Digital Commons Network^™

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Gerontology Institute Publications

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

The Health Care Safety Net In South Carolina: A Test Of Tenacity, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit to the state of South Carolina provided an opportunity to experience and understand the unique makeup of the health care safety net in a southern state. Site visitors had the opportunity to interact with health care providers, state officials, faith-based organizations and leaders of provider-driven volunteer initiatives. They also learned about the challenges of access to care in rural areas and among diverse population groups. The group visited the Sea Island Medical Center and Our Lady of Mercy Community Outreach and Wellness House; a migrant farm worker camp on Johns Island; and a “medical home” site, Medical …

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Gerontology Institute Publications

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …

Consumer Perspectives On Quality In Adult Day Care, Amy Leventhal Stern, Francis G. Caro

Gerontology Institute Publications

Purpose: The purpose of this project was to gain insight into the quality of care and services provided through adult day care from the user’s perspective. Design and Methods: The project utilized 13 focus groups to explore aspects associated with user needs, preferences, and satisfaction with adult day care centers. Results: Focus group participants described aspects of adult day care that are important in delivering quality care, program features that are effective, and key areas in need of improvement. Ensuring the safety of clients; having caring, friendly, and compassionate staff available to provide one-on-one attention; engaging clients in stimulating activities; …

An Interdisciplinary Learning Experience Through Applied Clinical Practice With Community Volunteers, Dana Howell, Nancy Devine, Lisa Portsman

Occupational Science and Occupational Therapy Faculty and Staff Research

Allied health professionals typically begin working on an interdisciplinary health care team immediately upon entering the workforce. Interdisciplinary health care teams are believed to be cost-effective, to result in better patient outcomes, and to lower staff burnout and turnover. Although teamwork often is standard practice in the workplace, allied health students may receive little to no formal training in working with other professionals while in school. Instead, it may be assumed that this knowledge is inherent or that developing the skills necessary to work as part of a team while on clinical affiliation or postgraduation is acceptable.

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …

Population Aging And The Rising Cost Of Public Pensions, John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Trends And Transitions In Children's Coresidence With Older Adults In Beijing Municipality, Zachary Zimmer, Xianghua Fang, Toshiko Kaneda, Zhe Tang, Julia Kwong

Poverty, Gender, and Youth

The reduction in family size in China and concurrent social and economic change are raising concerns that traditional sources of support may be eroding. This Population Council working paper paper examines a) whether rates of coresidence between older adults and their adult children in the Beijing municipality of China have been declining, and b) the determinants of coresidence and coresidence transitions. Results suggest that family support structures for the elderly, when they are facilitated through coresidence, remain basically intact, particularly for those who require the greatest amount of support. Further assessment is required to elucidate the effects of availability, need, …

Population Aging And The Rising Cost Of Public Pensions [Arabic], John Bongaarts

Poverty, Gender, and Youth

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful …

Barriers To Communication In Healthcare: Perceptions Of The Rural Elderly, Nicole Arachikavitz

Masters Theses & Specialist Projects

There is presently a lack of research on the types of communication barriers faced by the rural elderly when accessing health care. Furthermore, much of the research on the rural elderly is old and outdated. Thus, this thesis research sought to identify and explore communication barriers faced by the rural elderly when accessing healthcare. Specifically, the research in this thesis seeks to answer the following research questions: What types of communication barriers do rural elderly face when seeking health care? More specifically, what sorts of patient-provider communication barriers will the rural elderly of South Central Kentucky identify? An interview guide …

Commencement Program 2003, Loma Linda University

Commencement Programs

CONTENTS

2 | 2003 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Speakers

12 | The University Honorees

21 | The School Honorees

29 | The Programs

• School of Medicine, 30
• School of Dentistry, 37
• Graduate School, 45
• School of Nursing, 55
• School of Allied Health Professions - Physical Therapy, 60
• School of Allied Health Professions, 68
• School of Public Health, 77

Long-Term Care: Informed By Research, Francis G. Caro

Gerontology Institute Publications

Health services research has contributed to health policy and service developments that have led to major improvements in the quality of long-term care in the United States. This policy brief highlights a few areas in which publicly and privately funded research has informed the long-term care field.

Nevada "Nurselessness": An Acute Or Chronic Condition? An Examination Of The Etiology And Possible Treatment Alternatives, Jeanine Warren-Newmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Data released by the Department of Health and Human Services in February, 2001, revealed that Nevada has the lowest number of registered nurses per 100,000 population in the nation. The state’s population is growing faster than the nursing programs are currently able to produce new graduates. Current predictions are that the existing nursing shortage will become more severe and have a longer duration than has ever before been experienced. While there may not be one single identifiable causative factor, the aging nursing workforce, low unemployment, and the universal nature of the shortage magnify the problem. This paper focuses on the …

Functional Health Literacy In An Urban Primary Care Clinic, Nancy Trygar Artinian, M. Patricia Lange, Thomas Templin, Lynda G Stallwood, Christopher E. Hermann

Nursing Faculty Research Publications

The purpose of this study was to determine the level of functional health literacy in a sample of patients treated in 1of our 5 primary care clinics. A total of 92 randomly selected adults (mean age = 59 years) completed the TOFHLA while waiting for a scheduled appointment. Twenty eight percent of the sample had less than adequate levels of functional health literacy. Income, car ownership and education were significant and independent predictors of literacy level in this sample. Low levels of functional health literacy limit a patient's ability to read, understand and act on health information. It is essential …

The Educational Interaction Between Physical Therapy And Occupational Therapy Students, Kimberly K. Cleary, Dana M. Howell

Occupational Science and Occupational Therapy Faculty and Staff Research

The objectives of this study were to identify the prevalence of shared learning in U.S. physical therapy (PT) and occupational therapy (OT) education programs; determine what terminology is used for these courses; and identify perceived barriers, benefits, and challenges of the educational interactions. A survey, designed to collect information about the educational interaction between PT and OT students, was mailed to all program directors (n = 206) at each of the academic institutions (N = 103) in the United States with accredited or developing entry-level programs in PT and OT. A census study was conducted, and the entire study population …

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Gerontology Institute Publications

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

Determinants Of Old-Age Mortality In Taiwan, Zachary Zimmer, Linda G. Martin, Hui-Sheng Lin

Poverty, Gender, and Youth

Relationships among socio-demographic characteristics, general assessments of health, and old-age mortality are well established in developed countries. There is also an increasing focus on the connection between early-life experiences and latelife health. This paper tests these and other associations using representative survey data from Taiwan on the population aged 60 and older in 1989, 1993, and 1996 that have been linked to data on deaths between 1989 and 1999 from a national death registry. The study also explores the possible influence of Taiwan’s Universal Health Insurance Program, instituted in 1995, and whether or not the survival of some groups of …

How Indicators Of Socioeconomic Status Relate To Physical Functioning Of Older Adults In Three Asian Societies, Zachary Zimmer, Napaporn Chayovan, Hui-Sheng Lin, Josefina N. Natividad

Poverty, Gender, and Youth

In developed countries, socioeconomic status has been identified as one of the most important demographic and social determinants of older adult health. The relationship has not been well studied or contrasted across much of the developing world. Yet, with population aging occurring rapidly in much of Asia, understanding the factors that distinguish between those in better and worse health becomes important. To this end, the current study has two main aims. It first examines the degree to which two measures commonly used to indicate socioeconomic status, education and income, relate to the physical functioning of older adults in three Asian …

A Qualitative Review Of The Native American Caregivers Support Program: The Successes, Barriers, And Training Needs, Holly A. Beard, M. Yvonne Jackson, Meg Graves, Floyd Godfrey, Clare Houseman

Ellmer School of Nursing Faculty Publications

Caregiving is accepted as a natural part of life and is recognized as an inherent responsibility within the American Indian/Alaskan Native Community. A qualitative analysis was conducted employing constant comparative method to explain the current status of the Native American Caregiver Support Program (NACSP) funded by Title VI-C grants. The NACSP (Title VI-C) of the Older Americans Act (OAA) is administered by the Department of Health and Human Services (DHHS), Administration on Aging (AoA). The NACSP allows each tribal organization to develop a program to deliver supportive services that are tailored to the needs of their caregiver's while providing five …

The Medicare And Medicaid Intersection: Caring For Arizona's Seniors, Nora Super, Lisa Sprague, Judith D. Moore

National Health Policy Forum

This site visit to Phoenix examined the interplay between Medicare and Medicaid and how payment streams and regulatory requirements affect the delivery of health and long-term care services. The visit explored trends related to Medicare+Choice plan participation, physician acceptance of Medicare patients, and care management for individuals with chronic illnesses, such as Alzheimer’s disease. It also considered Arizona’s capitated Medicaid long-term care program, which recently implemented competitive bidding among plans in Maricopa County.

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Key Health Issues Facing Latinas, Dharma E. Cortés, Helen Cajigas, Odilia Bermúdez

Gastón Institute Publications

Acknowledging the relationship that exists among health outcomes, socioeconomic factors, and access to health care is key to understanding the health status of Latinas in Massachusetts. For example, poverty disproportionately affects Latinos in Massachusetts, and they have the lowest rate of health insurance in the Commonwealth despite the fact that Massachusetts has one of the most inclusive and comprehensive public health insurance programs in the nation. This situation impacts access to regular health care for Latinos and affects their overall health status. This fact sheet provides information on the following health areas of particular concern to Latinas: maternal and child …

Transitions Along The Continuum Of Care: Elderly And Disabled Persons In New York, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit examined transitions along the continuum of care for elderly and disabled persons in New York. The state offers its residents an extensive array of services, including nursing homes, home health care, personal care, and community-based services. New York spends more than any other state on its Medicaid program, which is reflected in a comprehensive benefit package, full-cost reimbursement of hospitals, high nursing home rates, and extensive coverage of personal care services. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed transitions …

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …

Grandparent Care In The United States: Comparisons By Race And Ethnicity, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to compare information on grandparent caregivers in the United States among members of five different racial and ethnic groups. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household.2 Data from the 2000 Census 5% Public Use Microdata Sample are used in our calculations. The …

Grandparent Care In The African-American Population, Jan Mutchler, Seungah Lee, Lindsey A. Baker

Gerontology Institute Publications

The purpose of this report is to provide information on African-American grandparent caregivers in the United States. Many grandparents are responsible for grandchildren who live with them in the same household. The 1996 Welfare Reform Act mandates that statistics be collected on grandparents who serve as caregivers to a grandchild. In response to this requirement, questions were developed for the 2000 Census of Population asking each adult about care for grandchildren living in the same household. We use the census information to identify grandparents who are caring for grandchildren in two different types of households: skipped-generation households, in which a …

Working Paper: Elders In Massachusetts Prefer Paid Caregivers, Francis G. Caro

Gerontology Institute Publications

Older Massachusetts residents would rather have paid professionals provide their long-term care than their own children, according to a recent UMass Poll of 461 Massachusetts residents.

How Long Do We Live?, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Period life expectancy is calculated from age-specific death rates using life table methods that are among the oldest and most fundamental tools of demography. These methods are rarely questioned, much less criticized. Yet changing age patterns of adult mortality in contemporary countries with high life expectancy provide a basis for questioning the conventional use of age-specific death rates and life tables. This paper argues that when the mean age at death is rising, period life expectancy at birth as conventionally calculated overestimates life expectancy. Estimates of this upward bias, ranging from 1.6 years for the United States and Sweden to …