Social and Behavioral Sciences Commons^™

Extreme Heat Vulnerability Among Older Adults: A Multi-Level Risk Index For Portland, Oregon, Jacklyn N. Kohon, Katsuya Tanaka, Dani Himes, Paula Carder, Eiji Toda, Bryant Carlson

Institute on Aging Publications

Background and Objectives

Extreme heat is an environmental health equity concern disproportionately impacting low-income older adults and people of color. Exposure factors, such as living in rental housing and lack of air conditioning, and sensitivity factors, such as chronic disease and social isolation, increase mortality risk among older adults. Older persons face multiple barriers to adaptive heat mitigation, particularly for those living in historically temperate climates. This study measures two heat vulnerability indices to identify areas and individuals most vulnerable to extreme heat and discusses opportunities to mitigate vulnerability among older adults.

Research Design and Methods

We constructed two heat …

Paperwork, Paradox, And Prn: Psychotropic Medication Deficiencies In Assisted Living, Sarah Dys, Paula Carder

Institute on Aging Publications

Individual state approaches to assisted living/residential care (AL/RC) licensing and oversight in the United States result in different practice standards and requirements, including psychotropic medication use. We examined 170 psychotropic medication deficiency citations issued to 152 Oregon AL/RC settings from 2015 to 2019. Applied thematic analysis resulted in the following themes: (1) documentation issues are primarily responsible for noncompliance, (2) unclear parameters place direct care workers in a role paradox, and (3) there is a persistent disconnect about when to seek qualified expertise before requesting psychotropic medications. AL/RC-specific mechanisms for medication prescription and administration are necessary to improve the structure …

Climate Change Policies And Older Adults: An Analysis Of States’ Climate Adaptation Plans, Bryant Carlson, Jacklyn N. Kohon, Paula Carder, Dani Himes, Eiji Toda, Katsuya Tanaka

Institute on Aging Publications

Background and Objectives

As climate change drives more frequent and intense weather events, older adults face disproportionate impacts, including having the highest mortality rates from storms, wildfires, flooding, and heat waves. State governments are critical in deploying local resources to help address climate change impacts. This policy study analyzes states’ climate adaptation plans to assess the methods through which they address the impact of climate change on older adults.

Research Design and Methods

This study uses content analysis to analyze available climate change adaptation plans for all U.S. states for strategies designed to increase resilience of older adults to impacts …

Wage And Cost Study Of Oregon Assisted Living And Residential Care Providers, 2022, Ozcan Tunalilar, Sarah Dys, Paula Carder, Diana Jacoby

Institute on Aging Publications

Senate Bill 703 directed Oregon Department of Human Services (ODHS) to conduct a study of licensed residential care (RCF) and assisted living (ALF) facilities, including those with a memory care (MC) endorsement, to evaluate: a) Total cost to provide care to residents, b) the sufficiency of the Medicaid reimbursement paid to facilities to meet the total cost of care, and c) the average compensation paid to direct care workers by the facilities by geographic region. ODHS contracted with the Institute on Aging (IOA) at Portland State University (PSU) to conduct a study to achieve these three objectives. In the fall …

Direct Care Staff Experiences In Oregon Assisted Living, Residential Care And Memory Care Communities, 2022, Paula Carder, Sarah Dys, Lindsay Schwartz, Diana Jacoby, Jacklyn N. Kohon, Dani Himes, Madeleine Fox, Sheryl Elliott, Lauren Bouchard, Portland State University Institute On Aging

Institute on Aging Publications

Resident care assistants (e.g., direct care workers, caregivers, personal care aides) provide the majority of services to assisted living, residential care and memory care-endorsed (ALF/RCF) residents. They faced significant burdens during the COVID-19 pandemic, which amplified existing challenges in some ALF/RCF communities, yet little is known about their work experiences. This qualitative study collected data through focus group and individual interviews with 21 resident care assistants and 12 external colleagues who have experience hiring, training or managing resident care assistants and other ALF/RCF staff, including registered nurse consultants, staffing agency operators, state policy staff, ALF/RCF community operations managers, and advocates. …