<p> The purpose of this project was to locate a potential funding source and write a grant to implement a music therapy program for people living with Alzheimer&rsquo;s disease and other dementias. There are over five million people in the United States who live with Alzheimer&rsquo;s disease and that number is expected to increase significantly. The costs of medication and the negative impacts of dementia require non-pharmacological treatments. </p><p> This program would be held at Alzheimer&rsquo;s Greater Los Angeles in Los Angeles. The May and Stanley Smith Trust was chosen as the funding source. If funded, this program would not only improve the quality of life of individuals suffering living with dementia but also their caregivers. Through various forms of music therapy (individual and group, including activity therapy where participants play instruments) and a support group for caregivers, this program is expected to lead to positive impacts on a large scale.</p>

<p> This dissertation investigates the relationship between marital history and individuals&rsquo; retirement resources, namely Social Security, employer-sponsored pensions, and non-housing wealth. Prior research provides a foundation for understanding marriage&rsquo;s positive relationship to retirement security, and suggests that marriage is financially beneficial and can even lessen some external factors that would otherwise damage a family&rsquo;s financial situation. Yet changing demographics, with fewer people in first marriages and rising numbers of individuals experiencing divorce and choosing to remain unmarried, suggest our understanding of this relationship for today&rsquo;s retirees may be limited. The purpose of this research is to identify which aspects of complex marital histories are associated with individuals&rsquo; retirement security, paying particular attention to gender differences. Using data from nine waves of the Health and Retirement Study (1992-2008), four facets of marital history are examined: marriage type, frequency, timing, and duration. Currently married and currently unmarried respondents are separated during the analyses in order to adequately capture the association between previous marital events and retirement resources. The results indicate that marital history is associated with Social Security, employer-sponsored pensions, and non-housing wealth differently, and that these relationships vary by gender and current marital status. The findings provide support for the argument that marital history, and in particular marital duration, has a strong relationship to retirement resources. Contrary to expectations, currently married women with longer marriages have less Social Security and pension income than married women who experienced shorter marriages. Marital history has no relationship to the retirement security of married men. For the unmarried groups, never married men have the lowest odds of receiving an employer-sponsored pension and have less non-housing wealth than both divorce and widowed men. Unmarried women&rsquo;s retirement security is associated with the type of disruption experienced; women with multiple past marriages have more resources if they are currently widowed but less if they are currently divorced. Further study is needed to understand how and why complex marital history factors have a relationship to retirement finances, and to expand our knowledge about certain understudied populations such as remarried women and never married men.</p>

AIMS The programme of research had two main aims: (1) to examine the relationships between objective financial status, subjective financial well-being, psychological well-being and physical health in later life, and (2) to examine the extent to which people aged 40 years and over are able and willing to prepare for their financial well-being in old age. DESIGN These aims were addressed during two separate research phases. Phase 1 consisted of two studies (1) an in-depth interview study and (2) a postal survey. Phase 2 comprised an indepth interview study. SETTING The programme of research was conducted in the West of Scotland. Both Phase 1 and Phase 2 interview studies were restricted to interviewees residing in Renfrew district. The Phase 1 postal survey covered a more extensive geographical area, encompassing three additional local government districts (Argyll and Bute, Dumbarton & Inverclyde). PARTICIPANTS Respondents were randomly selected from the Argyll and Clyde Health Board Community Health Index (CHI). Additional interviewees for the Phase 1 interview study were obtained through Renfrewshire Elderly Fora. Eighty-four individuals were interviewed in Phase 1 and a further 279 respondents completed postal questionnaires. Eighty-two interviewees participated during Phase 2. RESULTS Phase 1 found that social comparison processes largely mediate the relationship between objective and subjective financial well-being. Although subjective financial well-being was related to psychological well-being, objective financial status was not independently associated with psychological health. Both objective and subjective financial well-being were positively related to physical health. Phase 2 found that most respondents placed high importance on adequate financial resources and the need to plan for retirement. However, great diversity in planning behaviour was observed. Few respondents had considered provision for long-term care. CONCLUSIONS This research has demonstrated the association between financial well-being and psychological and physical health. Further research is needed to decipher the complex causal pathways through which financial well-being influences both the quality and quantity of life. It is strongly advocated that future studies include broader more comprehensive measures of financial well-being.

<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 importance of investigating relationships between depression and mineral intake is necessary due to concerns over the mental health and nutrition status of the growing older adult population in America. Due to lack of research in this area, the development of nutrition therapies for depressed older adults with special consideration for minerals is hindered. This study explored whether mean depression scores significantly differed between quartile intake groups of selenium, magnesium, zinc, and copper in a nationally representative sample of older adults (<i>n</i> = 901) from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). For all four minerals, those within the highest quartile of intake had significantly lower depression scores than those within the lowest quartile. Nutrition and mental health care professionals should be aware of a possible association between mineral intake and depression and emphasize healthy eating patterns and nutrient-dense diets to maintain optimal mental and physical functioning.</p>

<p> With the rapidly increasing older adult population in our nation and around the world, the number of people diagnosed with Alzheimer's disease (AD) and other related dementias also increases. Alzheimer's disease and other related dementias are devastating illnesses. The most important risk factor for dementia is advanced age. Adult day care programs are valuable services that assist people diagnosed with AD and their families. The purpose of this project was to obtain funding to support the expansion of an existing adult day care service so that older adults with limited resources can access services.</p>

A descriptive design was used to identify the differences between and among the variables studied: sex and age, marital status, amount of physical and occupational therapy, length of stay, total hospital charges, and discharge destination for patients 55 years of age and older, following a total hip arthroplasty. The setting was a 650-bed medical center in a Southwestern city. The population for this study was the medical records of 61 patients (27 male and 34 female, aged 55-84 years) with the DRG 209 assignment, major joint procedure, hip replacements only, and with primary diagnosis of osteoarthritis or rheumatoid arthritis. Data collection was done through a retrospective chart audit of patients discharged during the period from August 1, 1989, through April 5, 1990. The study findings were consistent with the literature in that older persons over 75 years of age have longer length of stay, require more rehabilitation post-operatively, and have an increased probability of being discharged to an intermediate or long-term care facility.

The concept being studied was nocturnal behaviors of persons diagnosed with Alzheimer's disease. Maslow's theory of human motivation and development served as the conceptual perspective for this exploratory study. The purposes of this study were: (1) to identify nocturnal behaviors of persons diagnosed with Alzheimer's disease; and (2) to develop a taxonomy that characterized these identified nocturnal behaviors. Eleven caregivers who were each providing care in the home for a family member with Alzheimer's disease were interviewed. Data were systematically obtained using demographic data sheets, guided interview questions, and a behavior checklist. The classification of two major and five minor categories along with their 22 activity categories comprised the taxonomy of nocturnal behaviors. Presentation of the findings included a narrative description of the analysis of data. Through comparative analysis, a variety of nocturnal behaviors were identified and supported.

A descriptive research design was utilized to identify the quality of life perceived by 46 male veterans, ages 55 to 75 years. They resided in a domiciliary. The data analyses of the four quality of life subscales showed human dignity, the living environment, and health and medical care with more positive outcomes than activities of body and mind. The subjects also viewed their self-assessed health and self-assessed quality of life as positive. The care of increasing numbers of aging veterans in institutional settings is a major responsibility and concern of the nursing profession. Nurses need to be cognizant of the perceptions veterans have regarding their quality of life. Only then can nurses develop appropriate care plans and interventions to enhance their quality of life. Nursing's goal is to assist the veteran to function at the highest level of which he is capable.

An exploratory descriptive design was used to describe the differences in reported incidents, falls, and proportion of falls with serious injuries before, during transition, and after a nursing home became restraint-free. The setting was a 60-bed nursing home in rural northwestern United States. Monthly and quarterly incident report summaries for the months of August, 1989, through April, 1991, were retrospectively reviewed to describe frequencies of incidents, falls, types of falls, and serious injuries from falls. Data analysis included paired t-tests to describe significant increases in incidents and falls after the facility became restraint-free, but a paired z-test found no significant difference in the proportion of serious injuries from falls. These study findings were consistent with the literature. The results of this study offer nurses in long term care an opportunity to utilize alternatives to physical restraints, thereby enhancing the dignity of their elderly residents.