The what matters most survey: A measurement evaluation of a self-reported patient values elicitation tool among cancer survivors.

Objectives: Patients with multiple chronic conditions, especially cancer survivors, face challenges in medical decision making. Previous research demonstrates how patient values can guide medical decisions, however facilitating patient values elicitation remains a challenge. This study aims to evaluate the psychometric properties of and refine the What Matters Most (WMM) Survey, a self-reported values elicitation tool, in a cohort of older veteran cancer survivors.

Implementation Lessons Learned: Distress Behaviors in Dementia Intervention in Veterans Health Administration.

Background And Objectives: Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an intervention to manage DBD in VA nursing home settings, or Community Living Centers (CLCs). This paper summarizes multiyear formative evaluation results including challenges, adaptations, and lessons learned to support sustained integration into usual care across CLCs nationwide.

Home-based primary care-mental health integration in the Veterans Health Administration: An updated evaluation of practice patterns.

Starting in 2008, the U.S. Veterans Health Administration required the integration of mental health providers (MH providers) in Home-Based Primary Care (HBPC) programs to promote access to and quality of mental health services for veterans enrolled in HBPC.

Care rejection and aggression among veterans with dementia with and without posttraumatic stress disorder: A multi-group analysis.

Background: In residential long-term care, military service veterans with co-occurring posttraumatic stress disorder (PTSD) and dementia encounter a range of physical and social stimuli that may serve as triggers of trauma-related distress that manifests as care rejection or aggression. Yet, PTSD rarely has been examined in research to understand behaviors of care rejection and aggression in veterans with dementia.

Objectives: Guided by the need-driven dementia-compromised behavior model, we examined the moderation effect of PTSD on pathways from background factors and interpersonal triggers to rejection of care and aggression among veterans with dementia with and without co-occurring PTSD.

Impact of an interdisciplinary intervention for distress behaviors in dementia on psychotropic drug use in Veterans Health Administration Community Living Centers: STAR-VA impact on psychotropic drug utilization.

STAR-VA is an interdisciplinary behavioral approach for managing distress behaviors in residents with dementia, implemented at Veterans Health Administration nursing homes. This study evaluated the impact of STAR-VA implementation on psychotropic drug use. The study design is a retrospective, quasi-experimental cohort analysis of residents enrolled as STAR-VA training cases compared with eligible residents at untrained sites to evaluate treatment effects on psychotropic medication use.

Impact of STAR-VA on Staff Injury and Disruptive Behavior Reports in VA Nursing Homes.

Objectives: Workplace disruptive behavior incidents can be costly for organizations, employees, and customers. Persons with dementia living in long-term care settings have a high risk of exhibiting distressed behaviors. We examined whether a resident-centered, behavioral intervention for residents with dementia led to a reduction in reported workplace disruptive behaviors and staff injury rate due to assault.

A mixed methods study on the manifestations of behavioural symptoms of dementia among veterans with and without posttraumatic stress disorder.

Aims: To explore how behavioural symptoms of dementia are manifested among veterans in residential long-term care settings, in the context of personal, interpersonal/social and environmental triggers and how the manifestations differ between veterans with and without posttraumatic stress disorder.

Design: Secondary analysis using a mixed methods approach.

Methods: We analysed text data from a stratified random sample of 66 cases derived from the programme evaluation dataset of the Staff Training in Assisted Living Residences-Veterans Health Administration (STAR-VA) intervention from 2013 to 2016, using framework analysis.

Rejection of Care and Aggression among Older Veterans with Dementia: The Influence of Background Factors and Interpersonal Triggers.

Objectives: To test relationships among background factors, interpersonal triggers, rejection of care, and aggression among veterans living with dementia in residential long-term care settings, based on the need-driven dementia-compromised behavior model.

Design: A mixed methods secondary analysis of program evaluation data from the Staff Training in Assisted Living Residences-Veterans Health Administration intervention implemented by the US Department of Veterans Affairs healthcare system.

Setting And Participants: In total, 315 older veterans who participated in the 2013‒2016 Staff Training in Assisted Living Residences-Veterans Health Administration program at 76 Community Living Centers (Veterans Affairs-operated nursing homes).

Problem-solving training for Veterans in home based primary care: an evaluation of intervention effectiveness.

Background: Veterans enrolled in Veterans Health Administration (VHA) Home Based Primary Care (HBPC), a program providing in-home medical and mental health care by an interdisciplinary care team, often face substantial physical, cognitive, and mental health challenges. This program evaluation examined the impact of a brief problem-solving intervention on depressive symptoms, quality of life, and problem-solving abilities for Veterans enrolled in HBPC.

Design: Pre- and post-intervention outcomes for Veterans, and qualitative feedback from Veterans and clinicians regarding program satisfaction.

An MDS 3.0 Distressed Behavior in Dementia Indicator (DBDI): A Clinical Tool to Capture Change.

Background/objectives: Persons with dementia frequently demonstrate distress behaviors in dementia (DBD), associated with poorer outcomes. This study aimed to create a measure of DBD from routinely administered Minimum Data Set (MDS 3.0) behavior section items that demonstrated sensitivity to change, for evaluation of intervention efforts for VA Community Living Center (CLCs) residents exhibiting DBD.

Addressing Behavioral Symptoms of Dementia Through STAR-VA Implementation: Do Outcomes Vary by Behavior Type?

Objectives: The STAR-VA program in Veterans Health Administration Community Living Centers (CLCs, nursing home settings) trains teams to implement a psychosocial intervention with residents with behavioral symptoms of dementia (BSD).

Methods: Across 71 CLCs, 302 residents selected as training cases had target behaviors categorized into one of 5 types: physically aggressive (PA), physically nonaggressive, verbally aggressive, verbally nonaggressive, and behavior deficit (BD).

Results: Across all groups, there were significant declines in team-rated behavior frequency (36%) and severity (44%), agitation (10%), distress behaviors (42%), depression (17%), and anxiety (20%).

Workforce Analysis of Psychological Practice With Older Adults: Growing Crisis Requires Urgent Action.

As the proportion and sheer number of older adults in the United States continues to increase, we need to plan for their behavioral health care. Access to accurate data about current workforce characteristics in psychology can provide essential information to inform workforce planning. In this paper, we present results of the American Psychological Association's Center for Workforce Studies survey of psychologists, with a focus on older adults.

Partnership to Enhance Resident Outcomes for Community Living Center Residents With Dementia: Description of the Protocol and Preliminary Findings.

The goal of this quality improvement project is to improve care planning around preferences for life-sustaining treatments (LST) and daily care to promote quality of life, autonomy, and safety for U.S. Department of Veterans Affairs (VA) Community Living Center (CLC) (i.

The Big Shortage: Geropsychologists Discuss Facilitators and Barriers to Working in the Field of Aging.

Geropsychology is a vibrant field of scientific study, pedagogy, and clinical practice, and the need for more geropsychologists will only expand as the population ages. This study involved in-depth, semi-structured telephone interviews with 30 clinical geropsychologists about their training and current work. Qualitative coding of interviews was undertaken using an inductive coding approach.

Development of a Bereavement Group in a Geriatric Mental Health Clinic for Veterans.

Objectives: This article describes the development and program evaluation of an 8-session outpatient geriatric mental health clinic bereavement group for United States military veterans who experienced the death of a loved one.

Methods: Group materials were developed based on a review of literature, with a focus on the dual process model of coping with bereavement and complicated grief treatment. Data are presented from 19 veterans who attended at least 4 of the 8 sessions across the five offerings of this group between 2013 and 2015.

Home is where the future is: The BrightFocus Foundation consensus panel on dementia care.

Introduction: A national consensus panel was convened to develop recommendations on future directions for home-based dementia care (HBDC).

Methods: The panel summarized advantages and challenges of shifting to HBDC as the nexus of care and developed consensus-based recommendations.

Results: The panel developed five core recommendations: (1) HBDC should be considered the nexus of new dementia models, from diagnosis to end of life in dementia; (2) new payment models are needed to support HBDC and reward integration of care; (3) a diverse new workforce that spans the care continuum should be prepared urgently; (4) new technologies to promote communication, monitoring/safety, and symptoms management must be tested, integrated, and deployed; and (5) targeted dissemination efforts for HBDC must be employed.

A Peer Mentorship Program for Mental Health Professionals in Veterans Health Administration Home-Based Primary Care.

Objectives: Mental health professionals working in integrated, interdisciplinary primary or geriatric care settings may have limited training for this growing model of care. Peer mentorship is one avenue of professional development support. We describe the development and evaluation of a peer mentorship program for mental health professionals working within Veterans Health Administration (VHA) Home Based Primary Care (HBPC) programs.

Come, join, lead: Attracting students to careers in aging and promoting involvement in gerontological societies.

Geriatric educators face the challenge of attracting more clinicians, scientists, and educators into geriatrics and gerontology, and promoting involvement in gerontological societies. A survey of psychologists (N = 100) examined factors that attract students in clinical/counseling psychology to practice with older adults, as well as experiences in organizational service. For 58%, interest in aging began at the undergraduate level, but for others interest developed later.

A pilot program of knowledge translation and implementation for newborn resuscitation using US Peace Corps Volunteers in rural Madagascar.

Background: Prevention of adverse perinatal outcome using the Helping Babies Breathe (HBB) neonatal resuscitation algorithm can reduce perinatal mortality in low income settings. Mercy Ships is a non-governmental organisation providing free healthcare education in sub-Saharan Africa and in an attempt to reach more rural areas of Madagascar with our neonatal resuscitation training we designed a novel approach in collaboration with US Peace Corps Volunteers (PCV). PCVs work in rural areas and contribute to locally determined public health initiatives.

Managing Challenging Behaviors of Dementia in Veterans: Identifying and Changing Activators and Consequences Using STAR-VA.

One of the most challenging clinical issues for long-term care staff is the management of dementia-related behavioral symptoms. STAR-VA is an interdisciplinary intervention for managing challenging behaviors of Veterans with dementia in Community Living Centers (CLCs) within the U.S.