We examined the potential contribution of sleep quality to the relation between mindfulness and subjective vitality, a marker of physical and psychological energy. Seven components of the Pittsburgh Sleep Quality Index were investigated as potential mediators of the association between dispositional mindfulness and subjective vitality in our sample of 219 older adults. Mindfulness, sleep quality, and subjective vitality were significantly and positively associated with each other. Sleep quality partially mediated the relation between mindfulness and subjective vitality, with two components responsible for this effect: habitual sleep efficiency and sleep-related problems experienced during the daytime. Implications of the association between mindfulness and subjective vitality in older adults via sleep quality are addressed, including the potential for interventions to improve sleep quality and well-being among older adults by inclusion of mindfulness training.

We examined associations between trait hope and preparation for future care needs (PFCN) among 66 older adult primary care patients in western New York. Participants completed a questionnaire assessing PFCN (awareness, information gathering, decision-making, concrete planning, and avoidance), and the Adult Trait Hope Scale. In multivariate regressions, lower hope, particularly less agency, was associated with more awareness of needing care, whereas higher hopefulness, particularly pathways thinking, was associated with increased decision-making and concrete planning. Greater hopefulness appears to be linked to goal-directed planning behaviors, although those with lower hope may actually be more aware of the need for planning. Evidence-based programming that encourages learned hopefulness may contribute to enhanced health planning and decision-making among older adult primary care patients.

The aim of this study was to investigate the effects of responsibility inferences on judgments about helping older parents and stepparents with activities of daily living, health management, and recovery in the aftermath of an illness or injury. Using Weiner’s theory of responsibility inferences as a guiding framework, we evaluated (1) the amount of intergenerational aid adult (step)children should provide, (2) the extent to which adult (step)children were perceived to be obligated to help, (3) the extent to which government agencies should assist, and (4) attitudes about older adults’ responsibilities to help themselves. A sample of 252 adults was obtained using the Qualtrics online survey platform. Hypotheses derived from Weiner’s theory received support regarding responsibility inferences and perceptions about public assistance and personal responsibility to resolve problems. The theory was only partially supported, however, when examining intergenerational help to older kin, being at fault reduced expectations for providing help only under some conditions, and perceived obligations to kin were never affected by culpability.

Greenwald, McGhee, and Schwartz (1998) developed the Implicit Association Test (IAT), a measure of mental associations between target pairs and positive or negative attributes. Highly associative categories yield faster responses than the reverse mental associations, which is thought to reflect implicit attitudes toward stereotypes. The present study investigated the effect of ethnic group on one’s implicit attitudes toward aging and gender stereotypes by comparing two groups of older adults, Asian Americans and Caucasian Americans, that likely hold different culture values. Past qualitative studies have established the existence of mental health stigma in Asian American populations, including negative Asian American perceptions of aging, but have not yet established a quantitative measure of this phenomenon. The age-attitude and gender-science IATs were administered to 20 Asian American and 20 Caucasian American older adults in the Southern California region. The results from the age-attitude IAT found that Asian American older adults demonstrated higher implicit bias toward aging, evidenced by faster responses to the category pairings associating “old” + “bad” and “young” + “good”. In contrast, performance on the gender-science IAT was similar for both groups, showing no strong bias toward gender stereotypes. Potential implications on the wellbeing of older adults, as stereotype threat and other forms of bias are already established harmful constructs in the population, are discussed.

This study was conducted to assess Masters of social Work students’ interest in gerontology. Students’ gerontological knowledge, attitude and experience with the aging population was examined to see if they have any influence on interest in working with older adults. The positivist worldview was used to identify students’ behavior toward older adults while checking to see if correlates to interest in working with that population. Survey questionnaire was used to collect information on student’s interest in working with older adults, their knowledge, attitude and experience. Modified versions of Palmore Facts on Aging Quiz (FAQ) and Kogan’s Attitude Toward Old People (KAOP) scales were used to collect information on students’ knowledge and attitude toward older adults. Additional questions about demographic data was included along with direct question on interest in working with the older adults. The results from the use of the quantitative approach allowed further statistical analysis using SPSS to identify relationships between the variables. The study found relationships between knowledge of aging and interest in aging-related work. The study recommends that future research examine factors that influence attitude and implementing gerontological education and training in social work programs to improve student’s interest in aging related work.

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of people 65 years and older. The rural health clinic failed to capture a single AWV in the previous year, despite having 1300 active Medicare patients in the clinic. The clinical question asked whether the implementation of an AWV program by nurse practitioners can yield improved compliance with recommended health screenings and vaccinations and diagnosed previously unrecognized clinical conditions. The Iowa model, health belief model and Donebedian's structure-process-outcome model were utilized for the introduction and implementation of the practice change. Evidence was derived from chart review of 50 patients and administration of the SF-36 survey before and following the AWV. Findings and conclusions suggest that the AWV generated improved compliance of preventive services and improved patient quality of life. Addressing preventive health strategies for aging adults is relevant to nursing practice because of the complex and chronic health challenges of this age group. These efforts can reduce the burden of suffering from chronic illness, prevent exacerbation and decline, improve quality of life, and reduce federal and individual health care expenditures to minimize the cost of advanced disease treatment.

The number of adults aged 65 years and over has been rising quickly, as has the rate of new onset sexually transmitted diseases within this population. Discussions of sexual health between physicians and older adults are currently lacking in frequency and effectiveness. Using the foundation of stereotype embodiment theory, the purpose of this study was to identify the factors that predict frequency of discussing sexual health with older adult patients. A comparative sample of geriatric physicians and family practitioners completed 2 researcher-developed questions and the Sexual Health Care Scale-Attitude tool that assessed their stereotype beliefs toward discussing sexual health with older adults using the 4 subscales--personal, patient, environmental, and colleague--and the frequency with which they discussed sexual health with their older adult patients. It was hypothesized that non-ageist attitudes would increase the frequency of discussions, and increase the personal factors, such as comfort level, of having such discussions. Multiple regression analysis and the chi-square test were used in data analysis. Frequency of sexual health discussions with older adult patients was dependent upon the physician type, age and gender, and how well the physician believed he or she had been educated to discuss sexual health with older adults. Comparatively, the geriatric physicians had more frequent discussions of sexual health with older adults than the family practitioners. The implications for social change include identifying the need for more specialized physician training in discussing sexual health with older adults to improve overall physical and emotional well-being of older adults and the study's recommendations for future research.

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival data were drawn from the 2015 Behavioral Risk Factor Surveillance System optional caregiver module dataset provided by the Centers for Disease Control and Prevention. Findings from multiple logistic regression analysis revealed that spousal caregivers had 42.7% lower odds than adult child caregivers of reporting unmet support needs related to service access. Dementia caregivers had 2.05 times higher odds of reporting unmet support needs of counseling, 1.31 times higher odds of reporting unmet support needs related to service access, and 1.91 times higher odds of reporting unmet support needs for respite care, relative to other caregivers. Caregivers residing in a suburban county had 28.7% lower odds and caregivers not residing in a metropolitan statistical area (MSA) had 30.5% lower odds of reporting unmet support needs related to service access, relative to caregivers residing in the center city of an MSA. Health care leaders and policymakers may use the findings to distribute resources and tailor interventions to better meet the needs of informal caregivers of older adults.

Seasonal influenza is associated with signiï¬?cant morbidity and mortality among older adults, aged 65 and older. Since vaccination is the single most effective preventive measure against seasonal influenza, clinicians and senior citizen center administrators need a better understanding of the perceptions of older adults concerning the reason for poor influenza vaccine uptake. The purpose of this study was to identify perceived factors that may be associated with poor influenza vaccination uptake among older adults. The health belief model (HBM) guided the study. The research questions examined perceptions predicting the odds of influenza vaccination uptake among older adults. This quantitative cross-sectional study consisted of administration of a newly developed 33-item questionnaire to a convenience sample of 147 older adult participants. A 2-week reliability test-retest on 50 participants indicated the instrument had moderate internal consistency (α -?¥ 0.7). Paired-sample t tests were not significant (p > .05), indicating that participants provided reliable responses across time. Ordinal regression analysis indicated that all HBM constructs were significantly associated (susceptibility, barriers, benefits, cues to action, and self-efficacy p = .000; severity p = .002) with frequency of influenza disease and recency of influenza vaccine uptake within 1 year. The social change implications from this study may help to improve vaccination uptake among older adults by providing senior public health decision makers and direct care clinicians with informed knowledge on perceptions and barriers that may play a role in influenza vaccination decision-making among older adults.

Family and friends provide substantial daily assistance to older adults with disabilities, but little is known about how that caregiving impacts the health of older adults. Using survey data on a nationally-representative sample of older adults and their caregivers, matched with Medicare claims, I explored several aspects of the relationship between caregiving and the health of older adults receiving care. I relied largely on Andersen’s behavioral model, which describes health services use as a product of predisposing, enabling, and need characteristics. I found that 33%-37% of older adults with unmet care needs at one point in time still have them one year later. I also found frequent change in the composition of older adults’ networks of caregivers. Having a formal caregiver was associated with lower odds of unmet care needs for women; conversely, men receiving care from a spouse had three times lower odds of unmet care needs than those receiving care from a non-spousal caregiver. Some caregivers use services such as respite care, training, and support groups, but some caregivers lack access to desired services. I found that caregivers reporting unmet service need were more likely to be Black and Hispanic, while service use was higher among caregivers providing help on a regular schedule. Care-recipient health and function was associated with both service use and unmet service need, but available measures of local caregiver service supply were not. Older adults frequently seek care in emergency departments (EDs), but this care may not always be necessary or desirable. I hypothesized, but did not find, that caregiver service use was associated with care-recipient ED use. Instead, chronic health conditions and other need factors were the strongest predictors of ED use. I found that care-recipients of male caregivers had lower rates of ED utilization for reasons that were urgent and not preventable. I also found that care-recipients of adult children had lower rates of non-urgent ED utilization than care-recipients of more distantly-related or unrelated caregivers. These findings suggest that unmet care needs might be reduced by improving access to formal care for older women with functional limitations and monitoring unmarried older men. In addition, improving service access for Black and Hispanic caregivers, and for caregivers who provide unscheduled care, could reduce caregivers’ unmet service need. Finally, targeting training and support services to male spousal caregivers could improve access both to needed daily care and to emergency care. Future research should focus on replicating these analyses after more data become available and on developing alternate measures of caregiver service supply.