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Recently, scholars have highlighted the detrimental consequences of technology-based ageism. Digital technology (DT) is commonly discoursed as an opportunity to promote Successful Aging. Nevertheless, the theoretical implications of ageism, DT, and Successful Aging are underexplored. This paper presents a new theoretical model of Digital Engagement and Ageism (D-EngAge), which elaborates on the potential impacts of ageism on digital engagement and participation in later life and explains how ageism may pose a threat to realizing the potential of DT to promote Successful Aging. The D-EngAge model was developed based on a synthesis of findings from 12 recent studies we conducted on the intersection of ageism and DT. Findings were synthesized through Iversen's clasification of four dimensions of ageism, demonstrating how ageism as a multifaceted construct has a reciprocal relationship with digital engagement on the micro- (individual), meso- (social interaction), and macro-levels (discourses and societal practices). Consequently, digital engagement on these levels may exacerbate or reduce technology-based ageism. This forum paper identifies ageism as a barrier to utilizing DT, critically discusses power imbalances, and deconstructs Successful Aging discourses regarding digital engagement. Theoretical implications and recommendations for future interventions and policy measures to mitigate ageism and promote digital engagement and participation in later life are presented. [ABSTRACT FROM AUTHOR]

Background and Objectives Population aging has led to an increased interest in cognitive health and, in particular, the role that stress plays in cognitive disparities. This paper extends previous work by characterizing coronavirus disease 2019 (COVID-19) stress type prevalence and its association with cognitive health in metro-Detroit among Black, Middle Eastern/Arab (MENA), and White older adults. Research Design and Methods Data come from a regionally representative sample of adults aged 65+ in metro-Detroit (N = 600; MENA n = 199; Black n = 205; White n = 196). We used generalized linear models to compare groups on sociodemographic, objective stress, and social stress indicators. Multiple group structural equation models evaluated whether COVID-19 stress predicted cognitive health and whether that association varied across racial/ethnic groups. Results MENA and Black older adults reported higher levels of objective stress than Whites. There were no racial/ethnic group differences in social stress. More objective stress was associated with better cognitive health, and more social stress was associated with worse cognitive health. The positive effect of objective stress was especially apparent for White older adults. Discussion and Implications Though it appears that minority stress was not exacerbated in the context of pandemic stress, links between greater objective stress and better cognitive health apparent among White older adults were not evident among MENA or Black older adults. Broadening health disparities research by including underrepresented populations allows us to elevate scientific knowledge by clarifying what is universal and what is unique about the stress process. [ABSTRACT FROM AUTHOR]

Background and Objectives Amyloid positron emission tomography scans can enhance the accuracy of dementia diagnoses. However, the perspectives and experiences of people with cognitive impairment and their care partners undergoing an amyloid scan are less well understood. Therefore, this review aimed to identify and summarize qualitative studies exploring patient and care partner experiences of undergoing an amyloid scan. Research Design and Methods We searched Embase, MEDLINE, and PsychInfo in March 2024. Articles were screened for inclusion by 2 reviewers and critically appraised using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Studies. Data from the included studies were synthesized using thematic synthesis. Results We identified 10 papers from 6 studies. We identified 4 themes: (1) motivations for undergoing an amyloid scan, (2) experiences of receiving the result, (3) emotional responses to the result, and (4) actions in light of the scan result. Participants reported undergoing the scan to determine the cause of cognitive impairment. They described the information gained from the scan as helpful but struggled to recall the correct terminology or implications of the scan. Emotional responses to the scan varied depending on the scan result. In light of the scan result, the most common action was making advanced plans; however, this was mainly discussed among participants with elevated amyloid. Discussions and Implications Amyloid scans can provide useful and actionable information. However, learning the scan result could be distressing. Future research is needed to balance the potential benefits and harms of amyloid scans. [ABSTRACT FROM AUTHOR]

This paper argues that the philosophy of ambiguity, associated with Maurice Merleau-Ponty and Simone de Beauvoir, provides a helpful framework for understanding the complex and paradoxical nature of old age outside the dominant categories of the "third" and "fourth" ages. Building on philosophical literature in cultural gerontology including that focused on the "art of living" and other approaches that draw on existentialist thought, it suggests "ambiguity" as a theme that has been overlooked in such literature. The advantage of this approach is that it can accommodate contradictory elements and thus underpin an integrated approach to old age. At the same time, in distinguishing between ontological and social dimensions of ambiguity, the conceptual framework offers a new perspective on ageism that can help clarify the distinction between ageism as oppression and the negative aspects of deep old age itself. The paper is structured as follows. After making the case for the value and importance of "ambiguity" as a framework for viewing old age, I set out the key aspects of this philosophy as found in the work of Merleau-Ponty and particularly Beauvoir. I then apply this framework to a discussion of 2 literary memoirs of deep old age, by Diana Athill and Florida Scott-Maxwell, respectively. I argue that the picture of old age that emerges contrasts with the hegemonic discourses enframed by successful aging and frailed old age and offers the possibility not only of a true appreciation of old age but also of a more meaningful life course itself. [ABSTRACT FROM AUTHOR]

Naïve yet threatening is how the South Korean news media have characterized some older adults who have taken to social media to air their political views. Labeled as "angry (digital) silver," these older adults using YouTube and other social media platforms for political activity are portrayed as digitally illiterate and aggressive. This paper examines the rhetoric surrounding older adults' digital media literacy in scholarship and popular news media with a focus on the news media's portrayal of older adults' digital political activity. By analyzing the use of language and various rhetorical strategies, I argue that specific rhetoric of caution, which warns against older adults' so-called lower digital media literacy, is used to invalidate their digital political activity. I draw upon the case of the "Taegukgi squad"—a political group mainly composed of older adults in South Korea—and the evolution of their digital presence. Addressing the media's biased portrayal of older adults' digital media literacy, this paper further invites reflection on controversies around the role of age in digital political activities around the globe. [ABSTRACT FROM AUTHOR]

This paper argues for a greater theorization of "place" within aging-in-place research. It extends calls for a relational conceptualization of place by demonstrating the need for aging-in-place researchers to also pay greater attention to territorial aspects of place. This complementary understanding will help establish a new spatial grammar within aging-in-place research, that not only would improve conceptual clarity to aging in place, but would also support a more critical engagement of aging in place in questions of inequality. The paper demonstrates this through a discussion of 2 forms of inequality pertinent to older people: the uneven capacity of places to support older people and experiences of social exclusion in relation to place attachment for older people from marginalized groups. [ABSTRACT FROM AUTHOR]

Background and Objectives Healthcare services are rarely designed to meet the needs of Indigenous people, resulting in culturally unsafe care and assessment tools. This paper describes a collaboration between North East Behavioural Supports Ontario (NEBSO), university researchers, and Indigenous communities to adapt a biographical assessment tool used by NEBSO to be culturally appropriate and safe for Indigenous older adults (55+) in long-term care facilities in Ontario, Canada. Research Design and Methods Over 36 months, this project applied an Indigenized, community-based participatory research (CBPR) and cultural safety framework to the adaptation process. Qualitative data sources include the guidance of an Indigenous Elder, an Anishinaabe Language Expert Group, and focus groups conducted along the North Shore of Lake Huron, Sudbury, and Cochrane, Ontario. Results The adapted tool shifts the focus from personhood to relationships, includes culturally relevant domains, and supports trauma-informed approaches. Five themes were identified during the adaptation process: (1) practicing a relational approach to care, (2) valuing Indigenous language, (3) understanding Indigenous trauma, (4) respecting cultural values and understandings, and (5) addressing systemic barriers to culturally safe care. Discussion and Implications Themes elucidated from this research process can inform future studies adapting mainstream practice tools and developing new tools for Indigenous populations. The collaboration and approach to this adaptation process demonstrated how cultural safety at systemic and practice levels can be addressed through CPBR partnerships between universities, organizations, and Indigenous communities. Findings support the need to evaluate the cultural safety of other assessments for older Indigenous adults in health care settings. [ABSTRACT FROM AUTHOR]

Many factors affect how individuals and populations age, including race, ethnicity, and diversity, which can contribute to increased disease risk, less access to quality healthcare, and increased morbidity and mortality. Systemic racism—a set of institutional policies and practices within a society or organization that perpetuate racial inequalities and discrimination—contributes to health inequities of vulnerable populations, particularly older adults. The National Association for Geriatrics Education (NAGE) recognizes the need to address and eliminate racial disparities in healthcare access and outcomes for older adults who are marginalized due to the intersection of race and age. In this paper, we discuss an anti-racist framework that can be used to identify where an organization is on a continuum to becoming anti-racist and to address organizational change. Examples of NAGE member Geriatric Workforce Enhancement Programs (GWEPs) and Geriatrics Academic Career Awards (GACAs) activities to become anti-racist are provided to illustrate the framework and to guide other workforce development programs and healthcare institutions as they embark on the continuum to become anti-racist and improve the care and health of vulnerable older adults. [ABSTRACT FROM AUTHOR]

Background and Objectives Chronological age is invariably used as a categorizing tool for spaces, collections, and programs in public libraries. With age-based conceptions of human experience in library practice, education, and scholarship primarily focused on those under the age 18, little is known how age-based classifications are implemented in public libraries, and with what impacts, for older library patrons. Research Design and Methods Stemming from a larger project that seeks to bring attention to the ways in which public libraries engage with community-dwelling older adults, this paper explores 51 older patrons' perspectives on the numbers and language (e.g. 55+, older adult, seniors, adult) assigned to older adults in library programs and which label best (or least) suits their sense of identity and, in turn, what language encourages or deters their engagement with library programs. Results Findings illustrate that age-based language describing older adult library programs is often at odds with patrons' perceptions of how library programming relevant to them ought to be labeled. Common to all participants was a clear dislike for the term "elderly." While most participants preferred "older adult" to "senior," others voiced no preference, as long as they felt heard and valued. Many participants linked the use of language used to describe library programs to being excluded from and treated differently from other (younger) library patrons. Discussion and Implications The language used to group and describe different library populations directly shapes feelings of belonging (or exclusion) in library programs. Insights from this research contribute to our evolving understandings of the ways in which language connected to age can shape one's sense of identity. Results also serve to cultivate a more sensitive and critical approach to the question of age within library science, and, by extension, the experiences of older adults who frequent the library. [ABSTRACT FROM AUTHOR]

Background and Objectives Ageism is oftentimes sugarcoated within humor. Paper birthday cards are 1 delivery approach in which ageist messages are perpetuated and reinforced through humor. Research Design and Methods A convenience sample of birthday cards (k = 227), all indicating a decade of age, were acquired from 7 national retail stores in Colorado Springs, CO. The decades sampled ranged from 21 to 100. With a predeveloped codebook, 3 raters coded the decade birthday cards on various variables, including age group, ageist tone, and humor. Results Birthday cards intended for age 30–60 contained significantly more ageist messages compared to cards intended for age 21 and age 70–100, which did not show a significant difference from each other. Additionally, birthday cards with humor showed more ageist messages than cards without humor. Characteristics of decade birthday cards were also explored. Discussion and Implications Consumers need to learn to evaluate these ageist messages in birthday cards to reduce the perpetuation of damaging stereotypes. [ABSTRACT FROM AUTHOR]

Background and Objectives Little is known about elements of long-term care (LTC) that promote quality of life (QoL) for older Indigenous and First Nations peoples. This systematic review aimed to extend understanding of those deemed most important. Research Design and Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic database and hand-searching were used to find published and unpublished qualitative studies and textual reports. A convergent integrated approach was used to synthesize data, according to the Joanna Briggs Institute methodology for mixed methods systematic reviews. Results Included papers (11 qualitative; seven reports) explored views and experiences of Indigenous residents, families, and LTC staff from North America (8), South Africa (1), Norway (1), New Zealand (1), and Australia (7). Elements of care included: (a) codesigning and collaborating with Indigenous and First Nations communities and organizations to promote culturally safe care; (b) embedding trauma-informed care policies and practices, and staff training to deliver culturally safe services; (c) being respectful of individual needs, and upholding cultural, spiritual and religious beliefs, traditional activities and practices; (d) promoting connection to culture and sense of belonging through sustained connection with family, kin, and Indigenous and First Nations communities. Discussion and Implications This review identifies elements or models of care that promote QoL for Indigenous and First Nations peoples in LTC. While included papers were mostly from the United States and Australia, the congruence of elements promoting QoL was evident across all population groups. Findings may be used to inform standards specific to the care of Indigenous and First Nations peoples. [ABSTRACT FROM AUTHOR]

Background and Objectives The age-friendly university (AFU) initiative embodies the collaborative efforts of promoting age inclusivity and diversity in higher education, embracing lifelong learning and civic participation in older people. This scoping review aims to explore the conceptualization of AFU, the experiences, and the strategies used in operationalizing the AFU principles of participating universities in becoming members of the age-friendly university network. Research Design and Methods A search of peer-reviewed papers published from 2012 to July 2021, conducted in nine databases using JBI scoping review methodology, found 1,752 articles. Of these, 13 papers were eligible for inclusion. Results Three themes were identified as key to becoming an AFU: (a) interdisciplinary collaboration within the university; (b) strong partnership with the community; and (c) alignment with global priorities and initiatives. Furthermore, identifying barriers to physical access in universities, such as signage, walkways, and transportation, addressing the less tangible issues of ageism and promoting intergenerational learning were essential to promote engagement of older people. Discussion and Implications This review underscores the need for a multidisciplinary approach within the university, the reciprocal benefits of authentic university–community collaborations, and the advantages of harnessing international resources and global influence to becoming an AFU. Although the principles of the AFU remain aspirational, the ideals championed by the pioneering universities in the AFU network brought the mutual benefits of intergenerational learning, the challenges and support required for older learners to the fore, propelling the AFU agenda forward. [ABSTRACT FROM AUTHOR]

Background and Objectives Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an intervention to manage DBD in VA nursing home settings, or Community Living Centers (CLCs). This paper summarizes multiyear formative evaluation results including challenges, adaptations, and lessons learned to support sustained integration into usual care across CLCs nationwide. Research Design and Methods STAR was selected as an evidence-based practice for DBD, adapted for and piloted in VA (STAR-VA), and implemented through a train-the-trainer program from 2013 to 2018. Training and consultation were provided to 92 CLC teams. Evaluation before and after training and consultation included descriptive statistics of measures of clinical impact and survey feedback from site teams regarding self-confidence, engagement, resource quality, and content analysis of implementation facilitators and challenges. Results STAR-VA training and consultation increased staff confidence and resulted in significant decreases in DBD, depression, anxiety, and agitation for Veterans engaged in the intervention. Implementation outcomes demonstrated feasibility and identified facilitators and barriers. Key findings were interpreted using implementation frameworks and informed subsequent modifications to sustain implementation. Discussion and Implications STAR-VA successfully prepared teams to manage DBD and resulted in improved outcomes. Lessons learned include importance of behavioral health–nursing partnerships, continuous engagement, iterative feedback and adaptations, and sustainment planning. Evaluation of sustainment factors has informed selection of implementation strategies to address sustainment barriers. Lessons learned have implications for integrating team-based practices into system-level practice. [ABSTRACT FROM AUTHOR]

Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population. [ABSTRACT FROM AUTHOR]

Drawing on the work of Simone de Beauvoir, this paper considers ageism as a structure of consciousness, with important convergences with, as well as departures from, those associated with gender. Specifically, it explores the double consciousness through which the self is experienced negatively as old, at 2 points in a woman's life course, namely midlife and "old age." The first kind of ageism works through the double standard of aging and the gender hierarchy, whereby women can no longer successfully comply with the objectification of the male gaze. This is a moment of intense age consciousness, tainted by a gendered narrative of decline, working jointly from the outside in and from the inside out. The second form of ageism has its source in the social world, in the reactions of other people to old age, resulting in an uneasy dialectic between one's own sense of an ageless or youthful self and the alien view of self as old. The paper proceeds as follows. After a brief account of Beauvoir's general philosophical approach, I compare and contrast the doubled consciousness associated with aging as a woman and with aging in a more general sense as described in The Second Sex and The Coming of Age , respectively. I then flesh out this conceptual framework by drawing on fiction and autofiction written by Beauvoir herself. Together, this approach vividly illuminates the important interconnections and intersections between ageism and sexism, the way they work together, as well as separately, across the female life course. [ABSTRACT FROM AUTHOR]

Background and Objectives Artificial intelligence (AI) is widely positioned to become a key element of intelligent technologies used in the long-term care (LTC) for older adults. The increasing relevance and adoption of AI has encouraged debate over the societal and ethical implications of introducing and scaling AI. This scoping review investigates how the design and implementation of AI technologies in LTC is addressed responsibly: so-called responsible innovation (RI). Research Design and Methods We conducted a systematic literature search in 5 electronic databases using concepts related to LTC, AI, and RI. We then performed a descriptive and thematic analysis to map the key concepts, types of evidence, and gaps in the literature. Results After reviewing 3,339 papers, 25 papers were identified that met our inclusion criteria. From this literature, we extracted 3 overarching themes: user-oriented AI innovation; framing AI as a solution to RI issues; and context-sensitivity. Our results provide an overview of measures taken and recommendations provided to address responsible AI innovation in LTC. Discussion and Implications The review underlines the importance of the context of use when addressing responsible AI innovation in LTC. However, limited empirical evidence actually details how responsible AI innovation is addressed in context. Therefore, we recommend expanding empirical studies on RI at the level of specific AI technologies and their local contexts of use. Also, we call for more specific frameworks for responsible AI innovation in LTC to flexibly guide researchers and innovators. Future frameworks should clearly distinguish between RI processes and outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives In the 21st century, the future of the Norwegian welfare state is broadly debated. In Norway, as in other countries, concerns regarding the sustainability and affordability of the welfare state in light of the projected population development have been voiced in public and academic discourse, and not least in governmental statements and documents. Because we consider texts, such as government white papers, as both products and producers of discursively based understandings of the social world, a close examination of policy documents can provide insight into the predominant understanding of a distinct phenomenon in a specific society at a particular point in time. Research Design and Methods The article is based on a critical discourse analysis of 3 recent Norwegian government policy documents addressing the older adult population. Results We demonstrate that prominent ideas from the widely contested successful aging paradigm are embedded and forwarded in current Norwegian policies, where ideas about successful and healthy aging produced and reproduced in the documents frame and shape expectations toward older adults. Discussion and Implications We argue that the ideas and ideals of successful aging and neoliberalism in parallel pave the way for changes in the historically generous and comprehensive Norwegian social democratic welfare state. For decision makers, the rhetoric of successful aging that emphasizes activity, productivity, self-reliance, and freedom of choice is undoubtedly more convenient to communicate to the public than explicit arguments for the necessity of downscaling public services. [ABSTRACT FROM AUTHOR]

Background and Objectives End-of-life (EOL) care quality encompasses multiple domains, which are typically studied in silos. This paper explores interrelationships across domains and how they simultaneously shape patterns of EOL care quality. Research Design and Methods Secondary analysis using National Health and Aging Trends Study. Latent class analysis was used to identify subgroups of decedents according to quality of symptoms and needs management, care experience, care processes, and site of death. Multinomial logistic regression was employed to investigate the association between decedent characteristics and class membership. Results Five groups of decedents were identified. Multiple sites of death with high care coordination (Class 4: 35%) comprised decedents with least concerns regarding symptom management and care experience. Decedents in Predominantly home deaths with no hospice use (Class 1: 26%), predominantly hospital deaths with low hospice use (Class 2: 18%), and multiple sites of death with hospice use (Class 3: 7%) presented similar symptom management and care experience patterns. Multiple sites of death with low care coordination (Class 5: 14%) comprised decedents experiencing poor quality EOL care across multiple domains. Non-Hispanic Black and Hispanic decedents were more likely to be in Class 2 and decedents with dementia diagnosis in Class 4. Discussion and Implications There is considerable heterogeneity in EOL care patterns. Assessing quality based on discrete metrics in silos may lead to unintended consequences like stinting of necessary care or increased caregiving burden on families. There is a need for greater focus on patient-centeredness and how care processes and structures interact in the context of shifting care patterns, care preferences, and payment reforms. [ABSTRACT FROM AUTHOR]

Background and Objectives Given the increasing academic interest in older migrants, this study aims at examining the likelihood of establishing contact and cooperation in a survey among first-generation migrants in Germany, comparing migrants of age 50 and older with younger migrants (aged 16–49). Research Design and Methods We analyze data from the Migrants' Welfare State Attitudes (MIFARE) study collected in Germany, which contains information about first-generation migrants from 9 different origin groups living in private households. Potential survey participants were contacted via mail and invited to participate in a paper- or online-based survey. In addition, an incentive experiment was implemented and age-dependent response rates were analyzed. Using logistic regression analyses, we compare older and younger migrants with regard to their likelihood of contact, cooperation, reaction to incentives, and mode choice. Results Within the MIFARE study, older migrants are more likely to be contacted than younger ones. Older migrants are also more likely to cooperate in survey research than younger migrants. Both groups respond equally positively to the use of unconditional incentives. Lastly, older migrants show a strong preference to fill out the questionnaire on paper, rather than online. Discussion and Implications Older first-generation migrants living in private households are easier to contact and are more likely to cooperate in survey research than younger first-generation migrants. Offering unconditional incentives and surveys on paper are likely to increase response rates among older migrants. [ABSTRACT FROM AUTHOR]

In India, where around 19,500 dialects are spoken, there is a great abundance of fiction quite rich in varied descriptions of old age and aging. While scholars like Pramod K. Nayar and Ira Raja have recently begun studying Indian literary texts written in English from the perspective of literary gerontology, those literary experiences of aging (which are originally in languages like Bengali, Tamil, Hindi, Oriya, etc.) are yet to be analyzed from a gerontological point of view. The present paper aims at studying the experiences of old age in 2 Indian short stories (one from Bengali Literature and another from Tamil Literature)—Bibhutibhusan Bandyopadhyay's "Drabomoyee Goes to Kashi" ("Drabomoyeer Kashibash" in Bengali) and T. Janakiraman's "The Puppet" ("Vilayattu Bommai" in Tamil). Regarding "Drabomoyee Goes to Kashi," the paper interrogates the problems in the emplacement of Hindu older widows to Kashi and explores the possibilities in Drabomoyee from ecofeminist and creatural perspectives. The discussions on "The Puppet" chiefly reflect on the social exclusion of the aging bodies of people living with dementia. Through the story of Venu, the paper shows that what the society or family generally expects from the older persons suffering from dementia may not do any good to them, and may instead lead to their institutionalization and other forms of exclusion. [ABSTRACT FROM AUTHOR]

Background and Objectives This review investigates the contribution of discursive approaches to the study of ageism in working life. It looks back on the 50 years of research on ageism and the body of research produced by the discursive turn in social science and gerontology. Research Design and Methods This study followed the 5-step scoping review protocol to define gaps in the knowledge on ageism in working life from a discursive perspective. About 851 papers were extracted from electronic databases and, according to inclusion and exclusion criteria, 39 papers were included in the final review. Results The selected articles were based on discursive approaches and included study participants along the full continuum of working life (workers, retirees, jobseekers, and students in training). Three main themes representing the focal point of research were identified, namely, experiences of ageism, social construction of age and ageism, and strategies to tackle (dilute) ageism. Discussion and Implications Discursive research provides undeniable insights into how participants experience ageism in working life, how ageism is constructed, and how workers create context-based strategies to counteract age stereotypes, prejudice, and discrimination. Discursive research on ageism in the working life needs further development about the variety of methods and data, the problematization of age-based labeling and grouping of workers, and a focus on the intersection between age and other social categories. Further research in these areas can deepen our understanding of how age and ageism are constructed and can inform policies about ways of disentangling them in working life. [ABSTRACT FROM AUTHOR]

Background and Objectives Numerous longitudinal studies suggest that technology use in late adulthood is associated with cognitive benefits. Using data from a randomized controlled trial, the current study examined whether computer use improves cognition in older adults with little to no previous computer experience. Research Design and Methods This study used data from the Personal Reminder Information and Social Management (PRISM) trial. Community-dwelling older adults with little previous computer experience (M Age = 76.15) were randomly assigned to learn and use a computer (the PRISM system, n = 150) or interact with parallel content delivered in a nondigital format (paper binder, n = 150) for 12 months. Objective and subjective cognitive outcomes were measured before (pretest) and after the intervention (posttest). Latent change score models and Bayesian analysis of variances were used to examine cognitive change at the ability and individual measure level. Results Computer training and use for 12 months did not lead to cognitive improvements at the ability level. Strong evidence against cognitive benefits at the individual measure level was also observed. Discussion and Implications Casual computer use does not provide enough cognitive stimulation to improve cognition in late adulthood. Cognitive benefits observed in longitudinal studies may be mediated by other factors or influenced by confounding variables. [ABSTRACT FROM AUTHOR]

Background and Objectives Social networks affect the health and well-being of older adults. Advancements in technology (e.g. digital devices and mHealth) enrich our ability to collect social networks and health data. The purpose of this scoping review was to identify and map the use of technology in measuring older adults' social networks for health and social care. Research Design and Methods The Joanna Briggs Institute methodology was followed. PubMed (MEDLINE), Sociological Abstracts, SocINDEX, CINAHL, and Web of Science were searched for relevant articles. Conference abstracts and proceedings were searched via Conference Papers Index, the American Sociological Society, and The Gerontological Society of America. Studies published in English from January 2004 to March 2020 that aimed to improve health or social care for older adults and used technology to measure social networks were included. Data were extracted by 2 independent reviewers using an a priori extraction tool. Results The majority of the 18 reviewed studies were pilot or simulation research conducted in Europe that focused on older adults living in the community. The various types of technologies used can be categorized as environment-based, person-based, and data-based. Discussion and Implications Technology facilitates objective and longitudinal data collection on the social interactions and activities of older adults. The use of technology to measure older adults' social networks, however, is primarily in an exploratory phase. Multidisciplinary collaborations are needed to overcome operational, analytical, and implementation challenges. Future studies should leverage technologies for addressing social isolation and care for older adults, especially during the coronavirus disease 2019 pandemic. [ABSTRACT FROM AUTHOR]

Like many countries, the increase in the population of older adults in Nepal has led to national policies and programs to address their needs. It would, however, also be fair to say that not enough is yet known about older adults and hence it is unclear if government programs truly address those needs. Nepal is a very poor country that is still largely rural and characterized by extremes of inequality based on caste/ethnicity, gender, region, and income/wealth. In this paper, we describe the demographic and social conditions of older adults in Nepal, inequality, sources, and limitations of the data about older adults, and public policy and programs for older adults. We believe that studies of older adults in Nepal would benefit from adopting social determinants of health, healthy aging, and life-course perspectives to both identify needs and formulate policy for older adults in Nepal. [ABSTRACT FROM AUTHOR]

This paper assesses the challenges and the benefits of 2 methodological approaches for improving the study of transnational mobilities of older adults: mixed methods and inclusiveness. The first approach refers to a mixed-methods research design based on surveys and qualitative interviews. We share our experience of conducting a "fully mixed-concurrent-equal-status-design" research project, for which we collected data through quantitative surveys on transnational practices of people aged 55+. Furthermore, we conducted semistructured interviews with adults aged 64+ living or who have lived in Switzerland and spend part of the year in Spain. The second approach relates to the use of an inclusive sample diversified in terms of nationality and migration backgrounds. The inclusive design affects the formulation of questions asked to all participants (and the response options provided in the survey), as well as decisions related to language choices and translations. These elements have to be considered to ensure that older adults from different backgrounds feel included. In a research project on transnational mobility of older adults, conducting an inclusive plus mixed-methods research project pushes researchers to find strategies to balance research objectives with available resources. Maximizing the research team's methodological background appears to be a suitable approach to address different population groups while working within a budget. [ABSTRACT FROM AUTHOR]

Background and Objectives Personhood is considered the cornerstone of person-centered care for people with dementia. However, there is little research on personhood in dementia care from the perspective of the person with dementia themselves. This article presents a qualitative evidence synthesis of the experiences and perceptions of people with dementia on personhood in dementia care. Research Design and Methods A systematic search of nine databases was conducted. In addition to initial screening, CART analysis was used to determine the most relevant papers. Thematic synthesis was conducted on 20 papers. The CASP tool was used to examine the quality of the included papers. GRADE CERQual analysis examined confidence in the review findings. Results People with dementia experience many changes due to the disease and the experience of being cared for in different settings. Personhood is affirmed through personal interactions with family, friends, other care recipients, and formal caregivers, as well as through continued engagement in social and occupational roles. Discussion and Implications The review has important implications for practice, regulation, and policy. The person and their personhood should be protected rather than undermined, and relationships should be enhanced not diminished by the formal care process. The focus should be on creating and amplifying opportunities for people with dementia to affirm the self through interactions with others and engaging in occupational and social roles to ensure continuity of self. [ABSTRACT FROM AUTHOR]

For all health conditions, reliable age-disaggregated data are vital for both epidemiological analysis and monitoring the relative prioritization of different age groups in policy responses. This is especially essential in the case of Coronavirus Disease-2019 (COVID-19), given the strong association between age and case fatality. This paper assesses the availability and quality of age-based data on reported COVID-19 cases and deaths for low- and middle-income countries. It finds that the availability of reliable data which permit specific analyses of older people is largely absent. The paper explores the potential of excess mortality estimates as an alternative metric of the pandemic's effects on older populations. Notwithstanding some technical challenges, this may offer a better approach, especially in countries where cause of death data are unreliable. [ABSTRACT FROM AUTHOR]

This supplement describes the content, processes, and outcomes of the Research Priorities in Caregiving Summit convened by the Family Caregiving Institute (FCI) at the Betty Irene Moore School of Nursing at UC Davis in March 2018. As described in the editorial introduction and the supplement's four papers, the summit sought to integrate and cross-pollenate the already compendious work on family caregiving to describe ways forward in the field. Thought-provoking commissioned synthesizing papers on issues of heterogeneity and trajectories of caregiving and its cultural embeddedness and on the potential of technology to shape and enhance caregiving interventions set the stage for a highly disciplined, multistaged process that resulted in the drafting of a set of research themes and priorities that were later finalized by faculty at the FCI. [ABSTRACT FROM AUTHOR]

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities. [ABSTRACT FROM AUTHOR]

Background and Objectives Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health. Research Design and Methods We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis. Results We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented. Discussion and Implications Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies. [ABSTRACT FROM AUTHOR]

Background and Objectives This paper describes the development and evaluation of a short caregiving self-efficacy measure. The self-administered 8-item Caregiver Self-Efficacy Scale (CSES-8) was developed to reflect components of typical caregiver support interventions and to be practical for inclusion in future self-efficacy and caregiving research. Research Design and Methods We administered the CSES-8 in 2 samples: participants in an intervention for caregivers of persons with cognitive disabilities, and a voluntary online survey for caregivers of adults. We evaluated the completion rate, item-scale correlations, reliability, descriptive statistics, and preliminary construct validity of the CSES-8 in both samples, and sensitivity to change in the intervention sample. Results The intervention caregivers' sample (N = 158) was 85% female (mean age = 65 years). The online survey sample (N = 138) was 90% female (mean age = 78). In both samples, the CSES-8 had excellent internal consistency reliability (.89 and.88) and good distribution with sufficient variability to detect change. Test–retest reliability was good in the online sample (.73). As evidence of construct validity, most hypotheses were confirmed in both samples. The CSES-8 was sensitive to change at 6 months for caregivers in the intervention program (p <.001). Discussion and Implications The CSES-8 is short, comprehensive with respect to common components of interventions to improve caregivers' quality of life, and sensitive to change. It can serve a useful role exploring mechanisms by which caregiver intervention studies work, and it can be helpful in examining whether self-efficacy mediates the effect of these interventions on various outcomes such as psychological well-being. [ABSTRACT FROM AUTHOR]

Background and Objectives Grandparenting trends have been increasing due to rises in female employment, economic stressors, and single-parent families. Because the level of grandparental involvement could either result in beneficial or adverse physical and mental health outcomes, this review aims to use a social–ecological model to compare the childcare experiences of primary and nonprimary grandparent caregivers and the effects of childcare on their physical and emotional health. Research Design and Methods This is a systematic review. CINAHL, Embase, PsycINFO, PubMed, and Scopus were searched for qualitative papers. A thematic analysis was conducted, and data were framed using the social–ecological model. Results Seventy-four qualitative studies were included. Four themes were generated: intrapersonal: attitudes and motivations (obligation and sense of responsibility, limited physical health, and emotional resources), interpersonal: relationships with grandchildren and adult children (grandparental roles and gendered differences, forging bonds with grandchildren, role ambiguities, conflicts and drawing boundaries, and support and relationships with others), organizational: social services and educational needs, and policy: financial and legal issues. Grandparental well-being is likely to be dependent on the context of the childcare provided, relational bonds with adult children and grandchildren, and the availability of a community and institutional, legal, and financial support. Discussion and Implications The act of grandparenting is laden with cost and reward. To ensure a better quality of life in grandparents' later years, joint efforts between policymakers, educators, and organizations are required to meet their childcare support needs such that they can fulfill their grandparenting roles with ease. [ABSTRACT FROM AUTHOR]

Background and Objectives Many investigators of Alzheimer's disease and related dementias (AD/ADRD) are unfamiliar with the embedded pragmatic clinical trials (ePCTs) and the indispensable pilot phase preceding ePCTs. This paper provides a much-needed example for such a pilot phase and discusses implementation barriers and additional infrastructure and implementation strategies developed in preparation for a nationwide AD/ADRD ePCT. Research Design and Methods Two pilot trials were conducted in 2 hospices sequentially to refine and test Aliviado Dementia Care—Hospice Edition, a complex quality improvement intervention for advanced dementia symptom management. Readiness for the subsequent full-scale ePCT was assessed by three milestones: ≥80% training completion rate ("feasibility"), ≥80% posttraining survey respondents indicating intention for practice changes ("applicability"), and at least 1 Aliviado care plan/assessment instrument administered in ≥75% of dementia patients admitted to home hospice within 1-month posttraining ("fidelity"). Results Participants included 72 interdisciplinary team members and 11 patients with AD/ADRD across the pilots. Feasibility, applicability, and fidelity outcomes (92%, 93%, and 100%, respectively) all surpassed the preestablished milestones (80%, 80%, and 75%). Main implementation challenges were related to hospice staff turnover, integration of the Aliviado toolbox materials within the electronic health records, and hospices' limited research experience and infrastructure. Discussion and Implications This pilot phase demonstrated feasibility, applicability, and fidelity required to proceed to the full-scale ePCT. Our study findings and discussions of additional infrastructure and implementation strategies developed following the pilot phase can inform researchers and clinicians interested in conducting AD/ADRD-related pilot studies for ePTCs or quality improvement initiatives. Clinical Trials Registration Number NCT03681119 [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, and transgender (LGBT) older adults are at particular risk for receiving inequitable end-of-life care. Their health care wishes may be ignored or disregarded, their families of choice are less likely to be included in their decision making, and they may experience increased isolation, bullying, mistreatment, or abuse, which ultimately contribute to receipt of poor-quality health care. This is particularly important during sensitive transitions along the care continuum to end-of-life settings; 43% of respondents of a 2018 survey of 865 hospice professionals reported having directly observed discriminatory behavior toward LGBT patients. Lack of visibility and accountability perpetuates vulnerabilities and the potential for discriminatory treatment. Unfortunately, while other areas of health care have prioritized and normalized collecting sexual orientation and gender identity (SOGI) data, hospices do not routinely assess patients' SOGI in the context of end-of-life wishes and decisions. Drawing insight from a sample of 31 in-depth interviews with older LGBT adults, this paper focuses on one participant's story—Esther's. We chose her story to illustrate how care can be compromised at the end of life if an open discussion with patients about what and who matters most to them at the end of life, is avoided. [ABSTRACT FROM AUTHOR]

Life-span developmental psychology includes a broad array of principles that have wide application to studying adult development and aging. Three principles have guided my past, current, and future research: (a) development being a cumulative, lifelong process with no one period taking precedence; (b) multiple processes influence development (e.g. age-, pathology-, nonnormative, and mortality-related processes); and (c) development is multidirectional and multidimensional. This paper elaborates on how these principles have guided my research studying resilience to adversity across the adult life span and how my research aligns with guiding elements of resilience across definitions and literatures. I also discuss my current and future research of applying these principles to studying resilience in midlife, which emphasizes how the defining features of midlife lend themselves to examining resilience, midlife continues to not be well understood, midlife health foreshadows health in old age, and the experience of midlife will evolve in the context of an increasingly diverse society. The last section elaborates on additional directions for future research, such as the promise of intensive longitudinal research designs that incorporate qualitative approaches and examining historical changes in midlife health and well-being. In conclusion, a life-span developmental psychology framework has wide application for elucidating the nature of resilience across the adult life span through the integration of its principles with existing paradigms and research designs that blend contemporary methods with mixed methodology. [ABSTRACT FROM AUTHOR]

Information on transgender people's health, and especially their experiences of aging, is lacking, including from major longitudinal studies of aging like the Health and Retirement Study and its sister studies in the Gateway to Global Aging Data project. This paper surveys the state of gender data collection among major longitudinal studies and finds that all but one fail to collect adequate information on participants' gender to determine participants' gender identities. It identifies the unique challenges that population-wide longitudinal data collection poses to current best practices for identifying transgender survey participants and proposes a modified "two-question model": one question for sex assigned at birth and a second for gender identity, both of which offer 3 responses. [ABSTRACT FROM AUTHOR]

Background and Objectives Black, African, and Caribbean (BAC) families are disproportionately affected by dementia but engage less with services. Studies reporting their experiences of dementia have tended to aggregate people from diverse backgrounds, without considering the impact of this diversity, or researchers' ethnicities. We investigated participants' and researchers' ethnic identities, exploring how this relates to findings. Research Design and Methods We searched electronic databases in September 2018, for qualitative studies exploring how participants of Black ethnicity understand and experience dementia and dementia care. We reported participants' and researchers' ethnicities, and meta-synthesized qualitative findings regarding how ethnicity influences experiences and understanding of dementia. Results Twenty-eight papers reported 25 studies; in United States (n  = 17), United Kingdom (n  = 7), and Netherlands (n  = 1). 350/492 (71%) of participants were in U.S. studies and described as African American; participants in U.K. studies as Caribbean (n  = 45), African/Caribbean (n  = 44), African (n  = 28), Black British (n  = 7), or Indo-Caribbean (n  = 1); and in Netherlands as Surinamese Creole (n  = 17). 6/25 (24%) of studies reported involving recruiters/interviewers matching participants' ethnicity; and 14/25 (56%) involved an author/advisor from a BAC background during analysis/procedures. We identified four themes: Dementia does not relate to me; Inappropriate and disrespectful services; Kinship and responsibility; Importance of religion. Discussion and Implications Studies were mostly from a U.S. African American perspective, by researchers who were not of BAC background. Themes of dementia diagnosis and services feeling less relevant to participants than the majority population resonated across studies. We caution against the racialization of these findings, which can apply to many differing minority groups. [ABSTRACT FROM AUTHOR]

Background and Objectives There are increasing numbers of older academics working in Higher Education Institutions worldwide. It is essential that academics' retirement experiences are clearly understood as they tend to have different retirement trajectories than other occupational groups. This meta-ethnography aims to answer the research question "what are the experiences of academics transitioning to retirement" by identifying and synthesizing qualitative research using a meta-ethnographic approach. Research Design and Methods A systematic literature search was conducted from January 2000 to September 2016 to identify qualitative studies focusing on academics' experiences of retirement. Two reviewers independently assessed the methodological quality of included papers. Concepts from each study were translated into each other to form theories, which were then combined through a "line-of-argument" synthesis. Results Twenty papers were included. Five themes were identified: (a) continuing to work in retirement, (b) the impact of the retirement transition on the academics' identity, (c) changing relationships through the retirement transition, (d) experiencing aging processes, and (e) planning for retirement. For most, retirement is characterized by continuing to work in aspects of their role, maintaining associated relationships, with gradual disengagement from academic activities. For another smaller group, the retirement pathway is experienced as an event, with complete detachment from academic activities. Discussion and Implications The review highlights that academics transitioning to retirement experience varying retirement pathways. Awareness of the benefits of comprehensive retirement planning programs could enable academics to choose a retirement pathway that facilitates a smooth transition to retirement. [ABSTRACT FROM AUTHOR]

Background and Objectives This paper critically reviewed the scientific literature on recreational activity (RA) behaviors in assisted living (AL) communities. Research Design and Methods A search of three databases yielded 70 quantitative, qualitative, and observational articles that met criteria for inclusion. Results AL residents participated in various types of RA, however, did so infrequently. Individual, interindividual, environmental, and relocation factors influenced RA behaviors, and participation may relate to positive consequences for residents and AL communities. This review identified multiple limitations in the literature related to construct definitions, measurement protocols, and incomplete or absent theoretical frameworks. Discussion and Implications To address these limitations, the current review proposes a multivariate measurement model and an interdisciplinary theoretical model of factors relating to RA, consistent with an ecological framework. The proposed models appreciate individual psychological factors that influence the multiple facets of human choice and behavior, as well as the interaction between individuals and the unique sociophysical environment of AL. This paper concludes with recommendations for future research, emphasizing studies that have applied implications for practice and policy. [ABSTRACT FROM AUTHOR]

Purpose of the Study This mixed-methods study explored the feasibility and acceptability of using a tablet-based research consent process with adults aged ≥65 years. Design and Methods In the first phase, focus group participants reported on their perceptions of a tablet-based consent process. In the second phase, older adults were randomized to view either a tablet-based or paper-based consent for a mock clinical trial. Measurements included: time to complete, adverse/unexpected events, user-friendliness, immediate comprehension, and retention at a 1-week delay. Results Focus group participants (N = 15) expressed interest in the novel format, cautioning that peers would need comprehensive orientation to use the technology. In the randomized pilot (N = 20), retention was 100% and all participants completed the protocol without the occurrence of adverse/unexpected events. Although the participants took longer to complete the tablet-based consent than the paper-based version, user-friendliness, immediate comprehension, and retention of the tablet-based consent were similar to the paper-based consent. Discussion and Implications The findings suggest that a tablet-based consent process is feasible to implement with older adults and acceptable to this population, but we would underscore that efforts to optimize design of tablet-based consent forms for older adults are warranted. [ABSTRACT FROM AUTHOR]

Background and Objectives Licensed nursing home administrators (NHA) and directors of nursing (DON) are responsible for nursing home quality and assuring optimal performance and job satisfaction/retention of their nursing home workforce. NHA/DON-focused studies have generated important foundational knowledge over the last three decades; yet, targeted research is needed to understand and apply the complexities of the black box of this top management team. This scoping review identifies, reviews, synthesizes, and maps the topical areas of research in NHA/DON positions in U.S. nursing homes. Research Design and Methods We conducted searches of 5 databases, yielding 3,479 records; screening/review yielded 88 unique records. We used thematic analysis to code the primary foci of the studies and the variables associated with the concepts of interest. Results Most papers (n = 40) focused on role characteristics, 23 examined approaches to management and leadership, 24 focused on perceptions about the role, and the remaining 12 examined role structure. The role-related themes linked to outcomes (n = 42), processes (n = 27), and structures (n = 30). Discussion and Implications We highlight important gaps for future research and offer a call to action for research, policy, practice, and education collaborations to accelerate the rate of research and translate the findings into best practices for NHA/DON to lead and manage the nursing home workforce and build capacity to ensure person-centered, high-quality care. Based on foundational descriptive studies, it is time to use what is known to design and implement interventions that enhance the capacity of NHA/DON to improve the structures, processes, and outcomes of nursing homes. [ABSTRACT FROM AUTHOR]

The article presents the topics of the COVID-19-related research papers that were published in the journal "The Gerontologist" in 2021. These include older adults' experiences with COVID-19, the impact of the pandemic on elderly inmates, and the case of compassionate ageism. Also provided are the Gerontological Society of America's recommendations for research on COVID-19 topics including vaccine development and healthcare practices such as telehealth.

Background and Objectives Older adults' self-perceptions of aging and being older can influence well-being and quality of life. This systematic scoping review aimed to map out current research on older adults' self-perceptions of aging and being older. Research Design and Methods The scoping review followed Arksey and O'Malley's methodological framework. A total of 5,037 records were identified (duplicates removed). After screening, a final 148 papers were included. Descriptives, including year of publication, methodology, age, gender, and location of participants, were calculated. Thematic analyses were conducted examining ways in which the topic was conceptualized. Results The most frequent method used in the research was quantitative. Participants were from 38 different countries. There were more female participants than male. Seven themes representing the main research emphasis emerged: attitudes towards one's own aging (n = 48), aging well (n = 23), aging stereotypes, self-stigma (n = 23), construction of aging identities (n = 22), subjective age (n = 18), the aging body (n = 8), and future self-views (n = 6). Discussion and Implications The research within these themes approach self-perceptions of aging using varying points of reference for what participants compare their age to. The methods used to illicit aging perspectives held their own assumptions about aging. [ABSTRACT FROM AUTHOR]

Background and Objectives Cognitive training therapies may delay cognitive deterioration in dementia. There is potential to enhance delivery through immersive virtual reality (IVR), as removing potential distractors for cognitively impaired individuals can enhance their experience, resulting in increased engagement. Evidence in this field is emerging and not yet synthesized. We aimed to summarize research investigating the use of IVR in dementia to evaluate the current extent of use, acceptability, feasibility, and potential effectiveness. We also aimed to identify gaps in current research and to create a set of recommendations in utilizing this therapy. Research Design and Methods A systematic literature review was conducted. Our review was registered with PROSPERO, registration number: CRD42019122295. We undertook searches of five databases, article references, and citations. Key authors in the field of health care VR were also contacted to identify additional papers. Articles were assessed for inclusion by two researchers independently. Data were extracted using standardized forms. Results Our search identified a total of 2,824 citations, following screening for duplicates and application of inclusion and exclusion criteria, five studies were included for analysis. Included studies were heterogeneous, with small sample sizes and mixed outcomes. Discussion and Implications We were unable to reach definitive conclusions over the use, acceptability, and effectiveness of IVR for dementia and mild cognitive impairment. Future studies should focus on ensuring their interventions are truly immersive, developing more robust controls and account for the rapid rate of obsolescence in digital technologies. [ABSTRACT FROM AUTHOR]

Background and Objectives Arts activities can improve social connectedness and foster reciprocity between people living with dementia and their caregivers. The extent to which the arts can help shape attitudes towards dementia remains unclear. This paper explores the impact of a 12-week visual arts program "Dementia and Imagination" on the attitudes of family and professional caregivers through a mixed-methods longitudinal investigation, underpinned by a conceptual framework of the arts in dementia care. Research Design and Methods One hundred and forty-six family and professional caregivers were recruited across three settings in England and Wales (residential care homes, a county hospital, and community venues). Quantitative and qualitative data on caregivers' attitudes and perceptions of the impact of the arts program were collected through interviews at three time points. Results Thematic analysis identified four themes shared across the caregivers: (1) Recognizing capabilities , (2) Social connectedness , (3) Improvements to well-being , and (4) Equality and personhood. Two further themes were distinct to family caregivers: (5) Duration of the effects of the art program , and (6) Enriched perspective. The final theme Inspiring professional development was distinct to the professional caregivers. The quantitative analysis found no effect for caregivers' attitude change over time. Family caregivers scored significantly lower than professional caregivers at each of the three time points. Discussion and Implications Art programs have the potential to make visible the capabilities of the people living with dementia, enabling caregivers to see the person behind the condition. This study highlights practice implications for future implementation, such as the role of the arts in dementia care education. [ABSTRACT FROM AUTHOR]

Background and Objectives Assisted living (AL) is a growing sector of the U.S. long-term care market, with its development driven largely by private market choices. However, consumers need information to choose the right AL community (ALC). This paper examined information available on U.S. state websites concerning ALC quality, costs, and services. Research Design and Methods Based on prior research and their analysis of a sample of state websites, researchers identified 39 key informational elements and grouped them into four categories, (a) ALC characteristics, (b) payment and services, (c) quality, and (d) website usability. Researchers then examined the presence of the 39 elements on 51 websites (U.S. states and the District of Columbia), meeting regularly to discuss findings and resolve differences. Results A majority of states provided basic information about individual ALCs (e.g. number of beds, ownership). Only 35% listed payment(s) accepted (e.g. Medicaid), and 31% indicated the availability of memory care. Nearly 70% posted inspection results, while only 43% provided information about complaints. Many met basic usability guidelines (e.g. type size), but locating content on many sites required multiple steps, and none met 5th-grade-or-below readability standards. Discussion and Implications A majority of websites provided important information, such as inspection results. However, many were lacking key elements concerning payment accepted and services. Finding what was available was burdensome. More work is needed to help states provide information that enables consumers to find ALCs that meet their needs. The lack of such information puts older adults at risk of inappropriate placements. [ABSTRACT FROM AUTHOR]

Background and Objectives Decisions about long-term care and financing can be difficult to comprehend, consider, and communicate. In a previous needs assessment, families in rural areas requested a patient-facing website; however, questions arose about the acceptability of an online tool for older adults. This study engaged older adults and family caregivers in (a) designing and refining an interactive, tailored decision aid website, and (b) field testing its utility, feasibility, and acceptability. Research Design and Methods Based on formative work, the research team engaged families in designing and iteratively revising paper drafts, then programmed a tailored website. The field test used the ThinkAloud approach and pre-/postquestionnaires to assess participants' knowledge, decisional conflict, usage, and acceptability ratings. Results Forty-five older adults, family members, and stakeholders codesigned and tested the decision aid, yielding four decision-making steps: Get the Facts , What Matters Most, Consider Your Resources, and Make an Action Plan. User-based design and iterative storyboarding enhanced the content, personal decision-making activities, and user-generated resources. Field-testing participants scored 83.3% correct on knowledge items and reported moderate/low decisional conflict. All (100%) were able to use the website, spent an average of 26.3 min, and provided an average 87.5% acceptability rating. Discussion and Implications A decision aid website can educate and support older adults and their family members in beginning a long-term care plan. Codesign and in-depth interviews improved usability, and lessons learned may guide the development of other aging decision aid websites. [ABSTRACT FROM AUTHOR]

Background and Objectives Transnationalism, defined as migrants having ties to the country of origin and the destination country, is mostly explored with qualitative data. Quantitative studies only use a small number of indicators. This is one of only a few studies to examine transnationalism based on multiple indicators and elaborate classes of transnationalism. The research questions are: What are the forms of transnationalism in which older migrants engage? And how do age, gender, income, and country of origin affect these forms? Research Design and Methods The paper used the Vivre/Leben/Vivere (2011/2012) subsample of migrants in Switzerland, aged 65–82 years. Transnationalism was measured using 11 indicators, including nationality, having family abroad, and sending remittances. Latent class analysis was used to distinguish between several forms of transnationalism. Latent class regression models subsequently explore the effect of age, gender, income and country of origin on these transnationalism forms. Results Four different forms of transnationalism were found among older migrants: least transnational , distant transnational , active transnational , and returning transnational. The models suggest that country of origin and income are important predictors, while age is less important and gender has no effect on falling in these transnationalism classes. Discussion and Implications The results confirm that our measure of transnationalism is an innovative approach toward exploring the different forms older migrants engage in. The method has several advantages over usual methods and can be used in future studies to analyze, for example, how different forms of transnationalism emerge as a consequence of policies relevant for older migrants, like care arrangements and pensions. [ABSTRACT FROM AUTHOR]