A Policy Mapping Analysis of the U.S. Congressional Approach to Medical Aid-in-Dying.

This study examines the goals of medical aid-in-dying (MAID) legislation introduced to the US Congress from 1994-2020 using a policy mapping analysis approach. Using congress.gov, we identified 98 bills, 23 bills were analyzed in this study. Most of the bills aimed to restrict the use of federal funds, to regulate the drugs commonly used for MAID, to prohibit the development of policies or practices supporting MAID, and to regulate practitioners' roles in MAID. In practice, these bills would limit patient access to MAID by restricting drugs, funds, health care services, legal assistance, policy, and research. These findings suggest there lacks congressional support for MAID, even though polls of the public are divided yet favorable. Policymakers who support MAID should consider affirmative policies that 1) prevent MAID policies from discriminating against vulnerable groups, 2) support funding to study the use of MAID, and 3) build avenues to allow all qualified people to access MAID in places where it is legal.

"They Just Took Him Out of My Life": Nursing Home Care Partner Experiences During the COVID-19 Pandemic.

The current study describes the impact of visitation restrictions on nursing home residents and their family caregivers from caregivers' perspectives during the coronavirus disease 2019 (COVID-19) pandemic. Family caregivers (N = 31) were recruited via social media and email listservs to complete an online survey. Researchers also completed semi-structured, one-on-one interviews with interested participants (n = 17). Caregivers reported experiencing disconnect from residents, confusion on the part of residents, and sadness. All caregivers were of the opinion that residents with dementia declined during lockdown and that they and their residents experienced irreparable harm from the prolonged separation. Providers, policymakers, and researchers must use the lessons learned from the COVID-19 pandemic in future situations. Protecting residents from a deadly disease is important, but long-term separation from family caregivers cannot be condoned again. [Journal of Gerontological Nursing, 48(2), 7-11.].

Neighborhood Age Composition and Self-Rated Health: Findings from a Nationally Representative Study.

Neighborhood age composition is an understudied area. Furthermore, existing empirical and conceptual work is conflicting, with some scholarship-indicating neighborhoods with older adults are beneficial and other scholarship suggesting it can be detrimental. Combining data from 7,197 older adults from the first wave (2011) of the National Health & Aging Trends Study and census tract data from the National Neighborhood Change Database, the purposes of our study were to: 1) identify the characteristics of neighborhoods experiencing different types of changes in age composition, and 2) examine the association between neighborhood age composition and self-rated health. Findings indicate that neighborhoods experiencing Concentration (where the number of older adults are declining but their percentage of the total population are increasing), the majority of which are in urban areas, have less aggregate economic resources, more indicators of neighborhood disorder, and less access to services and supports. Regression models also suggest older adults living in Concentration neighborhoods reported lower self-rated health compared to those living in the other three neighborhood types. Findings point to the importance of considering neighborhood age composition when targeting interventions and resources, and the potential consequences of being stuck in place in a neighborhood that does not meet elders' needs.

Family member roles in long term care: Lessons for the future from COVID-19.

This study investigates nursing home residents' and care partners' experiences during COVID-19 visitation restrictions. A nonprobability purposive sample of care partners was recruited via social media and email listservs. Care partners completed surveys (N = 30) and follow-up interviews (n = 17). Before COVID-19, care partners visited residents 3+ times per week for socialization and care. After restrictions, communication between care partners and nursing homes deteriorated. Families experienced reduced communication about residents' health statuses and little COVID-19 case information. Care partners expanded their advocacy roles, proposing policies to protect residents' rights. Care partners reported losing irreplaceable time with residents during restrictions. In future emergencies, we must balance the value of family visits with public health protection such as personal protective equipment (PPE).

Themes describing social isolation in family caregivers of people living with dementia: A scoping review.

INTRODUCTION: The number of people with dementia has been increasing. Evidence shows that over 16 million family caregivers provide unpaid care for people with dementia. However, family caregivers experience several challenges throughout their caregiving role, including that of social isolation. Although social isolation in people with dementia has been well documented, social isolation in their family caregivers has not received as much scholarly attention. This scoping review sought to address this dearth of research through the following research question: "What are themes, concepts, or constructs that describe social isolation of family caregivers for people living with dementia?". METHOD: An electronic search was conducted in PubMed, PsycInfo, and Scopus, using the following Boolean search phrase: dementia AND "social isolation" AND (caregiver OR carers). Content analysis was conducted to identify relevant themes. FINDINGS: The initial search yielded 301 studies. Through screening processes, 13 studies were eligible for review. Based on a synthesis of evidence, five themes emerged from the data: disease progression, psychological state, social networks, social supports, and technology. DISCUSSION: This review demonstrates that caregiving is related to social isolation in family caregivers of people living with dementia. The experience of social isolation was related to the progression of dementia, psychological states, and lack of supports. In contrast, social supports, social networks, and using technology may reduce social isolation. Identifying themes provides policy and practice implications, such as using information and communication technology to create and redefine social networks.

Residential Segregation, Social Cohesion, and Aging in Place: Health and Mental Health Inequities.

BACKGROUND AND OBJECTIVES: Research shows that living in segregated neighborhoods may have deleterious health outcomes via social, physical, and socioeconomic contexts that deepen existing inequities. However, there has been limited scholarship examining the effects of segregation on older adults, despite an increasing focus on aging in place. Guided by the Ecological Model of Aging, we examined the effects of segregation on older adults' self-rated health and mental health, accounting for both individual characteristics and neighborhood opportunities and risks (e.g., social cohesion) and the potential moderating role of race and economic vulnerability. RESEARCH DESIGN AND METHODS: We used data from the first 4 rounds of the National Health and Aging Trends Study (2011-2014) merged with tract-level census data for a final sample size of 3,084 community-dwelling older adults in urban areas. We conducted multivariate regression analyses after conditioning on residential location selection variables. RESULTS: There was no significant association between neighborhood segregation and self-rated health or between segregation and anxiety and depression symptoms. Consistent with the literature, perceived social cohesion was protective of health in each model. DISCUSSION AND IMPLICATIONS: Our findings highlight the need for more rigorous research on segregation and older residents that utilize longitudinal and spatial data. Our findings also have implications for policies and programs that aim to support the ability to age in place for older adults who have different racial identities and live in different neighborhood contexts. Because social cohesion can be a protective factor for older adults' health and mental health, policymakers and practitioners should support initiatives to increase social cohesion.