Статті в журналах: "Adult day care participants"

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Silverstein, Nina M., Cathy M. Wong, and Kristen E. Brueck. "Adult Day Health Care for Participants With Alzheimer’s Disease." American Journal of Alzheimer's Disease & Other Dementiasr 25, no. 3 (February 24, 2010): 276–83. http://dx.doi.org/10.1177/1533317510361237.

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Maynard, Marianne. "Exploring Adult Day Care Participants' Responses to Psychosocial Stressors." Occupational Therapy in Mental Health 10, no. 2 (October 29, 1990): 65–84. http://dx.doi.org/10.1300/j004v10n02_05.

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Cohen-Mansfield, Jiska, Steve Lipson, Kathy S. Brenneman, and L. Gregory Pawlson. "Health Status of Participants of Adult Day Care Centers." Journal of Health & Social Policy 14, no. 2 (September 26, 2001): 71–89. http://dx.doi.org/10.1300/j045v14n02_05.

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Cohen-Mansfield, Jiska, Ann L. Gruber-Baldini, William J. Culpepper, and Perla Werner. "Longitudinal Changes in Cognitive Functioning in Adult Day Care Participants." Journal of Geriatric Psychiatry and Neurology 9, no. 1 (April 1996): 30–38. http://dx.doi.org/10.1177/089198879600900106.

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This study examines longitudinal changes in cognitive functioning over the course of 2 years in participants of adult day care programs. Cognitive measures included the Brief Cognitive Rating Scale (BCRS) and the Mini-Mental State Examination (MMSE). Longitudinal data were available for five measurement points over 2 years for 82 participants (22 males and 60 females). Overall, results from this study suggest that there were significant cognitive declines on BCRS and MMSE, even after only 1 or 2 years in the study. The rates of impairment over the 2 years for BCRS and MMSE were highly correlated. Within each measure, the individual rates of decline were very heterogenous and were influenced by the presence, type, and prognosis of dementia. Participants with multi-infarct dementia had greater cognitive decline than did those with other types of dementias. Initial cognitive functioning and physician's prognosis of dementia trajectory were also significant predictors of change over time. Results suggest a floor effect in the BCRS.

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Hughes, Jaime M., and Jennifer L. Martin. "Sleep Characteristics of Veterans Affairs Adult Day Health Care Participants." Behavioral Sleep Medicine 13, no. 3 (March 21, 2014): 197–207. http://dx.doi.org/10.1080/15402002.2013.855212.

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Cohen-Mansfield, Jiska, and Philip W. Wirtz. "Characteristics of adult day care participants who enter a nursing home." Psychology and Aging 22, no. 2 (June 2007): 354–60. http://dx.doi.org/10.1037/0882-7974.22.2.354.

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Kirwin, Patricia M., and Lenard W. Kaye. "Service Consumption Patterns Over Time Among Adult Day Care Program Participants." Home Health Care Services Quarterly 12, no. 4 (February 12, 1992): 45–58. http://dx.doi.org/10.1300/j027v12n04_04.

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Werner, Perla, Jiska Cohen-Mansfield, Valerie Watson, and Sonia Pasis. "Pain in participants of adult day care centers: Assessment by different raters." Journal of Pain and Symptom Management 15, no. 1 (January 1998): 8–17. http://dx.doi.org/10.1016/s0885-3924(97)00274-1.

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Ramírez, Mildred, Jeanne Teresi, Douglas Holmes, and Lucja Orzechowska. "Institutional Risk Among African-American and White Adult Day Health Care Participants." Journal of Social Work in Long-Term Care 1, no. 2 (June 2001): 57–75. http://dx.doi.org/10.1300/j181v01n02_08.

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10

Vora, Paayal, Lydia Missaelides, Chau Trinh-Shevrin, and Tina Sadarangani. "Impact of Adult Day Service Center Closures in the Time of COVID-19." Innovation in Aging 4, Supplement_1 (December 1, 2020): 949. http://dx.doi.org/10.1093/geroni/igaa057.3472.

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Abstract Adult Day Service Centers (ADCs) are a form of community-based long-term care that address frail older adults’ health and social needs. Due to their congregate nature and participants’ compromised health, many ADCs have been forced to temporarily shutter during the COVID-19 pandemic. It is unknown how closures have impacted service delivery at ADCs. Guided by the Resiliency Framework, we (1) explore methods employed by ADCs during the pandemic to meet participant/caregiver needs and (2) determine how/whether these methods have mitigated the negative effects of ADC closures on participants and their caregivers. Both virtual focus groups and one-on-one semi-structured qualitative interviews were conducted with ADC staff members (n=20) across the United States. Preliminary results showed precipitous declines in physical, cognitive, and mental health of participants, as well as increased caregiver strain, particularly among dementia caregivers. However, ADCs found creative solutions to care for participants despite restrictions, creating, in their words, “centers without walls.” Staff developed virtual programs (e.g. support groups, music and exercise therapy) and conducted “door-step” visits to support productive engagement and combat loneliness. Telehealth supported care coordination and identification of emergent clinical problems. Results suggest that despite innumerable COVID-19-related challenges, ADCs demonstrated resilience and creativity in managing participants’ needs, fostered a sense of purpose, and provided caregiver respite. Further research on the effectiveness of remote programming and advocacy for sustainable reimbursement by payers is needed to ensure that ADCs can continue to provide older adults and their families with meaningful support as the pandemic wears on.

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Williams, Barbara, and Pamela Roberts. "Friends in Passing: Social Interaction at an Adult Day Care Center." International Journal of Aging and Human Development 41, no. 1 (July 1995): 63–78. http://dx.doi.org/10.2190/ghhw-v1qr-nacx-vbcb.

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This study explores the social interactions and friendships that exist among cognitively impaired adult day care participants. A five month participant observation of an adult day care center was conducted, involving fifty-three clients ranging in age from sixty-six to ninety-three. Findings indicate that the clients engage in a variety of social interactions and friendships, enabling them to maintain a sense of self as well as to adjust to the norms of the group. Specific areas to be discussed are: general socializing, enduring friendships, helping relationships and client integration. A descriptive approach such as this provides the opportunity to examine the complexity of social interactions, including the positive relationships available to the cognitively impaired elderly.

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Mamo, Sara, Kara Wheeler, and Olivia Perry. "A Conceptual Framework for Engaged Communication at Adult Day Services: A Mixed-Methods Study." Innovation in Aging 4, Supplement_1 (December 1, 2020): 213–14. http://dx.doi.org/10.1093/geroni/igaa057.689.

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Abstract Adult Day Services provide an opportunity for social engagement for older adults who might otherwise become isolated. Communication environments at many Adult Day Centers can be difficult for participants due to the high prevalence of hearing loss and poor acoustics in large activity rooms. The purpose of this study is to understand the hearing and social health status of participants across multiple group care settings as well as participants’ challenges and motivations to engage in social communication. A mixed methods approach was undertaken. Seventy-two participants from two Programs for All-inclusive Care for the Elderly (PACE®) completed quantitative measures: hearing test, cognitive screener (MOST™), IOM Social and Behavioral Determinants of Health, UCLA Loneliness Scale, and Instrumental Activities of Daily Living. Using maximum variation sampling based on hearing status and UCLA loneliness scores, ten participants were invited to complete one-on-one semi-structure interviews. Interviews aimed to learn more about how and why participants did and/or did not engage in social communication with other PACE participants. Transcripts were coded and thematic analysis was used to identify common barriers and motivations to communication. A conceptual framework was developed by integrating quantitative and qualitative findings to recognize what contributes to meaningful interactions or engaged communication. The findings from this study will contribute to the development of an intervention to address hearing loss and support communication for older adults in group care settings. In order to maximize the potential benefit of attending group-based day services, the communication barriers and motivations of older adults need to be addressed.

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Dubus, Nicole. "A Qualitative Study of Older Adults and Staff at an Adult Day Center in a Cambodian Community in the United States." Journal of Applied Gerontology 36, no. 6 (May 11, 2015): 733–50. http://dx.doi.org/10.1177/0733464815586060.

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Purpose: Adult day care programs in the United States are seeing an increase in culturally diverse patients. The purpose of this study was to better understand the subjective experiences of staff and Cambodian refugees attending an adult day center in the United States that provides services focused on the cultural needs of the older adults, such as Cambodian food, activities, and Cambodian staff. Design: This is a qualitative study using grounded theory to analyze 10 individual interviews from staff members and 80 individual interviews from participants who attend an adult day care program for Cambodians in a city in the northeast United States. Findings: Three primary themes emerged: The participants felt respected, there was a generational tension between the young staff and the participants, and the center acted as a cultural liaison between the medical providers and the participants.

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Jarrott, Shannon, and Aaron M. Ogletree. "Adult Day Services Outcomes: Delphi Review of an Integrated Participant Assessment System." Journal of Applied Gerontology 38, no. 3 (November 22, 2016): 386–405. http://dx.doi.org/10.1177/0733464816675423.

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Adult day services (ADS) aim to help elders age in place, but evidence of impact on participants lags behind caregiver research. To play a larger role in the continuum of care, ADS participant outcomes should regularly be documented with standard measures. We conducted a Delphi review of one integrated participant assessment system. Capturing physical, mental, and cognitive health indicators and activity engagement of typical ADS participants (i.e., frail elders eligible for nursing home placement), experts evaluated the system on instrument validity, relevance, and application. Practitioners and researchers completed multiple assessments of the system’s instruments and alternatives. Finally, panelists addressed the potential benefits and challenges of system adoption by ADS providers. Panelists concurred that such a system would benefit individuals, families, and providers; concerns related to cost and staffing requirements and appropriateness for distinct client populations. A refined system can reveal best practices to enhance ADS service delivery and participant outcomes.

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Strain, Laurel A., Neena L. Chappell, and Audrey A. Blandford. "Changes in Life Satisfaction Among Participants of Adult Day Care and Their Informal Caregivers." Journal of Gerontological Social Work 11, no. 3-4 (October 29, 1987): 115–29. http://dx.doi.org/10.1300/j083v11n03_09.

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16

Agarwal, Shivani, Jennifer K. Raymond, Mark H. Schutta, Serena Cardillo, Victoria A. Miller, and Judith A. Long. "An Adult Health Care–Based Pediatric to Adult Transition Program for Emerging Adults With Type 1 Diabetes." Diabetes Educator 43, no. 1 (November 15, 2016): 87–96. http://dx.doi.org/10.1177/0145721716677098.

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Purpose The purpose of the study was to evaluate an adult health care program model for emerging adults with type 1 diabetes transitioning from pediatric to adult care. Methods Evaluation of the Pediatric to Adult Diabetes Transition Clinic at the University of Pennsylvania included a cohort of 72 emerging adults with type 1 diabetes, ages 18 to 25 years. Data were extracted from transfer summaries and the electronic medical record, including sociodemographic, clinical, and follow-up characteristics. Pre- and postprogram assessment at 6 months included mean daily blood glucose monitoring frequency (BGMF) and glycemic control (A1C). Paired t tests were used to examine change in outcomes from baseline to 6 months, and multiple linear regression was utilized to adjust outcomes for baseline A1C or BGMF, sex, diabetes duration, race, and insulin regimen. Open-ended survey responses were used to assess acceptability amongst participants. Results From baseline to 6 months, mean A1C decreased by 0.7% (8 mmol/mol), and BGMF increased by 1 check per day. Eighty-eight percent of participants attended ≥2 visits in 6 months, and the program was rated highly by participants and providers (pediatric and adult). Conclusions This study highlights the promise of an adult health care program model for pediatric to adult diabetes transition.

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Lendon, Jessica P., Christine Caffrey, and Denys Lau. "ADVANCE DIRECTIVES: STATE REQUIREMENTS, PRACTICES, AND PREVALENCE IN ADULT DAY SERVICES CENTERS." Innovation in Aging 3, Supplement_1 (November 2019): S158. http://dx.doi.org/10.1093/geroni/igz038.566.

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Abstract Advance directives (ADs) are documents that express a person’s healthcare preferences if he/she is unable to make decisions. Adult day service centers (ADSC) may serve as an entrée to advance care planning for many people. This study examined the relationships among: 1-state requirements on ADSCs to provide information on ADs; 2-ADSC’s awareness of their state requirement; 3-ADSC’s practice in providing AD information; and 4-the percentage of ADSC participants with an AD. From the 2016 National Study of Long-Term Care Providers, 3,300 ADSCs reported that they maintained documentation of ADs in participants’ files. Nine states required ADSCs to provide information on ADs; 22% of ADSCs were located in these states. About 24% of ADSCs did not know if their states had requirements; among the 76% of ADSCs that reported knowing, 62% were correct and 37% were incorrect. About 80% of ADSCs provided AD information to their participants, while 41% of ADSC participants had an AD on file. Regression models controlled for size, chain and profit statuses, Medicaid-licensing, medical or social care model, electronic health records use, and Census region. Having state requirements was not independently associated with ADSCs’ practice of providing AD information or with the percentage of participants with an AD. Instead, ADSCs that thought their state had a requirement had greater odds of providing information on ADs, regardless of state requirements. Similarly, ADSCs that thought their state had a requirement and that provided AD information had a higher percentage of participants with an AD, independent of state requirements.

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Marrow, Jocelyn, Allison Roeser, Joseph Gasper, Nicolas G. LaRocca, and Debra Frankel. "Benefits of Multiple Sclerosis Adult Day Program Participation for People with Multiple Sclerosis." International Journal of MS Care 22, no. 5 (December 16, 2019): 201–7. http://dx.doi.org/10.7224/1537-2073.2019-019.

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Abstract Background: Multiple sclerosis adult day programs (MSADPs) are nonmedical service programs that provide care and support to people with multiple sclerosis (MS) experiencing levels of impairment that interfere with employment and activities of daily living. The purpose of this study was to identify how program participants think MSADPs benefit them. Methods: We conducted in-depth interviews with 95 people with MS who were MSADP participants. Interviews occurred as part of site visits to ten programs across the country. We supplemented participant interviews with interviews of program staff and ethnographic observation of activities at each site over 1 to 3 days. Results: Participants reported several benefits from participating in an MSADP. Almost universally, participants explained that receiving and giving social support were the most important benefits. Other positive outcomes described included increased emotional well-being, better understanding and acceptance of MS, practical know-how for accomplishing ordinary tasks, and increased mobility and improved motor functioning. Conclusions: Participants believe that MSADPs have a profound influence on their psychosocial health, much of which they attribute to membership in a socially cohesive community. Clinicians and policy makers should consider recommending these programs for people with MS who have unmet psychosocial needs and experience functional impairments.

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Newman, Sally, and Christopher Ward. "An Observational Study of Intergenerational Activities and Behavior Change in Dementing Elders at Adult Day Care Centers." International Journal of Aging and Human Development 36, no. 4 (June 1993): 321–33. http://dx.doi.org/10.2190/7pn1-l2e1-ulu1-69ft.

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This study investigated whether dementing adult day care clients demonstrate consistent positive behaviors (i.e., eye contact, smiling, attentiveness, etc.) during structured, weekly activities with young children that these adults do not demonstrate during similar activities when the young children are not present. The study built on a preliminary informal study conducted in conjunction with an intergenerational adult day care project. Participants for the study were twenty-one adult day care clients who have behavioral characteristics of Alzheimer's or related disorders. The study involved five consective weeks of planned, structured music activities prepared by a musical therapist as part of the regular intergenerational activities of the adult day care center. The same activities were repeated twice in the same day at each site, once with children present and once without them present. Two fixed videotape cameras recorded client behaviors in three-minute segments. Scoring was completed by trained, “blind” scorers. The scorers tallied positive behaviors by individuals for randomly selected ten-second segments of the taped intervals. Sessions with and without children were compared using non-parametric tests. Categories of behaviors were compared and specific observed behavioral changes were reported.

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Jarrott, Shannon E., Hye Ran Kwack, and Diane Relf. "An Observational Assessment of a Dementia-specific Horticultural Therapy Program." HortTechnology 12, no. 3 (January 2002): 403–10. http://dx.doi.org/10.21273/horttech.12.3.403.

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Horticultural therapy (HT) is used across the lifespan with individuals with a wide range of physical, social, and cognitive abilities. Older adults make up a large group of participants in horticultural activities. As the population of older adults grows, more adults face the risk of experiencing a dementing illness. Many families turn to institutional care programs, such as nursing homes and adult day service (ADS) programs, for assistance with the care of their relative with dementia. HT may be an appropriate activity to incorporate into dementia care activity programs, but formal evaluations of such programs are limited. The current study evaluated a 10-week HT program conducted with adults with dementia at an ADS program. Observations indicated that participants engaged in the horticultural activities for greater periods of time than the nonhorticultural activities. Participant affect during the horticultural and nonhorticultural activities was comparable. HT is appropriate for dementia care programs serving adults with a wide range of cognitive, physical, and social needs, and it should be considered as a viable alternative to more typical dementia care program activities.

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Lendon, Jessica, Vincent Rome, Christine Caffrey, Priyanka Singh, and Manisha Sengupta. "Advancing Adult Day Services Research: The 2016 and 2018 National Study of Long-Term Care Providers." Innovation in Aging 4, Supplement_1 (December 1, 2020): 618. http://dx.doi.org/10.1093/geroni/igaa057.2100.

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Abstract This presentation demonstrates how researchers can leverage data from the 2018 redesign and new content from the forthcoming NSLTCP survey of adult day services centers (ADSC) conducted by National Center for Health Statistics. For the first time, NSLTCP data will allow analyses at the services-user level. New policy-relevant topics about centers and ADSC participants include reasons for hospitalization, medication use, patient-centered and end-of-life care, staffing turnover, and unmet needs. Additionally, the presentation highlights latest findings from the 2016 survey. About 53% of centers were primarily medical model. Almost 79% of participants in medical model centers used Medicaid, compared to 51% in social model centers. About 4% of participants had at least one 90-day hospitalization. 40% of participants had difficulty bathing. The most prevalent chronic conditions were hypertension (50%), arthritis (38%), and diabetes (31%). Nearly 40% of participants had an advance directive. Findings are contextualized within the broader understanding of ADSCs.

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Ribeiro, Aline Cammarano, Stela Maris Mello Padoin, and Cristiane Cardoso Paula. "Therapeutical day-by-day of the hiv/aids teenagers: implications on nursing care." Revista de Enfermagem UFPE on line 4, no. 2 (March 31, 2010): 927. http://dx.doi.org/10.5205/reuol.822-7205-1-le.0402201061.

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ABSTRACTObjective: understanding the therapeutical day-by-day experiences of the HIV/AIDS teenager. This research scenario will be the pediatric and adult ambulatorial services in an Universitary Hospital in Brazil. Methodolgy: a qualitative study with a phenomenological approach using Martin Heidegger´s theorical and methodological references. In this research, the participants are teenagers with HIV/AIDS who attend to the above mentioned service and are aware of their diagnosis. A phenomenological interview will be carried out with the participants, with an orienting question. For the statements analysis the heideggerian method will be used, which is composed of two moments: the first one is the comprehensive analysis named vague and median and the second one is the hermeneutical interpretative analysis. Expected results: we foresee the approach between the teenagers and the nursing crew, aiming the construction of knowledge and contributing in daily practice and interventions, which were mediated by actions of caring, centered in health promotion and education for the development of self-caring. Descriptors: acquired immunodeficiency syndrome; human immunodeficiency vírus; teenagers; adolescent health; nursing; pediatric nursing; existentialism. RESUMOObjetivo: compreender a vivência do cotidiano terapêutico do adolescente que tem HIV/AIDS. O cenário da pesquisa será no serviço de ambulatório pediátrico e adulto de um Hospital de Ensino, no Brasil. Metodologia: estudo qualitativo com abordagem fenomenológica com a utilização do referencial teórico e metodológico de Martin Heidegger. Os participantes da pesquisa serão adolescentes que têm HIV/AIDS, que realizam acompanhamento no referido serviço e que sabem do seu diagnóstico. Será realizada entrevista fenomenológica, com a realização de uma pergunta orientadora. Para análise dos depoimentos será utilizado o método heideggeriano, o qual possui dois momentos metódicos: o primeiro é a análise compreensiva denominada vaga e mediana e o segundo momento análise interpretativa hermenêutica. Resultados esperados: vislumbra-se a aproximação do adolescente que tem HIV/AIDS e a enfermagem, com vistas a produção do conhecimento e contribuições nas práticas de intervenção. Essas mediadas por ações de cuidado, centradas na promoção e na educação em saúde para o desenvolvimento do cuidado de si. Descritores: síndrome da imunodeficiência adquirida; vírus da imunodeficiência humana; adolescente; saúde do adolescente; enfermagem; enfermagem pediátrica; existencialismo. RESUMENObjetivo: comprender la vivencia del cotidiano terapéutico del adolescente que tiene VIH/SIDA. El escenario de la investigación será en el servicio de ambulatorio pediátrico y adulto de un Hospital de Enseñanza, en Brasil. Metodologia: estudio cualitativo con abordaje fenomenológico con la utilización del referencial teórico y metodológico de Martin Heidegger. Los participantes de la investigación serán adolescentes que tienen VIH/SIDA, que realizan acompañamiento en el referido servicio y que saben de su diagnóstico. Será realizada entrevista fenomenológica, con la realización de una pregunta orientadora. Para el análisis de las declaraciones será utilizado el método heideggeriano, lo cual posee dos momentos metódicos: el primer momento es el análisis comprensivo denominado vago y mediano y el segundo, el análisis interpretativo hermenéutico. Resultados esperados: se vislumbra el acercamiento del adolescente que tiene VIH/SIDA y la enfermería, con vistas a producción del conocimiento y contribuciones en las prácticas de intervención. Ésas mediadas por acciones de cuidado, centradas en la promoción y en la educación en salud para el desarrollo del cuidado de sí. Descriptores: síndrome de inmunodeficiencia adquirida; virus de inmunodeficiencia humana; adolescente; salud del adolescente; enfermería; enfermería pediátrica; existencialismo.

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Soto, Yuliana, Susan Aguinaga, and Jacqueline Guzman. "Physical Activity Programming and Physical Function of Older Adults in Adult Day Centers: A Mixed-Methods Approach." Innovation in Aging 4, Supplement_1 (December 1, 2020): 300. http://dx.doi.org/10.1093/geroni/igaa057.962.

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Abstract With increased prevalence of Alzheimer’s disease, there is a need for long-term care services (e.g., Adult Day Centers (ADCs)) to provide physical activity (PA) programs to maintain physical function of older adults. ADCs report offering PA programs; however, information on PA programs and physical function of participants attending ADCs is limited. The study aims to a) explore perspectives of ADC directors on PA programming; b) examine physical function in older adults attending ADCs. A cross-sectional mixed-methods study was conducted among ADC directors and attending participants. Interviews were conducted with ADC directors to assess barriers and facilitators of PA programming. Physical function was assessed among ADC participants via the Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG). Five director interviews were conducted and three major themes emerged; 1) current PA programming limited by fear of falls, 2) staff training and retention, and 3) diversifying PA programming. Twenty-nine ADC participants enrolled in the study, Mage= 74.5±8.2 years; BMI= 29.2 ±7.4 kg/m2; MMSE= 25.6 ±3.3; 51.7% (n=15) African American; 79.3% (n=23) males. ADC participants scored 6.7±3.1 on the SPPB and 15.4±5.3 seconds on the TUG. Directors expressed the importance of PA; however, mentioned current programming was limited due to risk of falls and untrained staff in PA. Findings indicate that older adults attending ADCs have physical function scores indicative of high fall risk. Future PA programming may consider including alternative forms of PA while embedding falls prevention strategies to reduce risk of falls and improve physical function among ADC participants.

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Su, Sheng-Wen, Shwn-Jen Lee, Mei-Wun Tsai, and Hong-Ji Luo. "Exploring Managers’ Opinions on Planning and Designing Adult Day Care Centers." HERD: Health Environments Research & Design Journal 13, no. 3 (March 6, 2020): 99–109. http://dx.doi.org/10.1177/1937586720906824.

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Objective: To explore managers’ opinions on planning and design of location, building type, spatial layout, and interior design of adult day care centers (ADCCs). Background: The planning and design of new ADCCs affect subsequent service users and workflows. Studies explore the factors affecting such planning and design using qualitative methods and from the perspective of users. Quantitative methods are rarely employed to explore factors affecting planning and opinions on the design of ADCCs from administrators’ perspective. Methods: Stratified sampling was used to collect data from managers of ADCCs in Taiwan. A mixed-method approach with an analytic hierarchy process was used to quantify the relative importance of factors affecting location and building type selections. Participants responded to open-ended interview questions followed by focus group interviews to examine the key points for spatial layout and interior design. Results: The managers deemed support and attitudes from local residents (group weight = .208) and authorities (group weight = .187) as their first two critical location selection criteria. Regarding their opinions on the conditions of building type, those that prioritized the products and technologies of facility design were deemed the most critical (group weight = .193), followed by those that valued daylight quality (group weight = .161). Six key points of spatial layout and interior design were obtained from the focus group interviews. Conclusions: This study provides a reference for the effective planning of operations, including geographical location, building type, spatial layout, and interior refurbishment and design.

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Cohen-Mansfield, Jiska, Perla Werner, Valerie Watson, and Sonia Pasis. "Agitation Among Elderly Persons at Adult Day-Care Centers: The Experiences of Relatives and Staff Members." International Psychogeriatrics 7, no. 3 (September 1995): 447–58. http://dx.doi.org/10.1017/s1041610295002195.

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Two hundred participants (mean age = 80 years) from five senior day-care centers were included in a study of agitation. Staff members at the centers and participants' relatives rated the frequency with which participants displayed agitated behaviors, via an expanded version of the Cohen-Mansfield Agitation Inventory. The most frequent behaviors noted were general restlessness, repetitious sentences, verbal interruptions, and pacing. A three-factor solution for staff members' ratings included (a) physically nonaggressive behaviors, including general restlessness and pacing; (b) verbally agitated behaviors, including complaining and constant requests for attention; and (c) aggressive verbal behaviors, including cursing and temper outbursts. A three-factor solution for relatives' ratings included (a) physically nonaggressive behaviors, including general restlessness and pacing; (b) verbally agitated behaviors, including constant requests for attention and related interruptions; and (c) aggressive behaviors, including cursing, grabbing, kicking, and pushing. The syndromes of both models showed similarity to the factors found in a nursing home population, although differences were also apparent.

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Mak, Wingyun. "More Exercise Is Linked to Less Loneliness in Adult Day Health Attendees." Innovation in Aging 4, Supplement_1 (December 1, 2020): 320. http://dx.doi.org/10.1093/geroni/igaa057.1025.

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Abstract There is a growing evidence that more physical activity is linked to less loneliness (Cigna, 2018; Pels & Kleinert; 2016). It is less clear whether this relationship persists in older adults who are attending adult day health services and often have multiple comorbidities. In this study, we examined whether spending more time exercising would significantly predict whether adult day health attendees reported loneliness. We used UAS-NY data from a sample of 221 adult day health attendees from 2019 to early 2020 who scored five or greater on the Nursing Facility Level of Care Index, which is a score derived from assessments of cognition, communication and vision, mood and behavior, functional status, continence, and nutritional status. A logistic regression showed that after controlling for demographic variables, cognition, health, and quality of family relationships, participants were less likely to report loneliness if they had been attending adult day health services for at least six months or more (B=.86, p<.05), spent less time alone (B=-.45, p<.05), and exercised more (B=.47, p<.05; χ2(3)=15.6, p=.001). These results suggest that in addition to participating in adult day services and spending more time with others, exercising may have an impact on the experience of loneliness.

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Thomas, Cathleen Carney, Lisa Wallace, Jeff Alexander, and Aparna Vijayan. "The Relationship Between the Use of Adult Dementia Day Care and Caregiver Quality of Life." Perspectives on Gerontology 20, no. 3 (September 2015): 104–15. http://dx.doi.org/10.1044/gero20.3.104.

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Purpose To qualify the use of adult dementia day care services as an appropriate respite opportunity to improve the quality of life of the caregiver. Design and Methods Thirty familial caregivers from the Alzheimer's Association were recruited and divided into three groups based on number of days of use of day care services (non-use, 1–2 day use, and 3–5 day use). Survey data was self-report and measured using scores from the Evaluations Scale of Caregiver's Quality of Life. Quantitative results from the 20-item questionnaire were analyzed with Kruskal-Wallis and Mann Whitney U tests. Results The analysis showed statistically significant difference in the perception of burden for the group using day care 1–2 days per week than those that did not use the service at all. These findings were not seen in the group using the services 3–5 days per week. Implications Results lead toward the use of an adult day care program attended 3–5 days a week, incorporation of a support group with day care services, and the implementation of a structured home program for all participants to reduce caregiver level of burden.

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Hall, Jodi, Gary Mitchell, Catherine Webber, and Karen Johnson. "Effect of horticultural therapy on wellbeing among dementia day care programme participants: A mixed-methods study (Innovative Practice)." Dementia 17, no. 5 (April 11, 2016): 611–20. http://dx.doi.org/10.1177/1471301216643847.

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Fourteen people attending an adult day programme were recruited to a structured horticultural therapy programme which took place over 10 weeks. The effects were assessed using Dementia Care Mapping and questionnaires completed by family carers. High levels of wellbeing were observed while the participants were engaged in horticultural therapy, and these were sustained once the programme was completed. This study adds to the growing evidence on the benefits of horticultural therapy for people with dementia who have enjoyed gardening in the past.

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Sadarangani, Tina, Chau Trinh-Shevrin, and Abraham Brody. "BARRIERS AND FACILITATORS TO DELIVERING PERSON-CENTERED NUTRITION FOR ASIAN AMERICANS IN ADULT DAY HEALTH SETTINGS." Innovation in Aging 3, Supplement_1 (November 2019): S227. http://dx.doi.org/10.1093/geroni/igz038.835.

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Abstract Malnutrition is a growing problem in community-based long-term care settings. Delivering person-centered nutrition is particularly important in congregate settings serving ethnically diverse older adults who have strong culturally-derived preferences around food. We conducted in-depth semi-structured multi-stakeholder interviews (N = 13) in an adult day health center (ADHC) serving Asian immigrants to explore the ADHC’s capacity to deliver person-centered nutrition interventions. Thematic analysis showed ADHCs successfully promoted social interaction at meal-time. However, participants had limited choice and restrictions on additives, like sodium, making it difficult to honor participants’ cultural preferences. Lack of flavor, limited choice, and rushed mealtimes, driven by center policies and procedures, disproportionately affected persons with dementia. Among those with dementia, clinicians disagreed whether nutrition should be used to manage chronic illness or whether a more palliative approach was warranted. One potential way to address this challenge would be to enable greater choice within a supportive ADHC mealtime environment.

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Sperber, Nina R., Kelli D. Allen, Brenda M. DeVellis, Robert F. DeVellis, Megan A. Lewis, and Leigh F. Callahan. "Differences in Effectiveness of the Active Living Every Day Program for Older Adults With Arthritis." Journal of Aging and Physical Activity 21, no. 4 (October 2013): 387–401. http://dx.doi.org/10.1123/japa.21.4.387.

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Objective:The authors explored whether demographic and psychosocial variables predicted differences in physical activity for participants with arthritis in a trial of Active Living Every Day (ALED).Method:Participants (N = 280) from 17 community sites were randomized into ALED or usual care. The authors assessed participant demographic characteristics, self-efficacy, outcome expectations, pain, fatigue, and depressive symptoms at baseline and physical activity frequency at 20-wk follow-up. They conducted linear regression with interaction terms (Baseline Characteristic × Randomization Group).Results:Being female (p ≤ .05), less depressed (p ≤ .05), or younger (p ≤ .10) was associated with more frequent posttest physical activity for ALED participants than for those with usual care. Higher education was associated with more physical activity for both ALED and usual-care groups.Discussion:ALED was particularly effective for female, younger, and less depressed participants. Further research should determine whether modifications could produce better outcomes in other subgroups.

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Briley, M. E., and C. Roberts-Gray. ": Diets Of Children In Family Day Care Homes That Participate In Child And Adult Care Food Program." Journal of the American Dietetic Association 95, no. 9 (September 1995): A52. http://dx.doi.org/10.1016/s0002-8223(95)00526-9.

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Mahalingam, Mythreyi, Justin Xavier Moore, John P. Donnelly, Monika M. Safford, and Henry E. Wang. "Frailty Syndrome and Risk of Sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort." Journal of Intensive Care Medicine 34, no. 4 (July 5, 2017): 292–300. http://dx.doi.org/10.1177/0885066617715251.

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Background: Frailty is associated with increased morbidity and mortality in older persons. We sought to characterize the associations between the frailty syndrome and long-term risk of sepsis in a large cohort of community-dwelling adults. Methods: We analyzed data on 30 239 community-dwelling adult participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We defined frailty as the presence of at least 2 frailty indicators (weakness, exhaustion, and low physical activity). We defined sepsis as hospitalization for a serious infection with ≥2 system inflammatory response syndrome criteria, identified for the period 2003-2012. We determined the associations between frailty and risk of first sepsis and sepsis 30-day case fatality. Results: Among REGARDS participants, frailty was present in 6018 (19.9%). Over the 10-year observation period, there were 1529 first-sepsis hospitalizations. Frailty was associated with increased risk of sepsis (adjusted hazard ratio [HR] 1.44; 95% CI: 1.26 to 1.64). The total number of frailty indicators was associated with increased risk of sepsis ( P trend <.001). Among first-sepsis hospitalizations, frailty was associated with increased sepsis 30-day case fatality (adjusted OR 1.62; 95% CI: 1.06 to 2.50). Conclusions: In the REGARDS cohort, frailty was associated with increased long-term risk of sepsis and sepsis 30-day case fatality.

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Katz, Benjamin. "A COMMUNITY-BASED INTERVENTION TO IMPROVE COGNITIVE FUNCTION IN RURAL APPALACHIAN OLDER ADULTS." Innovation in Aging 3, Supplement_1 (November 2019): S553. http://dx.doi.org/10.1093/geroni/igz038.2039.

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Abstract Research suggests that social isolation in Appalachian older adults may be associated with reduced cognitive function. Despite this, few interventions for these individuals incorporate both social and cognitive components in a community-based setting. The “Memory Masterclass” program was developed to address this care challenge, and implemented through an Adult Day Services Center. With 29 community-dwelling older adult participants from western Virginia, the six-week pilot program focused on strategies and practices associated with improving long-term memory or executive function. In addition to the lifestyle-focused curricula, the course included group activities focused on connecting participants to community networks of resources that might enable them to successfully implement lifestyle changes. Findings support the feasibility of implementation with a wider group of rural Appalachian older adults and suggest that individual differences in self-reported memory may be closely tied to improvements following the program.

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Draper, Thomas W., Thomas B. Holman, Whitney White, and Shannon Grandy. "Adult Attachment and Declining Birthrates." Psychological Reports 100, no. 1 (February 2007): 19–23. http://dx.doi.org/10.2466/pr0.100.1.19-23.

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Attachment scores for 658 young adults living in the USA were obtained using the Experiences in Close Relationships scale. The participants came from a subsample of the RELATE data set, who had also filled out the adult attachment measure. Those young adults living in Utah County, Utah, an area of the country with a higher than normal birthrate (88% members of the Church of Jesus Christ of Latter-day Saints), also had higher than average adult attachment scores. While the methodology was not sufficient to assess causal direction nor eliminate the possibility of unidentified influences, an undiscussed psychological factor, adult attachment, may play a role in the numerical declines observed among nonimmigrant communities in the USA and Europe.

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Anderson, Keith A., Lyn Geboy, Shannon E. Jarrott, Lydia Missaelides, Aaron M. Ogletree, Lisa Peters-Beumer, and Steven H. Zarit. "Developing a Set of Uniform Outcome Measures for Adult Day Services." Journal of Applied Gerontology 39, no. 6 (June 14, 2018): 670–76. http://dx.doi.org/10.1177/0733464818782130.

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Adult day services (ADS) provide care to adults with physical, functional, and/or cognitive limitations in nonresidential, congregate, community-based settings. ADS programs have emerged as a growing and affordable approach within the home and community–based services sector. Although promising, the growth of ADS has been hampered by a lack of uniform outcome measures and data collection protocols. In this article, the authors detail a recent effort by leading researchers and practitioners in ADS to develop a set of uniform outcome measures. Based upon three recent efforts to develop outcome measures, selection criteria were established and an iterative process was conducted to debate the merits of outcome measures across three domains—participant well-being, caregiver well-being, and health care utilization. The authors conclude by proposing a uniform set of outcome measures to (a) standardize data collection, (b) aid in the development of programming, and (c) facilitate the leveraging of additional funding for ADS.

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Aguiñaga, Susan, and David X. Marquez. "Impact of Latin Dance on Physical Activity, Cardiorespiratory Fitness, and Sedentary Behavior Among Latinos Attending an Adult Day Center." Journal of Aging and Health 31, no. 3 (September 27, 2017): 397–414. http://dx.doi.org/10.1177/0898264317733206.

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Objective: The aim of this study was to determine whether a Latin dance program with sedentary behavior information would have an impact on physical activity, cardiorespiratory fitness (CRF), and sedentary behavior among older Latinos attending an adult day center (ADC). Method: Participants ( N = 21, 75.4 ± 6.3 years old, Mini-Mental State Examination [MMSE] score = 22.4 ± 2.8) were randomized into a dance or wait-list control group. Participants wore an accelerometer and inclinometer and completed a sedentary behavior questionnaire, and a nonexercise equation was used to calculate CRF. Results: Findings indicate small to medium effect sizes in the desired direction during midpoint of the intervention for physical activity, sedentary behavior–related outcomes, CRF, and self-reported sedentary behavior in the dance group; however; dance participants did not maintain that trajectory for the remaining 2 months of the intervention. Discussion: Future studies may consider implementing behavioral strategies during midpoint of the intervention to encourage participants attending an ADC to maintain physical activity and sedentary behavior changes.

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Blunk, Elizabeth M., and Sue W. Williams. "A COMPARISON OF ADOLESCENT AND ADULT MOTHERS' MATERNAL SEPARATION ANXIETY." Social Behavior and Personality: an international journal 27, no. 3 (January 1, 1999): 281–87. http://dx.doi.org/10.2224/sbp.1999.27.3.281.

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Maternal separation anxiety was compared for twenty adolescent and twenty adult mothers. The adolescent mothers were recruited from a high school teen parent program. Adult participants were recruited from two university day care programs. The Maternal Separation Anxiety Scale was used to assess the level of anxiety experienced by employed or school enrolled mothers when separated from their children. Analysis of variance indicated a group difference for separation anxiety with the adolescent mothers being significantly more anxious when leaving their children.

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Baltzell, Kimberly. "A 14-day follow-up of adult non-malarial fever patients seen by mobile clinics in rural Malawi." Malawi Medical Journal 32, no. 1 (March 31, 2020): 31–36. http://dx.doi.org/10.4314/mmj.v32i1.7.

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BackgroundWhile health providers consistently use malaria rapid diagnostic tests to rule out malaria, they often lack tools to guide treatment for those febrile patients who test negative. Without the tools to provide an alternative diagnosis, providers may prescribe unnecessary antibiotics or miss a more serious condition, potentially contributing to antibiotic resistance and/or poor patient outcomes. MethodsThis study ascertained which diagnoses and treatments might be associated with poor outcomes in adults who test negative for malaria. Adult patients for rapid diagnostic test of malaria seen in mobile health clinics in Mulanje and Phalombe districts were followed for 14 days. Participants were interviewed on sociodemographic characteristics, health-seeking behaviour, diagnosis, treatment and access to care. Mobile clinic medical charts were reviewed. Two weeks (±2 days) following clinic visit, follow-up interviews were conducted to assess whether symptoms had resolved.ResultsInitially, 115 adult patients were enrolled and 1 (0.88%) was lost to follow-up. Of the 114 adult patients remaining in the study, 55 (48%) were seen during the dry season and 59 (52%) during the wet season. Symptoms resolved in 90 (80%) patients at the 14-day follow-up visit (n=90) with the rest (n=24) reporting no change in symptoms. None of the patients in the study died or were referred for further care. Almost all patients received some type of medication during their clinic visit (98.2%). Antibiotics were given to 38.6% of patients, and virtually all patients received pain or fever relief (96.5%). However, no anti-malarials were prescribed.ConclusionsMobile clinics provide important health care where access to care is limited. Although rapid tests have guided appropriate treatment, challenges remain when a patient’s presenting complaint is less well defined. In rural areas of southern Malawi, simple diagnostics are needed to guide treatment decisions.

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Weeks, Lori E., and Karen A. Roberto. "Comparison of Adult Day Services in Atlantic Canada, Maine, and Vermont." Canadian Journal on Aging / La Revue canadienne du vieillissement 21, no. 2 (2002): 273–82. http://dx.doi.org/10.1017/s0714980800001525.

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ABSTRACTIn both Canada and the United States, adult day services (ADS) are an integral component in the array of long-term care services available. We compared characteristics of programs and participant characteristics in Atlantic Canada, Maine, and Vermont. Directors of 47 ADS programs responded to a mailed survey. Individual ADS programs in each province and state exhibited unique program and participant characteristics. ADS programs in the two countries differed with respect to: affiliation, location, levels of government support, participant fees, organizational sponsorship, hours of operation, months of attendance, and hours attended per day. Participant characteristics that varied between the two countries were educational level, physical needs, and cognitive status. The results of this study provide new comparative information that can be used in guiding future research and program development of ADS.

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Kesseler, Theresa A., and Lynette Rayman. "Undergraduate student-faculty collaborative research: A pilot study exploring care of a family member with dementia." Journal of Nursing Education and Practice 11, no. 3 (November 12, 2020): 17. http://dx.doi.org/10.5430/jnep.v11n3p17.

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Objective: Caregivers for a family member with dementia experience subtle but long-term role changes that can be attenuated with successful coping strategies. The aim of this paper is to describe an effective research initiative managed by an undergraduate student-faculty collaborative team to assess the physical, emotional, and financial effects of caregiving and identify the impact of using an adult day service.Methods: Using the collaborative model, undergraduate nursing students led a mixed method, pilot study. Eight students, mentored by two faculty, held weekly meetings to manage the research design. After reviewing literature evidence, students developed the methodology and carried out the research. The convenience sample included 10 caregivers, each having a family member with dementia, who attended an adult day center in a rural/suburban city in the Midwest. The Kingston Caregiver Stress Scale (KCSS), a 10-item assessment of caregiver stress using a 5-point Likert scale, measured quantitative data. Two focus groups were conducted to collect qualitative data.Results: Participants included 6 males/4 females ranging in age from 46-72 (M = 65, SD = 10.58). Participants provided care an average of 4.2 years (SD = 6.0) and reported moderate levels of caregiving stress on the KCSS (M = 30.5, SD = 9.7). Four themes emerged from focus groups: (a) common emotional responses, (b) benefits of adult day services, (c) overwhelming impact on daily life, and (d) caregiver social isolation.Conclusions: Respite services promoted resilience through opportunities to manage self-care, to perform daily tasks, and to decrease emotional burden. Undergraduate nursing students effectively planned and implemented the research. As future practitioners, they may be more inclined to participate in best practice because of their experience on a student-faculty collaborative team.

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Chestnut, Victoria M., Karen Vadyak, Matthew M. McCambridge, and Michael J. Weiss. "The Impact of Telephonic Follow-Up Within 2 Business Days Postdischarge on 30-Day Readmissions for Patients With Heart Failure." Journal of Doctoral Nursing Practice 14, no. 1 (January 19, 2021): 43–49. http://dx.doi.org/10.1891/jdnp-d-19-00079.

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BackgroundHeart failure (HF) is a chronic condition associated with high rates of hospital readmissions. The prevalence and costs of HF are expected to rise dramatically by 2030 (Heidenreich,et al., 2013).ObjectiveA 24-month, retrospective study was conducted using electronic medical record (EMR) chart review, seeking to identify if postdischarge follow-up phone calls decreased 30-day readmissions in individuals with HF.MethodsThe study included 705 adult participants who were admitted to the hospital for HF. Some received a postdischarge call within 2 business days of discharge, and some did not.ResultsParticipants who received the postdischarge call were less likely to be readmitted (20.1%) than participants who did not receive a postdischarge call (28.8%; p = .007). Participants who received the postdischarge call were more likely to have a follow-up visit within 14 days (70.1%) than participants who did not receive a postdischarge call (30.2%; p < .001).ConclusionsThe findings from this study may help to drive future transitional care strategies for individuals diagnosed with HF.Implications for NursingNurse-led transitional care interventions offer potential solutions to ensure safe, effective hospital discharges.

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Choutko-Joaquim, Sandra, Nadine Tacchini-Jacquier, Géraldine Pralong D’Alessio, and Henk Verloo. "Associations between Frailty and Delirium among Older Patients Admitted to an Emergency Department." Dementia and Geriatric Cognitive Disorders Extra 9, no. 2 (June 21, 2019): 236–49. http://dx.doi.org/10.1159/000499707.

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Background: Switzerland’s demographic trends show, as elsewhere on the planet, increasing numbers of older and very old adults. This suggests that its healthcare system will suffer serious repercussions, including in the use of care and especially the use of emergency services. Significant numbers of older adults will be at risk of developing multiple chronic conditions including one or more geriatric syndromes, such as frailty and delirium. Few studies to date have documented associations between frailty and delirium. Aim: To explore the relationships between frailty and delirium in older adult patients consulting (n = 114) at an emergency department (ED) in Switzerland. Method: A cross-sectional study was conducted in a peripheral hospital ED in the French-speaking part of Switzerland. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Delirium was assessed using the Confusion Assessment Method (CAM). Participants’ cognitive states were assessed using the 6-item Cognitive Impairment Test (6CIT) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQ-CODE), completed by the participant’s most significant informal caregiver. Results: The mean participant age was 77.6 years (SD = 7.7); the majority of the subjects were women (54%). The participants took an average of 4.7 different medications a day (SD = 3.2, median = 4). More than half (62%) of the participants were frail; 2 and 14% presented signs and symptoms of delirium and subsyndromal delirium, respectively. A weak but significant association between scores for frailty and delirium (p < 0.05) was demonstrated, and clinical observation confirmed this. A 4-h follow-up measurement of delirium in the ED revealed no significant or clinical difference. Conclusion: Although the literature describes strong associations between frailty and delirium in surgical units and community care settings, the present study only demonstrated a weak-to-moderate association between frailty and delirium in our ED.

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Carter, Jocelyn, Charlotte Ward, Deborah Wexler, and Karen Donelan. "The association between patient experience factors and likelihood of 30-day readmission: a prospective cohort study." BMJ Quality & Safety 27, no. 9 (November 16, 2017): 683–90. http://dx.doi.org/10.1136/bmjqs-2017-007184.

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ObjectiveHospital care comprises nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission.DesignProspective cohort study.SettingTwo inpatient adult medicine units at Massachusetts General Hospital, Boston, Massachusetts.ParticipantsEight hundred and forty-six patients admitted to study units between January 2012 and January 2016 who met eligibility criteria and consented to enrolment.Main outcomeOdds of 30-day readmission.ResultsOf 1754 eligible participants, 846 (48%) were enrolled and 201 (23.8%) were readmitted within 30 days. Readmitted participants were less likely to have a high school diploma/GED (44.3% not readmitted vs 53.5% readmitted, P=0.02). In multivariable models adjusting for baseline differences, respondents who reported being ‘very satisfied’ with the care received during the index hospitalisation were less likely to be readmitted (adjusted OR 0.61, 95% CI 0.43 to 0.88, P=0.007). Participants reporting doctors ‘always listened to them carefully’ were less likely to be readmitted (adjusted OR 0.68, 95% CI 0.48 to 0.97, P=0.03). Participants reporting they were ‘very likely’ to be readmitted were not more likely to be readmitted (adjusted OR 1.35, 95% CI 0.83 to 2.19, P=0.22).ConclusionParticipants reporting high satisfaction and good provider communication were less likely to be readmitted. Rates of readmission were increased among participants stating they were very likely to be readmitted though this association was not statistically significant. Incorporating patient-reported measures during index hospitalisations may improve readmission prediction.

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Ayalon, Liat. "Subjective Social Status as a Predictor of Loneliness: The Moderating Effect of the Type of Long-Term Care Setting." Research on Aging 41, no. 10 (August 27, 2019): 915–35. http://dx.doi.org/10.1177/0164027519871674.

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Much has been written about the important role that subjective social status plays in older adults’ well-being and subjective health. Less is known, however, about the potential role played by subjective social status in people’s sense of loneliness. In the present study, the author examined the role of subjective social status as a predictor of loneliness in adult day care centers (ADCCs) and continuing care retirement communities (CCRCs) over a 1-year period. The main analyses consist of data from 245 respondents (141 ADCC participants and 104 CCRC residents) who completed the interviews in Waves 1 and 2. A significant interaction between subjective social status and type of long-term care setting was found. Higher levels of subjective social status were associated with lower levels of loneliness in CCRCs, but no such association was evident in ADCCs. These findings are interpreted in view of the characteristics of the CCRC as a total institution versus the ADCC as a setting that provides support for only several hours per day, several days per week.

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Washburn, Allyson M., and Abby Schwartz. "INTEREST GROUP SESSION—QUALITATIVE RESEARCH: INNOVATIVE QUALITATIVE AND MIXED-METHODS STUDIES OF OLDER ADULTS’ LIVED EXPERIENCES IN NETWORKS OF CARE AND CARING." Innovation in Aging 3, Supplement_1 (November 2019): S554. http://dx.doi.org/10.1093/geroni/igz038.2041.

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Abstract Researchers are challenged both when querying older adults about their lived experience and later when analyzing these rich interview data to characterize and preserve their truths. This symposium presents innovative strategies to meet these challenges in ways that deepen our understanding of older adults’ lives within their networks of care and caring. Participants in two interpretive phenomenological studies were family caregivers. One examined the impact of the Virtual Dementia Tour® on participants’ perceptions of their family member’s lived experience of dementia, identifying changed realities and approaches to caregiving following their experience. The second analyzed in-depth interviews of aging caregivers about future care for their adult children diagnosed with autism spectrum disorders, finding that they had difficulty identifying caregiving support for the future while feeling the need to make plans and decisions now. Two mixed methods studies explored older adults’ experience of their current environment. In the first, measures of social cognition and engagement informed the interpretation of combined phenomenological-hermeneutic and conventional content analyses of nursing home residents’ responses to questions about their relationships, finding that they valued day-to-day social interactions as connections with longtime friends were maintained. The second study combined focus groups, in-depth interviews, and web-based surveys during the psychometric testing of the Person-Place Fit Measure for Older Adults to assess older adults’ experience of aging in a particular place with people they find important. The strategies detailed in these four papers transformed more conventional approaches to deepen our understanding of older adults’ experiences of their lives with others.

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Smith, Georgia, and Hannah Farrimond. "Active ageing, emotional care and the threat of stigma: Identity management in older adults using sleeping medication long-term." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 23, no. 3 (March 8, 2018): 255–72. http://dx.doi.org/10.1177/1363459318762034.

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Amid fears about the medicalisation of old age, the high prevalence of sleeping medication use in older cohorts is a significant public health concern. Long-term use is associated with a plethora of negative effects, such as cognitive impairment and risk of addiction. However, little is known about the lived experience of older adults using sleeping medication longer term. Episodic interviews lasting approximately 90 minutes were conducted with 15 independently living adults, aged 65–88 years, who were using sedative-hypnotic or tricyclic sleeping medication for more than 11 years on average. Thematic analysis shows that participants divided their rationale for use into two temporal periods: (1) to ensure physical ability in the daytime and (2) to ensure emotional stability at night. Long-term sleeping medication was thus characterised as a form of ‘emotional self-management’ of the negative emotions associated with later life, blotting out feelings of loss and loneliness by inducing sleep. Participants feared loss of access to their medication ‘supply’, employing strategies to ensure its continuity, while expressing shame about their dependence. However, identity management, in the form of explanations, minimisations and social comparisons, functioned to downplay their addiction. Through this, long-term sleeping medication users were able to elude the spoiled identities and multiple stigmas of both the ‘out of control’ addict and the unsuccessful older adult by asserting a positive identity; that of the ‘new’ older adult, actively medicating for success both day and night.

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Ayalon, Liat, and Ella Cohn-Schwartz. "The reciprocal temporal associations between subjective age and social relations in adult day care centers over a one-year period." International Journal of Behavioral Development 45, no. 1 (July 9, 2020): 69–77. http://dx.doi.org/10.1177/0165025420935620.

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Objectives: The present study evaluated the reciprocal temporal associations between one’s subjective age (or felt age) and one’s social relations in the adult day care center (ADCC) over two waves of data collection, spread about 1 year apart. Method: Participants from four ADCCs in Israel were approached in 2017 and repeatedly, in 2018 ( N = 224 in Wave 1 and N = 259 in Wave 2). The ADCC social network included both outgoing ties of familiar relationships with other ADCC members as reported by the respondent (out-degree centrality) and ingoing ties, based on reports of other ADCC members who were familiar with the respondent (in-degree centrality). Results: Out-degree and in-degree centrality at baseline were not associated with change in subjective age. Subjective age at the first time point was not associated with change in out-degree centrality, but it was negatively associated with change in in-degree centrality. Even after controlling for sociodemographic and health variables, adults who felt younger were subsequently cited by more ADCC members. Conclusions: The findings stress the importance of subjective age to one’s relationship in the ADCC. It is suggested that a younger subjective age is a desired quality in the ADCC.

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Bårdstu, Hilde Bremseth, Vidar Andersen, Marius Steiro Fimland, Lene Aasdahl, Hilde Lohne-Seiler, and Atle Hole Saeterbakken. "Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial." International Journal of Environmental Research and Public Health 18, no. 13 (June 22, 2021): 6682. http://dx.doi.org/10.3390/ijerph18136682.

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Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

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Dave, Jayna, Mamie White, and Alexandra Castro. "Parents’ Knowledge and Perspectives About the New CACFP Meal Guidelines: A Qualitative Investigation." Current Developments in Nutrition 5, Supplement_2 (June 2021): 116. http://dx.doi.org/10.1093/cdn/nzab035_024.

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Abstract Objectives Child day care centers that serve low-income families may qualify to participate in the US Department of Agriculture Child and Adult Care Food Program (CACFP) and receive reimbursement for meals and snacks served. In 2017, day care sites were mandated to follow the new CACFP meal guidelines. The objective of this study was to assess knowledge and perspectives about the new CACFP meal guidelines among parents of children attending day care sites. Methods Individual interviews and focus groups with parents of children at CACFP day care sites in two Texas cities. Qualitative data were coded and analyzed using using a modified version of focused coding and grounded theory methods. Themes and sub-themes were identified. Quantitative data were analyzed for frequencies and descriptives. Results A total of 54 parents participated via 29 individual interviews and 7 focus groups and completed questionnaires. All participants were females; majority were Hispanics and with income < $20,000, about 67% were aware of the new CACFP meal guidelines. Five major themes emerged: thoughts on menus and meals served at day care (sub-themes: overall menu, nutritional value, portion size, quality, variety of options), perceived child likability of foods served at day care, perceived child satiety, suggested changes to meals, and barriers to children eating meals at day care (sub-themes: time, child preferences). Conclusions This study helped identify thoughts and perceptions of parents of children attending CACFP day care. Issues identified should be systematically addressed and incorporated into CACFP menu planning at day care sites. Funding Sources NIH and USDA-ARS.

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Trent, Maria, Jamie Perin, Julia Rowell, Maunank Shah, Jennifer Anders, Pamela Matson, Rebecca M. Brotman, et al. "Using Innovation to Address Adolescent and Young Adult Health Disparities in Pelvic Inflammatory Disease: Design of the Technology Enhanced Community Health Precision Nursing (TECH-PN) Trial." Journal of Infectious Diseases 224, Supplement_2 (August 15, 2021): S145—S151. http://dx.doi.org/10.1093/infdis/jiab157.

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Abstract New approaches to pelvic inflammatory disease (PID) care among adolescents and young adults (AYAs) that optimize self-care and personalize treatment are warranted to address age and racial-ethnic PID-related health disparities. Here we describe the 13-month preliminary feasibility and acceptability outcomes of recruitment, retention, and intervention delivery for Technology Enhanced Community Health Precision Nursing (TECH-PN) randomized controlled trial. Urban AYAs 13–25 years assigned female sex at birth with acute mild-moderate PID provided baseline and follow-up interview data and vaginal specimens for sexually transmitted infection (STI), cytokine, and microbiota assessment. All participants received medications and text-messaging support. Participants were block randomized to either control or intervention. Control participants received 1 community nursing visit with self-management for interim care per national guidelines. Intervention participants received unlimited precision care services driven by interim STI and macrolide resistance testing results by an advanced practice provider. In the first 13 months, 75.2% patients were eligible, and 76.1% of eligible patients enrolled. Of the participants, 94% completed the intervention and 96%, 91%, and 89%, respectively, completed their 14-, 30-, and 90-day visits. Baseline laboratory results revealed infection rates that were highest for Mycoplasma genitalium (45%) followed by Chlamydia trachomatis (31%). Preliminary enrollment, STI, intervention delivery, and retention data demonstrate the feasibility and acceptability of the TECH-PN intervention and support rationale for precision care for PID among urban AYAs. ClinicalTrials.gov Identifier. NCT03828994.

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