Gerontologist最新文献

{"title":"Do older Hispanic immigrants receive more from public assistance?","authors":"Stipica Mudrazija, Sofia G Ayala","doi":"10.1093/geront/gnaf163","DOIUrl":"10.1093/geront/gnaf163","url":null,"abstract":"<p><strong>Background and objectives: </strong>Research shows that foreign-born adults, including those of Hispanic origin, are less likely than the U.S.-born population to access public benefits. However, we do not understand well the extent to which immigrants are underutilizing public benefits, how this may differ across different types of public supports, and how the trends in public benefits receipt have changed in recent decades.</p><p><strong>Research design and methods: </strong>We use 1998-2020 data from the Health and Retirement Study and apply structural equation models (SEM) to account for the direct and indirect impact of nativity and Hispanic ethnicity on the receipt of Social Security Disability Insurance (SSDI) benefits, Supplemental Nutrition Assistance Program benefits, and Supplemental Security Income and welfare benefits.</p><p><strong>Results: </strong>We find that older Hispanic immigrants are substantially less likely than the U.S.-born population to receive SSDI benefits, while more likely to receive means-tested benefits, primarily driven by their higher likelihood of poverty. However, we also document a declining use of public benefits by older immigrants relative to nonimmigrants during the years of Obama and Trump administrations, with arguably a somewhat accelerated pace during the latter. The magnitude of this decline is much more pronounced for Hispanic than non-Hispanic immigrants.</p><p><strong>Discussion and implications: </strong>Our findings suggest that older immigrants are likely not a disproportionate burden on the welfare system of our country and may even be underutilizing some aspects of it. They confirm the utility of using the SEM approach to account for the complex web of relationships linking basic demographic characteristics such as nativity with the outcomes of interest.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561881","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":"\"I'm fed up with life\": the lived experience of tiredness of life among nursing home residents.","authors":"Elisa Van Wiele, Hannah Thys, Jessie Dezutter, Stefanie Meul, Kaat Wils, Tinne Claes, Veerle Foulon, Bernadette Dierckx de Casterlé","doi":"10.1093/geront/gnaf161","DOIUrl":"10.1093/geront/gnaf161","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tiredness of life (ToL) in older adults is a phenomenon that is causing increasing social concern, with health care professionals reporting challenges in caring for those who are experiencing it. Nursing home residents, in particular, may be especially vulnerable to ToL. However, there is currently no scientific understanding of what ToL entails and how exactly nursing home residents experience this phenomenon. This study therefore aims to unravel the experience of ToL among nursing home residents.</p><p><strong>Research design and methods: </strong>This study employed a grounded theory design where 26 semistructured in-depth interviews with nursing home residents were collected. Data were analyzed iteratively using the Qualitative Analysis Guide of Leuven (QUAGOL).</p><p><strong>Results: </strong>The experience of ToL among nursing home residents is characterized by an interacting combination of several experiences of suffering: A disconnection from life, which manifests as a loss of drive and/or death wishes, is closely linked to a threatened sense of self, characterized by four types of loss: a loss of mattering, a loss of social connection, a loss of agency, and a loss of hope for the future.</p><p><strong>Discussion and implications: </strong>Our findings provide a deeper understanding of the ToL experience among nursing home residents. ToL appears to be a dynamic, complex, and layered phenomenon. Fostering a valued sense of self could guide care strategies for residents experiencing ToL. Further research is essential to unpack the specific dynamics underlying this experience.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499171","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":"Beyond \"worried well\": health care professionals' perspectives on improving subjective cognitive decline care.","authors":"Ryan A Mace, Mason J Stewart-McLellan, Makenna E Law, Dumichel Harley, Christine Ritchie, Stephen Bartels, Olivia I Okereke, Bettina B Hoeppner, Judson Brewer, Rebecca E Amariglio, Ana-Maria Vranceanu","doi":"10.1093/geront/gnaf159","DOIUrl":"10.1093/geront/gnaf159","url":null,"abstract":"<p><strong>Background and objectives: </strong>Subjective cognitive decline (SCD) is an early indicator of cognitive impairment and dementia risk, yet its clinical management remains inconsistent. Health care professionals play a critical role in identifying and addressing SCD, but their perspectives on barriers and facilitators to care are understudied. This study explored health care professionals' insights for improving SCD care.</p><p><strong>Research design and methods: </strong>We conducted five qualitative focus groups (n = 26) with multidisciplinary health care professionals providing care for older adults with SCD. Participants were recruited from diverse clinical settings within an academic medical center. Transcripts were analyzed using a hybrid deductive-inductive thematic analysis. We proposed strategies to overcome barriers to SCD care using the Expert Recommendations for Implementing Change framework.</p><p><strong>Results: </strong>Four major themes emerged: (a) Terminology, Identification, and Diagnosis-barriers related to inconsistent terminology, overlap with normal aging, and limited standardized guidelines; (b) Psychosocial Factors-stigma surrounding SCD, variability in patient motivation for interventions, and caregiver roles; (c) Access and Equity-disparities in culturally and linguistically concordant care, financial barriers, and exclusion from research; and (d) Health Care Systems-time constraints, referral delays, and clinic variability impacting the quality of care.</p><p><strong>Discussion and implications: </strong>Findings highlight systemic and psychosocial barriers to SCD care, as well as potential facilitators, including interdisciplinary collaboration and patient-centered strategies. Addressing these challenges requires targeted interventions to standardize terminology, improve provider education, enhance access, and promote equitable care. Future research should evaluate implementation strategies to optimize SCD management and reduce disparities in early dementia prevention efforts.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509305","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":"Bridging aging and disability to strengthen research.","authors":"Tamar Heller, Michelle Putnam","doi":"10.1093/geront/gnaf157","DOIUrl":"10.1093/geront/gnaf157","url":null,"abstract":"","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509306","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":"Unpacking the dynamics of transitional care units in Ontario, Canada.","authors":"Alexandra Krassikova, Lydia Yeung, Jennifer Bethell, Martine Puts, Sandra McKay, Sara Guilcher, Kerry Kuluski, Katherine S McGilton","doi":"10.1093/geront/gnaf155","DOIUrl":"10.1093/geront/gnaf155","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transitional care units (TCUs) provide short-term, low-intensity, restorative care to patients who are medically stable but unable to leave the hospital due to factors, such as lack of support. In Ontario, Canada, TCUs have been implemented over the past decade, yet little is known about their operation. This study aimed to explore the structural characteristics and the care processes of TCUs from the perspective of TCU managers.</p><p><strong>Research design and methods: </strong>An exploratory descriptive qualitative design was employed. Semi-structured interviews were conducted with seven TCU managers. A five-step inductive thematic analysis was used to identify themes. Participants' median age was 46 years (range 36-50), with four men and three women. Their experience as TCU managers at the time of the interview ranged from 2 months to 5 years.</p><p><strong>Results: </strong>The study results suggest variation across TCUs in terms of structure and patient populations served. Four themes were identified related to the care processes across seven TCUs: (1) ensuring safe transitions; (2) managing patients' expectations; (3) creating a team that works together; and (4) navigating a constantly changing environment.</p><p><strong>Discussion and implications: </strong>Taking into account the variability of models, implementation and evaluation of these programs require careful planning. The complex medical and psychosocial needs of TCU patients should be considered when designing these units to ensure effective and appropriate care delivery.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512784","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":"Niece and nephew dementia caregivers: family relationships and care dynamics.","authors":"Karen A Roberto, Jyoti Savla","doi":"10.1093/geront/gnaf154","DOIUrl":"10.1093/geront/gnaf154","url":null,"abstract":"<p><strong>Background and objectives: </strong>The dementia caregiving literature has largely ignored extended family caregivers who play a vital role in sustaining community living for older adults living with dementia. Guided by a life course perspective and grounded in a stress-coping framework, we focus attention on the caregiving experiences of nieces/nephews who have assumed the role of primary caregiver for their aunts/uncles, a topic that has received limited attention in the research literature.</p><p><strong>Research design and methods: </strong>Employing a mixed-methods design, we conducted interviews with 20 niece and 5 nephew primary caregivers (Mage = 55 years; R = 38-67). Interviews were analyzed following principles of the life history approach to understand how family history and dynamics shaped care responsibilities and practices; correlation analyses assessed associations with caregiver outcomes.</p><p><strong>Results: </strong>Interactions in childhood provided the foundation for establishing relationships with aunts/uncles. Two-thirds of the nieces/nephews never expected to be their relative's caregiver, but rather either gradually \"fell into it\" or abruptly assumed the role because of \"family circumstances.\" Caregivers relied primarily on their own family for help with care tasks; aunts'/uncles' family members and paid services provided targeted assistance. Nieces/nephews who relied on family support to assist with care experienced more caregiver burden and faced greater family strain.</p><p><strong>Discussion and implications: </strong>The nieces/nephews embraced their caregiver roles and were committed to ensuring their aunts/uncles received the care they needed. Findings contribute new knowledge about the complexity of extended family relationships and realities of dementia care amidst the transformations occurring in family life today.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295361","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":"\"I'm more confident now than I ever used to be\": a preliminary qualitative study of British older adults' perception and experience of aging positively.","authors":"Miriam Sang-Ah Park, Christopher Lo, Hyo-Jung Lee, Sangseok Moon, Blake Webber, Stephen Badham, Jodie Paterson","doi":"10.1093/geront/gnaf149","DOIUrl":"https://doi.org/10.1093/geront/gnaf149","url":null,"abstract":"<p><strong>Background and objectives: </strong>With the changing demographic of older adults population observed around the world, it is important that aging is not simply conceptualized as decline in functioning and physical health, but encompasses positive experiences that impact upon overall well-being. Looking at the aging experience in a particular sociocultural context allows for a more in-depth understanding that could then lead to promotion of positive aging and improvements in aging outcomes in that context.</p><p><strong>Research design and methods: </strong>The current qualitative study explores through Interpretative Phenomenological Analysis how UK adults have experienced aging. Semi-structured interviews were conducted with the aim to look closely into their subjective experiences and perceptions of positive aging in the UK. Analysis was undertaken through the lens of self-determination theory.</p><p><strong>Results: </strong>Participants maintained a sense of wellness and positivity despite the challenges they faced in their aged bodies and declining health. They demonstrated autonomy though self-acceptance and indulging personal interests, competence through generativity and preparedness, and relatedness through capacity for connection with others, and appreciating living harmoniously with those they cared.</p><p><strong>Discussion and implications: </strong>This study presents a conceptualization of positive aging that can be applied to understand the aging process and experiences of older adults more broadly, which could aid policy and interventions targeting older adults.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":"65 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977945","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":"Acceptability and satisfaction of a newly developed financial preparedness program for caregivers of older adults with a chronic illness.","authors":"Katherine Judge, Lauren Stratton, Claire Grant, Monica Moreno, Sam Fazio","doi":"10.1093/geront/gnaf148","DOIUrl":"10.1093/geront/gnaf148","url":null,"abstract":"<p><strong>Background and objectives: </strong>To address a gap in caregiver programming focused on financial literacy and preparedness, Managing Money: A Caregiver's Guide to Finances, a 1-hour online program, was evaluated to determine program acceptability and participant satisfaction.</p><p><strong>Research design and methods: </strong>Caregivers of individuals with chronic health conditions were recruited to attend a one-hour program focused on (1) understanding the financial impact of caregiving; (2) providing information on legal and financial documents; (3) how to prepare for discussions about finances and financial planning; (4) lowering risks of financial abuse and fraud; and (5) creating a backup plan for changes in care needs. Results were collected longitudinally, following participants to ninety days after attending the program.</p><p><strong>Results: </strong>Overall, participants (n = 99) found the program highly acceptable, with the majority of caregivers agreeing or strongly agreeing the program: identified financial issues; provided important information; content was easy to read and understand; topics were clear and well-organized; activities were helpful; length was good; and caregivers would recommend the program. Program materials were rated helpful with up to 40% of participants reporting they used materials after attending the program.</p><p><strong>Discussion and implications: </strong>Providing care for individuals with chronic health conditions poses significant challenges for informal caregivers. The impact of finances, knowledge base, and skills needed are often not included in an in-depth manner. The current program addresses this gap while also taking into consideration the need to develop pragmatic and scalable programs. The program may be useful in developing other targeted intervention protocols for caregivers.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267871","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":"\"It may cost you your money, it costs you your life\": a framework for financial hardship in dementia.","authors":"Krista L Harrison, Emily R Adrion, Juliana Friend, Sarah B Garrett, Madina Halim, Michael Terranova, Alissa B Sideman, Nicole D Boyd, Georges Naasan, Joni Gilissen, Pei Chen, Melissa D Aldridge, Daniel Dohan, Michael D Geschwind, Alexander K Smith, Christine S Ritchie","doi":"10.1093/geront/gnaf170","DOIUrl":"10.1093/geront/gnaf170","url":null,"abstract":"<p><strong>Background and objectives: </strong>Care for persons with dementia costs ∼ $500 billion annually in the United States. Few qualitative studies or conceptual frameworks of the financial experiences of people impacted by dementia exist. This study examined how patients and caregivers impacted by different types of dementia and at different points in the disease journey described financial issues within a palliative care context.</p><p><strong>Research design and methods: </strong>We conducted a secondary analysis of data from qualitative studies of palliative care needs in dementia (2018-2020) that systematically asked about financial challenges. Interview participants were recruited from a specialty dementia center. Using a hybrid inductive-abductive approach and thematic analysis, we created a conceptual framework to represent themes among people with varied experiences with dementia types and stages.</p><p><strong>Results: </strong>Among 52 participants recruited, 27 were former caregivers, 16 were current caregivers, and 9 were persons with dementia; experiences reflected Alzheimer's (n = 18), sporadic Creutzfeldt-Jakob (n = 12), Lewy body (n = 7), and other dementias (n = 15). Financial hardships resulted from mismatches between needs and resources people had (direct financial hardships), how they felt about resources (emotional financial hardships), or what they could do with resources (logistical financial hardships). Mitigators of financial hardship included long-term-care insurance, Medicaid, or wealth, while intensifiers included being middle-income and in the workforce during disease manifestation.</p><p><strong>Discussion and implications: </strong>Even in a well-resourced population, the financial toll of dementia can be substantial. The Direct-Emotional-Logistical framework of dementia financial hardship can be used to assess financial impacts in palliative care settings.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735198","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":"Dancing through transitions of aging: Creating meaning and seeking identities.","authors":"Emily A Greenfield, Lin Chen","doi":"10.1093/geront/gnaf172","DOIUrl":"https://doi.org/10.1093/geront/gnaf172","url":null,"abstract":"","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719060","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}