Gerontologist最新文献

{"title":"Supporting older people experiencing homelessness and memory problems in hostels: Learning from an ethnographic study.","authors":"Penny Rapaport, Gill Livingston, Jill Manthorpe, Caroline Shulman, Garrett Kidd, Ava Mason, Martin Knapp, Sophie Nadia Gaber","doi":"10.1093/geront/gnae187","DOIUrl":"https://doi.org/10.1093/geront/gnae187","url":null,"abstract":"<p><strong>Background and objectives: </strong>Older people with memory problems living in temporary hostel accommodation have longer stays and higher care needs than those without memory problems. In this ethnographic study, we aimed to elucidate how staff currently support older hostel residents with memory problems, what contextual factors determine support given and, what facilitates positive and meaningful outcomes for staff and residents.</p><p><strong>Research design and methods: </strong>We conducted interviews and participant observations with older people (≥50 years) experiencing memory problems and homelessness (interviews n=17, observations n=13), hostel staff and managers (interviews n=15, observations n=20) from seven residential facilities (six hostels and one care home), and health and social care practitioners (interviews n=17, observations n=7), from September 2021-December 2022 in London, England. We analyzed thematically from a critical realist position.</p><p><strong>Results: </strong>We identified four overarching themes: (1) Compensatory strategies and routines, (2) hostels are not homes, (3) meeting challenging interactions with compassion, and (4) facilitating opportunities for meaningful interactions. Social interactions for people with memory problems were restricted and, although sheltered by living in hostels, this did not equate to safety or provide opportunities for positive interactions.</p><p><strong>Discussion and implications: </strong>Staff worked hard to connect with older residents with memory problems, in resource and time-poor contexts, often left to provide care beyond their roles in contexts of unmet need. Our ethnographic account has informed co-design of a support intervention for hostel staff working with older people with memory problems, alongside recommendations for policy and practice.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do researchers identify and recruit dementia caregivers? A scoping review.","authors":"Bhavani Kashyap, Bethany Crouse, Beth Fields, Alyssa Aguirre, Talha Ali, Rachel Hays, Xiaojuan Li, Lily N Shapiro, Meng-Hua Tao, Ivana A Vaughn, Leah R Hanson","doi":"10.1093/geront/gnae189","DOIUrl":"https://doi.org/10.1093/geront/gnae189","url":null,"abstract":"<p><strong>Background and objectives: </strong>Studies involving dementia caregivers are essential to transform care and inform new policies. However, identifying and recruiting this population for research is an ongoing challenge. This scoping review aimed to capture the current methodology for identifying and recruiting dementia caregivers in clinical studies. A focus was placed on methods for underrepresented populations and pragmatic trials to guide pragmatic and equitable clinical studies.</p><p><strong>Research design and methods: </strong>Researchers conducted a literature search using PubMed, PsycINFO, EMBASE and Web of Science databases. Studies conducted in the United States that enrolled at least 10 caregivers and were published within the last 10 years (2013-2023) were included.</p><p><strong>Results: </strong>Overall, 148 articles were included in the review. The most common method for identification was community outreach, and paper advertisements for recruitment. Caregivers were most often approached in community settings, formal organizations, and/or dementia research centers. Most enrolled caregivers were female, White, and spouses of persons living with dementia. Race and ethnicity were underreported, as were the target recruitment goals. Limited studies were self-reported as pragmatic. Additionally, limited studies reported adaptations for methods of identification and recruitment in underrepresented populations.</p><p><strong>Discussion and implications: </strong>We identified gaps in current practices for the identification and recruitment of dementia caregivers. Future identification and recruitment methodologies should be tailored to the intervention's intent, health care setting, and the research questions that need to be answered, while balancing available resources. Additionally, transparent reporting of identification and recruitment procedures, target recruitment goals, and comprehensive demographic data is warranted.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Dental Care Use Following Marital Status Change in the Health and Retirement Study.","authors":"Shaw Hubbard, Portia Y Cornell","doi":"10.1093/geront/gnae151","DOIUrl":"10.1093/geront/gnae151","url":null,"abstract":"<p><strong>Background and objectives: </strong>Previous studies have indicated that married people are generally healthier than unmarried people, with lower mortality rates. Most work in this area has employed cross-sectional data, and few studies have examined change in marital status from married to unmarried as a potential social ecological determinant of dental health behavior. Here, we used longitudinal data to examine change in dental behavior over time following marital status change, and to explore whether self-reported gender may play a modifying role in any behavioral change.</p><p><strong>Research design and methods: </strong>Employing panel data from the Health and Retirement Study (1996-2018) to follow all individuals who entered the study in married/partnered status, and using both 2-way fixed effects and group-time average difference-in-difference models, we analyzed the association between any change in marital status and dental care use, compared with individuals who remained married. All analyses were stratified by gender.</p><p><strong>Results: </strong>Both types of difference-in-difference analyses indicated that both widowhood and divorce were associated with a decrease in dental care use in both genders. Divorced men saw the greatest decrease in dental care use. We found gender had a moderating effect on strength of association in all analyses.</p><p><strong>Discussion and implications: </strong>This research suggests that any change in marital status from married to unmarried has a detrimental effect on dental health behavior for both genders. Future research might investigate other potential barriers to dental care access these populations might face, in order to develop effective interventions.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma, Stereotypes, and Self-Disclosure: Disability and Empowerment in Older Adults on the Autism Spectrum.","authors":"A Henry Eliassen","doi":"10.1093/geront/gnae182","DOIUrl":"https://doi.org/10.1093/geront/gnae182","url":null,"abstract":"<p><p>Older adults on the autism spectrum exhibit a broad array of strengths and limitations. While exceptional abilities may be masked by difficulties in presentation and communication, hidden disabilities can lead to unmet needs for accommodation and support. Critical to the recognition of disabilities is subjects' readiness to disclose potentially stigmatizing conditions or concerns-weighing the benefits of self-disclosure (e.g., for effective medical care) versus risks (exposure of weaknesses or vulnerabilities). Strategic self-disclosure, based on reading of immediate social contexts, can be problematic for autistic persons who have difficulty processing social cues demarcating situationally appropriate boundaries. Disclosure of autism by older patients in clinical settings can lead to troubled interactions that reinforce stereotypes of aging conflated with disability and educe implicit biases regarding older patients and autistic persons. Future gerontological research and policy initiatives should be designed to empower older autistic adults (and others with lived experience of disability and marginalization) by including them as expert partners in the quest for needed societal change-challenging ableist assumptions embedded in traditional definitions of successful aging, promoting an open awareness context that normalizes the occurrence of disability, and fostering expectations of interdependence (as opposed to helpless dependency or complete independence).</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Home Administrators' Experiences of Work Stress and Intention to Quit During the COVID-19 Pandemic.","authors":"H Wayne Nelson, Joyce Weil, Mary Helen McSweeney-Feld, Bo Kyum Yang, Theresa Teta Barry, Natalie Thayer","doi":"10.1093/geront/gnae165","DOIUrl":"10.1093/geront/gnae165","url":null,"abstract":"<p><strong>Background and objectives: </strong>The coronavirus disease 2019 pandemic negatively affected nursing home administrators (NHAs). This study explores licensed and employed NHA's perceptions about what work stress events would drive their turnover intentions (TI) in year 3 of the pandemic.</p><p><strong>Research design and methods: </strong>As part of a larger survey-based research project collecting numerical and textual data, this study conducted content analysis with qualitative data. Narrative data from 3,859 discrete responses of 1,139 NHAs, from 50 states and Washington, DC, on 2 open-ended electronic survey questions asking about their work stress and TI were collected from February to March 2022. Categories and subcategories were counted and discussed in context as themes.</p><p><strong>Results: </strong>We identified 4 main narrative categories with subcategories about NHA's stress about the regulatory system (e.g., excessive, conflicting, changing regulations), staffing (e.g., insufficient, agency staff), organizational pressures (e.g., work overload), and macro system stressors (e.g., media representation of nursing homes). Three main TI categories with subcategories were identified: the long-term care (LTC) setting and system (e.g., regulatory demands, staffing, facility surveys); personal factors (e.g., stress, career opportunities); and others (e.g., \"I would never quit\" or \"I already decided to quit\").</p><p><strong>Discussion and implications: </strong>Whole community disaster planning, person-centered surveyor training, improved regulatory guidance, simplified reporting, adequate guidance assistance, and adequate staff could mitigate NHA stress and TI during crises. Administrator resilience should be recognized. Solutions for supporting NHAs can include long-term care industry participation in public health disaster preparedness coalitions, consistent regulatory guidelines with established communication channels, and ongoing crisis leadership training for administrators.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The National Institute on Aging's Resource Centers for Minority Aging Research: Development, Evolution, and Impact.","authors":"Sidney M Stahl, Peter A Lichtenberg, Lisa L Barnes, Naoko Muramatsu, Spero M Manson","doi":"10.1093/geront/gnae160","DOIUrl":"10.1093/geront/gnae160","url":null,"abstract":"<p><p>Spanning nearly 30 of the 50 years in which the National Institute on Aging (NIA) has existed, the Resource Centers for Minority Aging Research (RCMAR) program represents one of the most successful initiatives for advancing minority aging research and diversifying the scientific workforce within the Institute and across the National Institutes of Health. This article celebrates the genesis of the RCMAR program, beginning with the need to enhance this work, ranging from theories underlying the then-nascent field of health disparities research to study design, measurement, and analytic procedures. It describes the companion focus on preparing, expanding, and diversifying generations of future scholars/scientists to carry forward these advances. RCMAR's emphasis on promoting a comprehensive approach to research career development and building supportive learning communities heralded a more holistic approach to training than was previously the case. The discussion describes the evolution of the structure and emphases of the RCMAR program as it has responded to the frequently changing political, funding, and research environments. The article concludes by highlighting the major successes of this initiative, the challenges it faces, and opportunities afforded future growth as individual centers, the program at large, and NIA as a whole continue to innovate as they collectively address the original goals that remain relevant today and in the near future.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Exercise-Based Interventions to Support Healthy Aging in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Wei Qi Koh, Nutyathun Wora, Natasha Wing Laam Liong, Kristiana Ludlow, Nancy A Pachana, Jacki Liddle","doi":"10.1093/geront/gnae156","DOIUrl":"10.1093/geront/gnae156","url":null,"abstract":"<p><strong>Background and objectives: </strong>Healthy aging is a multidimensional construct, where various factors play a role in influencing well-being in older age. Many studies heavily emphasize the importance of physical activity, negating other aspects such as psychosocial or cognitive influences. This review aimed to evaluate the effectiveness of non-exercise-based interventions on the quality of life (QoL) and life satisfaction of community-dwelling, healthy older adults.</p><p><strong>Research design and methods: </strong>A systematic review and meta-analysis of randomized controlled trials was conducted. Four electronic databases were searched from inception. Three independent reviewers screened the articles and appraised the risk of bias. Data relating to study characteristics, interventions, and outcomes were extracted. The mean difference and standardized mean difference with 95% confidence intervals (CI) were synthesized to pool effect sizes. Outcomes that could not be included in the meta-analysis were synthesized narratively.</p><p><strong>Results: </strong>Thirty-six articles from 35 randomized controlled trials, involving 6,127 older adults, were included. Most were multicomponent interventions and involved supporting lifelong learning. Most participants were females (70.2%). Pooled analyses revealed small but statistically significant effects on overall QoL (standardized mean difference [SMD] = 0.26, CI: 0.00 to 0.53), and QoL subscales relating to mental health and psychological well-being (SMD = 0.26, CI: 0.12 to 0.41) and environment (SMD = 0.31, CI: 0.03 to 0.58). Effects on social health and functioning, and role functioning related to physical health were marginal. There were no improvements in other subscales. Results revealed nonstatistically significant improvements in life satisfaction.</p><p><strong>Discussion and implications: </strong>Multicomponent non-exercise-based interventions that support lifelong learning in older adults can support healthy aging, particularly in improving overall QoL, and mental health, social health, and environment QoL subscales.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiving Challenges From Persistent Pain Among Family Caregivers to People With Dementia.","authors":"Shelbie G Turner, Irina Mindlis, M Carrington Reid, Karl A Pillemer","doi":"10.1093/geront/gnae164","DOIUrl":"10.1093/geront/gnae164","url":null,"abstract":"<p><strong>Background and objectives: </strong>Many family caregivers to people with dementia experience persistent physical pain. Though caregivers' pain is associated with poor caregiving outcomes, there is little research on how pain challenges caregiving to yield poor outcomes. This study developed a typology of caregiving challenges from pain among family caregivers to people with dementia.</p><p><strong>Research design and methods: </strong>We conducted semistructured, in-depth interviews with 25 family caregivers living with persistent pain and caring for people with dementia. We inductively analyzed data via a thematic analysis approach, wherein we identified and categorized caregiving challenges stemming from caregivers' pain. We then analyzed how challenges were related to one another and their consequences for caregiving outcomes.</p><p><strong>Results: </strong>Analysis revealed 3 interrelated categories of caregiving challenges from living with pain: (a) physical (e.g., difficulty lifting care recipient), (b) psychological/emotional (e.g., worry about future care if their pain condition worsens), and (c) familial/relational (e.g., resentment toward family without pain for not helping with care). Caregivers reported that these challenges compounded one another in ways that made both caregiving and pain management more difficult. Moreover, challenges led to caregivers delaying or skipping care tasks. The nature of challenges and their connection to caregiving outcomes were dependent on various supporting factors, such as whether caregivers reported benefits from their own pain (e.g., greater empathy).</p><p><strong>Discussion and implications: </strong>The resulting typology informs a conceptual model to guide future translational research on caregivers' pain, including illuminating promising intervention targets of pain self-management programs for family caregivers to people with dementia.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating Ageism with Science: Robert Butler's Shaping of the National Institute on Aging.","authors":"Becca R Levy","doi":"10.1093/geront/gnae167","DOIUrl":"10.1093/geront/gnae167","url":null,"abstract":"<p><p>The physician, scholar, and activist Robert Butler devoted much of his life to trying to end ageism in order to create a society that provides older persons with equal rights and opportunities. His passion for fighting ageism led to his becoming the founding director of the National Institute of Aging (NIA) and set the stage for many of its achievements during the past 50 years. This article explores how Butler first became committed to overcoming ageism, how he made a strong case for setting up NIA as a headquarters to combat ageism with science, and how he launched NIA as a multidisciplinary organization that could draw on research, training, and public policy as weapons against ageism. Finally, this article highlights how Butler, through his anti-ageism activities in later life, personified the possibilities he had done so much to make available to older persons through his launch of NIA.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11712264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks and Outcomes of New Onset of Unmet Need for Mobility and Self-Care Daily Activities.","authors":"Laura P Sands, Lina Lee, Xiaofan Zhu, Maham Khan, Pang Du","doi":"10.1093/geront/gnae154","DOIUrl":"10.1093/geront/gnae154","url":null,"abstract":"<p><strong>Background and objectives: </strong>Among community-living older adults who have limitations in completing activities of daily living (ADLs), unmet need occurs when they cannot complete an ADL task because no one was available to help. Prior research described correlates of existing unmet needs but did not consider which older adults are at risk for new onset of unmet needs. This study assessed health characteristics that increased risk for new onset of unmet needs within a year and subsequent health outcomes.</p><p><strong>Research design and methods: </strong>Data are from 2011 to 2019 annual interviews of the National Health and Aging Trends Study. For each pair of 2 consecutive annual interviews, we determined whether new onset of unmet needs occurred between the first and second consecutive interviews. Mixed effects logistic regression models were computed to assess risks for new onset of unmet need across 14,890 paired observations from persons who needed help with mobility tasks and 12,514 paired observations from persons who needed help with self-care tasks.</p><p><strong>Results: </strong>Although demographic characteristics and chronic conditions had modest associations with new onset of unmet need, hospitalization between the 2 consecutive interviews was associated with a twofold increase in risk for new onset of unmet need. New onset of unmet need was associated with hospitalization, nursing home placement, and death in the year following the 2 consecutive annual interviews.</p><p><strong>Discussion and implications: </strong>The findings inform the need for frequent assessments of ADL care needs with the goal of preventing new onset of unmet needs, especially after hospitalization.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}