Developmental Evaluation of an Established Advisory Board

Abstract CJE SeniorLife developed the PCORI-funded Bureau of Sages, a research advisory board of nursing home community members and older adults, who live at home and receive long term services and supports (LTSS). Bureau members share experiences, build knowledge, and develop skills for working together to provide voice to the direction, design, and implementation of aging research. The PCORI-funded Sages in Every Setting project developed four additional bureaus, expanding and diversifying a pool of researchers, providers, and older adults living with LTSS who have the knowledge, skills, and opportunity to collaborate in research. Evaluation results reveal that the Sage Model is translatable into new settings; partners were able to adapt the provided resources; researchers receive useful input from bureaus to improve their work; and, participation in a research advisory board is a benefit to its members. In addition, we will share challenges to establishing and expanding the Sage Model. Part of a symposium sponsored by the Patient/Person Engagement in Research Interest Group.

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ACCESSING LONG-TERM SERVICES AND SUPPORTS: HOW DO ETHNIC MINORITIES NAVIGATE THE SYSTEM?

Innovation in Aging ◽

10.1093/geroni/igz038.711 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S197-S197

Author(s):

Lauren Ring ◽

Allen Glicksman

Keyword(s):

Older Adults ◽

Sources Of Information ◽

Community Members ◽

Minority Communities ◽

Cultural Minority ◽

Limited English Speaking ◽

Interaction Modeling ◽

English Speaking ◽

Services And Supports

Abstract The decision to seek Long Term Services and Supports (LTSS) can be challenging for older adults and family members. These challenges can be greater for members of certain ethnic/cultural minority communities who are not fluent in English. Our study examines the ways in which older adults in limited English-speaking communities (Spanish / Mandarin Chinese) navigate the use of LTSS. The findings will be used to evaluate disparities in service perception and access experienced by these populations. Our research examines the ways in which information is shared among community members and how they identify trusted sources of information. Ultimately, we wish to examine how these social networks and trusted neighborhood institutions do, or do not, connect older adults in need to the formal LTSS system. We use a modeling technique called Social Interaction Modeling (SIM), which allows for the inclusion of both conceptual and data based elements, to frame this process.

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RACIAL DISPARITIES IN COMMUNITY- AND INSTITUTION-BASED LONG-TERM SERVICES AND SUPPORTS

Innovation in Aging ◽

10.1093/geroni/igz038.2867 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S779-S780

Author(s):

Chanee D Fabius

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Homes ◽

Health Outcomes ◽

Racial Disparities ◽

Nursing Home Residents ◽

Home Health ◽

Services And Supports ◽

The Impact

Abstract Long-term services and supports (LTSS) are services provided to individuals with functional limitations and chronic conditions who need assistance to perform daily activities such as bathing, dressing, preparing meals, and administering medications, and can be provided in community settings via services such as home health, as well as institutions such as nursing homes. Racial disparities are persistent across systems of LTSS, with older adults of color receiving lower quality care and experiencing worse health outcomes than their white counterparts. Given the increasing diversity of the aging population, and the need to ensure equity in quality and health outcomes in LTSS, there is a greater need for more understanding of how experiences of care vary across multiple settings for diverse groups of older adults and the people who help them. This symposium will feature 5 presentations that provide novel insight regarding racial disparities in community- and institution-based LTSS. We focus on racial differences in functional needs and disparities among those receiving home health services and living in nursing homes. Individual presentations will describe 1) race and gender differences in physical functioning needs of older adults; 2) disparities in home health quality across racially diverse and low income geographic areas; 3) racial disparities in nursing home residents overtime; 4) racial and ethnic disparities in rates of 30-day rehospitalization from skilled nursing facilities among Medicare Fee-For-Service and Medicare Advantage patients; and 5) the impact of the unequal burden of care provided to minority nursing home residents by staff of color.

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Utilization and Expenditures of High-Need, High-Cost Older Adults With Disabilities

Innovation in Aging ◽

10.1093/geroni/igab046.601 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 158-158

Author(s):

Cleanthe Kordomenos ◽

Molly Knowles ◽

Micah Segelman ◽

Sarita Karon

Keyword(s):

Older Adults ◽

Nursing Home ◽

Inpatient Care ◽

Nursing Home Care ◽

Community Based ◽

Adults With Disabilities ◽

Care Models ◽

Patterns Of Utilization ◽

Services And Supports

Abstract The factors that lead people to have high needs for care can vary greatly, with implications for the best approaches to serving their needs. One high need group of interest is older adults with disabilities and multiple comorbidities. There is variation in need within this group. Of particular interest is the subset that is both high need and high cost (HNHC). We present work describing Medicare and Medicaid utilization and expenditures for this high need group and the HNHC subset. Over 7.6 million people were identified as high need; 13.6% of them also were defined as HNHC. Patterns of utilization differed between these groups, with the HNHC group more likely to use inpatient care and nursing home care, but less likely to use community-based long-term services and supports. These findings have implications for the development of care models that might best meet the needs of this population.

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A Profile of Black and Latinx Older Adults Receiving Care in Nursing Homes: 2011-2017

Innovation in Aging ◽

10.1093/geroni/igab046.923 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 241-241

Author(s):

Andrew Dick ◽

Bei Wu ◽

David Grabowski ◽

Mansi Agarwal ◽

Gayani Perera ◽

...

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Homes ◽

Minority Groups ◽

Ethnic Disparities ◽

Racial And Ethnic Disparities ◽

Current Trends ◽

Services And Supports

Abstract Between the years 1999-2008, a substantial increase in nursing home use occurred among Black and Latinx older adults, while white older adults’ use of nursing homes decreased. These disparate trends suggested potential racial and ethnic disparities in options for preferred long-term services and supports (LTSS) settings. Over the last decade, several initiatives have been put in place to support LTSS needs in the community. However, it is unclear whether Black and Latinx older adults are continuing to use nursing home services at disproportionate rates. We used LTCfocus data for 2011-2017 to explore current trends in nursing home use and access among Black and Latinx older adults in light of these current initiatives. Our findings reveal a continued rise in Black and Latinx older adults’ use of nursing homes while white older adults’ use continues to decline. More notably, there has been a decline in nursing homes servicing these minority groups.

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Assessing Functional Need of Minority Older Adults Across Two Long-Term Services and Supports Settings

Innovation in Aging ◽

10.1093/geroni/igaa057.583 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 180-180

Author(s):

Jasmine Travers ◽

Andrew Cohen ◽

Norma Coe ◽

Mary Naylor

Keyword(s):

Older Adults ◽

Nursing Home ◽

Activities Of Daily Living ◽

Daily Living ◽

Comparison Group ◽

Functional Limitations ◽

Minority Group ◽

Services And Supports ◽

Retirement Study

Abstract Research has suggested that growth in Black and Hispanic older adults’ nursing home (NH) use may be the result of disparities in options for long-term services and supports (LTSS). To investigate this issue, we aimed to determine whether there were no differences in the functional needs of racial and ethnic groups who received care in NHs versus the community. We identified respondents aged ≥65 years in the 2016 Health and Retirement Study who reported requiring caregiving help. We compared the site of care for Black and Hispanic older adults (minority group) to White older adults (comparison group). We performed unadjusted analyses to assess the association of functional need with community vs. NH care. Functional need was operationalized using a functional-limitations score and six individual activities of daily living (ADL). There were 186 minority older adults (community=78%, NH=22%) and 357 White older adults (community=50%, NH=50%). Across settings, minority older adults did not differ in age, marital status, and income, but a greater percentage of men were in NHs (48% versus 28%; p=0.01). The functional-limitations score was higher in NHs than in the community for both groups. Functional needs for the minority group were similar across the two settings in 2/6 ADLs (dressing p=0.11, toileting p=0.09), while White older adults in NHs were more impaired in all ADLs. Functional need for minority older adults primarily differed by setting while demographics did not. These are important factors to consider when implementing programs to keep older adults out of NHs and in the community.

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State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers

10.15868/socialsector.25076 ◽

2014 ◽

Cited By ~ 7

Author(s):

Susan C. Reinhard Reinhard ◽

Ari Houser Houser ◽

Enid Kassner Kassner ◽

Robert Mollica Mollica ◽

Kathleen Ujuari Ujuari ◽

...

Keyword(s):

Older Adults ◽

Family Caregivers ◽

Physical Disabilities ◽

Services And Supports ◽

People With Physical Disabilities

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Uitbraak COVID-19 in de verpleeghuiszorg

Tijdschrift voor Gerontologie en Geriatrie ◽

10.36613/tgg.1875-6832/2020.03.01 ◽

2020 ◽

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Homes ◽

Long Term Care ◽

Informal Caregivers ◽

Rapid Review ◽

Daily Routine ◽

Term Care ◽

Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

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Economic Uncertainties in Retirement: Risk Factors, Strategies, and Resilience

Innovation in Aging ◽

10.1093/geroni/igaa057.2392 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 685-685

Author(s):

Christine Bishop ◽

Karen Zurlo

Keyword(s):

Older Adults ◽

Financial Risk ◽

Family Care ◽

Student Loan ◽

Defined Contribution ◽

Income Sources ◽

Economics Of Aging ◽

Personal Management ◽

Services And Supports

Abstract Even with forethought and planning, a lot can threaten economic wellbeing in the years ahead for older adults retiring at typical retirement ages. Although results for any individual cannot be predicted with certainty, some risks are quantifiable: for example, mortality/ longevity and disability risks are reasonably well-defined. Risk of dementia is not so well understood, and may be changing. Financial risk might be seen as manageable, but older adults relying on retirement income sources can be especially vulnerable to unprecedented shocks to the general economy. We consider four aspects of this dilemma. First, older adults retiring with outstanding debts may have difficulty weathering financial shocks. Our first presentation provides up-to-date information about trends in indebtedness at older ages, especially focusing on newly salient types of indebtedness: medical and student loan debt, and debt incurred to smooth finances in the recent recession. Stewardship of finances during retirement can be a challenging personal management undertaking. Our second presentation will consider how dementia can complicate this process. Protection against outliving one’s resources is more complex and costlier in the era of defined contribution retirement accounts. Our third presentation will discuss strategies to combine retirement assets, including Social Security claiming, to hedge longevity risk. Finally, needs for long-term services and supports may be met with either paid or informal (family) care, or both, but cannot be predicted with certainty. Our fourth presentation examines the long-term impacts on families due to the difficulty in insuring against this risk. Economics of Aging Interest Group Sponsored Symposium.

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