. Education should focus on 1) capabilities and limitations in EM response and 2) clarity regarding bilateral sharing of information. Both entities report participation in multidisciplinary teams is valuable to foster collaboration on effective interventions in EM cases.
DEMENTIA-RELATED STIGMA IS ALIVE AND NOT WELL AMONG UNREGULATED HOME CARE WORKERS
Authors: Savundranayagam Marie , Basque Shalane , Gruneberg Audrey 
Published: December 2022

Abstract
Dementia-related stigma is pervasive despite the growing rates of dementia globally. The social cognitive model of stigma contends that stigma is created and maintained through negative stereotypes, prejudice, and discrimination towards people who belong to a group. Research on dementia-related stigma highlights the prevalence of stigmatizing views among formal care providers. However, little is known about how stigma is created and maintained by the ways in which frontline care providers talk about persons living with dementia. Accordingly, this study aimed to identify ways in which stigmatizing language is used by home care workers when describing routine care interactions with clients living with dementia. Semi-structured interviews were conducted with 30 unregulated home care workers, who shared their experiences caring for clients with dementia. We used conventional content analysis to identify themes related to dementia-related stereotypes, prejudice, and discrimination. Under stereotypes, persons with dementia were portrayed as objects, infants, not engaging, and cognitively and behaviorally unstable. Under prejudice, persons with dementia invoked pity, fear, disdain, and emotional fatigue. Under discrimination, participants shared experiences of excluding/ignoring, controlling, and using patronizing communication with persons living with dementia. Uncovering common examples of stigmatizing language offers opportunities to train home care workers to use person-centered communication. It is noteworthy that stigmatizing language emerged, when not asked about directly. Our findings underscore the persistence of dementia-related stigma and the need for training to eliminate stigma.
EVALUATION OF COGNITION IN PRIMARY CARE (CPC): A PILOT STUDY TO INCREASE EARLY DETECTION AND MANAGEMENT OF DEMENTIA
Authors: Fitzpatrick Annette , Gaster Barak , Raetz Jaqueline , Belza Basia , Suchsland Monica Zigman , Tracy Karen , Olivari Benjamin , McGuire Lisa 
Published: December 2022

Abstract
Despite evidence that early detection of mild cognitive impairment and dementia leads to improved patient care, these conditions remain under-diagnosed in primary care. To address this gap at University of Washington Medicine, we have developed and pilot-tested a program to increase cognitive evaluations and improve dementia care by primary care providers (PCPs). The Cognition in Primary Care (CPC) program was designed utilizing stakeholder-selected components of the GSA KAER (Kickstart-Assess-Evaluate and Refer) Model and Toolkit (2020 Edition), developed by the Gerontological Society of America (GSA). In this presentation we will describe evaluation of the CPC Program including (a) education training; (b) use of assessment tools integrated within the electronic health record (e.g. potentially harmful medications, depressive symptoms, alcohol use, sleep apnea, etc.); (c) practice recommendations such as dedicated evaluation appointments, diagnoses and referrals, and (d) PCP use of community resources for post-diagnosis support. A total of 66 PCPs participated in the series of 3 CME educational seminars. Over 93% of participants reported the content to be highly relevant and expected to incorporate it into their practice; commitments to use specific tools were made. Analysis is underway to determine impact of the program by comparing the above metrics before and after the training as well as between trained and untrained PCPs. Results from this evaluation will inform modifications to increase utilization of the CPC Model within UW Medicine, will be used to package the program to share with other primary care systems, and will guide future enhancements to the GSA KAER Toolkit.
DEMENTIA CARE THROUGHOUT THE TRAJECTORY AND ACROSS SETTINGS: RESULTS FROM THE DEVELOP AD RESEARCH STUDY
Authors: Hunt Lauren , Ornstein Katherine , Massimo Lauren 
Published: December 2022

Abstract
About 1 in 8 older adults in the United States has dementia, making it one of the biggest public health issues facing society today. The impact of dementia ranges across health and social systems, yet consideration of these contexts--which are of great relevance to patients and families--has been underexplored in prior research. In this symposium, we will present findings from the Deploying High-Value Longitudinal Population-Based data in Dementia Research (DEVELOP AD Research) study. This multicenter collaboration leverages existing population-based data sources to examine the health and social impacts of dementia throughout the trajectory of decline and across acute, long-term, and community-based settings. Session one will describe how acute care utilization increases in the years before the onset of incident dementia. Session two will examine the association between dementia and increased mortality risk after disruptive medical events, including hip fracture and pneumonia. Session three will report on the prevalence and patterns of medication overuse and misuse in community-dwelling people with dementia. Session 4 will estimate how many community-dwelling individuals, including those with dementia, could benefit from home-based medical care. Session 5 will focus on hospice use patterns and hospice care quality rating in people admitted to hospice for dementia versus other conditions. Together, these presentations provide a wide lens on the health and social experiences and needs of people with dementia at the national level, leading to a better understanding of how society can better address the challenges of caring for this growing population.