Journal of Applied Gerontology RSS feed -- OnlineFirst Articles

A Neighborhood Naturally Occurring Retirement Community: Views From Providers and Residents

Bronstein, L., Gellis, Z. D., Kenaley, B. L. — Mon, 23 Nov 2009 08:31:28 PST

Maximizing quality of life for older adults poses challenges for formal service providers. One strategy to identify and address factors influencing health/mental health and promoting autonomy of community-dwelling older people is through a Neighborhood Naturally Occurring Retirement Community (NNORC), a community development model of formal and informal home and community-based support. This article uses qualitative methods to report on critical themes generated from an initial evaluation of an NNORC using individual interviews with community partners that developed the program and Resident Council members living in the NNORC community. Findings reveal the need to support older adults aging in place, the importance of informal systems of care, access to trustworthy concrete service providers, and improved models of collaboration.

Comparing the Safety Culture of Nursing Homes and Hospitals

Castle, N. — Mon, 23 Nov 2009 08:31:28 PST

The purpose of this study was to compare the patient safety culture between nationally representative samples of hospitals and nursing homes. This research is important in expanding our understanding of safety culture, to better understand the differences and similarities between healthcare settings, and to promote shared learning of best practices between settings. Findings from the Nursing Home Survey on Patient Safety Culture (NHSPSC) were compared with findings from the Hospital Survey on Patient Safety Culture (HSOPSC). Of the 26 highly similar items in these questionnaires, 9 of the NHSPSC scores were lower than the HSOPSC scores (indicating poorer perceptions of safety culture), 1 score was identical, and 16 of the NHSPSC scores were higher than the HSOPSC scores (indicating better perceptions of safety culture). Some learning opportunity may present itself for both nursing homes and hospitals to improve safety culture. This may have a significant impact on quality of care and quality of life for residents.

Effects of Immigration and Age on Health of Older People in the United States

Wakabayashi, C. — Mon, 23 Nov 2009 08:31:27 PST

Following cumulative advantage/disadvantage theory and drawing longitudinal data from the 1996, 1998, 2000, 2002, 2004, and 2006 Health and Retirement Studies, this article examined the relationship between immigration experience and health transitions in late life among non-Hispanic White, non-Hispanic Black, and Mexicans in the United States. The results revealed that the timing of migration in the life course helped determine the ways in which individual health transitions would be associated with their aging process, and the pathways would be complex and vary based on the health outcomes and gender of the immigrants. For example, among women, the later-life immigrants would face most disadvantageous health trajectories as they aged with respect to activities of daily living limitations. The results suggested that the timing of U.S. immigration would affect the degree to which immigrants could take advantage of economic opportunities to accumulate financial resources that would benefit health later in life.

Gender Variations in the Levels of Social Support and Risk of Elder Mistreatment in a Chinese Community Population

Dong, X., Simon, M. A. — Fri, 13 Nov 2009 13:42:58 PST

This study aimed to examine gender differences in social support and risk of elder mistreatment (EM) in a community-dwelling Chinese population. The authors conducted a cross-sectional study of 141 women and 270 men aged 60 years or above. EM was assessed using the modified Vulnerability to Abuse Screening Scale (VASS), and social support was measured using the Social Support Index (SSI). After adjusting for sociodemographic factors, socioeconomic status, depression, loneliness, and medical conditions, lower levels of social support were associated with an increased odds of EM in men (odds ratio [OR] = 5.35, 95% confidence interval [CI] = 2.18-13.15, p < .001) and in women (OR = 5.39, 95% CI = 1.95-14.85, p < .001). Perceived social support, but not instrumental social support, was associated with increased odds of EM in men and women. These findings could have important implication for health care professional and social services agencies in the detection, management, and prevention of EM among the aging chinese population.

Medicaid Cost-Savings of Home- and Community-Based Service Programs for Elderly Persons in Florida

Shapiro, A., Loh, C.-P., Mitchell, G. — Mon, 09 Nov 2009 13:10:38 PST

This study is designed to address the estimated Medicaid cost-savings of selected home-and community-based service (HCBS) programs in the State of Florida. Utilizing Medicaid claim data for SFY 2000-2005, a propensity score matching procedure is used to simulate random assignment of seniors into matched treatment (HCBS users) and comparison (waitlist) groups. We then produce an algorithm that determines the differences in Medicaid expenditures between the two groups, producing an estimate of cost-savings. Some HCBS programs in Florida show evidence of Medicaid cost-savings. Median Medicaid cost-savings varied widely, ranging from a cost overage of US$277 per member per month (PMPM) to a cost-savings of US$229 PMPM. Cost-savings appears most consistently when analyzing nursing home costs. The results of this study provide further evidence that nursing home cost-savings can be achieved through home-and community-based services programs.

Rethinking the Value of Residents' Councils: Observations and Lessons From an Exploratory Study

O'Dwyer, C., Timonen, V. — Mon, 09 Nov 2009 13:10:37 PST

Little empirical research is available on residents’ councils (RCs) in care settings for older people. This article analyzes the operation of an RC in an Irish facility, drawing on direct observation of council meetings and interviews with resident participants and staff members. Though some participants benefited from having the opportunity to discuss their views during council meetings, few changes were introduced that affected nonparticipants. The article identified several barriers to the successful operation of the council, including the lack of independence of the council, inadequate skills in group facilitation, staffing shortages, lack of training, and management structures.

Social Ties and Depression: An Intersectional Examination of Black and White Community-Dwelling Older Adults

Mair, C. A. — Thu, 29 Oct 2009 16:30:32 PDT

Aging literature often links social ties to lower depression for older adults; however, research shows inconsistent findings by race and gender. Drawing from an "intersectionality" framework, this article explores whether the relationship between social ties and depression is moderated by race and gender for a nationally representative sample of diverse, community-dwelling older adults (aged 60 and older). Analysis of the most recent wave of the Health and Retirement Study (HRS) indicates that White men, Black men, White women, and Black women differ in terms of the relationship between social ties and depression. Main findings include (a) the overwhelming benefit of marriage and partnership, (b) pronounced differences between Black women’s and White women’s friend and kin ties, and (c) the potential vulnerability of older Black men. Findings highlight the importance of catering community-based elder support toward diverse aging populations. Potential community-based care solutions are discussed.

Would Older Adults Turn to Community Support Services for Help to Maintain Their Independence?

Wed, 14 Oct 2009 13:12:28 PDT

The purpose of this article is to determine whether middle-aged and older adults would identify community support services (CSSs) as a source of assistance for difficulties with the instrumental activities of daily living (IADLs). Furthermore, we determine factors related to the identification of home health and CSSs. Telephone interviews were conducted with 768 adults aged 50 and older. Respondents were presented with a vignette describing a situation where loss of independence is threatened. They were asked what they would do in that situation. Although less than 20% mentioned CSSs, nearly 50% mentioned either a home health or CSS. Findings suggest those less likely to mention a home health or CSS include men, older adults, and the foreign born. In addition, those with less education, functional health limitations, no social support, and a lack of knowledge of where to find information about CSSs mentioned home health or CSSs less often.

When Self-Presentation Trumps Access: Why Older Adults With Low Vision Go Without Low-Vision Services

Spafford, M. M., Rudman, D. L., Leipert, B. D., Klinger, L., Huot, S. — Wed, 14 Oct 2009 13:12:28 PDT

Reasons were sought for low-vision service nonuse in a group of Canadian seniors with self-reported low vision. Audio-recorded semistructured interviews were completed with 34 seniors with low vision: age range (70 to 94 years; mean: 82 years); 16 urban dwellers (12 women); 18 rural dwellers (14 women). Qualitative content analysis and template analytic techniques were applied to transcriptions. Informant nonuse of low-vision services involved: insufficient knowledge, managing for now, and practitioner behavior (inadequate rehabilitation education and management). Underlying seniors’ attitudes that shaped their self-presentation and service nonuse included a strong need for independence, a contextualization of vision loss relative to other losses, and an acceptance of vision loss in life. Service delivery strategies should consider not only knowledge access and healthcare practitioner behavior but also senior self-presentation strategies (e.g., viewing aids as counterproductive to independence). Subtle rural-urban attitudinal differences may further delay access for rural seniors; further research is advised.

Exploitation in Older Adults: Social Vulnerability and Personal Competence Factors

Pinsker, D. M., McFarland, K., Pachana, N. A. — Thu, 01 Oct 2009 10:48:33 PDT

Clinicians are frequently called upon to determine whether an older adult is at undue risk of exploitation and, in particular, financial exploitation. However, there is currently no widely accepted clinical model for describing or explaining who will fall victim to exploitation in later life, and identification of vulnerable older people has been a somewhat onerous process. In this article, an overarching theoretical framework for conceptualizing such forms of vulnerability and its assessment in older adults is presented. Central to this framework are various personal competence factors (i.e., intelligence, cognitive functioning, social intelligence, social skill, personality traits, physical functioning) that purportedly contribute to, or protect against, exploitation. Recommendations and argument for a more holistic approach to assessing and educating potentially vulnerable older adults are presented, as well as directions for future research.

Familial Transmission of Human Longevity Among the Oldest-Old in China

You, D., Gu, D., Yi, Z. — Wed, 30 Sep 2009 11:18:47 PDT

This paper investigates the relationship between longevity of parents and exceptional longevity (survival to age 80 or older) of offspring, using data from the first three waves of the Chinese Longitudinal Healthy Longevity Survey. We apply the Fixed-Attributes Dynamics method and logistic regression models to the data. Results of both methods show that the familial transmission of longevity exists at very old ages, and the transmission is same-sex linked between parents and offspring; that is, there is a strong father-son resemblance of longevity and a strong mother-daughter resemblance of longevity, but a non-significant or weak association of longevity between father and daughter or between mother and son.

Grant and Contract Management Within an Intergenerational Shared-Site Organization: A Case Study

Ruggiano, N. — Wed, 09 Sep 2009 10:58:16 PDT

Intergenerational shared-site (IGSS) organizations have expanded in number and scope over the past few decades. These organizations are based on a human service model that simultaneously provides services to children and older adults, many times under the same roof. Although there has been increased research on the psychological and social effects that intergenerational interactions have on participants, little is known about the organizational processes that occur within these organizations. Utilizing a triangulation of traditional field methods, this study attempts to expand existing knowledge of intergenerational organizations by examining the grant and contract management experiences of a large IGSS agency. The findings indicate that public funding sources for human services are segregated by generational focus, creating challenges to nonprofit intergenerational organizations in grant and contract acquisition and management. Recommendations for future research and implications for providers in IGSS settings are provided.

Assessment of Lighting in Independent Living Facilities and Residents' Perceptions

Hegde, A. L., Rhodes, R. — Tue, 08 Sep 2009 14:42:01 PDT

People above the age of 60 need three times more light than a 20-year-old to perform the same tasks. Providing high light levels with limited amount of glare in eldercare environments enables the residents to function and negotiate their living space with confidence. This study acquired quantitative measurements of light levels in two independent living facilities (ILF) as well as measured the perceptions of the residents regarding their visual environment in these facilities. The results indicate that the quantitative light levels in the ILF were low and inadequate for proper function by the residents in the space when compared to the suggested recommended lighting practice for senior living (Illuminating Engineering Society of North America, 2007). However, the residents rated the lighting as average to good or comfortable. The study raises several questions about the positive responses of the seniors as well as provides tips to facilities management on improving the interior lighting quality of their facilities.

Positive Attitudes Toward Older People and Well-being Among Chinese Community Older Adults

Lu, L., Kao, S.-F., Hsieh, Y.-H. — Tue, 01 Sep 2009 12:22:55 PDT

We aimed to explore older people’s attitudes toward aging and to further examine associations of such attitudes with their well-being in a Chinese society—Taiwan. Face-to-face interviews were conducted to collect data using structured questionnaires from a random sample of community older people (N = 316). We found that (a) older people possessed positive attitudes toward aging in general, but there were some group attitudinal differences associated with education attainment and urban residence; (b) older age, fewer social support, and less positive attitudes toward aging were related to more depressive symptoms; (c) younger age, greater social support, greater community participation, and more positive attitudes were related to higher happiness. The associations of positive attitudes with well-being were found after controlling for those of social support and community participation.

Older Adults Are Less Likely to Identify Depression Without Sadness

Gum, A. M., McDougal, S. J., McIlvane, J. M., Mingo, C. A. — Tue, 01 Sep 2009 12:22:55 PDT

Many older adults do not identify depression or the need for professional treatment. Late-life depression frequently occurs without dysphoria (i.e., depressed mood or sadness); in such cases, older adults may have particular difficulty identifying depression, leading to poor health outcomes. The aims were to examine the hypotheses that older adults would be more likely to identify depression and need for professional help in a vignette of a depressed older adult with sadness versus without sadness. In a randomized experiment, 244 community-dwelling older adults (60+) read one of two vignettes and answered questions about their perceptions of the problem, solutions, and their own background. Less than half (40.98%) identified the person as depressed (sad vignette: 48.33%; vignette without sadness: 33.87%). Participants were more likely to identify depression if they had personal mental health experience, more positive expectations regarding aging, and read the sad vignette. They were more likely to recommend professional help if they identified depression. Older adults’ identification of depression and need for professional help remain low, particularly in the absence of dysphoria.

The Positive Aspects of the Caregiving Journey With Dementia: Using a Strengths-Based Perspective to Reveal Opportunities

Tue, 25 Aug 2009 10:21:20 PDT

The increasing prevalence of dementia in older adults will increase the demands for care from families and the health care system. Caring for a relative with dementia is often viewed as burdensome and stressful in nature; however, of late, attention has been given to the positive aspects of the caregiving journey. The purpose of this article is to discuss the qualitative findings related to the positive aspects of family caregiving from a mixed methods study. A strengths-based perspective was used in the secondary analysis of six focus groups (N = 36) and three personal interview transcripts of family caregivers to persons with dementia. Findings reveal that family caregivers can view their role as an opportunity to give back, to discover personal strengths, and to become closer to the care receiver. The results suggest that identifying and mobilizing caregiver strengths can be an effective strategy for supporting family caregivers in their role.

Racial Differences in Perceived Burden of Rural Dementia Caregivers: The Mediating Effect of Religiosity

Sun, F., Kosberg, J. I., Leeper, J., Kaufman, A. V., Burgio, L. — Thu, 20 Aug 2009 11:50:20 PDT

This study explores whether religiosity explains racial differences in caregiving burden for a rural sample of dementia family caregivers. Data are from a probability sample of 74 non-Hispanic White and 67 African American dementia caregivers in rural Alabama. SPSS macros for estimating indirect effects in multiple mediator models are used to test the mediation effects of religiosity. White caregivers report higher burden, are less likely to use religious coping, and less likely to engage in organized religion than do African American caregivers. Church attendance is found to significantly (B = –.57, p < .05) mediate the racial differences on caregiving burden (R² = .07). Religious involvement in general, and church attendance in particular, seem to provide both spiritual and social psychological benefits to dementia caregivers. Thus, supplementing formal services with the services provided by religious organizations may be important in rural areas where formal resources are scarce.

Rethinking the Applied: Public Gerontology, Global Responsibility

Andrews, G. J., Muzumdar, T. — Thu, 20 Aug 2009 11:50:21 PDT

This study explores whether religiosity explains racial differences in caregiving burden for a rural sample of dementia family caregivers. Data are from a probability sample of 74 non-Hispanic White and 67 African American dementia caregivers in rural Alabama. SPSS macros for estimating indirect effects in multiple mediator models are used to test the mediation effects of religiosity. White caregivers report higher burden, are less likely to use religious coping, and less likely to engage in organized religion than do African American caregivers. Church attendance is found to significantly (B = –.57, p < .05) mediate the racial differences on caregiving burden (R² .07). Religious involvement in general, and church attendance in particular, seem to provide both spiritual and social psychological benefits to dementia caregivers. Thus, supplementing formal services with the services provided by religious organizations may be important in rural areas where formal resources are scarce.

Examining Change in Theory-based Physical Activity Beliefs of Culturally Diverse Older Adults

Fri, 14 Aug 2009 10:48:08 PDT

Using the theory of planned behavior as the theoretical framework, the purpose of this study was to elicit the salient modal physical activity (PA) beliefs and to examine changes in the modal PA beliefs before and after a 16-week pilot PA intervention in culturally diverse older adults. Participants were 48 adults between the ages of 50 and 93 years (71% Black, 56% ≤ high school education, 65% ≤ US$20,000 annual income) who were recruited for a pilot PA intervention. Beliefs were elicited before and after the intervention, and changes in the beliefs were analyzed qualitatively. Changes were detected in the modal beliefs. Future research should focus on interventions that target salient modal beliefs in this population to determine quantitative changes in ratings of beliefs and behavior.

Active Living Among Older Residents of a Rural Naturally Occurring Retirement Community

Grant-Savela, S. D. — Mon, 10 Aug 2009 10:42:39 PDT

This cross-sectional single case study of older residents (N = 197, mean age = 71.5 years) of a Midwestern rural naturally occurring retirement community (NORC) investigates patterns of active living and how they relate to sociophysical NORC characteristics and individual factors. The study uses a self-administered questionnaire (mailed to participants), which includes the Physical Activity Scale for the Elderly (PASE), and the study findings reveal that most respondents engaged in at least one leisure (93.9%) or household (94.4%) activity in the preceding 7 days and walking was the most prevalent activity; respondents who walked, as part of their routine activities (during the 7 days prior to study), had higher self-efficacy scores than nonparticipants (U = 563.5, p < .05); and self-efficacy was positively correlated with the frequency (r_s = .22, p < .01) and duration (r_s = .26, p < .01) of walking.

The Bridge From Then to Now: Tibetan Elders Living in Diaspora

Wangmo, T., Teaster, P. B. — Mon, 10 Aug 2009 10:42:38 PDT

This study presents how older Tibetan refugees have adapted to changing social and economic conditions in India. Participant observation and open-ended interview questions were used to explore life experiences of 14 older Tibetans living in India who participated in this study. Findings revealed that, after having to abandon familiar environments, these participants underwent harsh times in India but have adapted well. They have secured meaningful lives for themselves. Availability of children and institutional resources has proved beneficial at old age. Participants with children perceived that they were well cared for, which added to their satisfaction with present circumstances. However, those without children did not have any source of support and were dissatisfied. Religious activity was important for these participants. The ability to freely practice religion contributed to their satisfaction in exile. These findings are instructive for the treatment and acceptance of refugees throughout the world by contributing to the field of refugee aging and adaptation.

The Effects of a Physical Activity Program on Sleep- and Health-Related Quality of Life in Older Persons With Arthritis

Freburger, J. K., Callahan, L. F., Shreffler, J. H., Mielenz, T. J. — Mon, 03 Aug 2009 14:12:20 PDT

Few studies have examined the effects of physical activity on sleep in older adults. The purpose of this study was to examine the short- and long-term effects of an 8-week, low-to-moderate-intensity physical activity program on improvements in sleep and health-related quality of life (HRQOL) in a sample of community-based older adults with arthritis (N = 346). Participants were randomly assigned to an intervention group or control group that received the intervention on a delayed basis. Sleep and HROQL were assessed with self-report instruments at baseline and 8 weeks using intention-to-treat (ITT) and as-treated (AT) analyses. The intervention group was also assessed at 3 and 6 months. At 8 weeks, the intervention group reported fewer days waking up tired (ITT and AT results) and fewer days waking up at night and/or having poor mental health (AT results). Treatment effects were not maintained at 3 and 6 months.

Using an IADL Assessment to Identify Older Adults Who Need a Behind-the-Wheel Driving Evaluation

Dickerson, A., Reistetter, T., Trujillo, L. — Tue, 28 Jul 2009 12:21:18 PDT

Occupational therapists need to routinely assess driving ability in hospital and/or rehabilitation settings. The purpose of this study is to determine if the Assessment of Motor and Process Skills (AMPS), an observational tool of instrumental activities of daily living, could discriminate between older adult drivers who pass, pass with restrictions, or fail a behind-the-wheel (BTW) evaluation. Forty-six participants were evaluated with a BTW driving assessment and the AMPS. Two one-way ANOVAs found significant differences for both the motor and process scores suggesting the AMPS can be used as a screening tool for driving. Results also showed no significant difference in age between those participants who passed, failed, or needed restrictions supporting the concept that driving abilities are related more to function, not age. Exploration of minimum scores is discussed.

Morbidity Prevalence and Health Care Utilization Among Older Adults in India

Agrawal, G., Arokiasamy, P. — Fri, 24 Jul 2009 13:50:40 PDT

India is experiencing accelerated demographic transition. The country will face the challenge of dealing with problem of population aging in the coming decades. Amidst socioeconomic consequences, health risks among older adults are rising rapidly especially on account of noncommunicable diseases. Given such background, this study assesses the pattern of disease burden, health care utilization, and their covariates for older adults in two selected states based on the 60th round of National Sample Survey (NSSO) data. The states in focus are Maharashtra, the state ahead in demographic transition, and Uttar Pradesh, the state lagging in this process. Correspondingly, the overall prevalence of noncommunicable diseases is higher in Maharashtra compared with Uttar Pradesh. Multivariate logistic regression estimates further show that both the morbidity and health care utilization rates are increasing among older adults. At the same time, substantial disparities are demonstrated in the pattern of morbidity prevalence and health care utilization among older persons by demographic and socioeconomic factors and between Maharashtra and Uttar Pradesh.

A Web-Based Approach for Helping Communities Become More "Aging Friendly"

Lehning, A. J., Scharlach, A. E., Dal Santo, T. S. — Wed, 22 Jul 2009 08:46:37 PDT

This article describes an online conference and supporting Web site designed to help communities become better places in which to age. The "Creating Aging-Friendly Communities" online conference was designed to capture the emerging knowledge being accumulated by researchers, advocacy groups, grassroots organizations, and local governments across the country, and make it available to others who were interested in learning what they could do to make their communities more aging friendly. The article begins with a brief overview of the concept of "aging-friendliness," followed by evidence regarding the effectiveness of online modalities as mechanisms for knowledge dissemination. It then describes the innovative conference format, examining the extent to which the conference goals were achieved. The article concludes with implications for online learning modalities in general and efforts to foster aging-friendly communities in particular.

Evaluating Older Persons' Perceptions on Their Quality of Life in an Old People's Institution: A Zimbabwean Case Study

Hungwe, C. — Wed, 22 Jul 2009 08:46:38 PDT

This study evaluates perceptions on the quality of life of older adults and the extent to which they practiced self-determination in an institution. Participant observation, in-depth interviews, and life histories are used to study 16 older adults and 4 officials who are purposively selected and studied over 2.5 months between July and September 2002. Data are analyzed using the Miles and Huberman approach. Findings reveal that the ability to affect decisions pertaining to one’s care positively affects that individual’s perception of institutional life. The typical life course of an older male is also discussed. Older adults perceive their quality of life as negative and decreasing because they have little choice on their care and quality of life. The institution is affected by many adverse conditions in a socioeconomic environment, such as inflation at the rate of 4000% per annum, dwindling donor support, little government support, and negative attitudes of officials at Rubatsiro.

The Impact of Work Interferences on Family Caregiver Outcomes

Reid, R. C., Stajduhar, K. I., Chappell, N. L. — Wed, 22 Jul 2009 08:46:38 PDT

Most research into caregiver employment and outcomes conceives of employment as a dichotomous variable—employed or not. This study examines the relationship between work interferences and caregiver burden, well-being, and self-esteem within a modified stress process model. Regression models are employed using a population-based random sample of caregivers. Employment status effects on outcomes for the total sample are estimated, followed by estimations of the effects of work interferences on the same outcomes for the employed subsample. Employment status is unrelated to outcomes in the total sample. In the employed subsample, a 13-item work interferences scale is related to burden but unrelated to well-being and self-esteem. Of the 13 items, only "performance at work was affected because of caring for a care recipient" is associated with all three caregiver outcomes. These findings suggest that subjective assessment of work interferences may play a more important role than does employment status.

Correlates of Depressive Symptoms Among Hispanic Older Adults Living in Public Housing

Jang, Y., Chiriboga, D. A., Herrera, J. R., Schonfeld, L. — Fri, 10 Jul 2009 10:44:45 PDT

The study explored determinants of depressive symptoms among 297 Hispanic older adults living in public housing (M_age = 76.0, SD = 7.74). Following a basic stress model, the focus was on the effects of demographic variables, risk factors (functional disability, self-perceived health, and acculturation), and social resources (network of relatives and network of friends). Hierarchical regression analyses revealed that financial status, which was a significant predictor in the initial model, became non-significant when risk factors were taken into consideration. All three risk factors were found to be significant; depressive symptoms were predicted by greater levels of functional disability, more negative self-perceived health, and lower levels of acculturation. In the final model, networks of both relatives and friends were shown to be significant even after we controlled for the effects of demographics and risk factors. Findings discussed in the article were made in the context of culture and residential setting.

Hairstylists' Relationships and Helping Behaviors With Older Adult Clients

Anderson, K. A., Cimbal, A. M., Maile, J. J. — Thu, 02 Jul 2009 14:57:22 PDT

The "kind ear" provided by hairstylists (stylists) can be an important source of informal social support for their clients, yet little empirical research exists that examines this resource. In this study, the authors investigated the relationships and helping behaviors of stylists with one particular group of clients—older adults. Forty (N = 40) stylists from 31 randomly selected salons completed mail-based surveys. Stylists reported that their relationships with older clients were generally very close. When these older clients raised problems and concerns, stylists employed several different helping techniques, including showing sympathy and support. Stylists also reported that they were able to recognize symptoms of depression, dementia, and self-neglect. Finally, a number of stylists indicated that they would be interested in receiving formal training in mental health. These findings point toward the potential inclusion of stylists in community gatekeeper programs that provide an important link between informal and formal helping networks.

Comparison of Anxiolytic Effects of Acute Exercise in Older Versus Younger Adults

Youngstedt, S. D. — Thu, 02 Jul 2009 14:57:22 PDT

Although the anxiolytic effect of acute exercise is well established, there is little understanding regarding whether this effect differs across age. The purpose of this investigation was to compare anxiolytic effects of acute exercise in older versus younger volunteers. Older (n = 32, aged 59-75 years) and younger (n = 45, aged 18-30 years), aerobically fit volunteers were assessed. On 3 consecutive days, participants ran/walked for 60 min at 65% to 75% of heart-rate reserve. The Spielberger State-Trait Anxiety Inventory (Form Y1) was administered 5 min before and 20 min after each exercise bout. Mean state anxiety before and after exercise was analyzed by repeated measures age-by-gender-by-time ANOVA. A significantly greater anxiolytic effect of exercise in the older versus younger participants was found for the mean data (p < .001), as well as each of the 3 individual days. The results suggest greater anxiolytic effects of vigorous acute exercise in older compared to younger adults.

Stability of the Philadelphia Geriatric Center Morale Scale: A Multidimensional Item Response Model and Rasch Analysis

Ma, L., Green, K. E., Cox, E. O. — Wed, 01 Jul 2009 12:41:04 PDT

The purpose of this study was to explore the longitudinal structural and measurement invariance of the 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) using a multidimensional item response model and the unidimensional Rasch model in contrast to prior work employing classical test theory. Participants (n = 177) were assigned to three interventions and assessed at three time points. The structural analyses found that a 3-factor model fit better than a 1-factor or a 2-factor model using the Akaike information criterion (AIC) and Schwartz’s Bayesian information criterion (BIC) though not with the AIC_PCor the BIC_PC. With respect to item fit, differential item functioning (DIF) and correlation of item logit positions, the PGCMS was quite stable. However, Items 4 and 5 were problematic in terms of fit. The internal consistency reliabilities of three factors were also relatively lower than desirable at one point and adequate at others.

No One Is Immune: A Community Education Partnership Addressing HIV/AIDS and Older Adults

Orel, N. A., Stelle, C., Watson, W. K., Bunner, B. L. — Fri, 19 Jun 2009 12:54:25 PDT

There has been a dramatic increase in the number of new HIV diagnoses among people aged 50 to 64 in the United States, and according to the Centers for Disease Control and Prevention (CDC), in just 7 years (by 2015) 50% of those living with AIDS will be aged 50 or older. To address this public health concern, viable HIV/AIDS prevention and treatment options for individuals over the age of 50 are necessary. This article discusses the No One Is Immune initiative that planned, implemented, and coordinated evidence-based HIV/ AIDS prevention and education programs specifically tailored for middle-aged and older adults. Guided by the health belief model, an educational conference entitled "Sexuality, Medication, and HIV/AIDS in Middle and Later Adulthood" was conducted along with research activities that assessed HIV/AIDS knowledge gained using both qualitative and quantitative measures. This project can be replicated by other providers within the aging network.

Retraction: Effects of a Telephone-Based Exercise Intervention for Dementia Caregiving Wives: A Randomized Controlled Trial

Thu, 18 Jun 2009 14:02:45 PDT

This article has been retracted

Strengthening the Long-Term Care Workforce: The Influence of the WIN A STEP UP Workplace Intervention on the Turnover of Direct Care Workers

Dill, J. S., Morgan, J. C., Konrad, T. R. — Mon, 15 Jun 2009 10:34:30 PDT

Given high rates of turnover among direct care workers in long-term care settings, it is important to identify factors affecting organizational-level turnover rates. In this study, the authors examine the impact of a workforce intervention program (Workforce Improvement for Nursing Assistants: Supporting Training, Education, and Payment for Upgrading Performance [WIN A STEP UP]) on turnover rates of direct care workers in nursing homes. Using data collected yearly between 2002 and 2006 from 405 nursing homes in North Carolina, the authors employ random effects modeling to predict a dichotomous outcome of "above-average" versus "below-average" turnover. Results indicate that nursing homes participating in the WIN A STEP UP program are 15% more likely to have below-average turnover than are nonparticipating nursing homes. Organizational factors such as ownership type and Medicaid participation also influenced turnover, whereas labor market factors had no independent effects. The results suggest that workforce development projects that increase the training of direct care workers and provide associated rewards show some potential to lower turnover rates of the direct care workforce.

Exploring Factors Associated With Turnover Among Registered Nurse (RN) Supervisors in Nursing Homes

Kash, B. A., Naufal, G. S., Cortes, L., Johnson, C. E. — Thu, 04 Jun 2009 10:33:41 PDT

Because most turnover studies focus on certified nursing assistants (CNAs), licensed vocational nurses (LVNs), and administrators, little is known about registered nurses’ (RNs) higher turnover. This study builds on the current body of knowledge about turnover among RN supervisors in nursing homes. The article discusses a survey of RN nurse supervisors administered in more than 1,000 nursing homes that was merged with the 2003 Texas Medicaid cost report and the area resource file. Two 2-stage models are developed to predict RN turnover rates. RNs’ intent to leave predicts RN turnover through job satisfaction, perceived empowerment, and education level. High LVN and CNA turnover and high Medicare census are associated with higher turnover. Implications are that participation in management decisions and perceived wage competitiveness are an important determinant of RN retention in nursing homes. Future research should focus why RN supervisors with higher levels of education leave nursing homes.

Do Older Adults Anticipate Relocating? The Relationship Between Housing Relocation Expectations and Falls

Stoeckel, K. J., Porell, F. — Wed, 03 Jun 2009 10:48:55 PDT

The relationship between the occurrence of falls and the expectations older adults have about making future residential moves is examined in this research. Data from the 2002 Health and Retirement Study (HRS) are used to analyze self-reported probabilities of moving among a nationally representative sample of noninstitutionalized adults aged 65 and older. The results show that falls were predictive of anticipation of housing relocation as indicated by more than 50% reported probability of moving within the next 2 years. The results suggest that consideration of housing relocation is greater among older adults who experience tangible events indicative of a trajectory of deteriorating health.

Age Differences in the Demand-Control Model of Work Stress: An Examination of Data From 15 European Countries

Shultz, K. S., Wang, M., Crimmins, E. M., Fisher, G. G. — Wed, 03 Jun 2009 10:48:55 PDT

There have been many tests of Karasek’s demand–control model of work stress. However, no studies have examined how the model may differentially apply to older versus younger workers. Due to age changes in cognitive processing, the psychological demands of jobs may interact differently with controls for younger versus older workers. Therefore, the study uses data from the Eurobarometer to examine how the demand–control model of work stress may function differently for older versus younger workers. The results indicate that different controls may in fact buffer different types of job demands for younger versus older workers. The findings reveal that only the interaction between problem solving and time to complete tasks was significant for younger workers. For older workers, however, the interactions between time deadlines and having sufficient time to complete tasks, autonomy, and the interaction between problem solving and schedule flexibility are significant predictors of self-reported stress.

Transportation Difficulty of Black and White Rural Older Adults

Fri, 29 May 2009 09:29:53 PDT

This study explores self-reported transportation difficulty among rural older adults, using data from the University of Alabama at Birmingham Study of Aging for community-dwelling participants (255 Black and 259 White) residing in rural areas. The authors examine the relationship of predisposing characteristics, enabling resources, and measures of need for care with self-reports of transportation difficulty. Blacks report having more transportation difficulty than Whites (24.7% vs. 11.6%; p < .05). When the authors introduce other variables, race differences disappear, but there is a race-by-income interaction with transportation difficulty. Whites with lower incomes are more likely to have transportation difficulty than Whites with higher incomes. When data from Blacks and Whites are analyzed separately, income is the only variable associated with transportation difficulty among Whites. Among Blacks, income is not related to transportation difficulty but several variables other than income (age, gender, marital status, Mini Mental State Exam scores, and depression) are.

Nursing Home Staff Turnover and Retention: An Analysis of National Level Data

Donoghue, C. — Fri, 29 May 2009 09:29:54 PDT

The goals of this study are to provide national estimates of turnover and retention for registered nurses, licensed practical nurses, and certified nursing assistants in nursing homes, and to examine the associations between management tenure, organizational characteristics, local economic conditions, turnover, and retention. The 2004 National Nursing Home Survey is used as the primary source of data. The annualized turnover rate is found to be the highest among certified nursing assistants at 74.5%, followed by registered nurses at 56.1%, and licensed practical nurses at 51.0%. National retention rates reveal that between 62.5% and 67.3% of nurses have been employed at the same organization for more than one year. Director of nursing tenure, registered nurse hours per patient day, and certified nursing assistant hours per patient day show the most consistent associations to lower turnover and higher retention.

Older Adults' Responses to Hurricane Katrina: Daily Hassles and Coping Strategies

Henderson, T. L., Roberto, K. A., Kamo, Y. — Tue, 26 May 2009 10:34:07 PDT

Using the stress and coping model, this article explores how older adults prepared for and coped with the aftermath of Hurricane Katrina. Interviews with a sample of 122 displaced adults, 60 years of age or older, provided insights regarding the daily hassles they faced that included securing basic resources, facing communication difficulties, and finding transportation. Positive thinking, modified thinking, staying busy, and spirituality were categories that emerged from the qualitative analysis of 119 participants and explained coping by displaced older adults. Our findings reflect what and how older adults coped with a disaster and have implications for disaster preparedness.

Volunteering in "Old" Europe: Patterns, Potentials, Limitations

Hank, K., Erlinghagen, M. — Tue, 12 May 2009 10:44:32 PDT

This article aims at providing an overview of patterns, potentials, and limitations of formal volunteering among older Europeans. Based on data from the 2004 Survey of Health, Ageing and Retirement in Europe (SHARE), we first describe cross-national variations in formal voluntary engagement and report on recent research investigating societal determinants of volunteering. We then discuss general issues related to policies and programs promoting older people’s voluntary engagement. This is complemented by some critical remarks on the current "productive aging" debate in Europe. Pointing out limitations of volunteering in the older population, we conclude by suggesting a broad concept of aging, which encompasses both productive and consumptive elements, as an appropriate model for our aging societies.

Exploring the Influence of the Regulatory Survey Process on Nursing Home Administrator Job Satisfaction and Job Seeking

Holecek, T., Dellmann-Jenkins, M., Curry, D. — Thu, 07 Aug 2008 16:37:14 PDT

Nursing home administrators’ retention rate continues to be a serious problem. One factor potentially affecting administrator turnover that has received minimal research attention is the nursing home regulatory process. Using a random start systematic sample of 135 nursing home administrators, this study explores whether regulatory process perceptions, survey performance (number of deficiency citations on last survey), and demographic or facility variables are associated with job satisfaction and job seeking. Multivariate analyses revealed three main findings: (a) an overall positive perception of the survey process was a significant predictor of administrator job satisfaction and job seeking, (b) survey performance outcomes were not related to administrator job satisfaction, and (c) administrator job seeking was associated with perception of the survey process, performance outcomes, and four factors identified in prior research on staff turnover (type of facility, job tenure, salary, and job satisfaction). Results reinforce ongoing initiatives on retaining quality nursing home leadership.