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Alzheimer's disease or a related dementia (ADRD) disproportionately affects women with two-thirds of individuals with ADRD comprised of women. This study examined gender-related differences in the quality of staff-patient interactions and depressive symptoms among hospitalized older patients living with dementia. This secondary analysis utilized baseline data of 140 hospitalized older patients with dementia who participated in the final cohort of a randomized controlled trial (ClinicalTrials.gov identifier: NCT03046121) implementing Family centered Function-focused Care (Fam-FFC). On average, the participants (male = 46.1%, female = 52.9%) were 81.43 years old (

Emotional expressions in late-stage dementia have traditionally been studied within a deficit paradigm. Moving the narrative of the dementia trajectory from a solely negative pathological experience to one that acknowledges the potential for positive experiences aligns with international recommendations for living well with dementia. The purpose of this study was to extend prior research by examining the pattern of well-being using affect balance, the ratio of positive to negative affect, in nursing home residents living with dementia over 12 months and its association to factors that could potentially influence resident well-being. This study was a secondary analysis of baseline, 4 and 12-month data from a pragmatic clinical trial. A total of 536 residents with moderate to severe cognitive impairments from 55 nursing homes were included in the analyses. Results of the multivariable linear mixed model regression analysis indicated that resident function, the number of registered nurse hours devoted to care in the facility, and the quality of staff interaction predicted higher affect balance over time after controlling for other variables. The findings provide support for the utility of affect balance as a meaningful outcome measure of well-being for persons living with dementia. In addition, results point to specific interventions (i.e., maintaining/improving resident function, providing adequate nurse staffing levels, and improving staff communications skills) that can serve as the focus for both research and practice to help residents live well with dementia. Clinicaltrials.gov (NCT03014570).

The assisted living (AL) environment plays an important role in supporting residents’ satisfaction and helping them to age in place. The AL environment is multidimensional and has many interrelated components including staffing (e.g. direct care workers, nursing, activity staff), services provided (e.g. medical, mental health, pharmacy), amenities offered at the setting (e.g. beauty salon, library, exercise facilities), and the physical environment. Evidence suggests that aspects of the AL environment can enhance or detract from the physical function, well-being, social engagement, and behavioral outcomes among residents. The purpose of this study was to develop and test a multidimensional AL environment measurement model that includes indicators of staffing, services, amenities, and the physical environment. Baseline data was used from a study testing the Dissemination and Implementation of Function Focused Care in AL. A total of 54 AL facilities across three states were included in the sample. Settings ranged in size from 31 to 164 beds with an average size of 82.2 (SD=26.2) beds and the majority were for profit facilities (n=41, 74.5%). Structural equation modeling was used to test the proposed model. Results showed that the model fit the data (χ(2)/df=1.861, p

The purpose of this study was to test the reliability and validity of the Assessment of the Environment for Person-Centered Management of BPSD and the Assessment of Policies for Person-Centered Management of BPSD. The sample included 35 long term care facilities. There was evidence of reliability based on internal consistency and test-retest reliability of both measures. There was some evidence of validity based on Rasch model testing and INFIT and OUTFIT statistics. Across both measures there were six items with that were endorsed as present by all facilities. The INFIT and OUTFIT statistics were all within the expected range of .5 to 1.5 with the exception of four high OUTFIT statistics for the Assessment of the Environment for Person-Centered Management of BPSD. For the Assessment of Policies for Person-Centered Management of BPSD there were two items that had high INFIT statistics and six with low OUTFIT statistics and one with high OUTFIT statistics. Measure revisions are suggested including removal of some poor fitting items, items with no variance, and adding items to differentiate those very high in evidence of environments and policies that manage BPSD.

In 2016, the Gerontological Society of America (GSA) developed a research focus on the benefits and potential risks associated with pets among older adults. With the goal of developing a roadmap fo...

This study examined whether residents' level of resilience mediated the relationship between social support for exercise from staff and resident satisfaction in assisted living. This was a secondar...

This descriptive study examined the relationship between volunteer activities, depressive symptoms, and feelings of usefulness among older adults using path analysis. Survey data was collected via interview from residents of a continuing care retirement community. Neither feelings of usefulness nor volunteering were directly associated with depressive symptoms. Volunteering was directly associated with feelings of usefulness and indirectly associated with depressive symptoms through total physical activity. Age, fear of falling, pain, physical activity, and physical resilience explained 31% of the variance in depressive symptoms. Engaging in volunteer work may be beneficial for increasing feelings of usefulness and indirectly improving depressive symptoms among older adults.

The purpose of this survey was to explore volunteer preferences, perceived benefits and barriers, and the factors that influence volunteering among older adults living in a continuing care retirement community. This was a single group, one-time survey completed via a face-to-face interview. The sample included 127 older adults who were eligible and completed the survey. The majority were women (78%) and White (98%), with an average age of 88.0 (SD = 6.5) years. Engagement in volunteer activities ranged from 0 to 7, with a mean of .94 (SD = 1.30). Just under half (47%) of the participants were engaged in volunteer work, with the majority (87%) volunteering within the facility. Perceived benefits and barriers to volunteering were described. Chronic illness, age, time spent exercising, and resilience accounted for 25% of the variance in volunteer activity. Those who had fewer chronic illnesses, were younger, spent more time exercising, and were more resilient were more likely to volunteer. Findings from this...

Little is known about the health status of adults living in continuing care retirement communities (CCRC). Using matched-case control, 458 adults from the Health and Retirement Study (HRS) or a CCRC-based sample were compared on total comorbidity, self-rated health, home health services use, and hospitalizations. At year 2, the CCRC sample reported more comorbidities (96%) but significantly better self-rated health (96% good/excellent) than the HRS sample (93% comorbidity, 73% good/excellent; p < .01). There were no significant differences in frequency of home health use or hospitalization. Living in a CCRC appears to be associated with higher self-ratings of health in this sample.

Context: This was a qualitative study with focus groups that included researchers and health care providers with expertise in exercise and physical activities with adults. Objective: The purpose of this study was to explore professional perspectives on current practices and beliefs about screening of older adults prior to having them initiate a structured or independent physical activity program appropriate for their physical ability and interests. Design and setting: This qualitative study included five different focus groups held at four national professional meetings based on a standard interview guide. Participants: Forty-two practitioners and researchers participated in these focus groups. These individuals were selected for participation based on their expertise in aging, primary care, exercise science, or behavioral science. Results: The focus groups revealed professional perspectives articulating advantages and disadvantages of pre-exercise screening. Four major themes were identified: (1) rationa...

The purpose of this study was to consider the use of the Resident Profile as an evaluation tool for older adults considering a move to a CCRC setting. A total of 7,635 Resident Profiles were completed at 10 facilities. The average age of the participants was 81.8 ±.0, and over half were female (64%). There was a statistically significant difference in scores for each domain (function, physical parameters, cognition, social support, and mental health) of the Resident Profile, as well as the total score, between those who were recommended for independent living, assisted living or a skilled level of care. All domains of the Resident Profile together explained 15.5% of the level of care recommended. This tool can be used to help clinicians determine the level of care that is likely to be appropriate for the individual being evaluated. Future research should consider the relationship between the individuals score on the Resident Profile and successful living in the facility over time. In addition, fu...

The purpose of this study was to explore the use of alcohol in community-dwelling older adults and to consider differences in physical and mental health, function, cognitive status, and social supports between those who drink minimal (1 to 3 glasses weekly), moderate (4 to 7 glasses weekly), or no alcohol. A total of 3305 older adults with a mean age of 81.6 -/+ 6.0 participated in the study. Twenty-two percent (n = 709) of the participants had 1 to 3 drinks weekly, only 1% (n = 18) reported 4 to 7 drinks weekly, and none of the participants admitted to 8 or more drinks. There was no difference in drinking behavior with regard to age (F = 1.1, p.05) or social supports (F =.39, p.05). There was a difference in drinking behavior with regard to physical health (F = 4.9, p.05), functional status (F = 7.7, p.05), cognitive status (F = 11.8, p.05), and mental health (F = 6.9, p.05). Health care providers should use an individualized approach to alcohol use in older adults and help these individuals establish, as appropriate, safe drinking habits that will augment health and quality of life.

There is strong experimental evidence to indicate that regular exercise can prevent disease, decrease the risk of falling, reduce physical disability, improve sleep, and enhance mood and general well being. Despite these benefits, approximately 50% of sedentary adults who start an exercise program stop within the first six months of involvement. To help older adults initiate and adhere to a regular exercise program, a seven step approach was developed. The seven steps include. (1) education, (2) exercise prescreening, (3) setting goals, (4) exposure to exercise, (5) role models, (6) verbal encouragement, and (7) verbal reinforcement and rewards. The seven steps provide a useful guide for how to implement an appropriate exercise program, and how to help these individuals stick to such a program once it is initiated.