John Cagle, David Roth, Cynthia Boyd, Naaz A. Hussain, Ambrym Smith, Jenni Reiff, Daniel Scerpella
{"title":"ADVANCE CARE PLANNING FIDELITY TOOL IN THE CONTEXT OF COGNITIVE IMPAIRMENT: THE SHARE TRIAL","authors":"John Cagle, David Roth, Cynthia Boyd, Naaz A. Hussain, Ambrym Smith, Jenni Reiff, Daniel Scerpella","doi":"10.1093/geroni/igad104.0041","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0041","url":null,"abstract":"Abstract 2. Conducting high-quality advance care planning (ACP) conversations with persons living with ADRD and their family members is inherently challenging. Differing levels of cognitive function, judgment, ability to engage, and care partner involvement adds to the complexity of such ACP conversations, necessitating flexible fidelity monitoring to accommodate contextual factors. This presentation will focus on the process of measuring ACP fidelity. The SHARE ACP fidelity checklist was developed to measure the protocol adherence during ACP meetings, monitor for areas in which ACP facilitators may require re-training or additional support, and to inform analyses of the impact of the overall exposure to the study intervention. The fidelity checklist items are organized into three overarching domains: Meeting Set-Up, ACP Meeting Topics, and Facilitator Communication Skills. For the present study, a fidelity adjudication team from a pool of 7 raters, listened to and independently rated recorded conversations for protocol adherence. Each checklist item is scored ranging from 0 to 2 (0=not done; 1=needs improvement; or 2=effective) with higher scores indicating greater adherence. Fidelity ratings tended to improve over time, suggesting a facilitator experience effect. The goal to achieve an overall fidelity rating of ≥80% was met in 63% of dyad conversations. Based on subscale scores, project targets were most frequently met on the Communication Skills subscale and less frequently accomplished on the Meeting Set Up subscale. Despite some challenges, preliminary assessments of SHARE intervention fidelity appear promising, and evidence suggests the fidelity checklist is both valid and reliable.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138989093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A. Korat, Kyla Shea, Paul Jacques, Paola Sebastiani, Molin Wang, Walter Willett, Qi Sun, Jean Mayer, Harvard T.H. Chan, Gail Rogers, Kathryn Barger, Jennifer Lee, Kerry Wellenstein, Gregory Matuszek
{"title":"POSTPANDEMIC SUCCESSES AND CHALLENGES IN REOPENING OLDER AMERICANS ACT CONGREGATE MEALS","authors":"A. A. Korat, Kyla Shea, Paul Jacques, Paola Sebastiani, Molin Wang, Walter Willett, Qi Sun, Jean Mayer, Harvard T.H. Chan, Gail Rogers, Kathryn Barger, Jennifer Lee, Kerry Wellenstein, Gregory Matuszek","doi":"10.1093/geroni/igad104.0292","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0292","url":null,"abstract":"Abstract The COVID-19 pandemic required Older Americans Act (OAA) congregate nutrition programs to shut down in-person dining but continue serving meals in innovative ways. Re-opening provided a unique opportunity for congregate nutrition programs to continue these innovative changes and/or reinvent how they serve meals. These changes will be crucial for OAA nutrition programs to maintain their relevance, as all adults over age 60 qualify for OAA meals, yet fewer than that attend. To identify successful practices that could be adopted nationally and describe continuing challenges, we conducted surveys, focus groups, and interviews of congregate nutrition programs. Overall, 523 completed the entire survey, nine participated in focus groups, and three were interviewed. Responses came from across 47 states with most (94%) reporting permanently adopting service delivery methods implemented during the COVID-19 pandemic. Overall, nutrition programs described grab-and-go meals having attracted new participants during the pandemic and programs pairing other services with meals to appeal to and retain a wide range of participants. These include medically tailored meals, culturally relevant meals, partnerships with other organizations, and entertainment. These results can be used to strengthen congregate nutrition programs.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138985960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RISE: A COMMUNITY-BASED ELDER ABUSE AND SELF-NEGLECT RESPONSE INTERVENTION ADDRESSING A CRITICAL SYSTEMS GAP","authors":"D. Burnes, Karl Pillemer","doi":"10.1093/geroni/igad104.1152","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1152","url":null,"abstract":"Abstract Knowledge of effective interventions for elder abuse and self-neglect (EASN) is limited. Adult Protective Services (APS) represents the primary agency responsible for receiving reports and investigating suspected cases of EASN in the US. However, APS lacks a distinct, conceptually informed intervention phase to support EASN cases. Based on theory, research, and consultations with stakeholders, RISE was designed to address this intervention gap within overall EASN response systems. Informed by ecological-systems, relational, and client-centered perspectives, RISE is a community-based EASN intervention that integrates core modalities (motivational interviewing, restorative justice, teaming, supported decision making) demonstrating evidence and/or promising results in EASN and other domains. The intervention operates at Relational, Individual, Social, and Environmental levels of ecological influence. Specifically, RISE works with both older adult victims and others, including alleged harmers, their relationships, and strengthens the social supports surrounding them. RISE began as a pilot in two Maine counties, was expanded to the entire state, has been used in over 450 cases, was written into Maine’s 2023 budget, is now being implemented and tested in New Hampshire and Toronto, Canada, and is being expanded to the criminal justice system. This symposium will describe RISE’s development and conceptual underpinnings (presentation 1), findings on implementing “teaming” (social support), an intervention modality (presentation 2), a qualitative evaluation of RISE from the perspective of APS caseworkers (presentation 3), evidence of RISE reducing EASN recidivism (presentation 4), and case studies of implementing RISE (and its restorative justice modality) in the criminal justice diversion context (presentation 5). This is an Abuse, Neglect and Exploitation of Older Persons Interest Group Sponsored Symposium.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"THE STRONGERMEMORY PROGRAM: EXPLORING COGNITIVE BENEFITS AND FOSTERING COMMUNITY","authors":"Catherine Tompkins, Emily Ihara, Francesca Keesee, Mckenzie Lauber, Catherine Magee, Jessica Fredericksen, Rob Liebreich","doi":"10.1093/geroni/igad104.2882","DOIUrl":"https://doi.org/10.1093/geroni/igad104.2882","url":null,"abstract":"Abstract Background StrongerMemory is a brain health program centered on spending 30 minutes per day on handwritten journaling, reading aloud, and arithmetic exercises as a method to enhance cognition in older adults. The StrongerMemory research protocol is a 12-week program that includes a weekly meeting. After 104 participants completed the StrongerMemory research protocol, they were invited to participate in a focus group to share their experiences. Six focus groups were conducted by members of the StrongerMemory research team yielding 30 participants. Methods Focus groups were conducted virtually, with a set of pre-determined, open-ended questions centering around participant experiences and attitudes towards the StrongerMemory program. Participants were also asked to reflect on differences in their memory, cognition and well-being before and after StrongerMemory participation. Two researchers independently coded the focus group transcripts, and utilized the grounded theory analysis techniques of memoing and constant comparative analysis to explore the data. Common themes were then discussed. Results Five overarching themes emerged: Motivating, appreciating, challenging, committing, and enhancing. Conceptualizations of these themes focused on participants’ experiences and suggestions for strengthening the program. “Fostering community” was an outcome of the program often discussed. Conclusion The participant experience in StrongerMemory revealed unique perspectives on their motivation for participation and provided the researchers with new insights into the program such as fostering community within older adult groups. Further research includes exploring cognitive and social benefits of group participation in the StrongerMemory program.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"INTERDISCIPLINARY WELLNESS CLINICS IN LOW-INCOME SENIOR HOUSING COMMUNITIES","authors":"Sarah Holmes","doi":"10.1093/geroni/igad104.0598","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0598","url":null,"abstract":"Abstract Low-income older adults may qualify to live in subsidized housing via the Housing and Urban Development (HUD) Section 202 program. Established in 1959, Section 202 is the only HUD program that provides housing exclusively for older adults. More than 1.8 million older adults receive this type of federal housing assistance. Older adults living in low-income senior housing communities are mostly people of color, socioeconomically disadvantaged, and at risk for poor physical and mental health and adverse health outcomes. Additionally, they have limited access to healthcare services and other resources such as internet use, healthy food options, opportunities for physical activity, and safe indoor and outdoor physical environments. Further they are at increased risk of high emergency room utilization and transfer to nursing home settings. The purpose of this project was to develop Interdisciplinary Wellness Clinics for older adults living in low-income senior housing communities and provide direct services including such things as blood pressure monitoring, medication management, hearing evaluation and cerumen removal, foot and nail care, pain management, management of acute medical problems, immunizations, and Medicare Annual Wellness Visits. Interdisciplinary Wellness Clinics are provided monthly to four low-income senior housing communities and serve approximately 500 residents living in these communities. This symposium will provide a review of residents seen and services provided with a focus on findings identified and interventions implemented; a description of the Medicare Annual Wellness services; and a review of approaches used to engage residents in using these services.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RESEARCHERS BEWARE: CAUTIONARY TALES OF FRAUDULENT RESEARCH PARTICIPANTS AND WHAT TO DO ABOUT THEM","authors":"Justine Sefcik, Harleah Buck","doi":"10.1093/geroni/igad104.1174","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1174","url":null,"abstract":"Abstract This symposium presents a series of cases where gerontological researchers identified fraudulent participants and bots engaging in their studies. These presentations describe the complex nature of participants misrepresenting themselves and being creative to enroll in studies for financial incentives. Dr. Sefcik shares how a snowball sample led to participants enrolling in a study and misrepresenting themselves during virtual qualitative interviews. Dr. Boon illuminates how Facebook recruitment led to bot responses and steps taken to identify if participants were real. Dr. Frechman reveals how recruitment on social media platforms and email distribution lists led to bot attacks of the study survey. Dr. Carpenter explains a study involving a multi-methods approach in which a bot completed several surveys and an interviewee gave nonsensical responses. Dr. Wallace explains two types of fraudulent activity occurring, the first with bots completing an online survey and the second with deception during interviews. All presenters discuss their experiences of suspecting fraudulent research participation, approaches on how they verified participants, action steps to address misrepresentation, processes put in place to uphold the integrity of their studies, and tips to mitigate future fraud. This is a Nursing Care of Older Adults Interest Group Sponsored Symposium.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A QUALITATIVE ANALYSIS OF A DIGITAL FALL PREVENTION EXERCISE PROGRAM FOR OLDER ADULTS WITH INCREASED FALL RISK","authors":"Shannon Farrell, Nicole Bajdek, Mary Dishaw, Pamela Garabedian, Alisha Williams, Naomi Hachen, Kieran Reid, Nancy Latham","doi":"10.1093/geroni/igad104.3146","DOIUrl":"https://doi.org/10.1093/geroni/igad104.3146","url":null,"abstract":"Abstract Falls are a significant public health problem; one third of individuals aged 65 years or older fall each year. Strength and balance exercises reduce fall risk, but most older adults are inactive. Individuals at risk of falls need clear guidance to ensure exercises performed at home are safe and provide adequate challenge. The aim of this qualitative study was to investigate the experiences and perceptions of older adults with increased fall risk enrolled in a 3-month digitally delivered home-based fall prevention exercise program (DFP). Semi-structured interviews were conducted by an interview specialist on a sample of 16 participants (81% female, age 77.3±5.8 years). Interviews were transcribed, imported, and coded into Dedoose, a tool for qualitative analysis. Codes were refined with each interview and themes were generated from the final codes. Three themes were identified: adherence to a home-based digitally delivered fall prevention exercise program, impact of fall prevention exercises on activities of daily living (ADL), and benefits of home-balance exercises. Participants attributed adherence to the home exercise program with minimal in-person visits. Participants reported fear of falling increased as they aged; upon completion, participants felt reduced fear of falling in their ADL. Balance exercises were the most appealing due to the level of difficulty and motivation to improve balance. Participants recommended changes to improve the DFP exercise program, with majority wanting to continue the program. This qualitative analysis provides guidance to health professionals about the acceptability and recommended changes for a digitally delivered home fall prevention exercise program.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"INFRASTRUCTURES OF CAREGIVING: RECONSTITUTING HOMELINESS AND FAMILY IN SINGAPORE","authors":"Arthur Chia, Rahul Malhotra","doi":"10.1093/geroni/igad104.1216","DOIUrl":"https://doi.org/10.1093/geroni/igad104.1216","url":null,"abstract":"Abstract Caregiving comprises concrete everyday tasks that are built-on and revolve around the home, yet few studies have looked at caregiving as practice(s) that shape the home as a place of/for care. We examined the socio-material arrangements of people, activities, and things that enable caregiving at home, asking how caregiving is orchestrated, sustained, and delivered at home, and how the home is in turn re-constituted by caregiving. In-depth interviews were conducted with 40 family caregivers, aged 55-85 years, caring for their spouse and/or parent(s). Relations, activities, and things that enabled caregiving were analyzed through the theoretical lens of “care infrastructure”. Caregiving is enacted through a network of people and things – including family members, live-in hired helpers, medical and social workers; technologies like surveillance cameras and strategically placed mirrors at home to monitor care recipients; televisions turned-on 24/7; assistive devices such as wheelchairs and ramps, and placement of hospital beds at home, etc. – that change living arrangements and routines. Care tasks, responsibilities, and decisions are marked by negotiations, tensions, and compromises between people and with things. Caregivers appropriate, adapt, and improvise in situations of uncertainty, conflict, and impossible demand. We conclude that new socio-material arrangements of people, activities, and things that emerge because of caregiving change/disrupt the notion of home as a place of safety, familiarity, and comfort for caregivers. Understanding the emplacement/displacement and interconnection of things, activities, and people sheds light on how the home shapes the effects of caregiving and vice versa.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138991226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lance Pflieger, Kengo Watanabe, Max Robinson, Gustavo Glusman, J. Lapidus, Oliver Fiehn, Robert Moritz, N. Rappaport
{"title":"PROSPECTIVE MULTI-OMIC ANALYSIS OF HUMAN LONGEVITY COHORTS IDENTIFIES ANALYTE NETWORKS ASSOCIATED WITH LONGEVITY","authors":"Lance Pflieger, Kengo Watanabe, Max Robinson, Gustavo Glusman, J. Lapidus, Oliver Fiehn, Robert Moritz, N. Rappaport","doi":"10.1093/geroni/igad104.2245","DOIUrl":"https://doi.org/10.1093/geroni/igad104.2245","url":null,"abstract":"Abstract Serum based biomarkers of longevity have long been sought to explain the mechanisms of healthy aging and longevity. Using a 1:3 case cohort design, the Longevity Consortium has produced untargeted mass spectrometry based proteomic and metabolomic datasets from serum of four cohorts with longevity status, defined as those that reached the age corresponding to the 98th percentile of survival using sex specific and birth cohort specific survival percentiles. The cohorts are the Osteoporotic Fractures in Men study, the Study of Osteoporotic Fractures, the Health, Aging, and Body Composition Study, and the Cardiovascular Health Study. In this study, we integrate metabolomics and proteomics using machine learning and system biology approaches to construct multi-omic signatures predictive of longevity and healthy aging. We identify networks enriched for biomarkers previously shown to be associated with longevity such as apolipoproteins, along with novel associations, and we further compare with our findings in a mouse omics LC dataset of molecular changes induced by life-extending interventions. We show substantial differences between male and female longevity networks. The study highlights the effectiveness of using integrative systems biology methods to capture the heterogeneity of underlying molecular aging phenotypes, in order to generate a robust signature of longevity. The identified biomarker signatures may have significant implications for the development of personalized interventions aimed at promoting healthy aging and preventing age-related diseases.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PRECARIOUS HOUSING BEFORE, DURING, AND AFTER AN EPISODE OF LATE-LIFE HOMELESSNESS","authors":"Anthony C Traver, Holly Dabelko-Schoeny","doi":"10.1093/geroni/igad104.0206","DOIUrl":"https://doi.org/10.1093/geroni/igad104.0206","url":null,"abstract":"Abstract This qualitative study aims to understand how the living environments occupied by older adults before, during, and after an episode of homelessness inform their access to a healthy, stable, and dignified life. Indicators of accommodation, quality, and service integration are explored using the Aging in the Right Place conceptual framework. Through partnerships with a homeless shelter, a meal site, and a mental health outreach team in Columbus, OH, demographic questionnaires and semi-structured interviews were completed with 22 older adults with an episode of late-life homelessness. Nine direct service providers were also interviewed. Interviews were analyzed using the team-based flexible coding method in Nvivo 1.6.1. Results indicated that low or no income in late life forced older adults to occupy a continuum of precarious and low-quality living environments that include shared housing, doubling up, emergency shelters, institutional settings, and living on the land. AIRP indicators are discussed for each. Conflict, death of a support person, mental and behavioral challenges, unit deterioration, rental price increases, and social isolation forced OA down the housing continuum and into homelessness. Sub-optimal conditions interacted with age to exacerbate health conditions, create social isolation, and expose OA to harm. Informal and formal relationships, emergency shelter services, vouchers, and specific behaviors and attitudes were identified as critical for securing affordable and accommodating housing in which to age. Understanding the experiences of OPEH who are striving to occupy their subjective right place to age can help service providers and policymakers meet the unique needs of precariously housed OA.","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}