Cross-Sectoral Partnerships By Area Agencies On Aging: Associations With Health Care Use And Spending.

Area Agencies on Aging (AAAs)-which coordinate social services for older adults in communities across the US-regularly address social determinants of health, sometimes in partnership with other social services and health care organizations. Using data from a 2013 national survey of these agencies, we examined whether their partnership activities were associated with 2014 levels of avoidable health care use and spending for older adults in counties served by each AAA. Multivariate regression models adjusted for agency characteristics, county demographic characteristics, and health care supply factors.

Delivering Person-Centered Care: Important Preferences for Recipients of Long-term Services and Supports.

Objectives: Although assessing individual consumer preferences are an important first step in providing person-centered care, the purpose of this study was to identify the top 10 shared preferences that are important to a majority of consumers receiving long-term services and supports.

Design: A cross-sectional survey design was used.

Setting And Participants: Preference assessment interviews were conducted with 255 nursing home (NH) residents and 528 older adults receiving home and community-based services (HCBS).

Family Involvement in the Nursing Home and Perceived Resident Quality of Life.

Purpose Of Study: This study focuses on the relationship between family involvement and family perceptions of nursing home residents' quality of life (QOL).

Design And Methods: Resident and family variables from the 2012 Ohio Family Satisfaction Survey were merged with facility information from the Certification and Survey Enhanced Reports (CASPER). Hierarchical linear modeling was used to examine the association between family involvement and other predictors with perceived resident QOL.

Human-Animal Interaction and Older Adults: An Overview.

Both pet ownership and animal-assisted therapy are becoming increasingly popular in the United States, and the science of human-animal interaction (HAI) seeks to explore how these relationships with animals can impact health and well-being. In particular, one burgeoning area of research is the role of HAI in healthy aging, given the potential for HAI as an important feature of health and well-being in older adults. The purpose of this review is to summarize and evaluate existing research in this innovative area of scholarship, identifying the potential benefits and risks of both pet ownership and animals in therapeutic settings for older adults.

Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study.

Unlabelled: The U.S. National Pain Strategy calls for increased population research on "high-impact chronic pain" (ie, longstanding pain that substantially limits participation in daily activities).

CMS Strategies To Reduce Antipsychotic Drug Use In Nursing Home Patients With Dementia Show Some Progress.

The Centers for Medicare and Medicaid Services initiated three strategies (in March and July 2012 and in May 2013) to reduce the use of unnecessary antipsychotic medications in nursing homes, especially their widespread use to control behavioral symptoms of dementia. We examined 86,163 state recertification surveys conducted at 15,055 facilities in the period January 1, 2009-March 31, 2015. We found that these strategies were associated with increases in citations for only one of two targeted deficiencies (unnecessary drug use) and only after the third strategy (revisions to the federal guidelines for the citations) was implemented.

Managerial Ownership in Nursing Homes: Staffing, Quality, and Financial Performance.

Purpose Of The Study: Ownership of nursing homes (NHs) has primarily focused broadly on differences between for-profit (FP), nonprofit (NFP), and government-operated facilities. Yet, among FPs, the understanding of detailed ownership structures at individual NHs is rather limited. Particularly, NH administrators may hold significant equity interests in their facilities, leading to heterogeneous financial incentives and NH outcomes.

Quality of Life Trajectories of Older Adults Living in Senior Housing.

Quality of life (QoL) in the face of declining health, mobility, and social losses is a central issue for older adults. Our study examined changes in QoL over time for older adults residing in independent senior housing within continuing care retirement communities (CCRCs) and estimated how residents' social engagement during their first year influenced QoL over the next 4 years. Data were drawn from a 5-year panel study of 267 older adults who moved into senior housing within four CCRCs.

Who Hires Social Workers? Structural and Contextual Determinants of Social Service Staffing in Nursing Homes.

Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009-2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals.

Impact of life stories on college students' positive and negative attitudes toward older adults.

Gerontological educators are increasingly interested in reducing college students' negative, and promoting their positive, attitudes toward older adults. Over the course of a semester, students from six 4-year institutions viewed three life story videos (documentaries) of older adults and completed pre- and posttest surveys that assessed their positive (Allophilia Scale) and negative (Fraboni Scale of Ageism) attitudes. The authors assessed changes in attitudinal scales between treatment (with videos, n = 80) and control (no video, n = 40) groups.

Does cohort matter in the association between education, health literacy and health in the USA?

Growing empirical evidence supports the generally positive relationship between education, health literacy and health outcomes. However, little is known about cohort in this relationship. This study examined the role of cohort defined by 10-year age period in the association between educational attainment, health literacy and self-rated health.

Using art in an intergenerational program to improve students' attitudes toward people with dementia.

This study explored the effects of participating in an intergenerational service learning program called Opening Mind through Arts (OMA) on college students' attitudes toward people with dementia. In this program, students were paired one-on-one with elders who have dementia to support the elders' creation of visual art projects. They met weekly for one semester.

How Does Rurality Influence the Staffing of Social Service Departments in Nursing Homes?

Purpose Of The Study: Social service departments in nursing homes (NHs) are staffed by qualified social workers (QSWs) and paraprofessionals. Due to greater workforce challenges in rural areas, this article aims to describe the staffing levels and composition of these departments by rurality.

Design And Methods: Certification and Survey Provider Enhanced Reports data from 2009 to 2015 are used to examine the effect of rurality on social service staffing using random-effects linear panel regressions.

Activities in dementia care: A comparative assessment of activity types.

This exploratory study compares the impact of five activity types on the well-being of institutionalized people with dementia: the intergenerational art program Opening Minds through Art, art and music therapies, creative activities, non-creative activities, and no activities at all. We validated the Scripps Modified Greater Cincinnati Chapter Well-Being Observational Tool, and used that instrument to systematically observe N = 67 people with dementia as they participated in different activity types. People with dementia showed the highest well-being scores during Opening Minds through Art compared to all other activities.

How Does Medicaid Reimbursement Impact Nursing Home Quality? The Effects of Small Anticipatory Changes.

Objective: In 2006, Ohio changed its Medicaid reimbursement methodology for nursing homes (NHs) to promote more efficient staffing levels. This study examines the impacts of this policy change on quality.

Research Design And Subjects: Ohio NHs were categorized based on their anticipated change in reimbursement under a new reimbursement system initiated in 2006.

Measuring positive attitudes toward persons with dementia: A validation of the Allophilia scale.

Efforts to combat ageism typically focus on negative attitudes toward members of an out-group. Changing attitudes also requires assessment and enhancement of positive attitudes. This study examined the psychometric properties of Allophilia scale when used to measure college students' positive attitudes toward persons with dementia.

The Effects of Antipsychotic Quality Reporting on Antipsychotic and Psychoactive Medication Use.

Objective: The objective of this study is to examine how nursing homes changed their use of antipsychotic and other psychoactive medications in response to Nursing Home Compare's initiation of publicly reporting antipsychotic use in July 2012.

Research Design And Subjects: The study includes all state recertification surveys (n = 40,415) for facilities six quarters prior and post the initiation of public reporting. Using a difference-in-difference framework, the change in use of antipsychotics and other psychoactive medications is compared for facilities subject to public reporting and facilities not subject to reporting.

"It makes me feel like myself": Person-centered versus traditional visual arts activities for people with dementia.

During a 15-month period between February 2010 and April 2011, video data on (n = 38) people with dementia were collected during a person-centered and intergenerational arts activity program called Opening Minds through Art (OMA) at three different long-term care facilities in Ohio. A subsample of the OMA participants (n = 10) were also video recorded during traditional visual arts activities (e.g.

The Nursing Home Five Star Rating: How Does It Compare to Resident and Family Views of Care?

Purpose Of The Study: In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented a five-star rating system of nursing homes in the United States. These star ratings have been widely publicized both by CMS and the national and state media. Although the components of the star rating system take into account various dimensions of quality, satisfaction of nursing home residents and their families is not taken into consideration.

Nursing home prices and market structure: the effect of assisted living industry expansion.

Since the 1990s, there has been substantial expansion of facility-based alternatives to nursing home care, such as assisted living facilities. This paper analyzes the relationship between expansion of the assisted living industry, nursing home market structure and nursing home private pay prices using a two-year panel of nursing homes in the State of Ohio. Fixed effect regressions suggest that the expansion of assisted living facilities are associated with increased nursing home concentration, but find no effect on private pay nursing home prices.

Application of the model of allostasis to older women's relocation to senior housing.

Objectives: Adjustment to senior housing entails significant lifestyle changes and is a stressful process. The adaptation process is dynamic and has yet to be studied using the conceptual model of allostasis. This article presents exemplars of women whose profiles represent three allostatic states: successful adaptation (homeostasis), ongoing adaptation (allostasis), and maladaptation (allostatic load).

The urban-rural disparity in nursing home quality indicators: the case of facility-acquired contractures.

Objective: To identify and quantify the sources of the urban-rural disparity in facility-acquired contracture rates in nursing homes.

Data Sources: Survey inspection data of U.S.

Risk factors of falls in community-dwelling older adults: logistic regression tree analysis.

Purpose Of The Study: A novel logistic regression tree-based method was applied to identify fall risk factors and possible interaction effects of those risk factors.

Design And Methods: A nationally representative sample of American older adults aged 65 years and older (N = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used. Logistic Tree with Unbiased Selection, a computer algorithm for tree-based modeling, recursively split the entire group in the data set into mutually exclusive subgroups and fit a logistic regression model in each subgroup to generate an easily interpreted tree diagram.

Predictors of adherence with self-care guidelines among persons with type 2 diabetes: results from a logistic regression tree analysis.

Type 2 diabetes is known to contribute to health disparities in the U.S. and failure to adhere to recommended self-care behaviors is a contributing factor.

Response to regulatory stringency: the case of antipsychotic medication use in nursing homes.

This paper studies the impact of regulatory stringency, as measured by the statewide deficiency citation rate over the past year, on the quality of care provided in a national sample of nursing homes from 2000 to 2005. The quality measure used is the proportion of residents who are using antipsychotic medication. Although the changing case-mix of nursing home residents accounts for some of the increase in the use of antipsychotics, we find that the use of antipsychotics by nursing homes is responsive to state regulatory enforcement in a manner consistent with the multitasking incentive problem.