A Personalized Music Intervention in Nursing Home Residents Living With Dementia: Findings From a Randomized Study.

Utilizing a randomized control design, this mixed method study aimed to assess the impact of a personalized music intervention on mood, agitation level, and psychotropic drug use in individuals with moderate to advanced dementia residing in long-term care facilities. The sample comprised of 261 participants, with 148 in the intervention group and 113 in the control group. Data were collected from three sources: quantitative data from the Minimum Data Set and the Cohen-Mansfield Agitation Inventory, observational data of music-listening sessions, and an administrator survey regarding the lead staff person's perceptions of the intervention. Findings, based on Mixed Effect Models and content analyses, revealed positive impacts of the personalized music intervention on residents living with dementia. This low-cost, easily implementable intervention, requiring no special licensure for administration, can significantly enhance the quality of life for nursing facility residents.

Mason Caregivers Aiming for Resilience, Empowerment, and Support Study: Assessing Family Caregiver Burden Post-Intervention.

Background: Family caregivers of older adults living with dementia are known to experience higher burden levels. Methods: This empirical study conducted a sub-group analysis of burden levels of 97 family caregivers by the dementia severity of care recipients. Family caregivers were assessed before and after the 9-week Stress-Busting Program for Family CaregiversTM (SBP). Results: Family caregivers of older adults living with severe dementia had the highest baseline Zarit Burden Interview (ZBI) score of 27.7 which decreased to 25.0 (p < .05); family caregivers of those living with moderate dementia had a baseline ZBI score of 24.3 which decreased to 20.4 (p < .01); and family caregivers of those living with mild dementia had the lowest baseline ZBI score of 21.0, which decreased to 18.0 (p < .01). Conclusion: The SBP intervention was associated with a 15% reduction in burden scores for family caregivers of older adults living with dementia.

Community arts engagement supports perceptions of personal growth in older adults.

PURPOSE: The effects of arts engagement on older adults have been well-documented. However, the ways older adults overcome common situational and dispositional barriers to enhance personal growth and well-being are less known. METHODS: Fifty-six community dwelling older adults (71.3 ± 4.6 years) took part in dance, music, or a control workshop two times/week for ten weeks. Participants' personal growth was examined through focus groups and surveys in this mixed-methods study. RESULTS: Focus group and survey results revealed participants experienced personal growth through engaging in the dance and music arms of the experiment. Participants, especially those in arts workshops, described personal growth experiences aligning with four themes: increased social connections, developed new skills, utilized a growth mindset, and used creativity to overcome situational and dispositional barriers to participation. The barriers included musculoskeletal challenges, hearing impairments, and difficulty retaining new information. CONCLUSIONS: The study yielded high adherence and retention rates, and participants reported increased engagement within their communities. Our observations provide avenues for future practitioners and facilitators to create programming that empowers older adults and utilizes participants' ongoing feedback to support access, inclusion, and sense of community.

Characteristics of Nursing Facilities and Staff Willingness to Implement a Non-Pharmacological Intervention.

While non-pharmacological interventions could positively impact mood and behaviors of nursing-home residents who are living with dementia, some facilities are more willing to adopt such interventions than others. This study investigated the characteristics of Medicaid-funded nursing facilities that were associated with their willingness to implement a non-pharmacological intervention, personalized music. Using the publicly-available dataset (aka LTCfocus) from Brown University, this study examined characteristics of nursing homes in Virginia that have implemented or are in the process of implementing a personalized music intervention (n = 59) and that have decided not to implement it (n = 216). The findings indicate that nursing facilities with a higher proportion of long-term residents are more likely to implement the intervention. The findings can inform future research recruitment strategies. In addition, a greater understanding of the use of non-pharmacological interventions in relation to the characteristics of nursing facilities offers insight to policymakers and public health officials regarding resource allocations to facilities.

Creating Interprofessional Readiness to Advance Age-Friendly U.S. Healthcare.

A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, Creating Interprofessional Readiness for Complex and Aging Adults (CIRCAA), was to advance an age-friendly practice using evidence-based strategies to support wellness and improve health outcomes while also addressing the social determinants of health (SDOH). An interprofessional team employed a multidimensional approach to create age-friendly, person-centered practitioners. In this mixed methods study, questionnaires were disseminated and focus groups were conducted with two cohorts of CIRCAA scholars to determine their ability to incorporate learned evidence-based strategies into their own practice environments. Themes and patterns were identified among transcribed interview recordings. Multiple coders were used to identify themes and patterns and inter-coder reliability was assessed. The findings indicate that participants successfully incorporated age-friendly principles and best practices into their own work environments and escaped the silos of their disciplines through the implementation of their capstone projects. Quantitative data supported qualitative themes and revealed gains in knowledge of critical components of age-friendly healthcare and perceptions of interprofessional collaborative care. These results are discussed within a new conceptual framework for studying the multidimensional complexity of what it means to be age-friendly. Our findings suggest that programs such as CIRCAA have the potential to improve older adults' health by addressing SDOH, advancing age-friendly and patient-centered care, and promoting an interprofessional model of evidence-based practice.

Culturally Responsive Companion Program for a Japanese Woman with Dementia in a U.S. Nursing Home.

The older foreign-born population is predicted to increase in the United States. As a whole, this population in the long-term care setting is more likely to face greater challenges associated with loneliness and social isolation due to their smaller social networks, language and cultural differences. The benefits of person-centered care have been widely recognized and may be a potential remedy for such challenges felt by older immigrants. Using a qualitative case study approach, this study explored the staff perceptions of a culturally responsive companion program provided to an older Japanese woman with advanced dementia in the long-term care setting to understand the potential benefits of such a program. The first theme that emerged was that the client benefitted from the program in regard to her physical wellbeing, emotional wellbeing, language communication and cultural support. Given the support of Japanese companions, the client was able to express her needs and health symptoms effectively and the staff were subsequently able to provide culturally-sensitive care. The second theme that emerged was the perceived benefits received by the staff. The companion program improved the staff's ability to provide quality care for the resident. This study implies that culturally responsive companion programs may benefit foreign-born older individuals in improving their wellbeing in long-term care settings.

Compounding Complexity: Examining Multiple Factors Leading to Challenges Within Grandfamilies.

BACKGROUND AND OBJECTIVES: Grandparents who are raising their grandchildren in the absence of the biological parents, often referred to as custodial grandparents, are prevalent across the United States. The objective of this project was to establish a grounded theory as a tool for practitioners and researchers to understand the experiences of members of grandfamiles. RESEARCH DESIGN AND METHODS: In-depth, unstructured interviews with custodial grandparents and grandchildren from 15 grandfamilies were conducted. Classic grounded theory was the methodology used to ask the question, "What are the challenges within grandfamilies and how do they respond to these challenges?" RESULTS: The theory emerging from the data, Compounding Complexity, provides an explanatory framework of three interrelated categories of factors that affect complexity in grandfamilies: situational, relationship, and emotional complexity. Conflict and change were found to be consistent across the categories of Compounding Complexity. DISCUSSIONS AND IMPLICATIONS: Next steps include adding data from interviews with biological parents to Compounding Complexity and applying the theory. Understanding relationship, situational, and emotional complexity in the context of conflict and change enables practitioners to advance their work with grandfamiies.

A web-based training program for direct care workers in long-term care communities: Providing knowledge and skills to implement a music and memory intervention.

As dementia increases and the availability of at-home caregivers decreases, the need grows for effective training for direct care workers. Direct care workers have demanding schedules with restrictive availability and lack professional incentives to pursue specialized training. This study explored the impact of the Mason Music & Memory Initiative (M3I), a web-based, micro-learning training for direct care workers, combined with the implementation of the Music & Memory intervention. The training provided a foundational understanding of dementia and the person-centered music intervention. Twenty-five direct care workers, across two long-term care communities, completed the training modules over four weeks. All participants completed a pre- and posttest, determining their knowledge and understanding of dementia and the Music & Memory intervention adopted by their facilities. Many workers found the training to be informative and inspiring, noting improved behaviors in residents during the implementation of the M3I.

Results from a person-centered music intervention for individuals living with dementia.

AIM: Dementia is a chronic, costly disease affecting millions of people worldwide. Effective, affordable person-centered interventions are required to improve the lived experiences of individuals with dementia and their caregivers in various care settings. The present study examined the effects of a person-centered music listening intervention on mood, agitation and social engagement for individuals living with dementia. METHODS: This quasi-experimental study was carried out with participants at five community-based adult day health centers (n = 51). Standardized instruments were used to measure mood and agitation, and in-person and video-recorded observations of participant behavior were used to analyze changes before, during and after the intervention across four domains: mood, agitation, connecting to music and engaging socially. Within-person differences were examined using the Wilcoxon signed rank test, and between-group differences were examined using the Mann-Whitney U-test. RESULTS: Although standardized instruments did not yield statistically significant results, the behavioral observations showed a positive change in mood and a decrease in agitation. From pre- to post-intervention, there were statistically significant increases in joy, eye contact, eye movement, being engaged and talkativeness, and a decrease in sleeping and moving or dancing. CONCLUSIONS: Behavioral observations show the positive impact a person-centered music listening intervention might have on individuals living with dementia and attending adult day health centers. This affordable intervention provides a useful tool for caregivers that might improve the day-to-day experience of individuals living with dementia. Geriatr Gerontol Int 2019; 19: 30-34.

"Maintaining connections but wanting more": the continuity of familial relationships among assisted-living residents.

Social support is a key component of well-being for older adults, particularly for those who have moved from independent living to assisted living involving a transformation of roles, relationships, and responsibilities. Twenty-nine assisted-living facility residents were interviewed to understand the perceived continuity of relationships with family and friends. An inductive approach to thematic analysis revealed 1 main theme and 3 subthemes. The main theme that emerged was: maintaining connections but wanting more. Residents appreciated maintaining connections with family and friends, but often expressed feelings of discontentment with the continuity of former relationships. The subthemes included: appreciating family and friends, waiting for more, and losing control. Implications for research and practice are discussed.

A case study of professional change: the impact of the National Gerontological Social Work Competencies Survey.

Our society is aging, and this demographic change necessitates that all social workers have basic competency in gerontology. This article describes the results of a competency survey conducted in 2000, and how these results helped transform basic social work curricula and enhance gerontology-related resources. Results were used to encourage and assist social work faculty to infuse gerontological content into social work curriculum, which helped practitioners to gain the necessary knowledge and skills to meet the needs of a growing aging population. This social work education framework can be replicated in an effort to infuse gerontology content throughout other disciplines.

Older adults with Alzheimer's disease in a faith community.

In the first phase of this study, focus groups were conducted with 12 clergy to explore how to meet the needs of Alzheimer's disease patients and their families. The clergy reported that although they do reach out to these families, they have not received formal training, so they often do not know what families need. Members of their congregations who are trained in working with Alzheimer's patients need to partner with the clergy in reaching out to these families. Although this article mainly focuses on the clergy's perspective, in the second phase of the study, caregivers and early-stage Alzheimer's patients were asked to describe their experiences of spiritual connections related to Alzheimer's disease.

Collaborating, teaching and learning in a cyberspace community: a virtual AGE experience.

This paper describes one outcome of a collaborative teaching and learning partnership between two Universities via a Web-based environment. A description and evaluation of a semester-long project combining students from two different universities is examined. A total of 22 students participated as members of six different virtual health-care teams. Each team was charged with (1) creating a team contract; (2) completing an electronic patient medical record; and (3) a patient care plan. Students posted to discussion threads regularly using learning objects developed by faculty for Virtual AGE (vAGE-Active Gerontology Education). The successes and lessons learned for both students and faculty are discussed.

Developing visibility for aging in social work: the first NGSWC.

In March 2001, the Council on Social Work Education's (CSWE) Strengthening Aging and Gerontology Education for Social Work (SAGE-SW) project published an action agenda for social work and aging (CSWE/SAGE-SW, 2001). CSWE SAGE-SW, funded by the John A. Hartford Foundation from 1998 to 2004, had several charges in the first phase of funding, including the gathering of data through a thorough review of literature, focus groups, surveys and a variety of activities to garner expert input. This agenda, often referred to as the Blueprint, identified a number of serious issues regarding the lack of attention, preparation, leadership and interest in aging within the social work profession. It also provided some recommended actions to address these issues and help set the stage for the creation of the National Gerontological Social Work Conference. What were the issues at hand and why might a National Gerontological Social Work Conference (NGSWC) address some of these issues?

Increasing aging and advocacy competency: the intergenerational advocacy pilot project.

The Council on Social Work Education's (CSWE) Strengthening Aging and Gerontology Education for Social Work (SAGE-SW) project, funded by the John A. Hartford Foundation partnered with the National Committee to Preserve Social Security and Medicare (NCPSSM) to develop an Intergenerational Policy and Advocacy Project (IAP). This curriculum pilot project, based on a community organization model, was conducted with 13 baccalaureate social work (BSW) and master's social work (MSW) programs across the country and 122 students. The project was one method to pursue CSWE SAGE-SW's efforts to infuse aging content into social work foundation curricula, to support intergenerational teaching, to strengthen social work advocacy skills, and to provide social work students with positive experiences working with older adults. Pilot sites were asked to carry out the project as part of an existing course foundation or field practicum course. Project activities included collaboration with a variety of community agencies, holding issues or "town hall" forums in order to educate community members about critical policy issues affecting older adults; making contacts and establishing relationships with local, state and/or federal legislators; and conducting assessments of the service needs of older adults in the students' communities. Questionnaires, feedback, pre-post evaluations as well as brief accounts of each project are presented. Participants considered the IAP to be a successful project in terms of the objectives of increasing awareness and competency among social work students of aging issues and of promoting intergenerational linkages between older people and social work students.

Personal assistance providers' mistreatment of disabled adults.

This article describes a survey of 84 adults with disabilities who received personal assistance with activities of daily living from family members, informal providers, or agency personnel. Results showed that 30 percent reported mistreatment from their primary provider, and 61 percent reported mistreatment by another provider. Verbal abuse, physical abuse, and theft or extortion were the most common forms of mistreatment by primary providers. Verbal abuse, neglect, poor care, and theft were the most common forms of mistreatment by other providers. Adults with lower incomes were the most likely to experience mistreatment. Male providers were more likely to mistreat, as were providers who were inexperienced and who provided more than 50 hours of care per week.