Presidential Symposium: Disruption to Transformation of Communities of Care: Key Issues and Opportunities in Health Sciences

Abstract Consistent with the theme of the conference this year, this symposium explores the impact of the pandemic and our commitment to redress structural racism and health inequities on health of older adults, and our collective capacity to transform and innovate through our gerontological health sciences lens. Each presenter will focus on one sector of care: (1) the health system and healthcare workforce; (2) older persons; and (3) families and care partners. The first presenter provides a systems-level perspective on key disruptors in healthcare systems for care of older adults and the workforce, and emerging innovations to address increasingly transparent care inequities. Emerging research implications as a result of these disruptions will be highlighted. The second presenter highlights how the predominant features of the pandemic in older adults, loneliness and isolation, are co-occurring with significant resilience and innovation, and the resultant potential to create a paradigm shift in how we design and advance communities of care. The third presenter provides the perspective of family members and care partners of older adults during the time of the pandemic, focusing on disruptions that have informed changes going forward, innovations that have emerged, and implications for research to be addressed. Our discussant situates the presentations within the larger context of ‘the new normal’, with a particular focus on considering the global, inter-connected context of communities of care, a commitment to reducing inequities for older adults, and implications for health sciences education and policy.

Download Full-text

SOCIAL NETWORKS, HEALTH, AND WELL-BEING AMONG PEOPLE LIVING WITH DEMENTIA

Innovation in Aging ◽

10.1093/geroni/igz038.277 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S71-S71

Author(s):

Eleanor S McConnell ◽

Kirsten Corazzini ◽

T Robert Konrad

Keyword(s):

Older Adults ◽

Social Networks ◽

Well Being ◽

Sensor Technology ◽

Web Based ◽

Use Of Technology ◽

Care Partners ◽

The Impact ◽

The Relationship ◽

Health And Well Being

Abstract Although the impact of dementia on the health and well-being of those living with Alzheimer’s Disease and related Disorders (ADRD) and their care partners has been widely studied, less attention has been paid to how the disease impacts individuals within the context of their larger social networks. This symposium presents findings from a series of integrated studies aimed at strengthening measurement of health and well-being among older adults with living with dementia and well-being among members of their social networks. Findings will be presented from five studies: (1) a scoping review of social network measurement in older adults in chronic illness, including dementia, that emphasizes the use of technology in measuring older adults’ social networks; (2) a simulation study to evaluate the feasibility and reliability of sensor technology to measure social interaction among a person living with dementia and others in their immediate surroundings; (3) development of a web-based application that allows older adults to map and activate their social networks; (4) a qualitative analysis of interviews from persons living with dementia, their unpaid caregivers, and paid caregivers from an adult day health program concerning well-being focused outcomes; and (5) a mixed methods analysis of the feasibility of using both traditional and novel measures of health and well-being deployed among networks of people living with dementia. Emerging technologies for measuring social networks health and well-being hold promise for advancing the study of the relationship-based nature of care for people living with dementia.

Download Full-text

Kebebasan Hak Ijtihad Nikah Beda Agama Pasca Putusan Mahkamah Konstitusi

Jurnal Konstitusi ◽

10.31078/jk1239 ◽

2016 ◽

Vol 12 (3) ◽

pp. 604

Author(s):

Faiq Tobroni

Keyword(s):

The State ◽

Constitutional Court ◽

Constitutional Rights ◽

Interfaith Marriage ◽

The Third ◽

Interfaith Marriages ◽

Key Issues ◽

Marriage Laws ◽

Constitutional Right ◽

The Impact

This paper has three key issues. The first issue discusses the arguments constructed by applicant of judicial review (JR) to assess the constitutional rights’ violations caused by the application of Article 2 (1) UUP. The second issue discusses on how the Constitutional Court (MK) seated position of state associated marital affairs in the rejection of JR. The third issue discusses model of freedom of ijtihad (legal thought) on interfaith marriage as the impact of MK’s Decision. Based on the discussion, regarding to the first issue, the applicant of JR assess the application of Article 2 (1) UUP has legitimized the state as the sole interpreters of religious teachings for a requirement validity of the marriage. According to the applicant, the role is used by the state (The Office for Religious Affairs/KUA) to not accept interfaith marriage. This refusal led to the violation of some other constitutional rights. Furthermore, as the findings of the second issue, MK’s decision has placed the real position of state not as interpreters of religious teachings, but merely to accommodate the results of religious scholars’s ijtihad regarding marriage into the state law. Thus, it is not true that the state has violated the constitutional right to more intervene the religious life of citizens. Last findings as the third issue, MK’s decision has affected the model of ijtihad freedom on interfaith marriage. Actually interfaith marriage can still be served through the Civil Registry Office (KCS). KCS could be an alternative way to facilitate the interfaith marriages for all religions in Indonesia. Special for KUA, the institution reject to record interfaith marriage. In this way, it only accommodates freedom of ijtihad within the limits of ijtihad jama’i. KUA just accomodates ijtihad by institutions such as the Majelis Ulama Indonesia, Nahdlatul Ulama, Muhammadiyah and other similar institutions that reject interfaith marriage. Special for marriage in muslim community, ijtihad jama’i is better than ijtihad fardiy because the second could trigger the liberalization of marriage laws (temporary marriages, polygamy more than four, underage marriages and denial of recording).

Download Full-text

The Impact of COVID-19 Across Nursing Homes That Disproportionally Serve Minority Residents

Innovation in Aging ◽

10.1093/geroni/igab046.924 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 241-241

Author(s):

Amit Kumar ◽

Indrakshi Roy ◽

Amol Karmarkar ◽

Kimberly Erler ◽

James Rudolph ◽

...

Keyword(s):

Older Adults ◽

Nursing Homes ◽

The United States ◽

Structural Racism ◽

High Quality ◽

Total Death ◽

The Life Course ◽

The Impact ◽

Related Mortality

Abstract The Coronavirus-2019 (COVID-19) pandemic has disproportionally affected communities of color and older adults in the United States. Nursing homes (NHs) have reported over 130,000 COVID-19 deaths (or one-fourth of all US deaths) circa March 2021, a high share of the nation’s total death count (CMS COVID-19 NH Data). These inequities partially driven by barriers to care, segregation and structural racism have resulted in the unequal impact of COVID-19 across NHs (Li et al., 2020). In this presentation, I will describe NHs that disproportionally care for minority residents and the effect of NH composition on COVID-19-related mortality and outcomes. In 2020, minority older adults were less likely to have access to high quality facilities. From June – August, NHs with a high proportion of minority residents reported higher COVID-19 mortality rates per 1000 residents. Equal access to high quality of care across the life-course among racial and ethnic groups is needed.

Download Full-text

Prevention and Early Intervention Programs for Older Adults

The Oxford Handbook of Traumatic Stress Disorders, Second Edition ◽

10.1093/oxfordhb/9780190088224.013.28 ◽

2021 ◽

Author(s):

Karla Caballero ◽

Melba Hernandez Tejada ◽

Ron Acierno

Keyword(s):

Older Adults ◽

Early Intervention ◽

Older Persons ◽

Protective Factor ◽

Intervention Programs ◽

Treatment Programs ◽

Factors Associated ◽

Potentially Traumatic Events ◽

The Impact ◽

Current Risk

Age appears to be a consistent protective factor against developing posttraumatic stress disorder (PTSD) subsequent to trauma exposure, followed by social support and proper screening and intervention. However, factors associated with the aging process may complicate identification and treatment of PTSD in older persons, although interventions have been developed in recent years that may help mediate the impact of trauma and stress. This chapter reviews the current risk and protective factors associated with development and treatment of PTSD and comorbidities in older adults, describes research on secondary prevention and early intervention programs for older adults exposed to potentially traumatic events, provides an introduction to a screening/prevention instrument, and presents recommendations for adaptation of extant early traumatic stress treatment programs to meet the needs of older adults.

Download Full-text

Disability and Long-Term Care in Singapore

Innovation in Aging ◽

10.1093/geroni/igaa057.2476 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 705-705

Author(s):

Cynthia Chen Huijun ◽

Ngee Choon Chia

Keyword(s):

Older Adults ◽

Older Persons ◽

Healthy Aging ◽

Long Term Care ◽

Population Aging ◽

International Comparisons ◽

Term Care ◽

Life Lessons ◽

The Impact

Abstract Public systems for long term care (LTC) redistribute resources between generations. Population aging is one of the most significant transformations in the 21st century, where the number of older persons aged 60 years and above is expected to double by 2050, rising to 2.1 billion. We used the Future Elderly Model (FEM) to project the impact of population aging in Singapore up to the year 2050. The FEM is a dynamic economic and demographic microsimulation model. By 2050, the total number of older adults with potential limitation in activities of daily living (ADL) was projected to increase to 275 thousand (18.9%). With the increasing prevalence of disability and chronic diseases, older adults might not have sufficient savings to meet future needs sustainably, despite the expansion of disability insurance from ElderShield to CareShield Life. Lessons and best practices for LTC could be transferred from our experiences to other aging cities globally. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

Download Full-text

Unanticipated efficacy of SARS-CoV-2 vaccination in older adults

Immunity & Ageing ◽

10.1186/s12979-021-00219-y ◽

2021 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Graham Pawelec ◽

Janet McElhaney

Keyword(s):

Older Adults ◽

Clinical Trials ◽

Infectious Diseases ◽

Vaccine Efficacy ◽

Paradigm Shift ◽

Randomized Clinical Trials ◽

Senior Citizens ◽

Older Individuals ◽

Younger Adults ◽

The Impact

AbstractThe rapidity with which vaccines against COVID-19 have been developed and tested is unprecedented. As classically the case with randomized clinical trials, many studies excluded older adults. However, given the early realisation that senior citizens were most highly susceptible to COVID, older individuals have been included in licensing trials under these unusual conditions. The recently published results from the Comirnaty Vaccine (BNT162b) trial unexpectedly documented that vaccine efficacy was equally exceptionally high in older and younger adults. These extremely encouraging trial results with a neoantigen vaccine may suggest the beginning of a paradigm shift in our view of the impact of immunosenescence on vaccination against novel infectious diseases.

Download Full-text

The Impact and Response to Climate Change as Lived by Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2253 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 590-590

Author(s):

Robin Fenley ◽

Toni Antonucci ◽

Robin Fenley

Keyword(s):

Climate Change ◽

Older Adults ◽

Human Rights ◽

Older Persons ◽

The Sustainable Development ◽

Health And Human Rights ◽

The Public ◽

Aging Populations ◽

Development Goals ◽

The Impact

Abstract A growing body of literature documents the domino effects of climate change on the planet and all life. Chief among these changes is the rise in global temperatures, triggering record numbers of heatwaves, and stronger, more dangerous hydrologic events. While climate change looms as a preeminent threat to our planet and future, the public health and human rights ramifications are already apparent. As with many issues in this realm, the effects are felt to a greater degree by our aging populations. As disasters grow in frequency, the more vulnerable populations are at greater risk for more serious outcomes – and will suffer disproportionately from the effects of climate change – resulting in greater inequalities. With the consequences of climate change growing more drastic, these outcomes can be expected to climb unless sufficient measures are enacted to combat global warming. In this symposium we will highlight the link between climate change and its impact on the human rights of older adults, and how climate change threatens progress across the Sustainable Development Goals (SDG) - a blueprint for a more equitable and healthier planet - if decisive actions are not taken. This symposium will demonstrate what valuable opportunities exist to accelerate progress by leveraging the links between SDGs to combat inequalities and climate change. Panelists will discuss the adverse effects of climate change, the human rights and psychological impacts on older adults, and potential action steps and strategies for older persons to become empowered as advocates for climate change reform.

Download Full-text

The Color of COVID-19: Structural Racism and the Disproportionate Impact of the Pandemic on Older Black and Latinx Adults

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa114 ◽

2020 ◽

Cited By ~ 11

Author(s):

Marc A Garcia ◽

Patricia A Homan ◽

Catherine García ◽

Tyson H Brown

Keyword(s):

Older Adults ◽

Health Care Access ◽

Local Governments ◽

Federal State ◽

Structural Racism ◽

Weathering Processes ◽

Challenges And Opportunities ◽

State And Local ◽

The Impact ◽

Racial Ethnic

Abstract Objectives The aim of this evidence-based theoretically informed article was to provide an overview of how and why the COVID-19 outbreak is particularly detrimental for the health of older Black and Latinx adults. Methods We draw upon current events, academic literature, and numerous data sources to illustrate how biopsychosocial factors place older adults at higher risk for COVID-19 relative to younger adults, and how structural racism magnifies these risks for black and Latinx adults across the life course. Results We identify 3 proximate mechanisms through which structural racism operates as a fundamental cause of racial/ethnic inequalities in COVID-19 burden among older adults: (a) risk of exposure, (b) weathering processes, and (c) health care access and quality. Discussion While the ongoing COVID-19 pandemic is an unprecedented crisis, the racial/ethnic health inequalities among older adults it has exposed are longstanding and deeply rooted in structural racism within American society. This knowledge presents both challenges and opportunities for researchers and policymakers as they seek to address the needs of older adults. It is imperative that federal, state, and local governments collect and release comprehensive data on the number of confirmed COVID-19 cases and deaths by race/ethnicity and age to better gauge the impact of the outbreak across minority communities. We conclude with a discussion of incremental steps to be taken to lessen the disproportionate burden of COVID-19 among older Black and Latinx adults, as well as the need for transformative actions that address structural racism in order to achieve population health equity.

Download Full-text

VOICE FIRST TECHNOLOGY: SIMPLIFYING LIFE FOR COMMUNITY-DWELLING OLDER ADULTS LIVING WITH DEMENTIA

Innovation in Aging ◽

10.1093/geroni/igz038.1432 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S390-S390

Author(s):

Debra J Sheets ◽

Marilyn Malone ◽

Stuart W MacDonald ◽

Carl Asche ◽

Andre Smith

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Caregiver Burden ◽

Low Cost ◽

Community Dwelling ◽

Care Partners ◽

The Impact ◽

Community Dwelling Older Adults ◽

Purposive Sample

Abstract Voice first technology offers older adults with dementia support that may maintain independence, reduce social isolation and improve quality of life (QoL). This study investigates the impact of a voice-controlled technology customized to the needs of participants living with dementia and their caregivers. A mixed methods design focused on psychosocial factors and usability characteristics. The purposive sample consisted of older adults with dementia (n=12) and their care partners (n=12)) living independently in the community. Validated measures for cognition, depression, caregiver burden, quality of life and usability were included. Qualitative in-home interviews were conducted to assess impact on social connections and independence. Results indicate that voice first technology can reduce caregiver burden and can support the independence and QoL of older adults with dementia. The discussion considers the value of low cost voice first technology as a way to support older adults with dementia and their caregivers.

Download Full-text

Economic Inequality Over the Life Course: Causes and Effects of Cumulative Dis/Advantage Processes

Innovation in Aging ◽

10.1093/geroni/igaa057.1957 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 585-586

Author(s):

Jessica Kelley ◽

Stephen Crystal ◽

Jessica Kelley

Keyword(s):

Older Adults ◽

Life Course ◽

Student Loans ◽

Economic Inequality ◽

Age Groups ◽

Later Life ◽

Economic Policies ◽

Structural Racism ◽

The Life Course ◽

The Impact

Abstract Economic inequality has grown rapidly in all age groups in the past several decades. In each successive cohort, the wealth gap grows for young people and seems to accelerate faster over the life course. While rising inequality has taken its toll on Baby Boomers, we have become acutely aware of the increasing economic pressures across the entire life course (work precarity; student loans) that will manifest in the greatest degree of inequality in older adulthood seen to date. This session explores the forces that have shaped the degree of inequality among current older adults and are setting the stage for future cohorts of older adults. Presenters will explore several aspects of this issue: the growing state of the “risk retirement,” the impact of income inequality on later-life wealth and health, the structural racism written into economic policies intended to help Americans accumulate wealth and maintain health, and the market disadvantage for GED recipients compared to high school diploma recipients.

Download Full-text