Geriatrics Commons^™

Implementation Of A Volunteer-Based Hospital Program For Older Adults, Elizabeth Collins, Md, Kristine Swartz, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

• A multi-faceted, volunteer-led, hospital-based program1has been shown to: •Reduce the incidence of delirium •Decrease hospital length of stay •Reduce hospital costs.
• Implementation of such a program requires upfront investment.
• A smaller, volunteer-based visitation program for older adults may provide support for the allocation of more hospital resources in delirium prevention and establishment of a formal Hospital Elder Life Program1in this institution.
• This research aims to investigate: •If the implementation of a visitation program is feasible at this hospital •Volunteer experience with the program.

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

Lgbt Senior Health Disparities: Information Resources To Bridge The Gap, Gregg A. Stevens, Tony Nguyen, Francisco J. Fajardo

Library Faculty Publications

As the senior population in the United States increases, the aging LGBT (lesbian, gay, bisexual, transgender) population should also see comparable growth rates. Health care providers and social service organizations will care for more LGBT seniors with special needs beyond the general population of older adults as they are more at risk for certain conditions. This article identifies some specific health disparities and examines several organizations that work to improve LGBT senior health by providing critical health information to LGBT older adults, caregivers, and health care professionals.

The Correlation Between Quality Of Care And Type Of Room In Long-Term Care Facilities In The Shenandoah Valley Of The Commonwealth Of Virginia, Hannah Twomey

Senior Honors Projects, 2010-2019

The purpose of this study was to examine if there was a present correlation the quality of care a resident in a long-term care facility received and the type of room they resided in. The researcher conducted a quantitative, cross-sectional research study of direct care healthcare providers (n=77) in four long-term care facilities in the Shenandoah Valley of Virginia through the documentation of a paper survey. The survey questions were adapted from Nursing Home Survey on Patient Safety Culture and participants responded according to their personal habits regarding the quality of care they gave residents and feelings about their place …

Age-Related Changes In Visual Processing Speed: A Pilot Study Using The Motor Free Visual Perception Test- 4, Amber Zadravecz, Kassidy Ha, Lauren Gollnick, Stephanie Pawek, Zoe Studer

Dissertations, Masters Theses, Capstones, and Culminating Projects

Older adults are at a significantly increased risk of being involved in motor vehicle accidents. Evidence reveals that visual processing speed decreases with age, which may impact driving. The Motor-Free Visual Perception Test- Third Edition (MVPT-3) is used as a pre-driving assessment and has an age-normed Response Time Index that measures visual processing speed. In 2015, a new version, the new Motor-Free Visual Perception Test- Fourth Edition (MVPT-4), was published. The new MVPT-4 does not yet demonstrate its utility in measuring visual processing speed. The purpose of this study was to explore if differences in visual processing speed between younger …

Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White

Dissertations, Masters Theses, Capstones, and Culminating Projects

The purpose of this study was to examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through an online survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” which indicates an overall misunderstanding associated with …

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Dissertations, Masters Theses, Capstones, and Culminating Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained …

Resilience And Protective Factors In Older Adults, Jessica Mcclain, Katelyn Gullatt, Caroline Lee

Dissertations, Masters Theses, Capstones, and Culminating Projects

Evidence suggests resilience promotes successful aging in place and protective factors promote resilience. This study sought to investigate whether or not the combination of three protective factors, physical health, social support, and self-efficacy are all of equal importance in predicting resilience among Marin County older adults, or if some individual protective factors have a greater impact on resilience than the others. Fifty-eight participants ages 62 and higher were recruited from senior community programs and personal contacts. Four self-report questionnaires were completed by the participants in this exploratory, cross-sectional, quantitative design. SPSS was used for a descriptive and multivariate analyses to …

Individualized Music Improves Social Interaction Of Women, But Not Men, With Dementia, Emily Farrer, Diana Hilycord

Butler Journal of Undergraduate Research

Dementia is tragic both for patients with the disease and for their family members. As this neurodegenerative disorder progresses, cognitive functions deteriorate, agitation and aggression increase, and mood worsens (McDermott, Orrell, et al., 2014; Spiro, 2010; Vasionyté & Madison, 2013). Non-pharmacological approaches, such as active music therapy or passive music listening, can be effective in reducing these symptoms. However, no past studies have examined how music listening affects the social interactions of patients with dementia. As such, this study examined whether nursing home residents with dementia are more engaged and interactive if they listen to individually selected music for 15 …

The Interprofessional Management Of Geriatric Patients Undergoing Head And Neck Cancer Treatment In U.S. Nursing Homes, Rashida Wiley, Vidushi Gupta, Riddhi A. Daftary, Jessfor Baugh, Anh H. Tran, Dorothy Lynne Cataldo, Yang Kang, Takashi Komabayashi

Dental Medicine Faculty Publications

A dental approach toward interprofessional management, treatment planning and rehabilitation of diagnosed individuals undergoing cancer therapies is essential. Literature review focuses on presurgery oral hygiene instructions, pre-radiography/chemotherapy dental clearance, complications and management during radiotherapy/chemotherapy; post-radiotherapy/ chemotherapy oral healthcare; and adjunctive measures.

Assessing Dementia And Mild Cognitive Impairment Within The Home, Kate Sobanik, Melinda Blais

Thinking Matters Symposium Archive

What are useful assessments which can be administered by occupational therapists for homebound adults with dementia or mild cognitive impairment that will influence practice patterns?

“Older Adults And Their Experiences With Home Care And Assisted Living”, Faith Robinson

Thinking Matters Symposium Archive

As the state of Maine and the U.S. population at large continues to age, discussion about future care and living arrangements for older adults has become an increasingly relevant issue. Older adults are often faced with a range of options for housing, including staying in their home in their community while receiving home care services, or moving to an assisted living facility.

Currently a gap in the research exists as to the attitudes, perceptions, and lived experiences of the older adults themselves around these decisions, experiences, and the meaning of “home” in our older years. This study aims to provide …

Evaluation Of Group Movement Programs (Plié And Paired Plié) For People With Memory Loss, Alzheimer’S Disease Or Dementia, Martin Blanco, Deborah Barnes

GW Research Days 2016 - 2020

Today, one in ten people ages 65 and older have Alzheimer’s dementia. This serious condition often causes great suffering among affected individuals and their families, and there are no medications that stop or slow the disease. It is therefore important to evaluate alternative interventions that may benefit both patients and their care partners. Preventing Loss of Independence through Exercise (PLIÉ) and Paired PLIÉ are group movement programs that combine neuroscience and integrative medicine for individuals with dementia. We analyzed data from [N=39] anonymous evaluation surveys performed as part of two ongoing randomized control trials. Survey data included general questions on …

Comparison Of Existing Methods For Algorithmic Classification Of Dementia In The Health And Retirement Study, Kan Z. Gianattasio, Qiong Wu, M Maria Glymour, Melinda C. Power

GW Research Days 2016 - 2020

Background: Dementia ascertainment is difficult and costly, hindering the use of large, representative studies such as the Health and Retirement Study (HRS) to monitor trends or disparities in dementia. To address this issue, multiple groups of researchers have developed algorithms to classify dementia status in HRS participants using data from HRS and the Aging, Demographics, and Memory Study (ADAMS), an HRS sub-study that systematically ascertained dementia status. However, the relative performance of each algorithm has not been systematically evaluated.

Objective: To compare the performance of five existing algorithms, overall and by sociodemographic subgroups.

Methods: We created two standardized datasets: (a) …

(Video) Barriers To Implementing Advance Care Planning In The Healthcare Setting, Dona Occhipinti, Matias Attene Ramos

GW Research Days 2016 - 2020

Objectives: Current barriers to implementing Advanced Care Planning (ACP) will be examined as applied to the healthcare system.

Methods: A literature review was performed looking at the current practices of ACP (e.g. filling out advanced directives (AD), Medical Orders for Life Sustaining Treatment (MOLST)/ Physician Orders for Life Sustaining Treatment (POLST), etc.), physician comfort level with having end-of-life discussion (EOL), successful/unsuccessful interventions to increase ACP/EOL discussions among health care providers (HCP), and the current political environment with respect to physicians’ ability to implement ACP/EOL discussions. Cochrane, Pubmed, and Google Scholar were searched for papers written in English after …

Hospital-Based Physicians' Intubation Decisions And Associated Mental Models When Managing A Critically And Terminally Ill Older Patient., Shannon Haliko, Julie Downs, Deepika Mohan, Robert Arnold, Amber E Barnato

Articles, Abstracts, and Reports

BACKGROUND: Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences.

OBJECTIVE: We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant.

METHODS: Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter. We used an "expert" model to code the …

Identification Of Risk Factors Associated With Falls In The Long Term Care Setting, Jacqueline L. Patel, Dnp, Ms, Anp-Bc

Doctor of Nursing Practice Projects

Background: Falls threaten the safety of older adults in long term care (LTC).

Objectives: To assess environmental, clinical and pharmacological causes of falls as well as compare Fall Risk Assessment Score, Brief Interview of Mental Status (BIMS) score, Activities of Daily Living (ADL) scores, age and gender of residents with one fall, recurrent falls, and no falls.

Methods: Using a descriptive-comparative design, we included a convenience sample of 290 adults ≥50 years old at our LTC facility. Fall and recurrent fall groups were matched to those with no falls. We assessed environmental, clinical and pharmacological variables, Fall Risk Assessment Scores, …

The Famous Names Discrimination Task As A Biomarker Of Alzheimer's Disease Risk: An Erp Study, Elizabeth Rose Paitel

Master's Theses (2009 -)

Current ERP research emphasizes age- and pathology-related declines in neural processing in the form of attenuated amplitudes and prolonged latencies. Notably, there is a gap in the ERP literature regarding neural processing trajectories in the time between healthy young adulthood and clinical MCI/AD samples. fMRI research, however, has demonstrated periods of increased, compensatory activation in healthy, cognitively intact APOE ɛ4 carriers both during resting state and event-related tasks (Bondi, Houston, Eyler, & Brown, 2005; Evans et al., 2014; Filippini et al., 2009; Rao et al., 2015), consistent with compensatory theories of cognitive aging (Cabeza, 2002; Park & Reuter-Lorenz, 2009; Reuter-Lorenz …

Mechanisms Of Fatigue With Aging: Evidence From The Whole-Limb To The Single Cell In Humans, Christopher W. Sundberg

Dissertations (1934 -)

Aging is accompanied by a loss of muscle mass and increased fatigability of limb muscles making it difficult for old adults to generate the force and power necessary to perform daily activities, such as ascending a flight of stairs. The mechanisms for the age-related increase in fatigability in old and very old adults (≥80 yrs) and whether there are differences between men and women are unknown. The purpose of this dissertation was to determine the mechanisms for the age-related increase in fatigability in men and women by studying fatigue at the level of the whole-limb and within the muscle cells. …

The Impact Of Advance Directives On The Intensity Of Care Received In The Acute Care Setting In Older Adults, Marsha Helen Tyacke

Dissertations (1934 -)

The proportion of older adults in the U.S. is rapidly increasing. One-third of Medicare expenditures occur in the final year of life, with nearly half resulting from acute exacerbations of chronic, progressive diseases(Riley & Lubitz, 2010). Older adults prefer comfort over life-sustaining care, and decreased intensity of care is associated with improved quality of life at the end-of-life (EOL). Advance directives (ADs) have been proposed as mechanisms to improve congruence between patient wishes and EOL care; however, the impact of ADs on care delivered in the acute care setting at the EOL for this population is unclear. A retrospective, correlation …

Biomarker And Clinical Trial Design Support For Disease-Modifying Therapies: Report Of A Survey Of The Eu/Us: Alzheimer's Disease Task Force, Jeffrey Cummings, Nick Fox, Bruno Vellas, Paul Aisen, Guogen Shan

Environmental & Global Health Faculty Research

BACKGROUND: Disease-modifying therapies are urgently needed for the treatment of Alzheimer’s disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities. OBJECTIVES: The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs. DESIGN/SETTING/PARTICIANTS: A survey of members of the EU/US Alzheimer’s Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what …

Factors Associated With End-Of-Life Planning In Huntington Disease., Nancy R Downing, Siera Goodnight, Sena Chae, Joel S Perlmutter, Michael Mccormack, Elizabeth Hahn, Stacey K Barton, Noelle Carlozzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: Knowledge of one's gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample.

METHODS: Data are from 503 participants in the HD Quality of Life study. Participants completed an online health-related quality-of-life survey that included questions regarding EOL planning and self-reported HD symptoms. Frequencies were calculated for EOL planning by the HD stage. Bivariate analysis and logistic …

Conserved Brain Myelination Networks Are Altered In Alzheimer's And Other Neurodegenerative Diseases., Mariet Allen, Xue Wang, Jeremy D Burgess, Jens Watzlawik, Daniel J Serie, Curtis S Younkin, Thuy Nguyen, Kimberly G Malphrus, Sarah Lincoln, Minerva M Carrasquillo, Charlotte Ho, Paramita Chakrabarty, Samantha Strickland, Melissa E Murray, Vivek Swarup, Daniel H Geschwind, Nicholas T Seyfried, Eric B Dammer, James J Lah, Allan I Levey, Todd E Golde, Cory Funk, Hongdong Li, Nathan D Price, Ronald C Petersen, Neill R Graff-Radford, Steven G Younkin, Dennis W Dickson, Julia R Crook, Yan W Asmann, Nilüfer Ertekin-Taner

Articles, Abstracts, and Reports

INTRODUCTION: Comparative transcriptome analyses in Alzheimer's disease (AD) and other neurodegenerative proteinopathies can uncover both shared and distinct disease pathways.

METHODS: We analyzed 940 brain transcriptomes including patients with AD, progressive supranuclear palsy (PSP; a primary tauopathy), and control subjects.

RESULTS: We identified transcriptional coexpression networks implicated in myelination, which were lower in PSP temporal cortex (TCX) compared with AD. Some of these associations were retained even after adjustments for brain cell population changes. These TCX myelination network structures were preserved in cerebellum but they were not differentially expressed in cerebellum between AD and PSP. Myelination networks were downregulated in …

Adult Day Service Providers: Untapped Potential For Care Coordination, Nicole Ruggiano, Ellen L. Brown, Karen L. Fortuna

Nursing & Health Sciences Research Journal

Adult Day Services (ADS) have become increasingly available for community-dwelling older adults who are often experiencing multiple chronic conditions and/or dementia. ADS providers spend a significant amount of time with their clients and offer the opportunity for a wealth of clinical information that can be used by primary care providers and specialists for decision-making about patient care. There are also opportunities for hospitals to coordinate care transitions with ADS providers by involving them with discharge planning with appropriate patients who require post-hospital care. However, ADS providers are often viewed as social service providers, and there is little known about the …

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive …

Word-List Intrusion Errors Predict Progression To Mild Cognitive Impairment, Kelsey R Thomas, Joel Eppig, Emily C Edmonds, Diane M Jacobs, David J Libon, Rhoda Au, David P Salmon, Mark W Bondi, Alzheimer’S Disease Neuroimaging Initiative

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: Preclinical Alzheimer's disease (AD) defined by a positive AD biomarker in the presence of normal cognition is presumed to precede mild cognitive impairment (MCI). Subtle cognitive deficits and cognitive inefficiencies in preclinical AD may be detected through process and error scores on neuropsychological tests in those at risk for progression to MCI.

METHOD: Cognitively normal participants (n = 525) from the Alzheimer's Disease Neuroimaging Initiative were followed for up to 5 years and classified as either stable normal (n = 305) or progressed to MCI (n = 220). Cox regressions were used to determine whether baseline process scores on …

Fighting Frailty With The Mediterranean Diet, Edward F. Ansello

Director's Editorials from Age in Action

It’s appropriate for each of us to examine our eating habits, not just our nutrition intake. The various aspects of the Mediterranean Diet hold potential benefits beyond the important feature of helping to reduce frailty.

Lewy Body Dementia, Edward F. Ansello

Director's Editorials from Age in Action

While Alzheimer’s disease is the most common and widely known cause of dementia, it is not the only cause. Dementia with Lewy Bodies (DLB), in fact, may be the second most common cause of progressive dementia but it is certainly less well known.

Our Anniversary, Edward F. Ansello

Director's Editorials from Age in Action

The Virginia Center on Aging celebrates 40 years.

Addressing The Spiritual Needs Of People Aging With Dementia And/Or Lifelong Disabilities, Kathy Fogg Berry

Case Studies from Age in Action

Educational Objectives

1. Present the need for spiritual care as part of holistic care for people living with dementia and/or lifelong disabilities.

2. Distinguish the difference between spirituality and religion.

3. Discuss how to assess the spiritual needs of people living with dementia and/or lifelong disabilities.

4. Show through case study examples specific ways to address the spiritual needs of people living with dementia and/or lifelong disabilities.