In Their Own Words: The Challenges Experienced by Certified Nursing Assistants and Administrators During the COVID-19 Pandemic.

This qualitative study aimed to provide an in-depth understanding of the challenges experienced by certified nursing assistants and administrators during the unprecedented COVID-19 crisis. We conducted 6 administrator interviews and 10 remote focus groups with day and evening CNAs at 5 nursing homes ( = 56) in downstate New York. Content analysis was conducted, and emerging themes were identified across sites and roles.

Perspectives of certified nursing assistants and administrators on staffing the nursing home frontline during the COVID-19 pandemic.

Objective: To identify best practices to support and grow the frontline nursing home workforce based on the lived experience of certified nursing assistants (CNAs) and administrators during COVID-19.

Study Setting: Primary data collection with CNAs and administrators in six New York metro area nursing homes during fall 2020.

Study Design: Semi-structured interviews and focus groups exploring staffing challenges during COVID-19, strategies used to address them, and recommendations moving forward.

Dementia-Focused Person-Directed Care Training With Direct Care Workers in Nursing Homes: Effect on Symptom Reduction.

The majority of older adult nursing home residents have dementia and are at risk of not having their care needs met, largely due to communication deficits. Promoting comfort and minimizing distress for these residents is important. Direct care workers (DCW) and clinical staff completed a 6-day training on a person-directed care (PDC) model-a model guided by the needs of the individual that focuses on empowering DCW to understand and support resident preferences and remaining abilities supported by relationship development and consistent staffing.

A Substance Misuse Intervention Program in Postacute Care: Who Declines Participation?

Objectives: Alcohol and substance misuse has been under-acknowledged and underidentified in older adults. However, promising treatment approaches exist (e.g.

What Predicts Hospice Use in the Nursing Home?

The choice to utilize hospice care in the nursing home when residents are experiencing progressive decline can promote positive quality of care and comfort for residents at the end of life. Concurrent hospice and nursing home care can be less aggressive, and improve symptom management and perceived quality by family members. Using a secondary analysis of retrospective data from the electronic medical record, this study identified predictors of hospice use among 300 nursing home decedents using a six-month look back period.

Developing a Training for Certified Nursing Assistants to Recognize, Communicate, and Document Discomfort in Residents With Dementia.

Nursing home residents with advanced dementia experience significant symptom burden and may be unable to articulate their needs. Observational tools, such as the Pain Assessment in Advanced Dementia (PAINAD) scale, are available to evaluate changes in behavior that may signify discomfort or pain. Studies proposing a short and effective curriculum, primarily for certified nursing assistants (CNAs) on how to use and incorporate the PAINAD in daily patient care, are scarce.

The Social Context of Driving Cessation: Understanding the Effects of Cessation on the Life Satisfaction of Older Drivers and Their Social Partners.

Older adults with vision loss and a friend or family member were interviewed over a 2-year period. We examined the effects of driving cessation on life satisfaction among older adults and a social contact. Drivers' use of public transportation was examined as a moderator.

Use of an Exercise Technology in Post-Acute Care of a Skilled Nursing Facility: A Feasibility Study.

Objectives: Use of exercise technologies has benefits for community-dwelling older adults in terms of improved gait and balance. But research on the feasibility of use of exercise technologies in various geriatric health care settings is lacking. Hence, the current study examined the feasibility of implementing an exercise technology intended to augment rehabilitation in patients receiving post-acute care (PAC) in a skilled nursing facility (SNF).

Depression recognition and capacity for self-report among ethnically diverse nursing homes residents: Evidence of disparities in screening.

Aims And Objectives: To examine agreement between Minimum Data Set clinician ratings and researcher assessments of depression among ethnically diverse nursing home residents using the 9-item Patient Health Questionnaire.

Background: Although depression is common among nursing homes residents, its recognition remains a challenge.

Design: Observational baseline data from a longitudinal intervention study.

End-of-Life Conversations and Hospice Placement: Association with Less Aggressive Care Desired in the Nursing Home.

Education about end-of-life care and treatment options, communication between family and health care providers, and having advance directives and medical orders in place are important for older adults with chronic, progressive decline and end-stage disease who spend their last days in the nursing home. This study used retrospective data (6 months before death) of long-stay nursing home decedents (N = 300) taken from electronic health records to capture the end-of-life experience. Findings showed for almost all decedents, Do Not Resuscitate and Do Not Intubate orders were in place, and just over one-half had Do Not Hospitalize and No Artificial Feeding orders in place.

Developmental regulation with progressive vision loss: Use of control strategies and affective well-being.

The present study addresses older adults' developmental regulation when faced with progressive and irreversible vision loss. We used the motivational theory of life span development as a conceptual framework and examined changes in older adults' striving for control over everyday goal achievement, and their association with affective well-being, in a sample of 364 older adults diagnosed with age-related macular degeneration. Using longitudinal data from 5 occasions at 6-month intervals, we examined intraindividual change in control strategies, and how it was related to change in affective well-being, in terms of self-rated happiness and depressive symptoms.

A population study of correlates of social participation in older adults with age-related vision loss.

Objective: To examine personal characteristics, disease-related impairment variables, activity limitations, and environmental factors as correlates of social participation in older adults with vision loss guided by the World Health Organization's International Classification of Functioning, Disability and Health Model.

Design: Baseline data of a larger longitudinal study.

Setting: Community-based vision rehabilitation agency.

The Positive Association of End-of-Life Treatment Discussions and Care Satisfaction in the Nursing Home.

With the progression of dementia, the need for families and health care providers to have discussions about end-of-life (EOL) treatments arises. EOL treatment decisions often involve whether or not medical interventions intended to prolong life-such as resuscitation, artificial nutrition and hydration, and use of antibiotics-are desired. It is unclear if family satisfaction with care in the nursing home may be associated with involvement in EOL treatment discussions.

Addressing depression in a long-term care setting: a phase II pilot of problem-solving treatment.

Purpose: This was a Phase II pilot study of a problem-solving treatment (PST) to address subsyndromal depression in residents of long-term care facilities. Our goal was to demonstrate PST implementation feasibility and to identify PST's potential for reducing depressive symptoms in this geriatric health care setting.

Methods: Eligible participants were randomized to receive a PST treatment (six 1-hour sessions) or a social contact comparison (6 "friendly" visits) after an initial baseline assessment.

Vital conversations with family in the nursing home: preparation for end-stage dementia care.

Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone.

The Vision-Specific Optimization in Primary and Secondary Control (OPS) Scale.

Objective: To successfully address the challenges of age-related visual impairment in rehabilitation and health care settings, it is crucial to gain a better understanding of the psychological and behavioral adaptations that occur in these populations. The purpose of this study was to modify the Optimization in Primary Secondary Control Scale (OPS) (Heckhausen Schulz and Wrosch 1999) to assess the utilization of lifespan control strategies among older adults with visual impairment.

Method: The Optimization in Primary and Secondary Control Scale (OPS) (Heckhausen et al.

Change in psychological control in visually impaired older adults over 2 years: role of functional ability and depressed mood.

Objectives: The life-span theory of control is applied to study change in vision-specific control strategies in visually impaired older individuals, depending on performance in instrumental activities of daily living (IADL) and depressed mood.

Method: Longitudinal data from visually impaired individuals (at baseline: N = 364; mean age = 82.8 years; visual acuity less than 20/60) measured at three occasions with 1-year intervals in-between were analyzed.

Perceived overprotection, instrumental support and rehabilitation use in elders with vision loss: a longitudinal perspective.

Objectives: This study's purpose was to investigate changes in perceived overprotection - a problematic aspect of close relationships - over time in relationship to instrumental support receipt and vision rehabilitation service use in a sample of older adults with vision impairment.

Methods: Participants were 584 older adults with chronic vision impairment who were interviewed three times over a 12-month period. Longitudinal data were analysed using a latent growth curve methodology to examine change over time in perceived overprotection and instrumental support in relation to vision rehabilitation service use.

The impact of culture change on elders' behavioral symptoms: a longitudinal study.

Objectives: Distressing behavioral symptoms often associated with dementia are not uncommon in the long term care setting. Culture change with its "person-centered approach to care" provides a potential nonpharmacological intervention to reduce these symptoms. The purpose of this study was to examine the relationship between a culture change initiative and nursing home elders' behavioral symptoms.