Examining Engagement and Usability in an Online Discussion Platform for Older Adults: Findings From Pilot Studies.

Social media may facilitate older adults' ability to engage socially and explore health information, but it can present difficulties for older adults. Therefore, it is important to explore older adults' experience of usability and user engagement. We conducted two rounds of pilot studies where we used Facebook to engage older adults.

Age and Mental Health Symptoms Among Chinese Persons With HIV: The Mediating and Moderating Role of Perceived Discrimination.

The association between age and mental health symptoms among persons with HIV (PWH) is inconsistent, and little is known about the mediators and moderators of this association. This study aimed to examine the association between age and mental health symptoms, as well as the mediators and moderators of perceived discrimination. Data were from 1,304 PWH who completed a cross-sectional survey in five areas of China.

Using meta-research to foster diverse, equitable, and inclusive collaborative research networks.

Fostering diverse, equitable, and inclusive collaborative research networks is important for advancing the field of aging research. Despite sizeable investment in research consortia and career development programs, there has been only moderate progress toward diversifying the research workforce studying aging. Without critically examining what works and what does not, continuing to place more resources into these same strategies may not result in a substantial improvement in diversity or the creation of collaborative networks.

A Pilot Randomized Controlled Trial of Integrated Palliative Care and Nephrology Care.

Background: There has been a call by both patients and health professionals for the integration of palliative care with nephrology care, yet there is little evidence describing the effect of this approach. The objective of this paper is to report the feasibility and acceptability of a pilot randomized controlled trial testing the efficacy of integrated palliative and nephrology care.

Methods: English speaking patients with CKD stage 5 were randomized to monthly palliative care visits for 3 months in addition to their usual care, as compared with usual nephrology care.

Investigating the causal effect of cognition on the self-reported loss of functional dentition using marginal structural models: The Panel on Health and Ageing of Singaporean Elderly study.

Aim: To assess the effect of cognition on the loss of functional dentition.

Materials And Methods: We used data from the three waves of the Panel on Health and Ageing of Singaporean Elderly study (n = 4990 at baseline, 774 complete cases analysed) over 6 years (2009-2015). The outcome was the loss of functional dentition (<21 teeth).

Implementing a quality improvement program to reduce falls and increase patient medication satisfaction in an academic medical center.

Background: Hospitalized older adult medication-related falls are common and understudied.

Local Problem: There were organizational educational gaps identified in assisting nurses to recognize and mitigate medication associated side effects that may predispose hospitalized older adults to fall.

Methods: A quality improvement project that utilized pre and post-test design.

A national qualitative study of Hospital-at-Home implementation under the CMS Acute Hospital Care at Home waiver.

Background: The Centers for Medicare & Medicaid Services (CMS) announced the Acute Hospital Care at Home (AHCaH) waiver program in November 2020 to help expand hospital capacity to cope with the COVID-19 pandemic. The AHCaH waived the 24/7 on-site nursing requirement and enabled hospitals to obtain full hospital-level diagnosis-related group (DRG) reimbursement for providing Hospital-at-Home (HaH) care. This study sought to describe AHCaH implementation processes and strategies at the national level and identify challenges and facilitators to launching or adapting a HaH to meet waiver requirements.

Outcomes of home-based primary care for homebound older adults: A randomized clinical trial.

Background: Homebound older adults are medically complex and often have difficulty accessing outpatient medical care. Home-based primary care (HBPC) may improve care and outcomes for this population but data from randomized trials of HBPC in the United States are limited.

Methods: We conducted a randomized controlled trial of HBPC versus office-based primary care for adults ages ≥65 years who reported ≥1 hospitalization in the prior 12 months and met the Medicare definition of homebound.

Association between frailty and cognitive function in older Chinese people: A moderated mediation of social relationships and depressive symptoms.

Background: To date, few studies have focused on examining either the direct or indirect effect of physical frailty on cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their individual components in the role of depressive symptoms as a mediator between frailty and cognitive impairment.

Methods: This study included a total of 7525 Chinese older adults from the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Essential Reform in Long-Term Care.

This article focuses on factors contributing to the state of long-term care in this country. It highlights federal legislation which delegated much oversight to the states resulting in the lack of uniform standards for leadership qualifications, staffing levels, and payment. It describes how existing payment models and hierarchical leadership styles contribute to the system's inability to recruit and retain qualified staff and the need for education to prepare nurses and direct caregivers to work with the complex population in today's nursing homes.

Hospice interventions for persons living with dementia, family members and clinicians: A systematic review.

Background: Hospice care was initially designed for seriously ill individuals with cancer. Thus, the model and clinicians were geared toward caring for this population. Despite the proportion of persons living with dementia (PLWD) receiving hospice care substantially increased over the past 10 years, and their longer lengths of stay, established hospice interventions for this population are scarce.

Older adults' personal health information management: The role and perspective of various healthcare providers.

The management of personal health information (PHI) by older adults (OAs) takes place within a socio-technical context and requires the support of various stakeholders, including healthcare providers. This study investigates provider roles in supporting OA personal health information management (PHIM), barriers they face, and related design implications for health information technology (HIT). We interviewed 27 providers serving OAs in Seattle, WA.

A Scoping Review of the Experiences of Adolescents and Young Adults in the ICU, Their Family Members, and Their Health Care Team.

Adolescents and young adults (AYAs) may be cared for in a pediatric or adult ICU. Specific needs of AYAs differ from those of populations typically found in either ICU. This review identifies research focused on experiences of AYAs in ICUs, their family members, and the health care professionals who care for them, revealing limited research about AYAs in ICUs: 10 articles met inclusion criteria and findings revealed that AYAs want to be treated as individuals and need health care professionals to partner with them.

A Pilot Observational Exploratory Study of Well-Being in Hospice Interdisciplinary Team Members.

Introduction: Well-being and turnover intent represent key aspects to the promotion of a healthy workforce. Alarming levels of burnout and low levels of well-being have been documented in health professionals across care settings. Not only do high levels of burnout, low well-being and high turnover affect health professionals, but they are associated with poor patient care.

A qualitative analysis of communication workflows between adult day service centers and primary care providers.

Objectives: Our study documented communication workflows across adult day care centers (ADCs) and primary care providers (PCPs) around complex needs of persons living with dementia (PLWD). We also identified barriers and facilitators to productive communication in clinical decision support and clinical information systems.

Materials And Methods: We conducted 6 focus groups with ADC staff (N = 33) and individual semistructured interviews with PCPs (N = 22) in California.

Association between home health agency ownership status and discharge to community among Medicare beneficiaries.

To investigate the association of ownership status, discharge rate and length of stay (LOS) of home health care (HH) services under the prospective payment system (PPS). We used 2016-2018 Outcome Assessment and Information Set (OASIS) data sets for Medicare beneficiaries. Two outcome variables were investigated: rate of discharge from an HH agency and LOS.

Multiple Chronic Conditions among Seriously Ill Adults Receiving Palliative Care.

The objective of this study was to characterize multiple chronic conditions (MCCs) among seriously ill adults receiving palliative care at the end of life. A latent class analysis was conducted to identify latent subgroups of seriously ill older adults based on a baseline Charlson comorbidity index (CCI) measurement, a measure of comorbidity burden, and mortality risk. The three latent subgroups were: (1) low to moderate CCI with MCC, (2) high CCI with MCC, and (3) high CCI and metastatic cancer.