Turnover among Community Mental Health Workers in Ohio.

This study examined turnover of community mental health workers in 42 randomly selected mental health agencies in Ohio. The turnover rate in 2011 was 26 %. A regression analysis indicated that agencies with lower turnover offered higher maximum pay and were smaller in size, while those offering career advancement opportunities, such as career ladder programs, had higher turnover.

Can Interpreting Nonsignificant Findings Inform the Lessons Learned From an Intervention?

Reducing Disability in Alzheimer's Disease (RDAD) is an evidenced-based intervention for individuals with dementia and their caregivers aimed at reducing the psychosocial strain of the caregiver and improving functional ability of the individual with dementia. Overall efficacy, acceptability, and feasibility outcomes have been published regarding RDAD; however, no specific outcome information has been published on the objective physical performance measures (PPM) of gait speed, functional reach, and balance. Data from the Replication of RDAD (n = 508) was utilized to test the hypothesis that each PPM would show change for participants who completed the program.

Program Components and Outcomes of Individuals With Dementia: Results From the Replication of an Evidence-Based Program.

This study examines whether the delivery of three components, (a) exercise training, (b) behavior management skill building, and (c) dementia-related education, in an evidence-based program are differentially associated with changes in outcomes for individuals with dementia (IWDs) after 3 months. Data come from 508 IWDs participating in the community replication of the evidence-based "Reducing Disability in Alzheimer's Disease" program. Regression results indicate that after 3 months, more exercise sessions are associated with improvements in physical functioning, mobility, minutes exercising, and symptoms of depression; more dementia education sessions are related to fewer restricted activity days; and more behavior management sessions are related to more symptoms of depression.

Improving policies for caregiver respite services.

This paper provides a template for the decade ahead regarding the delivery, supply, and funding of caregiver respite services. Policy changes are needed to address these issues as concerns about our country's ability to meet future caregiving needs are growing along with our aging population. Federal initiatives and state-level policies and programs affecting respite are reviewed and directions for policy advancement are highlighted.

The arts, health, and aging in america: 2005-2015.

In advance of the White House Conference on Aging (WHCoA) in 1981, 1995, and 2005, the arts and aging communities held mini-conferences to ensure that arts, culture, and livability were part of larger public policy discussions. This article takes a historical look at recommendations from the 2005 WHCoA Mini-Conference on Creativity and Aging in America, including arts in health care, lifelong learning, and livability through universal design. Overarching recommendations in 2005 requested investments in research, including cost-benefit analyses; identification of best practices and model programs; program dissemination to broaden the availability of arts programs.

Impact of the care coordination program "Partners in Dementia Care" on veterans' hospital admissions and emergency department visits.

Introduction: "Partners in Dementia Care" (PDC) tested a care-coordination program based on partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association chapters. The hypothesis posited PDC would reduce the likelihood and number of veterans' hospital admissions and emergency department (ED) visits, particularly for those with more cognitive impairment or behavioral symptoms.

Methods: The sample included 328 veterans with dementia and their primary family or friend caregivers from five matched sites (two randomly selected treatment sites).

Activity and well-being of older adults: does cognitive impairment play a role?

This analysis assesses the activity level of 324 older adults and the relationship of activity to quality of life with a specific emphasis on the role of cognitive ability. Although the number of older adults with cognitive impairment continues to grow, few studies have examined the variation in activity and quality of life based on the older adults' cognitive status. Results indicated that cognitively impaired older adults were less active than their nonimpaired peers; however, correlations revealed that regardless of impairment status, more activity was related to a higher quality of life.

Examining direct service worker turnover in three long-term care industries in Ohio.

This is the first study to examine direct service worker turnover and its predictors across three provider types: nursing homes, home health agencies, and providers of services for the developmentally disabled. Stratified random sampling procedures were used to select provider types across five geographic regions in Ohio. Data were collected from administrative staff.

Shared decision-making in dementia: A review of patient and family carer involvement.

This paper reviews empirical findings concerning the decision-making process of persons with dementia and their family carers, with a particular focus on the extent and determinants of involvement of persons with dementia in the decision-making process. To be included in this review, studies needed to be published in peer-reviewed journals between 1999 and 2014, report empirical data from participants with dementia and/or their family carers, and pertain to the involvement of persons with dementia and their family carers in decisions about everyday care, medical care and treatment, or long-term care. A total of 36 studies were included.

'I wish they would remember that I forget:' The effects of memory loss on the lives of individuals with mild-to-moderate dementia.

Purpose Of Study: Due to changing cognitive and functional capabilities, individuals with dementia face challenging care-related issues such as feelings of embarrassment, relationship strain, and symptoms of depression and anxiety. Limited research exists examining individuals with dementia's perceptions and concerns about these issues and how their perspectives can impact the quality and process of their illness experience.

Design And Methods: As part of a larger study, individuals with dementia (n = 114) answered five open-ended questions about their illness experience including: (1) daily routine, (2) concerns about memory loss, (3) relationships with others, (4) fears, and (5) what they wish others understood/knew.

Predictors of Inpatient Utilization among Veterans with Dementia.

Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at the P < 0.

Measuring cultural justifications for caregiving in African American and White caregivers.

Objectives: This report will elucidate the psychometric properties of the Cultural Justifications for Caregiving Scale (CJCS) and evaluate the differences in cultural values and demographic variables among a group of African American and White caregivers. The CJCS measures the cultural reasons for and expectations about providing care to an older relative.

Methods: CJCS data were collected from 202 adults caring for an older relative with memory loss.

A controlled trial of Partners in Dementia Care: veteran outcomes after six and twelve months.

Introduction: "Partners in Dementia Care" (PDC) tested the effectiveness of a care-coordination program integrating healthcare and community services and supporting veterans with dementia and their caregivers. Delivered via partnerships between Veterans Affairs medical centers and Alzheimer's Association chapters, PDC targeted both patients and caregivers, distinguishing it from many non-pharmacological interventions. Hypotheses posited PDC would improve five veteran self-reported outcomes: 1) unmet need, 2) embarrassment about memory problems, 3) isolation, 4) relationship strain and 5) depression.

Evidence-Based Program Replication: Translational Activities, Experiences, and Challenges.

With a growing number of evidence-based programs, it is necessary to understand the translation activities, experiences, and challenges of program replication in a community setting. This article reviews the implementation tasks necessary for agencies to implement the Reducing Disability in Alzheimer's Disease (RDAD) intervention. It presents the importance of using original evidence-based program protocols and enhancing them to best fit service settings by reviewing the translation and implementation activities of (a) selecting and training program and supervisory staff; (b) recruiting, screening, and consenting participants to enroll in the program; and (c) developing a manual to guide community-based program replication.

Statewide implementation of "reducing disability in Alzheimer's disease": impact on family caregiver outcomes.

There have been few replications of efficacious evidence-based programs for dementia caregivers offered in community settings. This study highlights the replication of the evidence-based Reducing Disability in Alzheimer's Disease program and explores the changes in outcomes for participating caregivers and whether those changes are related to level of program utilization. With data from 219 caregivers, regression results indicate that more exercise sessions are associated with a decrease in caregiver strain and more behavior management sessions are associated with a decrease in unmet needs after 3 months.

Sidney Katz, MD: a new paradigm for chronic illness and long-term care.

Dr. Sidney Katz's legacy to the field of gerontology is internationally recognized as his success at developing standardized measures and processes, beginning with the activities of daily living index, for the functional assessment of older adults with chronic conditions necessitating long-term services and supports. That work served as the bedrock for his subsequent major accomplishments, which improved rehabilitation services through interdisciplinary team work and attention to the patient-family constellation; reformed the regulation of nursing homes, refocusing it on resident outcomes and quality of life; and promulgated the concept of active life expectancy as a new approach to measuring the quality of later life.

Caregiver outcomes of partners in dementia care: effect of a care coordination program for veterans with dementia and their family members and friends.

The objective is to test the effectiveness of Partners in Dementia Care (PDC), a care-coordination program that integrates and improves access to medical and nonmedical services, while strengthening the informal care network and providing information, coaching, and emotional support. PDC was delivered via a partnership between Veterans Affairs (VA) Medical Centers (VAMCs) and Alzheimer's Association chapters, for caregivers of veterans with dementia living in the community and receiving primary care from the VA. The initial sample was 486 caregivers of 508 veterans with diagnosed dementia.

Characteristics of Depressed Caregivers of Veterans With Dementia.

This study examined the characteristics of caregivers and persons with dementia (PWD) to determine their association with caregiver depression. Participants included 508 PWD (veterans) and 486 caregivers from Boston, Houston, Providence, Beaumont (Texas), and Oklahoma City, identified from diagnoses from medical records and recruited from February 2007 to July 2009, for a larger study evaluating Partners in Dementia Care, a care-coordination intervention. Characteristics evaluated for PWD included activities of daily living, instrumental activities of daily living, cognitive impairment, and disruptive behavior.

Balancing Caregiving and Work: Role Conflict and Role Strain Dynamics.

Positing role conflict as a bidirectional construct in which work interferes with caregiving (WIC) and caregiving interferes with work (CIW), this study investigated its antecedents (demands and support of caregiving and work) and consequences (role strain). A national sample of 583 women between the ages of 50 and 64 years identified using random-digit-dial procedures completed a telephone survey. Structural equation modeling revealed that caregiving demands were positively associated with CIW and caregiving burden; instrumental caregiving support reduced CIW and caregiving burden.

Negative caregiving effects among caregivers of veterans with dementia.

Objectives: : This investigation was guided by the stress process model and had two objectives: first, to describe the extent of negative caregiving effects for family caregivers of veterans with dementia, and second, to identify salient predictors of negative caregiving effects.

Design: : Data were obtained from baseline, structured telephone interviews with family caregivers of veterans enrolled in "Partners in Dementia Care," a clinical trial testing a care coordination intervention.

Participants: : The study included 486 family caregivers of veterans with dementia who received primary care from the Department of Veterans Affairs healthcare system and lived at home.

Inclusion of caregiver supports and services in home- and community-based service programs: recent reports from state units on aging.

Caregivers have an important role in assisting frail and/or disabled individuals to maintain their independence in the community. Support to assist caregivers in this often stressful and demanding role is critical to sustaining the caregivers' health and ability to provide care. This paper reviews federal policy changes since 2000 that have expanded and enhanced services for informal caregivers.