scholarly journals THE TIPPING POINT STUDY: DIGITAL DETECTION AND DECISION SUPPORT FOR OLDER ADULTS AND FAMILIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S597-S597
Author(s):  
Kimberly D Shea ◽  
Kimberly D Shea
Keyword(s):  
Older Adults ◽  
Cultural Sensitivity ◽  
Independent Living ◽  
Mexican American ◽  
Wearable Sensors ◽  
Health And Safety ◽  
The United States ◽  
Census Bureau ◽  
Tipping Point ◽  
Safety Issues

Abstract In 10 years, the United States will experience a “dependency” ratio of one working age adult (20-64 years old) to one non-working person (> 65 or 85 years old will comprise 19 million of the non-working people (US Census Bureau, 2008). Busy working adults will have to be vigilant to determine when to make life-changing decisions about health and safety issues for people that depend on them. Older adults have gradual and cumulative physical and/or psychological aging changes or can experience significant events. Knowing when to make a life-changing decision, such as when to intervene with independent living due to safety risks, is difficult even when situations have constant vigilance. Eventually, older adults experience a seemingly abrupt, sudden and absolute point where a life changing decision must be made. This is the Tipping Point. Health data, derived from unobtrusive wearable sensors, are algorithmically synthesized to provide critical information on impending concerns via an electronic portal will help the busy working adult to predict and prevent the Tipping Point. This application of precision health care results in targeted and personalized education thus avoiding a potentially catastrophic Tipping Point. This symposium provides insight into five aspects of the Tipping Point: 1) significance of identification, 2) theoretical foundation for environmental and cultural sensitivity, 3) feasibility outcomes from a Mexican American population, 4) methodology for synthesizing quantitative metrics from multivariate streams of data, 5) creation of a culturally sensitive electronic portal to display predictive information and education about consequences

scholarly journals Architecture of a Smart Home for Aging in Place

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 39-39
Author(s):  
Neda Norouzi
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Aging In Place ◽  
The United States ◽  
Census Bureau ◽  
United States Department ◽  
Social And Emotional ◽  
Age In Place ◽  
Department Of Health ◽  
Private Homes

Abstract The United States Department of Health and Human Services (2017) estimates that there are 65 million people age 60+ residing across the fifty states. A national survey conducted by the American Association of Retired Persons (AARP) indicates that 76% of people ages 55+ prefer to age-in-place and live independently (2018). The Census Bureau American Community Survey (2015) estimates that 13 million adults have difficulties living independently, 80% of which receive assistance in their private homes. However, only 50% of these homes meet the physical needs of people who choose to age-in-place (AARP, 2018). Recent advancements in technology have led to the development of smart homes. Technology can support aging-in-place and independent living by offering necessary tools for building systems that identify behavioral patterns and offer automated decision-making. However, not all older adults are customed to using technology or comfortable with being monitored with artificial intelligence (Wang et al., 2019). In response to this concern, the current study used grounded theory framework to analyze 62 interviews of people ages 55-93 to indicate if and how older adults prefer to utilize technology in their homes. The results of the study presented that while some older adults felt they might be too old to learn and use technology, nearly 85% of the interviewers agreed that incorporating technology in the built environment could benefit them. They are especially willing to learn and use technology in their homes when the benefits are related to their health, social and emotional connection, entertainment, safety, and daily chores.

scholarly journals 543 - Cultural Considerations for Older LGBTQ Adults During the COVID-19 Pandemic: Case and Review

2021 ◽  
Vol 33 (S1) ◽  
pp. 85-86
Author(s):  
M. Alejandra Grullon ◽  
Valeriya Tsygankova ◽  
Bobbi Woolwine ◽  
Amanda Tan ◽  
Adriana P. Hermida
Keyword(s):  
Older Adults ◽  
Attention Deficit Disorder ◽  
Independent Living ◽  
Psychiatric Treatment ◽  
Social Activity ◽  
Strong Support ◽  
The United States ◽  
Culturally Competent ◽  
Social Distancing ◽  
Prevention Method

IntroductionThroughout the COVID-19 pandemic, older adults have been disproportionately impacted by both illness and fatalities. Of the nearly 39 million adults over age 65 in the United States, approximately 2.4 million older adults identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). LGBTQ older adults face unique challenges due to their intersecting identities and histories, including the effects of heterosexism, ageism, and being more likely to live alone, be single, and not have children. As we implement social distancing as a primary COVID-19 prevention method, older adults have faced increased isolation.MethodsWe presented a case of a lesbian older adult patient who has experienced increased depression during the COVID-19 pandemic. A table will be added featuring culturally competent recommendations for LGBTQ older adults from a literature review.ResultsA 77-year-old female with history of major depression, attention deficit disorder, hypertension, xerostomia, and polymyalgia rheumatica. The patient has been on multiple trials of medications for depression as well as ECT treatments. She was initially engaged to a man and after some years fell in love with a woman. The patient is currently single and has no children. She typically has a strong support system with her lifelong friend and attends church. She transitioned from independent living to an adult living facility, with the hope of increased social activity and connectedness. However, due to COVID-19, she experienced her move as extremely difficult, and was disappointed that all social activities were canceled. For a period of several months, she was unable to visit her chosen family, was limited to attending church via Zoom, and was restricted from multiple areas of the complex. As a result, she reported increased depression, anxiety, and difficulty sleeping with passive suicidal ideation due to isolation and no direct family support.ConclusionOlder LGBTQ populations are at disproportionately higher risk for mental health conditions and with the current social distancing measures in place, social isolation and loneliness has been exacerbated.Connection with accepting family and community are well documented in the literature as key protective factors and sources of resiliency in LGBTQ populations. Culturally competent care is integral to psychiatric treatment of older LGBTQ adults.Note:This abstract was presented at the American Association of Geriatric Psychiatry 2021 Annual Meeting.

scholarly journals 1470. Epidemiology of Invasive Pneumococcal Disease (IPD) Following 18 years of Pneumococcal Conjugate Vaccine (PCV) Use in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S736-S737
Author(s):  
Tamara Pilishvili ◽  
Ryan Gierke ◽  
Monica M Farley ◽  
William Schaffner ◽  
Ann Thomas ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Genome Sequencing ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
The United States ◽  
Census Bureau ◽  
Incidence Rates ◽  
Whole Genome ◽  
Vaccine Type

Abstract Background PCVs have been recommended for U.S. children since 2000. A 7-valent vaccine (PCV7) was introduced in 2000. This was replaced by a 13-valent vaccine (PCV13) in 2010. PCV13 was also recommended for adults aged ≥ 65 years in August 2014. We evaluated PCV impact on IPD. Methods IPD cases (isolation of pneumococcus from sterile sites) were identified through CDC’s Active Bacterial Core surveillance during 1998-2018. Isolates were serotyped by Quellung or whole genome sequencing and classified as PCV13-type and non-vaccine-type (NVT). Incidence rates (cases/100,000) were calculated using U.S. Census Bureau population denominators. Results From 1998 through 2018, overall IPD rates among children aged < 5 years decreased by 93% (from 95 to 7 cases/100,000). PCV13-type IPD decreased by 98% (from 88 to 2 cases/100,000). Among adults aged ≥ 65 years, overall IPD rates decreased by 60% (from 61 to 25 cases/100,000). PCV13-type IPD rates declined 86% (from 46 to 7 cases/100,000). Declines were most dramatic in the years following PCV7 introduction, with additional declines after PCV13 introduction in children (Figures 1 and 2). Serotypes 3, 19A, and 19F caused most of the remaining PCV13-type IPD. NVT IPD rates did not change significantly among children. Among adults aged 50-64 years, NVT IPD increased by 83% (from 6 to 12 cases/100,000) (p< 0.01). Among adults aged ≥ 65 years, NVT IPD increased by 22% (from 15 to 18 cases/100,000) (p< 0.01). The most common NVTs in 2018 were 22F (10% of all IPD), 9N (7%) and 15A (5%). Among children, the proportion of cases with meningitis increased from 5% to 14% (p< 0.01), and the proportion with pneumonia/empyema increased from 17% to 31% (p< 0.01). Among adults, the proportion of cases with meningitis did not change (3%), while the proportion with pneumonia/empyema increased from 72% to 76% (p=0.01). Figure 1: Incidence of invasive pneumococcal disease among children aged < 5 years, 1998-2018 Figure 2: Incidence of invasive pneumococcal disease among adults aged ≥ 65 years, 1998-2018 Conclusion Overall IPD incidence among children and adults decreased following PCV introduction for children, driven primarily by reductions in PCV-type IPD. NVT IPD increased in older adults, but these increases did not eliminate reductions from PCV13-type IPD. Disclosures Lee Harrison, MD, GSK (Consultant)Merck (Consultant)Pfizer (Consultant)Sanofi Pasteur (Consultant)

Examining the role of ageing-in-place organisations in building older adults’ disaster resilience

2020 ◽  
pp. 1-26
Author(s):  
Claire Pendergrast ◽  
Basia Belza ◽  
Ann Bostrom ◽  
Nicole Errett
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Health And Safety ◽  
The United States ◽  
Local Context ◽  
Disaster Resilience ◽  
Structured Interviews ◽  
Ageing In Place ◽  
Building Activities

Abstract Older adults are more susceptible to adverse health outcomes during and after a disaster compared with their younger counterparts. Ageing-in-place organisations such as senior centres and Villages provide social services and programming for older adults and may support older adults’ resilience to disasters. This study examines the role of ageing-in-place organisations in building disaster resilience for older adults. Semi-structured interviews were conducted with a purposive sample of 14 ageing-in-place organisation leaders in King County, Washington in the United States of America. The sample included representatives of five government-run senior centres, seven non-profit senior centres and two Villages. Interviews were audio-recorded and professionally transcribed. We used a combined inductive and deductive approach to code and thematically analyse the data. Ageing-in-place organisation leadership recognise disasters as a threat to older adults’ health and safety, and they see opportunities to provide disaster-related support for older adults, though the type and extent of participation in resilience-building activities reflected each organisation's unique local context. Organisations participate in a variety of disaster-related activities, though respondents emphasised the importance of collaborative and communication-focused efforts. Findings suggest that ageing-in-place organisations may be best equipped to support older adults’ disaster resilience by serving as a trusted source of disaster-related information and providing input on the appropriateness of disaster plans and messages for the unique needs of older adults ageing-in-place.

Future of Cancer Incidence in the United States: Burdens Upon an Aging, Changing Nation

2009 ◽  
Vol 27 (17) ◽  
pp. 2758-2765 ◽  
Author(s):  
Benjamin D. Smith ◽  
Grace L. Smith ◽  
Arti Hurria ◽  
Gabriel N. Hortobagyi ◽  
Thomas A. Buchholz
Keyword(s):  
United States ◽  
Older Adults ◽  
Cancer Incidence ◽  
The United States ◽  
Census Bureau ◽  
Incidence Rates ◽  
Population Projections ◽  
Demographic Changes ◽  
Younger Adults ◽  
The Impact

Purpose By 2030, the United States' population will increase to approximately 365 million, including 72 million older adults (age ≥ 65 years) and 157 million minority individuals. Although cancer incidence varies by age and race, the impact of demographic changes on cancer incidence has not been fully characterized. We sought to estimate the number of cancer patients diagnosed in the United States through 2030 by age and race. Methods Current demographic-specific cancer incidence rates were calculated using the Surveillance Epidemiology and End Results database. Population projections from the Census Bureau were used to project future cancer incidence through 2030. Results From 2010 to 2030, the total projected cancer incidence will increase by approximately 45%, from 1.6 million in 2010 to 2.3 million in 2030. This increase is driven by cancer diagnosed in older adults and minorities. A 67% increase in cancer incidence is anticipated for older adults, compared with an 11% increase for younger adults. A 99% increase is anticipated for minorities, compared with a 31% increase for whites. From 2010 to 2030, the percentage of all cancers diagnosed in older adults will increase from 61% to 70%, and the percentage of all cancers diagnosed in minorities will increase from 21% to 28%. Conclusion Demographic changes in the United States will result in a marked increase in the number of cancer diagnoses over the next 20 years. Continued efforts are needed to improve cancer care for older adults and minorities.

scholarly journals Extension for Community Healthcare Outcomes (ECHO) Telementoring in the Military: Where We Are Now, Opportunities and Challenges

2021 ◽  
Author(s):  
Joanna Katzman ◽  
Laura Tomedi ◽  
Robin Swift ◽  
Erick Castillo ◽  
Connie Morrow ◽  
...  
Keyword(s):  
Health And Safety ◽  
The United States ◽  
Healthcare Outcomes ◽  
Community Healthcare ◽  
Safety Issues ◽  
Current State ◽  
Session Attendance ◽  
Military Retirees ◽  
Growth And Change ◽  
The Military

ABSTRACT Introduction In collaboration with the ECHO (Extension for Community Healthcare Outcomes) Institute since 2012, the Army, Navy, and Air Force have developed medical teleECHO programs to address various health and safety issues affecting military personnel. This article describes and compares the current state of military teleECHOs as well as the growth and change over time. Materials and Methods This study evaluated continuing education units (CEUs) offered, average session attendance, and number of spoke sites for current military teleECHO programs across the service branches. Results Between 2012 and 2019, the military teleECHO initiative grew from one program to seven different teleECHO programs, covering topics from pain to diabetes to amputee care. Military ECHOs now provide training to 10 countries and 27 states in the United States. Between October 2018 and September 2019, the military ECHO programs provided a total of 51,769 continuing medical education (CME) hours to a total of 3,575 attendees from 223 spoke sites. Conclusions The military has successfully used the ECHO model to improve the health and safety of active-duty military, retirees, and dependents.

scholarly journals Pandemic Preparedness of Care Homes Serving Older Adults in the Wake of COVID-19: An Exploratory Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 482-482
Author(s):  
Iftekhar Amin
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Independent Living ◽  
Adult Population ◽  
Sampling Technique ◽  
The United States ◽  
Care Homes ◽  
Snowball Sampling ◽  
Predominantly Minority ◽  
Memory Care

Abstract Recent COVID-19 pandemic has disproportionately affected the older adult population worldwide. According to CDC, among older adults over 60 years the risk increases with age, with the highest risk of serious illness and death among those over 80 years. While public has been receiving messages about the risks and how to take preventive measures, it is not clear how the care homes serving older adults have been preparing. Data have been collected as part of an ongoing study from 30 independent living, assisted living, and memory care facilities across the United States. The centers were selected with a snowball sampling technique. Administrators of the centers were interviewed with a semi-structured questionnaire. It was apparent that although awareness of risks was high, preparation appears to be inadequate with little resources available at the time of the survey. Variation of preparedness based on the sociodemographic characteristics of the residents suggests that homes that serve predominantly minority and economically disadvantaged have greater likelihood of lacking preventive resources. It is critical that facilities serving older adults be prepared to ensure an effective healthcare response in the wake of novel viruses, such as COVID-19.

scholarly journals Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living

2015 ◽  
Vol 37 (3) ◽  
pp. 537-560 ◽  
Author(s):  
CLARA BERRIDGE
Keyword(s):  
United States ◽  
Older Adults ◽  
Monitoring System ◽  
Low Income ◽  
United States Of America ◽  
Independent Living ◽  
The United States ◽  
Third Party ◽  
Passive Monitoring ◽  
Daily Lives

ABSTRACTPassive monitoring technology is beginning to be reimbursed by third-party payers in the United States of America. Given the low voluntary uptake of these technologies on the market, it is important to understand the concerns and perspectives of users, former users and non-users. In this paper, the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. This includes experiences of adoption, non-adoption, discontinuation and creative ‘misuse’. The analysis of interviews reveals three key insights. First, assumptions built into the technology about how older adults live present a problem for many users who experience unwanted disruptions and threats to their behavioural autonomy. Second, resident response is varied and challenges the dominant image of residents as passive subjects of a passive monitoring system. Third, the priorities of older adults (e.g. safety, autonomy, privacy, control, contact) are more diverse and multi-faceted than those of the housing organisation staff and family members (e.g. safety, efficiency) who drive the passive monitoring intervention. The tension between needs, desires and the daily lives of older adults and the technological solutions offered to them is made visible by their active responses, including resistance to them. This exposes the active and meaningful qualities of older adults’ decisions and practices.

scholarly journals Older Vietnamese Have the Highest Prevalence of Disability Compared to White and Other Asian Groups

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 548-548
Author(s):  
Hoang Nguyen ◽  
Christina Miyawaki ◽  
Kyriakos Markides
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Independent Living ◽  
Reference Group ◽  
Self Care ◽  
The United States ◽  
Point Estimate ◽  
Poverty Level ◽  
New Findings ◽  
Hispanic White

Abstract The COVID-19 pandemic has highlighted the vulnerability of older adults with pre-existing health conditions and disabilities. A 2011 study reported that Asian older adults had lower prevalence of disability compared to non-Hispanic white. We revisited the estimate a decade later using the recently released 2015-2019 Public Use Microdata Sample (PUMS) from the American Community Survey (ACS). We estimated the prevalence of six types of disability in adults aged 60 years and older who self-identified as Vietnamese, Chinese, Filipino, Japanese, Korean, Asian Indian, or non-Hispanic White. We also compared the risk for each disability type between Vietnamese and non-Hispanic White (reference group) using the adjusted (age, sex, marital status, education and poverty level) odds ratios. All analyses used survey weights for point estimate and the jackknife method for standard error. Significantly higher prevalence of limitations in independent living, self-care, cognitive function, and blindness were reported by Vietnamese than by non-Hispanic White. Vietnamese also had the highest prevalence in all six types of disability of the Asian groups examined. The adjusted odds ratio of limitations in independent living, self-care, and cognitive function was significantly higher for Vietnamese than non-Hispanic White. These findings suggest a possible negative outcome trend with the aging of the Vietnamese population. We discuss the historical accounts of Vietnamese in the United States as war refugees and family reunion migrants, provide possible explanations for these new findings including changing demographic structures, and make recommendations for policy and practice that incorporate existing social and cultural resources in the Vietnamese community.

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