<p> The purpose of this study was to identify, through meta-analytical techniques, evidence-based recommendations for the type, frequency, and duration of exercise to slow the progression of dementia. Inclusion criteria were that the research had to be published between January 2000 and January 2012 and include both pre- and post-Mini Mental State Examination (MMSE) scores. After conducting extensive computer-aided and manual searches, eight studies were chosen for analysis. Of those eight studies, one study in particular indicated the optimal type, frequency, and duration of exercise to slow the progression of dementia, which was walking four times per week for thirty minutes per session. Future research should include the impact of other forms of exercise on the progression of dementia and the role of physicians in the prescription of exercise to slow the progression of dementia.</p>

<p> In the late 1980's assisted living emerged as a self-proclaimed new style of providing long-term care and supportive services. Assisted living as espoused by its early proponents and by industry leaders embodied certain specific philosophical tenets, such as dignity, autonomy, meeting scheduled and unscheduled needs and aging in place, in their daily operations. These tenets distinguished assisted living from other forms of institutional care such as nursing home care. In the past twenty years the assisted living industry has matured and grown substantially. However, despite the maturing of the industry and the general agreement on the basic tenets little is known about the degree to which the industry embodies these principles. </p><p> In addition public policy and consumer preferences have grown in their focus on substituting assisted living for nursing home care. Moreover, the degree to which assisted living can and does substitute for nursing home care has been largely unexamined. Elder care advocates and researchers have more and more called attention to the increasing acuity level of assisted living residents. </p><p> This study consists of three related components, each of which will broaden the understanding of current assisted living facilities and their residents. The first study examines person environment fit in assisted living. Lawton's theory of person environment fit, has largely defined the construction and physical environment of assisted living since the 1980's. Changes in Lawton's theory were proposed by Guiata and Jones in the Journal of the American Medical Association in 2012 in reaction to the increased level of dementia in assisted living residents. A third non-theoretical analysis using exploratory factor is designed assist with development of new constructs in person environment fit theory. The second study examines changes in assisted living facilities and residents from 1999 to 2010. This study uses the only two national surveys of assisted living, The 1999 National Survey of Assisted Living and the 2010 National Survey of Residential Care Facilities. This study will examine both facility level and resident level characteristics to explicate resident acuities and to examine the degree to which facilities are accommodating these acuities. The third study examines facility characteristics associated with discharge of residents from assisted living facilities. Understanding resident discharge from assisted living will give a better understanding how assisted living facilities meet scheduled and unscheduled needs of residents as well as embody the philosophical concept of aging in place. </p><p> The contribution of this research is improved understanding of the current assisted living facilities and residents and better understand the importance of facility characteristics in person environment fit and in aging in place. This contribution is significant because assisted living residents are a vulnerable population with no protection under federal statutes and limited protection in most states. If indeed, as advocates and researchers assert, assisted living residents mirror nursing home residents in acuity then this research will assist with developing policies to protect this vulnerable population.</p>

<p> This project report served as a framework for an aging and disability lifestyle blog named Evolving Abilities. It listed resources and highlighted the vitality and value in aging with a disability by promoting a realistic and dynamic perspective written by a disability gerontologist. The niche audience targeted people aging with disabilities (or chronic health conditions). Evolving Abilities supported connectedness and full inclusion by addressing ageism and ableism.</p>

<p> Decisions near the end of life must be made at a time of great emotional upheaval and rely on knowledge that few people possess outside of healthcare. Complicating this is that choices appear to change as older adults become more ill and approach death. Thus, healthcare providers must help older patients navigate this complexity to make decisions that are consistent with patients' priorities and wishes. Research examining end-of-life decisions has been descriptive in nature, looked at decisions from among younger adults, or examined decision making among those with cancer diagnoses. In addition, the research often focused on prospective decisions among healthy elders. Much less is known about decision-making processes used by older adults with a limited prognosis. </p><p> The aim of this dissertation was to examine decision-making processes among older adults with a limited prognosis who were in the midst of making significant healthcare decisions. The goal was to explore the phenomenon from within the context of the end of life to bring forth the missing voice of these elders. </p><p> Twenty community-based adults (13 men, 7 women, ages 67-97) with a prognosis of less than 12 months were recruited through the San Francisco Veterans' Administration Medical Center and the University of California, San Francisco, Division of Geriatrics. One-on-one interviews were conducted in participants' homes using a semi-structured interview guide. Interviews were recorded and transcribed verbatim. Grounded theory was used to analyze the interviews to allow themes and concepts to emerge organically from the data. </p><p> Two main themes emerged: <i>maintaining a sense of control </i> and <i>decision making in the context of ambiguity.</i> Participants rarely discussed actual decisions and preferred to delegate end-of-life decisions. By using different approaches to express their priorities and goals, they maintained the <i>sense</i> of control without being <i> in</i> control. The actual context of decisions could not be understood a priori, which resulted in uncertainty and ambivalence that influenced how decisions were made. </p><p> By understanding how older adults approach late-life decisions, healthcare providers can better support their patients as they make different choices and help guide patients to choices that are consistent with their stated preferences and priorities.</p>

<p> Breast cancer is a disease that continues to affect people of all ages, but especially older adults. The number of people impacted by this disease continues to grow and there is a rapid increase in women who are newly diagnosed with breast cancer. The primary risk factors for breast cancer are age and gender. The purpose of this project was to develop a breast cancer comprehensive resource packet for adults, age 65 years and older, who have been newly diagnosed with breast cancer. This packet incorporates patient education, possible coping strategies about living with breast cancer, useful tips for healthy living, and information on how to transition from living with breast cancer to becoming a cancer survivor. This packet provides a resource tool for breast cancer patients including beneficial tips directly from breast cancer survivors that may create an easier transition of living with breast cancer for those newly diagnosed.</p>

<p> The United States population of elderly persons is growing quickly, causing an increase in concern for their health care needs. Dementia is a condition that affects the elderly. With an increase in persons with dementia, there is also an increase in apprehension of care choices. National data and published literature were used to study dementia and its effects on the patient and their family caretakers. The study concluded that minority families were less likely to institutionalize elderly dementia patients into nursing care due to a variety of cultural biases. White dementia patients had the highest number of admittance into nursing homes. This was also prevailing in the specialty care unit for dementia patients. Understanding the cultural differences and needs of the minority patient can help organizations improve the disparity among dementia patients admitted into nursing homes.</p>

<p> The purpose of the study was to investigate the prevalence and effects of vision impairment co-existing with other comorbid conditions. Utilizing the 2008 National Health Interview Survey, the most recent nationally representative data including expanded vision, health conditions, and activity questions, this study examined the effect of vision impairment co-existing with selected comorbid conditions among non-institutionalized older adults age &ge; 55 years. Specifically, this study compared 4 groups: (a) older adults with neither vison impairment nor comorbid conditions, (b) older adults with vision impairment only, (c) older adults with comorbid conditions only, and (d) older adults with both vision impairment and each of the comorbid conditions to examine the prevalence and effect of vision impairment and comorbid conditions on selected mobility and vision activity limitations, and participation restrictions. Using complex sample techniques to conduct frequency analyses and logistic regression procedures, this study compared these groups of older adults to document the likelihood of experiencing mobility and vision activity limitations, and participatory restrictions. </p><p> These results suggest that older adults reporting vision impairments are a heterogeneous population, overwhelmingly use corrective lenses, and experience substantial mobility and vision activity limitations, and participatory restrictions; however, relatively few report using low vision aids or rehabilitation services. In addition, these results revealed, even when controlling for age, sex, race/ethnicity, marital status, region of residence, and health status, older adults with vision impairment and any of the selected comorbid conditions were statistically significantly more likely to report mobility and vision activity limitations, and participation restrictions. Moreover, when comparing older adults reporting vision impairment co-existing with comorbid conditions older adults reporting either vision impairment only or a comorbid condition only, the results suggest vision impairment had the largest statistically significant effect on the likelihood of mobility or vision activity limitations, or participatory restriction in 29 of the 44 logistic regression analyses. These findings are significant as vision impairment is framed as a public health concern, and can inform improvements in programs and services for older adults. Finally, these findings highlight the need for expanded research examining the effect of specific eye diseases and comorbid conditions among older adults. </p>

<p> The purpose of this study was to investigate the value of older adult volunteers in the workplace, specifically looking at the management and service delivery impact of the Long Beach Fire Ambassador Program on existing community relations efforts and employee morale, from the Command Staff perspective of the Long Beach Fire Department. The study identified seven themes that specified the value of Ambassador Program volunteers to management: supporting community relations, supporting employee morale, appreciation, extended family, pride, purpose, and significance. Ambassador and Program contributions to life safety and quality of life&mdash;for Ambassadors, their families, and the community at large&mdash;were also recurrently expressed. Results showed that older adult volunteers uniquely have much to offer and have an increasingly vital role in the workplace.</p>

<p> This thesis compared the perceptions of older adult recovering substance abusers with the perceptions of alcohol and drug treatment providers on what each sample believed would be the most appropriate delivery methods and locations for alcohol and drug treatment services to individuals 50 years of age and older. Sixty participants, 30 subjects from each sample group, completed a questionnaire created by the researcher. Results showed there were no significant differences in perceptions of older adult substance abusers and drug treatment providers about the most appropriate treatment methods and locations for treatment. Additional findings included suggestions from participants about ways to improve current treatment modalities and locations. Results suggested the need for provider education on age-specific issues faced by the older adult addict. </p>

<p> The purpose of this study was to determine wellness specific requests of the Baby Boomer population in reference to choosing a skilled nursing facility for self and family members. Participants are any individual born from 1946 &Dot;C 1964 with access to the survey via internet or hard copy. A survey was emailed using various hosting sites, such as corporate emails, social media sites, and forwards to additional contacts, containing questions regarding physical, social, and intellectual wellness preferences in the nursing setting. Returned survey responses through PsychData totaled 462, totaling 436 useable surveys. All data analyses were conducted using SPSS version 21.0, using a significance level of p &le; .05: for all analyses. Results of the study show that the specific demographics of income and education may not significantly determine the extent to which a Baby Boomer will prefer certain dimensions of wellness in a skilled nursing facility. However, gender has a significant impact on both physical and social wellness preferences based on Mann Whitney analysis. Physical wellness questions regarding meal options, walking trails, supervised exercise programs, adapted exercise programs, and overall wellness were all significantly different at p &lt;.001. Mean scores indicate women place slightly greater importance on each measure of physical wellness. Social wellness and gender shows association when measuring (1) distance of facility from family members and potential visiting friends, (2) family proximity to facility (3) animal interaction, and (4) volunteer opportunities. While the differences between genders are statistically significant for four of the five social wellness questions, there is only a noticeable difference for animal interactions. Additionally, intellectual wellness is important to Baby Boomers, exhibited by selections of ongoing educational programs and accessibility to technology and internet communication via Wi-Fi availability. In conclusion, the majority of Baby Boomers surveyed seek physical and social wellness opportunities in long term care, specifically skilled nursing despite income and education levels.</p>