bluuebunny/crossref_metadata_2025_split huggingface dataset:
WHAT IS MEMORY CARE IN ASSISTED LIVING?
Authors: Smith Lindsey , Jutkowitz Eric , Thomas Kali 
Published: January 2025

Abstract
Memory care is the most common type of specialized care provided in assisted living (AL) settings. This specialized care caters to people living with dementia and other forms of cognitive impairment. However, what constitutes specialized memory care varies according to who and how the setting is defined. We use the lenses of the state, industry, and consumers to describe the prevalence of ALs with memory care across the US. We created a national directory of ALs and their state licenses to identify those ALs designated as providing specialized memory care by the licensing agency, classified according to whether the state holds these ALs to additional standards or simply requires disclosure. To identify AL communities considered memory care by industry professionals, we relied on a dataset of AL organizations from the National Investment Center (NIC), a nonprofit organization focused on providing data, analytics, and connections to the senior housing and care industries. Finally, to view AL communities through the lens of (potential) residents and their families, we used business advertisement descriptions from Data Axle, a business advertising database. We found that 28% of the 13,715 large (greater than 25 beds) AL communities in our national AL directory were identified as memory care by state licensing agencies, 60% by NIC, and 26% by Data Axle. Our findings raise questions regarding how the care provided in these settings may vary based on who defines memory care.
DEPRESSION AMONG MIDDLE-AGED AND OLDER INFORMAL CAREGIVERS IN 19 COUNTRIES: A CROSS-NATIONALLY HARMONISED STUDY
Authors: Jiang Nan , Pagan Jose , Wu Bei , Li Yan 
Published: January 2025

Abstract
The health of the caregivers is crucial to sustain informal care provision, while depression is an important health risk concept. In this study we aim to conduct multi-country, population-based studies on caregivers’ depression and examine the association of caregiving with depression in 19 countries. We included 142,741 adults aged ≥ 45 years in our sample. Depression was measured using established cut points in shortened Center for Epidemiologic Studies Depression (CES-D) or EURO-D scales. We conducted multivariable logistic regression analyses to explore the association of the past 12-month caregiving with depression. Over 30% of participants in our sample were engaged in caregiving with particularly high rates observed in Denmark, China, France, and Sweden. After controlling for potential confounders, caregivers had a significantly higher risk of having depression (OR = 1.13, 95% CI = 1.02-1.25) compared to non-caregivers. The associations were stronger in China, India, South Korea, Spain, and the United Kingdom than in other countries. Our findings suggest that urgent attention must be given to developing strategies that address the unique challenges faced by caregivers, fostering their well-being while maintaining high-quality care standards. Future interventions and policies need to aim at mitigating the mental health burden experienced by caregivers and ensuring sustainable and effective care support.
OLDER MIGRANTS IN THEIR SOCIAL CONTEXTS
Authors: Ritter Ashley , Glicksman Allen , Diederich Freya 
Published: January 2025

Abstract
It is recognized that a comprehensive understanding of the experiences and circumstances of older adults necessitates an examination of the broader social, institutional, and political frameworks within which they reside. The migration of older individuals entails a transformation in their relationships with family members, social networks, service providers, and governmental institutions. Lawton’s Environmental Press model, which posits that the influence of environmental factors on health and well-being intensifies as individuals age and become more fragile, can be extended to older migrants. Such individuals may find themselves relying more heavily on familial support, social networks, formal caregiving services, and governmental assistance to maintain their health compared to their native environments. The four papers presented in this panel explore the challenges confronting older migrants within these expansive contexts, probing the ways in which these contexts can either positively or negatively impact the well-being of older adults. The papers progress from an examination of familial dynamics (Reyes) to the broader societal milieu (Torres), followed by an analysis of formal care systems (Glicksman et al.), and concluding with an investigation of governmental policies at the national level (Kilkey). Collectively, these papers underscore the significance of social, institutional, and governmental frameworks in shaping the health and well-being outcomes of older migrants. Moreover, the papers underscore the necessity of employing diverse research methodologies, including surveys, qualitative inquiries, secondary data analyses, and literature reviews, to address the multifaceted nature of these issues and to cater to the specific inquiries at hand. International Aging and Migration Interest Group Sponsored Symposium
PLACE OF ORIGIN AND USE OF FORMAL HEALTH SERVICES
Authors: Glicksman Allen , Albert Steven , Davey Adam , Friedman Ari , Lai Philip , Rodriguez Misha , Schrauf Robert , Liebman Michael 
Published: January 2025

Abstract
The point of contact between older immigrants and the formal health system is an area of concern for providers, policy makers and researchers. The challenges that often appear in any interaction between older adults and formal providers are exacerbated when the older person is an immigrant because of language and cultural differences, challenges in a family where migration has taken place, and lack of familiarity with the local system for providing care. Attempts to understand these interactions require attention to two sources of diversity – on the one hand the place of origin of the older migrant and all the social, cultural and policy differences in the places of origin on the one hand and the diversity of types of encounters (ambulatory, emergency department, in-patient hospital) with the formal system and the related issues of insurance status on the other. Our study, using data on encounters between persons speaking Chinese, Spanish or Russian to examine use of the three types of encounters to examine patterns of service use for persons with similar health insurance and primary diagnoses. We will focus on the Chinese speakers and their distinctive pattern of use of formal health service compared to the other groups (Including white and Black English speakers). This is especially true in the lower rate of using emergency departments compared to the other groups. We will also address the challenges to studying immigrant experience in health settings when only language of interaction and not place of birth are collected by health providers.
FOSTERING AGE-FRIENDLY INITIATIVES IN SMALL UNIVERSITIES: A CASE STUDY OF SOUTHERN OREGON UNIVERSITY
Authors: Toyokawa Noriko 
Published: January 2025

Abstract
Compared to their larger counterparts, small U.S. higher education institutions face distinct challenges in implementing Age-Friendly University (AFU) initiatives. This presentation spotlights the AFU initiatives that Southern Oregon University (SOU) implemented as the case of such a higher education institution. Despite its resource constraints, such as the lack of aging-centered academic programs and an on-campus aging institute, SOU exemplifies AFU principles by its faculty’s developing courses to involve retired individuals through community partnerships and cultivate meaningful intergenerational interactions. While discussions on lifespan development topics provided in those courses have produced positive learning outcomes, they have also unveiled areas for improvement. Older adults desire more direct involvement to share their wisdom and expertise with students. In response, incorporating age diversity as a valuable resource, SOU strategically plants to enhance existing academic programs by infusing innovation into courses and promoting mutual learning between generations. For instance, a course in Adult Development and Aging is being re-designed so that collaborative groups of students and older adults will utilize electronic design tools and artificial intelligence to craft a book conveying older adults’ messages for the next generation. This addresses the needs of older adults and enhances technology skills for both groups. After examining the university’s current effort in the AFU initiative, this presentation will delve into small institutions’ unique challenges in promoting AFU initiatives. Recommendations will be explored, emphasizing the vital role of adapting existing courses to foster sustainable lifelong learning across generations.
DEMENTIA PROGRAMS FOR PERSONS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES (IDD) AND THEIR CARE PARTNERS
Authors: Barton Kelli 
Published: January 2025

Abstract
There are limited evidence-based dementia programs for individuals with intellectual or developmental disabilities (IDD) and their care partners. Alzheimer’s Disease Programs Initiative grants through the Administration for Community Living provide an opportunity to expand evidence-based dementia programs to serve the IDD population. This presentation will discuss outcomes and lessons learned from the implementation of two dementia programs, Reducing Disability in Alzheimer’s Disease (RDAD) and Care Ecosystem, with the IDD population and their care partners through three funded projects. We employed a mixed-method approach to explore program impact and identify lessons learned that can inform dementia programming for the IDD population. Feedback from semi-structured partner interviews and regular meetings revealed several common themes. Partners identified the opportunity to provide dementia and IDD education to staff and to the community as a significant benefit and as crucial to establishing a foundation for program implementation. Further, while many care partners were formal caregivers, whose relationship and experience with the person with dementia typically differ from informal caregivers, results from the RDAD implementation showed promising trends in outcomes for both individuals and care partners. For example, behavioral symptom-related severity among individuals with IDD and behavioral symptom-related distress among care partners both decreased (p=0.07 and p=0.14, respectively), as measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q). Evidence-based dementia programs have much to offer the IDD population and their care partners; however, protocol modifications are needed to ensure physical and cognitive accessibility for individuals with IDD and to meet the needs of informal caregivers.
ADRD RISK REDUCTION HEALTH COACHING
Authors: Zanjani Faika , Hawks Cate , O’Donnell Kennedy , Berman Brian , Sargent Lana 
Published: January 2025

Abstract

Objectives
The development of the Richmond Brain Health Initiative (RBHI) was guided by the need to address local brain health service gaps to improve Alzheimer’s/Dementia (ADRD) health disparities in racially diverse communities. This paper focuses on the ADRD Risk Reduction Health Coaching program component.

Methods
The program is currently in implementation, focused on recruiting diverse older adults living in the Richmond, VA metro area, with the following risk factors: diabetes, hypertension, cardiovascular disease, or subjective cognitive decline. Weekly lifestyle telephone health coaching for 12 weeks was offered, followed by a monthly (6-month) maintenance stage. Health coaching calls last an average of 15-30 minutes per session. The intervention protocol target lifestyle risk via education, learning objectives, personal risk assessment, attitudes, and lifestyle behavioral change goal setting.

Results
The current study sample (n=49) is 96% 60+ years old (n=38), 38% African American/Black (n=18), 6% Hispanic (n=3), 70% female (n=33), 11% military veterans (n=5), 53% live alone (n=25). Preliminary mean differences indicate improvement in ADRD knowledge: baseline mean = 25.8, 12-week = 28.6; Physical Activity: baseline mean = 1.50 hours/week, 12-week = 3.00 hours/week; Social Activity: baseline mean = 2.07 hours/week, 12-week = 2.57 hours/week; Cigarettes: baseline mean = 0.62/day, 12-week = 0.30/day; Alcoholic Drinks: baseline mean = 1.50/week, 12-week = 1.10/week; and Medication adherence: baseline = 86%, 12-week = 100% adherence. CONCLUSIONS: This study showcases a model for reducing ADRD risk and promoting brain health in racially diverse communities by improving access to ADRD community services.
IMPLEMENTING REACH COMMUNITY IN AN INTEGRATED HEALTH SYSTEM: IMPACT AND LESSONS LEARNED
Authors: Herrick Tamara 
Published: January 2025

Abstract
This project examined the implementation of the Resources for Enhancing Alzheimer’s Caregiver Health (REACH) Community program within primary care and geriatrics settings, facilitated by Licensed Clinical Social Workers (LCSWs). The integration of LCSWs into the healthcare system offers a unique opportunity to provide comprehensive care by addressing both medical and psychosocial aspects of dementia caregiving. Their expertise in psychosocial assessment and intervention enables holistic care that addresses the multifaceted needs of care partners and their families. REACH Community is an evidence-based intervention for care partners of individuals living with dementia that focuses on safety, care partner health and emotional well-being, and behavior management. The intervention consists of four core sessions one-on-one with care partners, with additional sessions as an option if needed. Sessions can be delivered face-to-face, by telephone, or telehealth. With the emergence of COVID-19, all sessions transitioned to remote delivery via telehealth Zoom platform or telephone. Pretest posttest design assessed program impact. Key outcome measures included: Caregiver Frustration, caregiver well-being (Zarit Burden Inventory), and mood (PH-Q4). Pre-posttest results indicated that participants had an improvement in well-being, mood, and caregiver frustration following participation in the REACH Community program. The evaluation contributed valuable insights into the feasibility and effectiveness of integrating the REACH Community program into primary care and geriatrics settings utilizing LCSWs. We continue to offer the program in primary care and geriatrics center settings and REACH Community is part of our growing toolbox of evidence-based programs providing support to care partners of people living with dementia.
TRENDS IN RECEIPT OF PAID FAMILY CARE AMONG OLDER ADULTS WITH FUNCTIONAL IMPAIRMENT IN THE UNITED STATES, 2011–2022
Authors: Reckrey Jennifer , Liu Yifan , Qian Yiqing , Ornstein Katherine 
Published: January 2025

Abstract
While caregiving is frequently conceptualized as either paid care (e.g., home health aides, home care workers) or family care (e.g., spouses, children), family members may also receive payment to provide care (i.e., paid family care) through state-level Medicaid-waiver programs or through private arrangements within families. This study examines trends in paid family care prevalence over time and identifies factors associated with receipt of paid family care among older adults with functional impairment using the National Health and Aging Trends Study. Prevalence of paid family care increased slightly over time, with 7.0%, 5.9%, and 8.1% of the sample receiving paid family caregiving in 2011, 2015, and 2022 respectively. In 2022, 27.8% of those with any form of paid help received paid family care; 27.1% was funded privately and 72.9% was funded by other payers like Medicaid. As compared to those with a non-family paid helper, older adults with paid family care were more likely to be female (78.1% vs. 55.6%, p=0.028), Black/non-Hispanic (29.2% vs. 11.5%, p&lt;0.001), and receive Medicaid (62.5% vs. 33.1%, p&lt;0.001). They reported more chronic conditions (4.1 vs 3.2, p=0.012), impairment in more self-care tasks (3.18 vs 2.44, p=0.043), and more total weekly hours of care (20.0 vs 11.2, p&lt;0.001). Paid family care makes a meaningful contribution to total care, particularly among those with high care needs. Future work examining paid family care both within and outside of the Medicaid system should explore the impact of paid family care on older adults and their larger family unit.
TOGETHER IN CARE: ELEVATING THE IMPORTANCE OF FAMILY AND PAID CAREGIVERS
Authors: King Jessica , Scales Kezia , Robins Amy , Gingerelli Toni 
Published: January 2025

Abstract
In 2023, PHI and the National Alliance for Caregiving (NAC) launched “Together In Care: The Direct Care Worker and Family Caregiver Initiative” with funding from the John A. Hartford Foundation. The goal of the initiative is to promote policy changes that address the interrelated needs of family caregivers and paid caregivers in the context of long-term care for older adults and people with disabilities, and particularly in home and community-based services (HCBS). Priority topics for the initiative include improving care team integration for family members and paid caregivers; advancing self-direction options and supports; and securing funding for new research on the underexplored nexus of paid and unpaid care. This presentation will begin by describing the conceptual rationale for focusing on the interconnection and overlap between paid and family caregivers, referencing the limited extant literature on this topic. We will then discuss the methodology and evaluation of our efforts to develop a shared caregiving policy agenda across diverse partners — who include federal and state officials, national experts and movement leaders, and long-term care providers — highlighting successes and lessons learned. The presentation will underscore the importance of using evaluation research methods to inform and assess the implementation and impact of complex policy advocacy interventions; share practical approaches and methods; and end with a discussion of the extensive research gaps and opportunities that have been identified through this innovative initiative.
AN EXAMINATION OF RELATIONAL COORDINATION AMONG PAID AND FAMILY CAREGIVERS IN THE ARIC COHORT
Authors: Ornstein Katherine , Reckrey Jennifer , Ballew Shoshana , Coresh Josef , Wolff Jennifer 
Published: January 2025

Abstract
The oldest-old (ages 85+) are disproportionately at risk for impaired function and reliant on support from caregivers. However, studies of caregiving typically fail to comprehensively enumerate and assess the capacity of both family and paid caregivers, shared care networks, and change over time. In this session we will describe the conceptualization and development of ARIC Cares, a caregiving study that will be embedded within the Atherosclerosis Risk in Communities Study (ARIC), a multisite prospective cohort of ~4,000 individuals ages 81-101 that has been characterized for &gt;30 years. Existing studies of how caregiver factors relate to outcomes for older adults generally evaluate a limited set of measures specific to family caregivers (e.g., relationship to older adult). The role that paid caregivers play in meeting care needs in the community is consistently undervalued and less well studied. ARIC Cares will simultaneously assess family and paid caregivers and utilize the theory of relational coordination for understanding the dynamics of caregiving teams. ARIC Cares, which will focus on the end-of-life period and examine outcomes for older adults and their caregivers, will enumerate older adults’ care networks at 6-month intervals, in 4 diverse communities. Rigorous evidence regarding the caregiving experience, particularly focused on how teams of family and paid caregivers work together, could inform initiatives to improve quality of life among older adults and their caregivers. An understanding of these networks is critical as serious illness care, including complex dementia care, increasingly shifts to community settings where coordination between family and paid caregivers is vital.
RIGHTSIZING: A COLLABORATION BETWEEN PSYCHOLOGY AND EXTENSION TO HELP OLDER ADULTS DEAL WITH SENTIMENTAL CLUTTER
Authors: Dozier Mary , Krafft Jennifer , Turner Pamela , Bales Diane , Moore Susan , Smith Laura , Harris-Speight Jasmine , Buys David 
Published: January 2025

Abstract
Excessive clutter can create a barrier for older adults to maintain functional lives in their homes; however, interventions for hoarding are lengthy, expensive, and often unavailable, particularly for rural-dwelling older adults. Using the Rightsizing Program as an example, this presentation will highlight the synergy between Extension and academic faculty to promote aging in place across diverse states. The Rightsizing Program is a collaboration between Extension specialists at Mississippi State University (MSU) and University of Georgia (UGA) and psychology faculty at MSU with specific expertise in hoarding disorder. The program focuses on sentimental clutter, which can be particularly difficult for older adults to discard. The psychology faculty were able to integrate both their research and clinical expertise to inform program development. For example, there was an added emphasis on decreasing sense of guilt around clutter (e.g., explicitly stating that it is “okay to let go of items.”) that has been clinically observed to occur when older adults are reticent to let go of aspects of their past selves (e.g., clothes that no longer fit). The Rightsizing Program has been presented to 238 individuals and has increased access to both psychoeducation about hoarding and clutter as well as had the additional benefit of facilitating recruitment for psychological studies on hoarding on MSU campus. Partnership between Extension specialists and mental health researchers allows for a rapid dissemination of research findings, while also promoting ongoing research efforts.
CREATING AND SUSTAINING EXTENSION PARTNERSHIPS TO REACH RURAL OLDER ADULTS: THE STAY STRONG STAY HEALTHY PROGRAM
Authors: Miller Kristin , Weitzel Kelsey , Meinertz Naomi 
Published: January 2025

Abstract
Due to out-migration of family members and a lack of transportation and access to resources, rural-dwelling older adults often experience greater social isolation, which is linked to worse health outcomes and a loss of independence. Gerontological researchers have identified that increased participation in social activities can lead to increased social connections among rural-dwelling older adults. Through educational programs, the Cooperative Extension (Extension) system connects older adults with opportunities to engage in community programs to reduce social isolation and support older adults living independently longer. Despite the widespread success of Extension programs, the implementation and collaborative efforts that contribute to the success of these programs are unrecorded in empirical literature. In this presentation, we address this gap by presenting on the Stay Strong Stay Healthy (SSSH) program. SSSH is as an example of the successful implementation of a multi-state Extension program that improves psychosocial and physical health outcomes for both rural and urban older adults. Using the SSSH program as a model, we outline the community-based research principles that inform the collaborations between Extension campus researchers, Extension agents, and stakeholders to reach rural-dwelling older adults. We will draw on a current example of adapting the SSSH program for less ambulatory older adults in rural areas guided by a community advisory committee. By leveraging the resources and expertise of Extension, researchers can enhance the real-world impact of their work and contribute to the reduction of social isolation and increased ability to live independent for rural-dwelling older adults.