Journal of Applied Gerontology最新文献

Family care partners (FCP) of persons living with dementia provide extensive care and experience significant stress. Hospice nurses and social workers seldom receive training to help FCP. This article describes the development and pilot testing of Enhancing Dementia Instruction and Tool in Home Hospice Care (EDITH-HC). This intervention provides 1) instructional videos for clinicians about dementia-specific end-of-life care and 2) a worksheet for clinicians and FCP to complete together to identify and address FCP stressors and concerns. EDITH-HC development involved co-developing and revising draft intervention materials based on two rounds of structured input from FCP (n = 10), hospice nurses and social workers (n = 5), and research/content experts (n = 4); and a single-arm pilot test of the intervention to assess initial feasibility and acceptability (n = 13). Initial pilot testing indicates the intervention is feasible and acceptable. A larger randomized pilot study to determine feasibility and acceptability is underway.

Informal caregiving plays a critical role in affecting older adults' quality of life. Utilizing organized and effective formal support helps mitigate caregiver burdens and meet caregiving demands. This study examined the correlates of formal service use and help-seeking in a nationally representative sample of caregivers of older adults, drawing on data from 2017 National Study of Caregiving. Multiple linear regression analyses were conducted to investigate potential correlates, including predisposing (e.g., age), enabling (e.g., education), and need (e.g., care recipient's dementia status) factors. Results showed that racial minorities, better education, caring for older adults with dementia, and more ADL and IADL limitations were associated with greater service use. Caregiver role overload was positively associated with both service use and help-seeking. Findings address the knowledge gap by identifying the risk and protective factors for both service use and help-seeking, which can help practitioners identify the at-risk caregivers and direct tailored services accordingly.

Declines in older adults' cognitive and physical health pose challenges to maintaining their independence. Robots can improve independent living and facilitate aging-in-place. Despite recent innovations in healthcare robotics, the use of robots has not advanced significantly among older adults. This review seeks to understand human-robot interactions in older adults, focusing on their experiences and perceptions of robots for independent living. We identified 17 studies that utilized qualitative methods to investigate older adults and/or their caregivers' experiences and perceptions of robots designed to help older adults improve independent living. Drawing on content analysis, we identified eight themes: usefulness, ease of use, safety, reliability, self-efficacy, satisfaction, emotional connection with the robot and reciprocity, and intention to use. The findings provide insights to improve existing robots and guide future research about designing robots with higher acceptance. This review may have implications for policymakers, practitioners, and researchers working with robotics to support healthy aging-in-place.

Older adults benefit from a multidisciplinary approach to perioperative care, with reductions in length of stay and postoperative readmission. To explore perioperative communication, we conducted in-depth, semi-structured interviews with anesthesia, surgery, and primary care providers caring for older patients in northern New England. Communication barriers included cumbersome health information exchange with system fragmentation across and within electronic health records resulting in clinician and administrative burden and unnecessary duplication of services. Clinicians expressed the value of preoperative communication across specialties but described a lack of timely communication with colleagues caring for shared patients and uncertainty about specialty roles and responsibilities. Preferences and use patterns of communication modalities varied across specialties, but the need for direct, secure communication linked to the patient chart was consistent. Clinicians emphasized the importance of communication for efficiency and patient safety and suggested strengthening perioperative care pathways through improvements in technological and organizational infrastructure and interprofessional relationships.

The prevalence of serious mental illness (SMI) and substance use disorders (SUD) among residents in skilled nursing homes is increasing yet staff are generally not equipped to care for these residents. There is a pressing need to identify and assess practices, including training, intervention, screening, and service integration, that can support nursing home staff to better support residents with SMI and SUD. This narrative literature review examines the literature to identify what is known about this population as well as the current state of care, barriers to better care, and promising practices to support improved outcomes. Using the evidence from the peer-reviewed literature, the authors make recommendations to advance research and practice for this growing population of residents. Strategies to integrate behavioral health services into the nursing home and provide more holistic programmatic social support, behavioral health, and community integration strategies in nursing homes appear to be promising practices.

The workforce is not prepared to meet the needs of the number of older adults (OAs) across the globe. The study examines the Theory of Planned Behavior via the Working with Older Adults Scale (WOAS) in a group of university-aged international students to better understand global perceptions of working with older adults. We also compared North American and International students' attitudes, perceived behavioral control, and intention to work with older adults. Students were enrolled at a public university in Canada. Participants completed the WOAS, Ageism Attitude Scale, and answered an open-ended question, "How are older adults viewed in your culture?" Attitude, Subjective Norm, and Perceived Behavioral Control predicted Intention to work with older adults for the full sample, and subgroups. While there were many similarities, North Americans had lower intention to work with older adults and higher ageism than International students. Further research is necessary to understand these cultural nuances.

This study cross-sectionally examined associations between older adults' aging attitudes and subjective cognitive decline as well as moderating effects of current positive affect and depressive symptoms. Data were collected via an online survey among U.S. adults 65+ (N = 339, 55.5% female, M_age = 71.7, SD ± 4.78) with no self-reported diagnosis of dementia. SCD was measured with the Everyday Cognition scale; attitudes to physical change, psychological growth, and psychosocial loss in aging were measured with the Attitudes to Aging Questionnaire. A Poisson regression analysis showed that overall aging attitudes, attitudes to physical change, and psychosocial loss were associated with SCD, but attitudes to psychosocial growth were not. More positive attitudes to physical change were associated with lower SCD; more negative attitudes to psychosocial loss were associated with higher SCD. The association between more positive attitudes to physical change in aging and lower SCD was accentuated with lower current positive mood and higher current depressive symptoms.

Background: Attrition is a significant methodological concern in longitudinal studies. Sample loss can limit generalizability and compromise internal validity. Methods: Wave one (n = 346) and wave two follow-ups (n = 196) of the 1Florida ADRC clinical core were examined using a 24-month visit window. Results: The sample (59% Hispanic) demonstrated retention rates of 77.2% and 86.2% in waves one and two, respectively. Predictors of lower retention in wave one included older age, amnestic MCI or dementia, and lower cognition and function scores. Completing a baseline MRI and lack of hippocampal atrophy were associated with higher retention in both waves. In wave two, a greater neighborhood disadvantage score was associated with attrition. Discussion: Predictors of retention changed over time, possibly due to the early withdrawal of the most vulnerable in the initial wave. Understanding predictors of retention can facilitate retention strategies, reduce attrition, and increase the validity of findings.

Social isolation is disproportionately experienced by homebound older adults, including those who receive home-delivered meals. We used a three-phase, human-centered design approach to create and evaluate training resources focused on social isolation for meal-delivery drivers. We hypothesized that these training resources would increase meal-delivery drivers' behavioral intentions to have meaningful interactions with their clients. Working with subject matter experts and meal-delivery drivers, our team developed and produced a training video and website and evaluated the resources with a sample of meal-delivery drivers in Rhode Island, Texas, and Mississippi via an online survey. Respondents (n = 94) were 64% female, 65% age 55+, and 79% white. Respondents reported improved (p < .001) agreement with the main outcome, "I intend to regularly have meaningful social conversations with the clients I see." Through these scalable training resources, drivers may increase their intention to have meaningful conversations with older adults at risk for social isolation.

Quality of life (QOL) for older adults in Puerto Rico was significantly impacted during the COVID-19 pandemic, yet there has been little attention to this topic. This study examines the association between COVID-19-related attitudes and QOL and the mediating role of the psychological sense of community (PSOC) in this context. Data are from a COVID-19 knowledge, attitudes, and practices survey with a nonprobability sample of 213 Puerto Rican adults aged 60+ in 2021. We conducted a mediated linear regression model using Hayes's PROCESS macro. Results showed that both COVID-19 attitudes and PSOC positively related to QOL. Additionally, COVID-19 attitudes also had a positive effect on PSOC and an indirect, positive effect on QOL through PSOC. These findings suggest that enhancing older adults' positive attitudes and strengthening community connections should be central to public health strategies, especially in community-oriented cultures like Puerto Rico.