<p> Traditional nursing homes are based on a model that can limit a resident&rsquo;s ability to make basic choices, minimize opportunities to direct their own lives, and ultimately destroy the human spirit. As an alternative to the traditional model, the household model is an arrangement in which small groups of residents direct their daily lives in a shared home setting (a household), supported by a decentralized self-led service team of frontline professionals empowered to be responsive to the residents&rsquo; needs. While many frontline nursing staff members are advocates of the need for change, it is also common for them to react negatively toward the process of household model implementation. The purpose of this qualitative study was to examine nurse aides&rsquo; and licensed nurses&rsquo; reactions to household model implementation. Sixteen semi-structured interviews were transcribed verbatim, divided into 524 units of meaning, and coded using concepts of Oreg, Vakola, and Armenakis&rsquo; (2011) theoretical model, derived from 60 years of qualitative studies on change recipients&rsquo; reactions to organizational change. In this model, employee reactions are a function of antecedents, categorized as pre-change (individual characteristics and internal context) and change antecedents (change process, perceived benefit/harm, and change content). Antecedents influence affective, cognitive, and behavioral reactions to change and, subsequently, lead to change consequences, including work-related and personal consequences. Two trained independent coders reviewed transcripts and achieved 70% agreement. Explicit reactions accounted for 48% of comments, followed by antecedents (27%) and change consequences (25%). Most common antecedents were related to change process (71%), perceived benefit/harm (24%), and change recipient characteristics (4%). Study participants reported difficulties with cross training, initial experiences of hardship and fear, confusion over the new model, and perceptions that it would be harmful to staff members and residents. Although experiences improved over time, some staff members, who self-identified as positive individuals, still reported perceived harm and engaged in resistant behaviors. Explicit reactions to change were behavioral (41%), cognitive (33%), and affective (26%). Most staff members supported household model implementation through their actions. They communicated with each other to learn and to cope with change. While three staff members actively resisted changes, they still supported at least some aspects of the household model. Cognitive and affective reactions were mixed, ranging from excitement and happiness to fear, nervousness, and frustration. Core household model components were received as positive, especially for residents. Concerns regarding work accounted for 94% of all reported organizational change consequences and included insufficient household staffing, harder working conditions, insufficient time to get everything done (or to do it well), and widespread feelings of isolation. The theoretical model for analyzing organizational change proved to be useful in understanding nursing staff members&rsquo; reactions to household model implementation and for identifying proactive steps to manage this change. Ongoing education is recommended to ensure staff members follow through with changes over time and to reduce confusion and perceptions of harm. The household model may need to be staffed at a higher level, at least initially, to maintain the same quality of care as in the traditional care delivery model. Ongoing team training within each household can serve to improve operations and balance responsibilities of blended roles. Due to the decentralized environments, potential feelings of isolation among residents and staff members are anticipated, which can be alleviated through regular multi-household gatherings.</p>

<p>The purpose of this directed project was to develop a four-hour workshop for Gerontologists and associated health professionals to assist older adults in understanding the Medicare products available to them. The workshop was specifically developed for delivery through a non-profit called ?In Transition Planning,? which is an educational platform to assist aging individuals with the aging process through education, community involvement and training. The four-hour workshop was based on the ?Medicare and You? booklet developed by the Centers for Medicare and Medicaid Services (CMS) sent to older adults prior to turning 65 years old and annually. This workshop covers the basics of Medicare planning, which includes elections on basic Medicare, Medicare Advantage, and Medicare Supplemental Plans that a senior receiving Medicare needs to consider. Workshop materials were sent to three expert reviewers, who gave suggestions for revision. General suggestions included adding material about Medicaid and rules for dual eligibles, discussing identity theft as it relates to one?s Social Security card, including breaks in the presentation, and condensing some of the material for the time allotted. The workshop will educate Gerontologists and associated health professionals about the different components of Medicare and insurance coverage available to older adults.

<p> Providing healthcare to the ever-rising elderly population has become a severe challenge and a top priority. Emerging innovations in healthcare, such as remote health monitoring technologies, promise to provide a better quality of care and reduce the cost of healthcare. However, many elderly people reject healthcare innovations. This lack of adoption constitutes a big practical problem because it keeps the elderly from benefiting from technology advances. The phenomenon is even more pronounced among elderly women, who represent the majority of the elderly population. </p><p> A plethora of studies in the field of technology adoption resulted in sound, but highly generalized theories that are too parsimonious to provide practical insight into the phenomenon of elderly healthcare technology adoption (EHTA). There is a call to arms for novel approaches that facilitate the creation of models that expand technology adoption theories to the specifics of EHTA. This dissertation is a response to this call to arms, and it contributes to modeling practice in the EHTA field. It uses fuzzy cognitive mapping to design a novel mixed-methods modeling approach. Since elderly women constitute the majority of the elderly population, this dissertation treats elderly women&rsquo;s health technology adoption (EWHTA) as the case-in-point.</p><p>

<p> Each year, approximately 10,000 baby boomers will reach age 65. The baby boomer generation encompasses 26% of the total U.S. Population. As members of the baby boomer generation reach older adulthood, they continue to experience mental health issues such as depression, anxiety, as well as medication and alcohol abuse. These mental health conditions are associated with higher rates of health care usage. In addition, an older adult may jointly suffer from a lower quality of life, increased complex illnesses, disability, and mortality/increased risk of suicide. If an older adult does not have the appropriate mental health support services, he or she may overuse the healthcare system. Obtaining mental health services is still considered taboo for some, while for others the services may not be accessible. Conversations from Home Telemental Health aims to employ innovative technology in telehealth to improve mental health delivery services for the baby boomer population. Its mission is to provide accessible and effective evidence-based therapy designed to engage baby boomers, address their mental health needs, and minimalize premature institutionalization. Conversations from Home&rsquo;s goal as a non-profit organization is to become a leading provider of telemental health services to individuals aged 50 and older in the Westside of Los Angeles and the South Bay. This proposal will provide a detailed evaluation of how Conversations from Home will accomplish these objectives.</p><p>