Climate Change Policies and Older Adults: An Analysis of States' Climate Adaptation Plans.

Background And Objectives: As climate change drives more frequent and intense weather events, older adults face disproportionate impacts, including having the highest mortality rates from storms, wildfires, flooding, and heat waves. State governments are critical in deploying local resources to help address climate change impacts. This policy study analyzes states' climate adaptation plans to assess the methods through which they address the impact of climate change on older adults.

Extreme Heat Vulnerability Among Older Adults: A Multilevel Risk Index for Portland, Oregon.

Background And Objectives: Extreme heat is an environmental health equity concern disproportionately affecting low-income older adults and people of color. Exposure factors, such as living in rental housing and lack of air conditioning, and sensitivity factors, such as chronic disease and social isolation, increase mortality risk among older adults. Older persons face multiple barriers to adaptive heat mitigation, particularly those living in historically temperate climates.

"This 'Family Setting' Is Not that Anymore": Rewards and Challenges of Adult Foster Home Owners.

Small residential care settings for older adults and people with disabilities are found throughout the United States. Those with fewer than 25 residents account for half of residential care settings. Adult foster homes (AFH) are under-studied although they provide personal and health-related services to residents, including people with Alzheimer's disease.

State Variability in the Prevalence and Healthcare Utilization of Assisted Living Residents with Dementia.

Objectives: Almost 1 million older and disabled adults who require long-term care reside in assisted living (AL), approximately 40% of whom have a diagnosis of Alzheimer's disease and related dementias (ADRD). States vary in their regulations specific to dementia care that may influence the presence of residents with ADRD in AL and their outcomes. The objectives of this study were to describe the state variability in the prevalence of ADRD among Medicare beneficiaries residing in larger (25+ bed) ALs and their healthcare utilization.

The Impact of Communication Impairments on the Social Relationships of Older Adults: Pathways to Psychological Well-Being.

Purpose Social contact is known to be vital for older adults' mental and physical health but, because communication impairments often co-occur with other types of disability, it is difficult to generalize about the relative impact of a communication impairment on the social relationships of older adults. Specific aims of the study were to examine whether the severity of a communication impairment was associated with a range of social measures and to examine the association between these characteristics and psychological well-being. Method Community-dwelling older adults ranging in age from 65 to 94 were recruited for the study of Communication, Health, Aging, Relationship Types and Support.

Correlates of Administrator Tenure in US Residential Care Communities.

Objective: To determine community- and individual-level correlates of administrator tenure in US residential care communities (RCCs).

Design: Secondary data analysis of the 2010 National Survey of Residential Care Facilities designed by the National Center for Health Statistics. Analysis was conducted using Tobit regression.

State Regulatory Approaches for Dementia Care in Residential Care and Assisted Living.

Purpose: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic.

State Regulation of Medication Administration by Unlicensed Assistive Personnel in Residential Care and Adult Day Services Settings.

Residential care settings and adult day services are two community-based care options used by older adults with chronic health conditions. Most states have regulatory provisions that allow unlicensed assistive personnel (UAP) to administer medications. The current national policy study examined state regulations to identify which states permit UAP to administer medications, as well as staffing and training requirements.

Direct care worker's perceptions of job satisfaction following implementation of work-based learning.

The purpose of this study was to understand the impact of a work-based learning program on the work lives of Direct Care Workers (DCWs) at assisted living (AL) residences. The research questions were addressed using focus group data collected as part of a larger evaluation of a work-based learning (WBL) program called Jobs to Careers. The theoretical perspective of symbolic interactionism was used to frame the qualitative data analysis.

Age-Friendly Portland: a university-city-community partnership.

This article addresses the question of how creating an age-friendly city has come to be an important policy and planning issue in Portland, Oregon. In 2006, researchers from Portland State University's Institute on Aging examined the meanings of age friendliness among a broad range of participants in Portland, Oregon. The research was conducted in conjunction with the World Health Organization's (WHO) Age-Friendly Cities project and followed the completion of two earlier non-WHO-related projects.

"Learning about your residents": how assisted living residence medication aides decide to administer pro re nata medications to persons with dementia.

Purpose: This study identified how unlicensed staff members decide to administer medications prescribed pro re nata (PRN) to residents of assisted living (AL) settings designated for persons with dementia. Theories of knowledge, including explicit and implicit knowledge, discretion, and judgment, guided the analysis.

Design And Methods: Data were collected and analyzed using qualitative methods.

Medication administration errors in assisted living: scope, characteristics, and the importance of staff training.

Objectives: To compare rates of medication errors committed by assisted living staff with different training and to examine characteristics of errors.

Design: Observation of medication preparation and passes, chart review, interviews, and questionnaires.

Setting: Stratified random sample of 11 assisted living communities in South Carolina (which permits nonnurses to administer medications) and Tennessee (which does not).

Understanding the intersection of individual needs and choices with organizational practices: the case of medication management in assisted living.

Purpose: Making choices about everyday activities is a normal event for many adults. However, when an adult moves into an assisted living (AL) community, making choices becomes complicated by perceived needs and community practices. This study examines the relationship between choice and need in the context of practices, using medication administration practices as the case in point.

Consumer discourse in assisted living.

Objectives: The aim of this article is to discuss the cultural construction of the assisted living consumer. Based on theories of consumer studies, it focuses on organizational strategies employed by assisted living practitioners to promote consumer choice and independence while mediating potential risks.

Methods: Data include field notes, participation in manager-training programs, and interviews with residents and family members during a 22-month study of three Oregon facilities.

A comparison of two methods for identifying frail Medicare-aged persons.

This article compares the efficacy of two screening methods to identify frail Medicare-aged persons using self-report questionnaire data: a clinical judgment method developed by nurse and social worker professionals in a community-based long-term care department and an empirical research method previously developed by the Center for Health Research using computer formulas and stepwise logistic regression coefficients. A sub-aim was to see whether the empirical method proved robust over time by measuring aggregate utilization and mortality in frail and nonfrail cohorts, which would increase the interest of physicians, managed care organizations, and other agencies providing service to Medicare beneficiaries.