Digital Commons Network^™

How Do Us States Define Person-Centered And Family-Involved Care In Assisted Living Regulations, Paula Carder, Lindsey Smith, Jennifer N. Bunker, Cassandra L. Hua, Erh-Chi Hsu, Isabelle Boun, Olivia M. Ainsworth, Kali S. Thomas, Eric Jutkowitz

Institute on Aging Publications

Introduction: A large share of assisted living (AL) residents have a diagnosis of dementia or cognitive impairment, and these individuals can benefit from person-centered care and family-involved care. This study examines whether and how states’ AL licenses address these topics.MethodsThis research analyzed a national database of 249 unique licensing requirements that govern 35,602 ALs in all states and associated regulations, including those that govern memory care (MC) services. We reviewed each regulation for the presence of person-centered or family involved care and then used content analysis of license requirements with at least one relevant policy to identify key categories and …

The Scope And Impact Of Walking The Talk For Dementia 2024, Sherril B. Gelmon, Kate Irving, Walter Dawson, Jonathan Adrián Zegarra-Valdivia, Lingani Mbakile-Mahlanza, Fernando Aguzzoli-Peres

Institute on Aging Publications

Walking the Talk for Dementia (WTD) is a global educational initiative integrating a walk along the Camino de Santiago with a symposium to combat dementia stigma, raise awareness, and foster inclusion.

Creating Community Through Walking The Talk For Dementia, Kate Irving, Fernando Aguzzoli Peres, Walter D. Dawson, Jonathan Adrián Zegarra-Valdivia, Lingani Mbakile-Mahlanza, Iracema Leroi, Sherril B. Gelmon

Institute on Aging Publications

Objectives

Creating community is not only therapeutic—it has been described as essential. This study explores a process of community-building among people with lived and professional experience in the dementia field, during Walking the Talk for Dementia (WTD), a week-long, immersive event on the Camino de Santiago in Spain. Absence of community can lead to fragmented support for both people living with dementia and their care partners and for those working in the field. Achieving a sense of community, however, can be complex.

Methods

A qualitative evaluation was conducted with 79 participants from 27 countries, incorporating pre-, during and post-event reflections. …

The Social Side Of Aging In Place: Community, Belonging, And Cultural Fit, Michael Crespo

University Honors Theses

Aging in place, or the capacity of older adults to remain in their homes and communities as they age has been a central tenet of the field of gerontology and the gerontological social policy area. Although access to physical facilities and service provision has been the main focus of traditional studies, contemporary experience demonstrates that social and cultural issues are equally important as determinants of the quality of life. This thesis discusses the influence of social networks, cultural congruence, and community belonging on the aging in place experience. The content of the study is based on the Ecological Model of …

Trends In Private Equity Acquisitions Of Assisted Living Facilities., Jennifer N. Bunker, Yashaswini Singh, Gauri Gadkari, John Bowblis, Lindsey Smith, Paula Carder, Sean Huang, Momotazur Rahman, Kali S. Thomas

Institute on Aging Publications

This cross-sectional study examines trends in private equity acquisitions of assisted living facilities across the US.

Communities Of Practice: Aging, Emergency Management, And Churches In Rural Clackamas County, Oregon, Lukas Robert Aberle

Dissertations and Theses

As the population of the United States ages, questions arise of how to best care for older adults in daily life and emergency situations. This research looks at the daily activities of churches to see how they affect everyday and emergency care practices. As a collaboration with Clackamas County government, I researched the relationship between churches and care through participant observation and interviews during the summer of 2024 to understand congregations’ support for older members, the role of church congregations in emergency management, and the implications of the decline in religious participation alongside aging in the United States. I found …

Industries, Self-Rated Health, And Status Characteristics: An Exploration Of Health In Industries At The Intersection Of Race/Ethnicity, Gender, And Disability, Emmanuel Legarreta

Dissertations and Theses

While industries, occupations, and health outcomes have been widely studied, research has neglected self-rated health (SRH) and the intersectionality of different status characteristics in various industries. Using an IPUMS version of the Current Population Survey, this study explores the possible relationships between industries and SRH. More specifically, it seeks to find if workers' disability status, racial minority status, or gender moderates (i.e., differentiates) the relationship between their industry and SRH. Findings show that certain industries are significant predictors of SRH, and that women with disabilities working in Mining and Construction, and Business and Repair Service have significantly worse SRH than …

Responding To The Needs Of Dementia Care Partners: Recommendations For Policy Change At The State And Federal Levels., Walter D. Dawson, Jenn Reed, Allison Lindauer, Sherril B. Gelmon

Institute on Aging Publications

The need to optimize supports of Alzheimer's disease and related dementias (ADRD) care partners through policy innovation is high. This study sought to frame the care and support needs of multiple historically underrepresented populations who may be underserved and/or have difficulty accessing culturally specific services and determine specific policies that may reduce ADRD care partner burden and improve wellbeing. Qualitative data were gathered through interviews ( = 24) with leaders of organizations that support people living with ADRD and focus groups ( = 5) with dementia care partners from four communities historically underserved in the United States (Asian, Black, Indigenous, …

Stimulated Cytokine Production, Attachment, And Emotional Well-Being In Dementia Spousal Caregivers, Daniel L. Argueta, Sarah Roberts, Kelly N. Brice, E Lydia Wu-Chung, Vincent D. Lai, Jensine Paoletti-Hatcher, Bryan T. Denny, Charles Green, Samantha Henry, Multiple Additional Authors

Psychology Faculty Publications and Presentations

Proinflammatory cytokine production may be related to poor emotional adjustment in dementia spousal caregivers. People who display attachment insecurity may be at increased risk for adverse caregiving experiences and poor psychosocial outcomes.

Heightened Risk: Childhood Trauma And Anticipatory Grief Exacerbate The Impact Of Loneliness On Depressive Symptoms And Lps-Stimulated Cytokines In Dementia Caregivers, Kelly N. Brice, Jensine Paoletti-Hatcher, E Lydia Wu-Chung, Vincent D. Lai, Daniel L. Argueta, Michelle A. Chen, Itee Mahant, Bryan T. Denny, Charles Green, Luis D. Medina, Multiple Additional Authors

Psychology Faculty Publications and Presentations

Dementia spousal caregivers are at a disproportionate risk for adverse mental and physical health outcomes. Loneliness is associated with depressive symptoms and proinflammatory cytokine production among caregivers. Additionally, childhood trauma, anticipatory grief, and poor sleep quality are all associated with enhanced stress reactivity. This study used a cross-sectional design to investigate whether loneliness is associated with proinflammatory cytokine production and depressive symptoms in caregivers, and whether these relationships are strongest among caregivers who report high levels of childhood trauma, high amounts of anticipatory grief, or poor sleep quality. A sample of 111 dementia spousal caregivers provided blood samples and completed …

Assessing Older Adult Behavioral Health Diagnoses In Oregon By Geographical Area, Physical Disability Status, And Age., N F. Parsons, Allyson Stodola, Ellis Hews, Nirmala Dhar, Sheryl Elliott, Sarah Dys, Walter D. Dawson

Institute on Aging Publications

This repeated cross-sectional study aims to assess potential differences among behavioral health (BH) diagnoses for older adults. Differences in services across urban versus rural/remote areas may contribute to deeply entrenched barriers to improved BH for this population.

Analyzing The Intention To Volunteer Through The Integrated Model Of Behavioral Prediction, Sage Mendre

University Honors Theses

Nationwide, a significant portion of adults lack basic, functional literacy skills. To combat functional illiteracy in the United States, non-profit organizations who focus on literacy require the services of volunteers. In Portland, Oregon, the Portland Literacy Council (PLC) is responsible for training volunteer tutors to help people learning English as a second language (ESL) and native English speakers who want to improve their literacy skills. The integrated model of behavioral prediction (IMBP) is a communication theory that identifies the core factors that can lead to the intention to perform a behavior. The connection between volunteering in literacy environments and IMBP …

Is Ride-Hailing A Potential Solution For Older Adults After Driving Cessation? The Role Of Objective And Perceived Accessibility, Minju Kim Song

Dissertations and Theses

Due to age-related physical and cognitive changes, older drivers have a greater risk of crashes and are restricted by age-dependent regulation. Nonetheless, many older adults in the United States maintain a car-dependent lifestyle and still prefer driving. When driving cessation or reduction becomes necessary, a primary concern is finding suitable alternative transportation modes. However, the availability of alternative transportation modes does not guarantee their actual use of these options.

As a relatively new transportation mode, ride-hailing services, such as Uber and Lyft, offer on-demand, door-to-door transportation and may be a feasible transportation solution for older adults who stop driving. While …

Mindfulness As A Buffer Against Death Anxiety: Implications For End-Of-Life Care, Chad Alexander

University Honors Theses

Death anxiety, defined as the distress associated with the awareness of mortality, has profound psychological and cultural impacts. Western societies often respond to death salience through avoidance and medicalization, reinforcing defensive strategies described by Terror Management Theory. This project aimed to investigate whether mindfulness can serve as a buffer against death anxiety. A structured literature review was conducted using PsycINFO, PubMed, the Portland State University Library, and Google Scholar between January 2025 and April 2025. One study found that mindfulness moderated the effects of death anxiety on health-related quality of life in people living with HIV. Two experiments linked mindfulness …

Spousal Bereavement Enhances Proinflammatory Cytokine Production To Acute, Psychological Stress., E Lydia Wu-Chung, Ryan L. Brown, Robert Suchting, Jensine Paoletti-Hatcher, Michelle A. Chen, Angie S. Leroy, Kyle W. Murdock, Cobi J. Heijnen, Christopher P. Fagundes

Psychology Faculty Publications and Presentations

Early widowhood is characterized by chronic stress and is associated with a higher risk of incident depression and cardiovascular-related morbidity and mortality. Peripheral inflammation is involved in the pathogenesis of major depressive disorder and atherothrombosis and may represent a common mechanism underlying widow(er)'s elevated risk for both health conditions. Chronic psychological stress sensitizes the release of proinflammatory cytokines during the peripheral stress response. The present study examined whether recent spousal bereavement enhances the inflammatory response to an acute, psychological stressor. Recently widowed older adults (n = 143) and non-widowed controls (n = 69) participated in a quasi-experimental study, during which …

An Equitable End: Meeting The Needs Of Queer Families Within Deathcare, Nyssa Peck

University Honors Theses

This thesis seeks to explore end-of-life care experiences of queer families, focusing on interactions with palliative and hospice caregivers. Currently, end-of-life (EOL) practitioners in institutional and medical care settings are often poorly equipped to interact with queer families due to inadequate cultural training models, personal biases, and ignorance regarding the queer identities of their clients. This manifests in substantial inequities within deathcare systems regarding the accommodation of the unique needs of queer familial structures. Drawing upon multidisciplinary scholarship, I sought to examine these needs, which diverge from that of heterosexual families due to queer families’ absence of legal protections and …

Cost Comparison Of Congregate, Motel, And Village-Type Shelters For People Experiencing Homelessness, Jacen Greene, Todd Ferry, Emily Leickly, Franklin H. Spurbeck

Homelessness Research & Action Collaborative Publications and Presentations

Village and motel shelters exemplify the expanding field of “alternative” shelters for people experiencing homelessness, largely defined in contrast to “traditional” congregate shelters. Little research compares the financial costs of alternative and traditional shelter models. The research team analyzed cost data for 13 alternative shelters (six villages and seven motel shelters) and nine traditional congregate shelters in Portland, Oregon. Costs were assessed per “unit” (i.e. shelter bed or motel room) to account for differences in shelter sizes. Village shelters had the highest per-unit set-up costs ($99,630), followed by motel shelters ($88,462), while congregate shelters had the lowest ($43,692). Congregate shelters …

The Dementia Care Partner Hub: An Innovative Approach To Addressing Unmet Social And Health Needs, Sherril Gelmon, Jenn Reed, Walter D. Dawson

OHSU-PSU School of Public Health Faculty Publications and Presentations

The well‐being of care partners of people living with dementia, who are family, friends, or neighbors and often unpaid, is often not addressed explicitly in clinical dementia care. Care partners, especially those from systematically marginalized communities, experience substantial unmet social and behavioral needs. We reviewed role model programs and conducted focus groups and interviews with care partners and representatives of community organizations and government agencies. We developed the concept of a Dementia Care Partner Hub as a “one‐stop shop” to connect dementia care partners and service providers with information and resources, meeting a need that is not currently addressed in …

Cardiometabolic Multimorbidity And Dementia Onset Among Middle-Aged And Older Adults: Differences By Race/Ethnicity., Siting Chen, Ana R. Quiñones, Corey L. Nagel, Nicholas J. Bishop, Heather G. Allore, Jason T. Newsom, Jeffrey Kaye, Anda Botoseneanu

Psychology Faculty Publications and Presentations

Racial/ethnic minoritized groups in the U.S. have higher prevalence of cardiometabolic multimorbidity and experience higher risk of dementia. This study evaluates the relationship between cardiometabolic multimorbidity and dementia onset according to racial/ethnic group in a nationally representative cohort of U.S. middle-aged and older adults.

Assisted Living, Residential Care, And Memory Care Staffing Level Dynamics: Oregon, 2017–2023, Sarah Dys, Ozcan Tunalilar

Institute on Aging Publications

Objectives

To examine changes in staffing levels over time in Oregon assisted living and residential care (AL/RC) communities between 2017 and 2023.

Design

Longitudinal study of licensed AL/RC communities.

Setting and Participants

A total of 1720 setting-year observations from 535 individual AL/RC communities in Oregon between 2017 and 2023.

Methods

Primary data were collected through the Oregon Community-Based Care (CBC) study. Staffing levels were estimated as care staff hours per resident per day and reported overall and by staff type, including registered nurses, licensed practical nurses, certified nursing assistants, certified medication aides, unlicensed care staff, life enrichment staff, and social …

Young Adults’ Views On Personal Death, Victor N. Soto

Anthós

Within academic discussions of death and dying, there is a deficit of qualitative studies on how young adults view personal death. This article explores young adults’ (18-24) views on personal death using inductive coding of the transcriptions of three 1:1 interviews and one focus group. Soto’s findings show that young adults view their personal death in three ways: 1) they reflect on family death experiences as frames of reference for personal death, 2) they rely on a life well- lived to ease anxiety around personal death, and 3) they use humor as a coping mechanism in thinking about and discussing …

'T-W-O': External Challenges And Coping Strategies Of Chinese Social Work Service Organisations During The Epidemic, Bin Xu, Bowen Mcbeath, Haobo Xi

School of Social Work Faculty Publications and Presentations

During the peak years of COVID-19, Chinese social work service organisations actively participated in the preventing and controlling of the pandemic. These organisations also faced external challenges that reflected changing public health policies, contractual and fiscal changes, and immense service needs. This paper describes the specific external challenges that a purposive sample of 11 Beijing-based social work service organisations experienced because of the pandemic, as well as the strategies they used to address them. We find that project and fiscal precarity were the greatest external risks faced by social service organisations. In order to mitigate these concerns, the organisations actively …

Book Review Of, Calling Family: Digital Technologies And The Making Of Transnational Care Collectives, Michele Gamburd

Anthropology Faculty Publications and Presentations

Book Review: Calling Family: Digital Technologies and the Making of Transnational Care Collectives

Faculty Senate Monthly Packet October 2024, Portland State University Faculty Senate

Faculty Senate Monthly Packets

The October 7, 2024 monthly packet includes the October agenda, appendices, and the Faculty Senate minutes and attachments from the meeting held October 7, 2024.

Promoting Cultural Humility, Belonging, And Inclusion To Improve Well-Being Among Direct Care Staff In Oregon Assisted Living, Residential Care, And Memory Care Communities, 2024, Jacklyn Kohon, Dani Himes, Laura Rodriguez, Sarah Dys, Paula Carder, Diana Jacoby, Madeline Fox

Institute on Aging Publications

The voices and experiences of those working and living in assisted living, residential care, and memory care (AL/RC) settings in Oregon are highlighted in this study to understand cultural humility, belonging, inclusion, and intersectional experiences related to sustaining the workforce and promoting quality care. This qualitative study collected data through individual and focus group interviews with a total of 68 people, including 25 direct care staff, voice memos or interviews with 9 former direct care staff, interviews with 9 administrators, interviews with 7 management representatives (owner/operators, human resources specialists, directors of operations, among other titles), and interviews with 18 current …

Climate And Extreme Weather Event Impacts On Administrators, Direct Care Staff, And Residents In Oregon Assisted Living, Residential Care, And Memory Care Communities, 2024, Dani Himes, Jacklyn Kohon, Madeline Fox, Laura Rodriguez, Sarah Dys, Diana Jacoby, Paula Carder

Institute on Aging Publications

This brief report on AL/RC staff and resident experiences with climate events highlights the voices of AL/RC direct care staff, former direct care staff, residents, administrators, and management representatives to promote well-being in these care settings. This study can inform Oregon’s efforts to support long-term care workforce readiness for future climate emergencies and inform future quantitative data collection on AL/RC and other long-term care workers, including those employed in home health agencies, nursing facilities, and adult foster homes.

"It Feels Like I'M A Step Closer To My Ultimate Goal Of Stable Housing:" A Qualitative Study Of Unhoused People's Experiences In Alternative Shelters In Portland, Emily Leickly, Jacen Greene, Todd Ferry

Psychology Faculty Publications and Presentations

In recent years, alternatives to congregate shelters have emerged, including tiny home villages and motel conversions. Existing research indicates that these alternative shelter modalities are associated with positive outcomes for shelter guests. This qualitative study was conducted with 11 participants staying in three alternative shelters tailored to support specific groups: lesbian, bisexual, gay, transgender, queer, intersex, and asexual (LGBTQIA+) people, women, and medically vulnerable people. Participants reported a number of facilitators and barriers to meeting their personal goals (e.g., permanent housing, medical care). Key facilitators included the relative privacy, autonomy, and safety of alternative shelters, and support for guests with …

Admission And Discharge Practices Among Assisted Living Communities: The Role Of State Regulations And Organizational Characteristics, Cassandra L. Hua, Lindsey Smith, Sheryl Zimmerman, Gauri Gadkari, Paula Carder, Philip D. Sloane, Christopher J. Wretman, Kali S. Thomas

Institute on Aging Publications

A better understanding of factors associated with assisted living admission and discharge practices can help identify communities that are more likely to allow residents to age in place. This study examined how state regulations and assisted living organizational characteristics relate to community admission and discharge practices for bathing, getting out of bed, and feeding.

Prevalence And Correlates Of Antipsychotic Medication Use In Oregon Assisted Living, Sarah Dys, Ozcan Tunalilar, Paula Carder

Institute on Aging Publications

Objective

Investigate how assisted living and residential care (AL/RC) and memory care (MC) contexts are associated with the 90-day prevalence of antipsychotic medication use (APU), considered a quality measure in long-term care.

Design

All licensed AL/RC settings in Oregon received an annual mailed questionnaire to provide aggregate resident demographics, health acuity, health service use, payment type, and organizational policies. Organizational measures were collected from state websites.

Methods

Random intercepts regression models were estimated to assess organizational and resident population characteristics associated with 90-day APU prevalence over 3 study waves (2017-2019).

Setting and Participants

We examine 932 observations in 463 AL/RC …

Faculty Senate Monthly Packet June 2024, Portland State University Faculty Senate

Faculty Senate Monthly Packets

The June 3, 2024 monthly packet includes the June agenda, appendices, and the Faculty Senate minutes and attachments from the meeting held June 3, 2024.