Geriatrics Commons^™

Hdqlife: Development And Assessment Of Health-Related Quality Of Life In Huntington Disease (Hd), N E Carlozzi, S G Schilling, J-S Lai, J S Paulsen, E A Hahn, J S Perlmutter, C A Ross, N R Downing, A L Kratz, M K Mccormack, M A Nance, K A Quaid, J C Stout, R C Gershon, R E Ready, J A Miner, S K Barton, S L Perlman, S M Rao, S Frank, I Shoulson, H Marin, M D Geschwind, P Dayalu, S M Goodnight, D Cella

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is a chronic, debilitating genetic disease that affects physical, emotional, cognitive, and social health. Existing patient-reported outcomes (PROs) of health-related quality of life (HRQOL) used in HD are neither comprehensive, nor do they adequately account for clinically meaningful changes in function. While new PROs examining HRQOL (i.e., Neuro-QoL-Quality of Life in Neurological Disorders and PROMIS-Patient-Reported Outcomes Measurement Information System) offer solutions to many of these shortcomings, they do not include HD-specific content, nor have they been validated in HD. HDQLIFE addresses this by validating 12 PROMIS/Neuro-QoL domains in individuals with HD and by using established PROMIS …

In The Information Age, Do Dementia Caregivers Get The Information They Need? Semi-Structured Interviews To Determine Informal Caregivers’ Education Needs, Barriers, And Preferences, Kendra Peterson, Howard Hahn, Amber J. Lee, Catherine A. Madison, Alireza Atri

Dartmouth Scholarship

Most patients with dementia or cognitive impairment receive care from family members, often untrained for this challenging role. Caregivers may not access publicly available caregiving information, and caregiver education programs are not widely implemented clinically. Prior large surveys yielded broad quantitative understanding of caregiver information needs, but do not illuminate the in-depth, rich, and nuanced caregiver perspectives that can be gleaned using qualitative methodology. We aimed to understand perspectives about information sources, barriers and preferences, through semi-structured interviews with 27 caregivers. Content analysis identified important themes

The Age-Friendly Cities Project In Bowling Green: A Narrative History, Hannah Ruggles

Mahurin Honors College Capstone Experience/Thesis Projects

An age-friendly city is one that “encourages active ageing by optimizing opportunities for health, participation and security in order to enhance quality of life as people age. In practical terms, an age-friendly city adapts its structures and services to be accessible to and inclusive of older people with varying needs and capacities.” Bowling Green was the seventh city in the US to join the World Health Organization’s Global Network of Age-Friendly Cities and is currently in year three of a five-year project. The developments over the past two years have been guided by the principle that senior residents of Bowling …

Factors Associated With Unmet Needs Among African-American Dementia Care Providers, P. J. Desin, Allison M. Caban-Holt, Erin L. Abner, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed …

Walking-Induced Fatigue Leads To Increased Risk In Older Adults, S. Morrison, S. R. Colberg, H. K. Parson, S. Neumann, R. Handel, E. J. Vinik, J. Paulson, A. I. Vinik

Rehabilitation Sciences Faculty Publications

Background- For older adults, falls are a serious health problem, with more than 30% of people older than 65 suffering a fall at least once a year. One element often overlooked in the assessment of falls is whether a person's balance, walking ability, and overall falls risk is affected by performing activities of daily living such as walking.

Objective- This study assessed the immediate impact of incline walking at a moderate pace on falls risk, leg strength, reaction time, gait, and balance in 75 healthy adults from 30 to 79 years of age. Subjects were subdivided into 5 equal groups …

Engaging Older Adults To Build Social Capital, Beverly K. Lunsford, Danielle Janes

Nursing Faculty Publications

Countries are considering the healthcare implications as the proportion of older adults increases, including rising healthcare costs and resources needed as more adults want to "age in place" or continue living in the community. More in home resources and support services will be needed for older adults to continue living independently at homes. Older adults are an incredibly untapped resource with a continuing need to contribute to society and a willingness to help others. Older adults are working longer than ever before, so they have the potential to build their own social capital for meeting the needs of aging colleagues. …

Is The Geriatric Impact Ipad Test A Valid Measurement Of Cognitive Function In Older Adults?, Heather Elise O'Dell

Graduate Theses and Dissertations

The number of older adults will rapidly increase within the next generation (Brookmeyer, Johnson, Ziegler-Graham, & Arrighi, 2007). Alzheimer’s disease risk increases with age, especially after age 60 (NIA, n.d.). Aging leads to a decrease in functional independence, and this side effect is exacerbated by cognitive decline (Johnson, Lui, & Yaffe, 2007). Executive function is a predictor of Alzheimer’s disease onset and progression (Zhang, Han, Verhaeghen, & Nilsson, 2007). The Geriatric ImPACTTM test is a potential new and more convenient testing methods than traditional methods used. The purpose of this research is to validate the Geriatric ImPACTTM test by comparing …

Reporting Practices, Knowledge And Opinion Of Policy Regarding Drivers With Dementia Among Arkansas Neurologists And Geriatricians, Erika Martin Gergerich

Graduate Theses and Dissertations

Background: States have various policies regarding a physician's ability or responsibility to report at-risk drivers with dementia to the Department of Motor Vehicles (DMV). Some states have mandatory reporting policies, others have optional reporting policies and some have no policy regarding this issue. Arkansas has no reporting policy regarding drivers with dementia to the DMV. Therefore, physicians in Arkansas face the risk of liability if they report a patient against their will to the DMV in good faith. Neurologists and geriatricians are often in a position to diagnose and treat individuals with dementia. Research Questions: The following three research questions …

Hood's Theory Of Aging, Drew Michael Hood

All Graduate Theses, Dissertations, and Other Capstone Projects

This thesis proposes that the theory of gerotranscendence can be improved by emphasizing life course events that influence the gerotranscendence process. Further, this paper proposes that teaching gerotranscendence to long-term care staff and residents with Hood's theory of aging and with a departmental framework will yield better results in staff following gerotranscendence best practices and thus result in increased resident development towards gerotranscendence.

Effects Of Video Enhancement In A Stated-Choice Experiment On Medical Decision Making, Susanne Hoffmann, Joachim Winter, Francis G. Caro, Alison Gottlieb

Gerontology Institute Publications

Background. The internet can be useful in administering stated-choice experiments to understand medical decision making and refine the content of patient decision aids. In internet-based stated-choice experiments, video and audio files can be used to provide information to respondents. Quality of data may or may not be affected.

Objectives. In a methodological experiment concerned with administration of a stated-choice experiment on the internet concerned with knee-replacement surgery, we compared the data quality obtained with video-enhanced and conventional text formats.

Methods. Members of the RAND Corporation’s American Life Panel and 50 years of age or older (n=1616) were randomly assigned to …

[Sabbatical Report], Dana Burr Bradley

Sabbatical Reports

Write, submit and present information on geriatrics.

Let’S Play: Understanding The Role And Significance Of Digital Gaming In Old Age, Julie A. Skalsky Brown

Theses and Dissertations--Gerontology

Despite a marked increase in the use of digital games among older persons, there is insufficient research that provides insight into the gaming experiences of this population. A major demographic shift within the senior gaming market has ushered in a new perspective on the use of digital games as a tool for physical and cognitive health, and improved socialization. It is proposed that individual notions of play, which are developed over the life course, influence digital game play engagement and interaction preferences, and contribute to well-being. This study explored how self-perceptions of play over the course of the senior gamer’s …

Making Space For Dying: Portraits Of Living With Dying, Elise Lark

Antioch University Dissertations & Theses

In Making Space for Dying: Portraits of Living with Dying, I describe the everyday lived experience of dying and the care culture within freestanding, community-based, end-of-life residences (CBEOLR) utilizing portraiture and arts-based research. I craft four case studies into “portraits,” based on interviews, on-site visits, up-close observation, and field notes. In the person-centered portraits, I reveal the inner landscape of two terminally ill women, with data represented in poetry. In the place-centered portraits, I “map” the social topography of two CBEOLRs to illustrate how lives and care of the dying are emplaced, from the perspectives of community leaders, …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Senior Transportation Abstracts: A Focus On Options, Helen Kerschner, Nina M. Silverstein

Gerontology Institute Publications

This collection of abstracts represents a publication of importance for understanding the needs, challenges, solutions, and/or every day issues related to senior transportation services. While several of the abstracts include information about senior driver safety, the collection’s primary purpose is to present a holistic approach to transportation options for older adults. Such a collection is timely because, although the practice of providing transportation to older adults is not new, research and preparation of practical informational and technical materials related to older adult transportation service needs and service delivery are quite recent.

Massachusetts Senior Legal Assistance Project Needs Evaluation: Current Demand For Legal Services, Alison Gottlieb, Lauren A. Martin, Ellen A. Bruce

Gerontology Institute Publications

The Gerontology Institute at the University of Massachusetts Boston was contracted to conduct a statewide needs assessment for the MSLAP. As agreed upon by the MSLAP Advisory Board, the focus of this assessment was to analyze the demand for services Massachusetts legal service providers have experienced recently as a means to understanding the legal needs of Massachusetts elders (age 60 and older). A second needs assessment was conducted by the Massachusetts Executive Office of Elder Affairs. That needs assessment surveyed home care workers and other elder agency personnel to gauge their assessment of elders’ legal needs in Massachusetts. Read together, …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

Evaluation Of Verbal Behavior In Older Adults, Amy Gross

Dissertations

Older adults make up a large and increasing portion of the population (U.S. apply those assessments to the evaluation of verbal behavior in older adults with and without dementia. The research addressed two questions. First, in what way do verbal behavior problems differ between older adults with and without dementia? Second, does language deteriorate in a pattern compatible with Skinner's analysis of functionally independent verbal operants? Thirty-one participants were categorized into Control (n=15) and Dementia (n=16) Groups based on their score on the Dementia Rating Scale-2. Verbal behavior assessments were administered to participants on two occasions, separated by one week. …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Gerontology Institute Publications

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.

Independent Living Outcomes Evaluation Project, Craig J. Padgett

All Graduate Theses, Dissertations, and Other Capstone Projects

This project developed specific examples of skills and resources for three example categories of ILST and developed recommendations for enhancing the creation of goals. It was important to develop indicators into a tiered structure for reinforcing those skills and resources into knowledge through an added educational component. Methodology was developed and necessary instrumentation and processes were designed for implementation. And, an informed consent was designed for any organization providing Independent Living Skills Training (ILST).

Assessing Gaps In Services For Geriatric Patients With Mental Health Needs, Angela Nelson

All Graduate Theses, Dissertations, and Other Capstone Projects

Older adults in southwest Minnesota have limited options regarding mental health services. Sanford Tracy Medical Center and Sanford Westbrook Medical Center sought to identify the needs of this population so they can better serve their patients. The following research questions were asked: Do local service providers feel gaps in services exist for older adults experiencing mental health needs in the rural southwestern Minnesota communities of Tracy and Westbrook and the surrounding areas? Do area service providers feel that geriatric patients would benefit from a mental health intervention implemented within the primary healthcare setting? A survey of area geriatric service providers …

Assessing Stakeholder Opinions Of Medical Review Of Impaired Drivers And Fitness To Drive: Recommendations For Massachusetts, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

Driving is the main mode of travel for Americans age 65 and older, and although older adults are generally found to be safe drivers, aging often brings about functional limitations and an increase in medications that can impede safe driving and fitness to drive (Rosenbloom, 2003; Kissinger, 2008; Adler & Silverstein, 2008). Effective licensing policies and Medical Advisory Board practices are critical components in identifying medically at-risk drivers and may even have a role in the transition to alternative transportation options; yet, states vary greatly in their approach to licensing and renewal practices and in the utilization, composition, and function …

Using Internet‐Based Vignette Methods To Understand Elder Residential Choices, Francis G. Caro, Teck Ho, Daniel Mcfadden, Alison Gottlieb, Christine Yee, Taizan Chan, Joachim Winter

Gerontology Institute Publications

This paper illustrates an innovative method of administering fractional factorial surveys (vignettes) using the internet. The approach makes it possible to use video clips to deliver information. The method also provides subjects with interactive options before making judgments. A study to determine the views of older people regarding residential options is used to illustrate the method. The study found that the following characteristics of vignette persons affected subject recommendations: personal introduction, functional status, social network, and current housing characteristics. However, characteristics of retirement community features and personal financial status did not affect recommendations.

Llmhs Elderly Services Outreach Program: Lincoln, Lyon & Murray Human Services, Jamie Olson

All Graduate Theses, Dissertations, and Other Capstone Projects

Right now there is a lack of professional and community knowledge regarding the services LLMHS provides to those over age 65. Thus, there are elderly who are in need of help who are not getting connected to a county long term care social worker. The elderly may need help to simply get connected to resources, have questions answered, correct misconceptions about long term care, get recommendations, or assistance paying for home and community based services. There are also many providers and professionals with questions about what LLMHS does and does not do as well as what the assistance programs can …

In Step With Our Parents: 3-Part Educational Series, Kate Boisen-Macdonald

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project is to educate adult children caring for their parents, so they can identify as caregivers so they can better cope with, identify with, and/or navigate the role of care giving, and be aware of the resources available to them.

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Gerontology Institute Publications

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Caring For People With Alzheimer's Disease Or Dementia In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Romaine Turyn

Disability & Aging

It is clear that caring for people with Alzheimer’s disease and dementia is a growing public health issue. Alzheimer’s is a progressively deteriorating disease that can last anywhere from 1 to 15 years. Families are the primary caregivers and will continue to need support to manage the care of their loved ones, to coordinate services within the long term care system and to maintain their own health and well-being.

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 …