Geriatrics Commons^™

A Profile Of Assisted Living Direct Care Workforce Training Requirements Across The United States, Erh-Chi Hsu, Paula Carder, Lindsey Smith, Zhiqing E. Zhou, Olga Yakusheva, Anna S. Beeber, Eric Jutkowitz, Kali Thomas

Institute on Aging Publications

Objectives

To characterize assisted living (AL) direct care worker (DCW) training requirements across the United States and how these regulations have changed over time. Specifically, we examine state-level profiles of training regulations, including duration, frequency, content, source of materials, evaluation, and changes in regulatory coverage.

Design

Cross-sectional and longitudinal descriptive study using state policy data and AL directories from 2019, 2021, and 2023.

Setting and Participants

All US states' AL training–related regulations; all ALs and AL beds governed by those regulations.

Methods

We used a mixed-methods approach with an explanatory sequential design (QUAN → qual), first conducting health services regulatory …

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. …

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, …

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.

Multimorbidity And Associated Informal Care Receiving Characteristics For Us Older Adults: A Latent Class Analysis, Ruotong Liu, Corey L. Nagel, Siting Chen, Jason T. Newsom, Heather G. Allore, Ana R. Quiñones

Psychology Faculty Publications and Presentations

Older adults with varying patterns of multimorbidity may require distinct types of care and rely on informal caregiving to meet their care needs. This study aims to identify groups of older adults with distinct, empirically-determined multimorbidity patterns and compare characteristics of informal care received among estimated classes. Methods Data are from the 2011 National Health and Aging Trends Study (NHATS). Ten chronic conditions were included to estimate multimorbidity patterns among 7532 individuals using latent class analysis. Multinomial logistic regression model was estimated to examine the association between sociodemographic characteristics, health status and lifestyle variables, care-receiving characteristics and latent class membership. …

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.

Does Assisted Living Provide Assistance And Promote Living?, Sheryl Zimmerman, Robyn Stone, Paula Carder, Kali Thomas

Institute on Aging Publications

Assisted living has promised assistance and quality of living to older adults for more than eighty years. It is the largest residential provider of long-term care in the United States, serving more than 918,000 older adults as of 2018. As assisted living has evolved, the needs of residents have become more challenging; staffing shortages have worsened; regulations have become complex; the need for consumer support, education, and advocacy has grown; and financing and accessibility have become insufficient. Together, these factors have limited the extent to which today's assisted living adequately provides assistance and promotes living, with negative consequences for aging …

The Remote Assessment And Dynamic Response Program: Development Of An In-Home Dementia-Related Care Needs Assessment To Improve Well-Being, Lindsey M. Miller, Diane N. Solomon, Carol J. Whitlatch, Shirin O, Hiatt, Chao-Yi Wu, Christina Reynolds, Wan-Tai Michael Au-Yueng, Jeffrey Kaye, Joel Steele

Psychology Faculty Publications and Presentations

Background and Objectives

The Remote Assessment and Dynamic Response (READyR) Program was developed in order to address the current lack of early-stage dementia care planning programs that assess the care needs of persons with dementia. The goal was to create a program informed by care values and ongoing ecologically valid data. The objectives of this study are to describe the development and design process of the READyR Program, and to evaluate the utility of the READyR Program for identifying dementia-related care needs.

Research Design and Methods

A prototype of the web-based READyR Program tool was first created using digital activity …

Estimation Of Excess Mortality Rates Among Us Assisted Living Residents During The Covid-19 Pandemic., Kali S. Thomas, Wenhan Zhang, David M. Dosa, Paula Carder, Philip Sloane, Sheryl Zimmerman

Institute on Aging Publications

The devastating effects of COVID-19 among older adults residing in long-term care settings have been well documented.1 Although much attention has been paid to COVID-19–associated mortality in nursing homes,2 less is understood about its effects on assisted living residents. Most assisted living residents are aged 80 years or older and many have multiple chronic illnesses, making them highly susceptible to poor outcomes of COVID-19.3 This study examines the excess mortality among a US cohort of assisted living residents during the COVID-19 pandemic.

To What Extent Do Local Nursing Home Prescribing Patterns Relate To Psychotropic Prescribing In Assisted Living?, Kali Thomas, Christopher J. Wretman, Philip D. Sloane, Paula Carder, Lindsay Schwartz, Anna S. Beeber, Sheryl Zimmerman

Institute on Aging Publications

In nursing homes (NHs), psychoactive medication use has received notable attention, but less is known about prescribing in assisted living (AL). This study examined how antipsychotic and antianxiety medication prescribing in AL compares with NHs.

Revisiting The Role Of Physicians In Assisted Living And Residential Care Settings, Sarah Dys, Lindsey Smith, Ozcan Tunalilar, Paula C. Carder

Institute on Aging Publications

As the United States population ages, a higher share of adults is likely to use long-term services and supports. This change increases physicians’ need for information about assisted living and residential care (AL/RC) settings, which provide supportive care and housing to older adults. Unlike skilled nursing facilities, states regulate AL/RC settings through varying licensure requirements enforced by state agencies, resulting in differences in the availability of medical and nursing services. Where some settings provide limited skilled nursing care, in others, residents rely on resident care coordinators, or their own physicians to oversee chronic conditions, medications, and treatments. The following narrative …

Impact And Mortality Of Covid-19 On People Living With Dementia: Cross-Country Report, Aida Suárez-González, Gill Livingston, Lee Fay Low, Suzanne Cahill, Niamh Hennelly, Walter D. Dawson, Wendy Weidner, Martina Bocchetta, Cleusa P. Ferri, Jordi A. Matias-Guiu, Multiple Additional Authors

Institute on Aging Publications

This report brings together international evidence on the impact of the COVID-19 pandemic on people living with dementia and an overview of international policy and practice measures to mitigate the impact of COVID-19 among people living with dementia.

Key Findings

• We have collected data on impact and mortality of COVID-19 in people living with dementia in 9 countries: The United Kingdom (UK), Spain, Ireland, Italy, Australia, the United States (US), India, Kenya and Brazil.
• The share of people whose deaths were linked to COVID-19 in care homes who had dementia ranges from 29% to 75% across those countries. Within countries, …

State Variability In The Prevalence And Healthcare Utilization Of Assisted Living Residents With Dementia, Kali S. Thomas, Wenhan Zhang, Portia Y. Cornell, Lindsey Smith, Brian Kaskie, Paula C. Carder

Institute on Aging Publications

Objectives: Almost 1 million older and disabled adults who require long‐term care reside in assisted living (AL), approximately 40% of whom have a diagnosis of Alzheimer's disease and related dementias (ADRD). States vary in their regulations specific to dementia care that may influence the presence of residents with ADRD in AL and their outcomes. The objectives of this study were to describe the state variability in the prevalence of ADRD among Medicare beneficiaries residing in larger (25+ bed) ALs and their healthcare utilization.

Design: Retrospective observational national study.

Participants: National cohort of 293,336 Medicare fee‐for‐service enrollees residing in larger (25+ …

Enriching Clinical Learning Environments Through Partnerships: Academic And Practice Partnerships To Strengthen Care For Older Adults In Residential And Assisted Living Settings, Juliana Cartwright, Diana L. White

Institute on Aging Publications

This report was prepared by Oregon Health & Science University (OHSU) School of Nursing and the Institute on Aging at Portland State University to describe an academic-community partnership using the Enriching Clinical Learning Environments through Partnerships (ECLEPs) model. This two-year project was conducted with 34 students in the RN-BSN program in eight assisted living (AL) communities and ElderPlace, a PACE program serving residents in assisted living and other residential settings. Quality improvement was the focus of the project. Features of the ECLEPs model include:

• An intentional partnership between academic and clinical organizations
• Relationship-based; shared decision making
• Long-term commitment between partners …

The Institutional Context That Supports Team-Based Care For Older Adults, Anna Foucek Tresidder

Dissertations and Theses

The aging population in the U.S. is dramatically increasing; it is predicted that not only will individuals live longer but also that they will live with multiple chronic diseases that could require high levels of medical and social resources. While the aging population increases, the number of health care providers choosing to specialize in caring for the elderly is decreasing just as dramatically. Teams are believed to be a possible response to more efficiently use the providers available, take advantage of alternative provider types, and integrate a range of health and social services to meet patient needs more effectively. Interdisciplinary …

Humor-Related Social Exchanges And Mental Health In Assisted Living Residents, Ann Elizabeth Mcqueen

Dissertations and Theses

Social contact is known to be vital for older adults' mental and physical health, but few studies of social interactions have taken place in long-term care settings. The current study investigated whether the psychological well-being of assisted living residents was influenced by factors associated with residents' social interactions involving humor. Specific aims of the present study were to develop and test a measure related to humor-related social exchanges, to examine how humor-related social exchanges affect residents' mental health, and to explore whether humor-related social exchanges mediated the effects of resident and facility characteristics on indices of mental health. One hundred …

Aging-In-Place Research At Orcatech: Making Sense Of The Data, Tamara Hayes

Systems Science Friday Noon Seminar Series

The Oregon Center for Aging and Technology (ORCATECH) seeks to facilitate successful aging and reduce the cost of healthcare by establishing the evidence base for technologies supporting aging-in-place research and care. This is done through pilot studies evaluating the role of the technologies, as well as large longitudinal studies in which sensors are placed in the homes of community-dwelling elders to monitor daily patterns of activity, walking speeds, medication adherence, and other behaviors. These sensors collect continuous data that reflect normal variability in behaviors as well as trends that may indicate problematic changes in cognition or mobility. Because data are …

Audiological In-Service Regarding Hearing Impairment And Its Impact On Communication In The Geriatric Population, Marie Barlow Lassell

Dissertations and Theses

At least two studies have been found conducted in the area of audiological in-services and their impact on the people to whom they were presented. In 1981, Dancer and Keiser studied the effects of empathy training on geriatric-care nurses and in 1985, Dampier, Dancer, and Keiser studied changing attitudes of college students toward older persons with hearing loss. Both of the studies investigated the effect of in-service training on empathy, rather than using the traditional academicallyoriented in-service program approach. Both studies found statistical results indicating a significant positive change in the subjects' feelings toward hearing impaired geriatrics. Additionally, Dancer et …

Foster Family Care For The Aged, Donald V. Sekora

Dissertations and Theses

The following was a research practicum instituted as an actual project for the State of Montana Welfare Department between June, 1970, and May, 1971. The project had a two-fold purpose in being conceived: one purpose was to fulfill a graduate school academic requirement; and the second purpose was to fulfill a responsibility to the people of Montana who would eventually gain some benefits from this project. The series of written documents that follow are the description of that project's conception and actualization in six Montana counties. The first part is the project idea and theory; the next two parts consist …