Older adults often engage in few activities, for short periods of time, and typically engage with one item without switching to other items. The purposes of this study were (a) to further evaluate the MSWO preference assessment as well as the utility of the brief free-operant presentation method with older adults with dementia to identify preferred activities, (b) to determine if non-variable selection during a free operant preference assessment was due to repetitive behavior through concurrent engagement analyses, and (c) to determine the reinforcing effectiveness of stimuli identified via the single-array MSWO and free operant preference assessments through a reinforcer assessment. The results suggest that for 6 of the 7 participants the free operant was a better predictor for time allocation and engagement with a preferred activity. The results suggest that the single array MSWO was not as predictive of time allocation or engagement as the free operant, resulting in false positives. The results also suggest that individuals not switching items may be a result of the environment rather than a symptom of dementia (repetitive behavior), showing that it was not that the participants could not switch, but rather that they chose not to switch.

The purpose of this study was to identify the extent of adoption of microwave ovens by older adults in Blacksburg, Virginia. Level of adoption was defined and determined as a function of 1) frequency of use of the microwave oven in comparison to the range, and 2) complexity of food preparation. Mere ownership was not considered as an indicator of adoption. Focusing on the final stage of Rogers theory of adoption (1962), three levels of adoption were determined: High, medium, and low. A random sample of 75 adults 65 years and older was selected from the listing of retired personnel in the 1997-98 Virginia Polytechnic Institute and State University faculty and staff directory. Telephone interviews were conducted to collect information regarding current microwave oven usage patterns and decisions for future use and purchase. Relationships between level of adoption, and user characteristics and microwave oven characteristics were statistically tested. Results from the study indicate that 56% of these older adults who own a microwave oven are high adopters; i.e. they used the microwave more than the range and performed high complexity tasks. About 52% reported using the microwave oven more frequently than the range. Nearly all respondents were satisfied with the microwave oven in terms of speed and convenience, while 60% were satisfied with quality of foods cooked in the microwave oven. There was no significant difference in level of adoption with age, gender, health condition, and knowledge of microwave oven use. However, level of adoption was significantly higher among older adults who were "never" married or "previously" married compared to those that were "currently" married. Also, level of adoption was significantly lower among those older adults who had touch controls on their microwave oven compared to those with rotary dials. Other significant results of this study dealt with future use and purchase decisions. About 93% of the respondents indicated a desire to continue using a microwave oven in the future and about 76% indicated that they would purchase one in the future if their current microwave oven "dies." Results from this study have implications for appliance manufacturers who can increase sales by targeting this group, researchers in household equipment who can study adoption of other innovative appliances, and developers of retirement communities who might consider providing a microwave oven for use by residents or provide a space where one can be placed. / Master of Science

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / As healthcare increasingly shifts to home and community-based settings, informal caregiver responsibilities are increasing beyond assistance with activities of daily living to include complex care procedures previously performed by licensed caregivers in clinical settings. With an aging population, increasing numbers of older adults are assuming a caregiving role, a trend that is projected to continue into the foreseeable future. These older caregivers performing complex care procedures such as wound care. The purpose of this dissertation study was to understand how older adult caregivers manage complex wound care procedures. Aims were to 1) develop a theory for how caregivers manage; 2) identify themes related to resources needed, and 3) determine resources available through the existing Medicaid 1915(c) waivers program. Aims 1 and 2 were achieved using qualitative analysis of interviews with 18 older adult caregivers aged 65 and older who were performing wound care in the home for a care recipient. Grounded theory methods were used to develop a theoretical framework describing the process of how the participants managed caregiving. The resultant theory, Pushing Through, consisted of five phases: 1) accepting the role, 2) lacking confidence, 3) creating a system, 4) trusting in self, 5) owning the outcomes. Secondary analysis of the interview data used thematic analysis methods to identify resources used or needed for the caregiver role. The resultant themes were (a) connection to a healthcare professional, (b) written instructions, (c) access to wound care supplies, (d) access to durable medical equipment, (e) financial resources, (f) personal care coverage, and (g) socialization and emotional support. Aim 3 used descriptive analysis of Medicaid 1915(c) home- and community-based services waivers for adults aged 65 and older for all 50 states plus the District of Columbia to identify the frequency and type of waiver services available for supporting caregivers. Results revealed that the number of services offered by state Medicaid waiver programs varied greatly across the country. Respite in varying forms was the most frequently available service. Findings from this dissertation will contribute to the development of evidence-based strategies to sustain older adult caregivers within their caregiving role.

Aside from a change in their physical environment from home to a long-term care facility, most clients with dementia in a long-term care (LTC) setting experience an advanced level of degenerative change in both cognitive and body functions, which leads to increasing challenges in engagement in occupation. To analyze their occupational performance, establish therapy goals, and measure the outcomes of intervention, occupational therapy practitioners use assessment tools in the therapy process (American Occupational Therapy Association [AOTA], 2014). However, there is the significant mismatch between existing assessment tools and the clinical need to properly capture functional progress in residents with dementia in a LTC setting. Therefore, this project introduces the FPM-D, which was specifically designed for residents with moderate to moderately severe dementia in LTC facilities. To maximize the usefulness of this new instrument, the author reviewed previous attempts made to address the need and obtained feedback from current occupational therapy practitioners in this setting. This new assessment tool is 1) designed to assess the function of clients with dementia; 2) has a progress-tracking feature with different timelines; 3) takes less than 15 minutes for administration; 4) allows customization of target activities, 5) includes only items appropriate for a LTC setting; and 6) assesses both cognitive and physical aspects of function based on the Cognitive Model in occupational therapy practice (Lazzarini, 2005). Along with the development process, this project includes plans for evaluation and dissemination. The follow-up study for evaluation aims to investigate the usefulness of the instrument in the LTC clinical setting and dissemination activities focus on disseminating this innovation in occupational therapy practice. The author believes that this new instrument will make a positive contribution to the quality of occupational therapy services in LTC facilities by effectively meeting the clinical needs of residents with dementia.

No description available.

No abstract Provided / Thesis / Master of Science (MSc)

No description available.

No description available.

The objective of this DNP project was to highlight the significant impact of health promotion in older adults. As of January 2011, Medicare covers an Annual Wellness Visit (AWV), which is a result of the Affordable Care Act. The AWV allows patients the benefit of receiving covered wellness and preventive care services. Through surveys this project explored what healthcare providers and patients know about the Medicare AWV and what barriers and/or challenges they have experienced with the AWV. The responses to the surveys revealed that providers have misconceptions about the Medicare AWV and some of the patients did not know that Medicare part B offers a covered annual wellness visit. There were several barriers identified by both patients and providers and these barriers will be discussed and explored in this paper.