Journal of Applied Gerontology

In this research, the author reviewed 70 studies that had examined the relationship between staffing levels and quality in nursing homes (covering the years 1991 to 2006). The results of the review including all of this literature show that approximately 40% of the quality indicators examined show an association with nursing home staffing levels. Nevertheless, this finding is further interpreted in the context of the limitations of many of these prior studies. The author discusses the limitations of poor quality staffing data, small sample size, quality indicators used, methodological concerns, and underspecified models inherent to many prior studies. The author finds no study representing a “gold standard” exists in this area. Still, the few studies that seem methodologically most robust would seem to indicate that an association between nursing home staffing levels and quality exists. However, the author concludes that studies in this area need to be further enhanced.

The purpose of this study was to examine independent and interactive roles of self-reported vision status and upper and lower limb disability as predictors of falls in people 65 and older. Data from the 2002 and 2004 panels of the Health and Retirement Study were analyzed using binary logistic regression. Results indicated a reduced or eliminated role of vision status after upper and lower limb disabilities were controlled. Gender differences were found with respect to health conditions that predicted falls; however, vision status was not found to have a moderating influence on upper and lower limb disability in predicting falls for men or women. Implications for exercise programs designed for older people with visual impairments are discussed.

This study examines older Chinese Internet users' participation in voluntary associations, communities, and politics, focusing on members of a senior-oriented computer training organization based in Shanghai, China. The results show that the Internet can facilitate the civic engagement of these older Chinese, as illustrated by their active participation in Internet-promoting activities, devotion to starting new computer clubs in local communities, and efforts in persuading government officials to provide necessary resources for establishing and maintaining local computer clubs. The findings suggest the following: The Internet can be a useful concept (in contrast to its online informative and communicative functions per se) to facilitate civic engagement in the offline world, computer clubs might be a more attractive approach to civic engagement among older Chinese, and the Internet's impact is mediated by the historical and political contexts of older Chinese. These findings call for a broader understanding of the impact of the Internet on civic engagement.

Popular stereotypes of aging affect the performance of seniors in a number of different domains, from memory performance to physiological response. The authors undertook a review of this area, in which they examined 17 studies that looked at the impact of stereotype primes on older individuals' cognitive, physical, physiological and psychological performance. Analyses included investigating the effects of both positive and negative age stereotypes, and implicit and explicit priming methodologies. The authors utilized a meta-analytic technique on a subset of studies that examined the impact of priming on memory performance. This yielded an effect size of 0.38. The results suggest that popular stereotypes of aging (and the corresponding subtle changes in the testing environment) are important variables to consider for those researchers testing performance of seniors.

This study examines plans for future caregiving made by family members of younger (n = 59) and older adults (n = 16) with serious mental illness (SMI). An online survey was advertised through a newsletter of the National Alliance on Mental Illness. Qualitative analyses yielded four areas of caregiver concern: health of the care recipient over time, ability of caregivers to sustain support, social support available for the care recipient, and financial burden of care. Despite these concerns, few caregivers reported completed plans for future caregiving. One fourth of the caregivers had made no plans, nor had they discussed future caregiving with others. Although most would prefer other relatives to assume care in the event they could not sustain support, these expectations may not be communicated openly. Generating discussion on this pertinent topic has implications for the aging society regarding how best to care for those with SMI and their caregivers.

The purpose of this systematic review of health science literature was to examine the current state of science regarding advance directive decision making (ADDM) among independent community-dwelling older adults. Seventeen studies fitting study inclusion criteria established for the purpose of this systematic review were examined. Findings revealed that ADDM has predominantly been explored among widowed, divorced, or never married female Caucasian independent community-dwelling older adults aged 65 years and older possessing a high school level of education. Numerous older adult/health care provider barriers to advance directive discussion and completion were found to exist. There is a lack of research regarding ADDM among independent community-dwelling male older adults, older adults from various ethnic and cultural backgrounds, and older adults receiving lower levels of education. Study replication and the implementation of new studies are needed to strengthen the existing body of older adult, advance directive, evidence-based research.

This study assesses whether physical activity, depression, fatigue, or perceived health are affected by use of a walking aid in residents of an assisted-living facility. From an assisted-living facility, 21 participants who were independent ambulators (n = 8) or who used a cane or walker (n = 13) participated. Physical activity was measured with accelerometers, and depression, fatigue, and perceived heath status were assessed with questionnaires. There were no differences in physical activity, depression, fatigue, or perceived health status between those using and those not using assistive devices. However, 15% of the participants reported moderate to severe depression, and 40% of participants reported at least mild depression. Depression was strongly correlated to fatigue. Thus, physical activity, depression, fatigue, and perceived health are not associated with walker or cane use in assisted-living facilities. Nevertheless, among all, mild depression is prevalent and strongly correlated to fatigue.

The present study is an initial exploration of the psychological well-being of residents of an assisted-living facility (ALF) designed and managed for elders of an American Indian tribe. A total of 56 tribal member elders, including 13 facility residents and 43 nonresidents, completed scales measuring happiness, quality of life, perceived social support, and loneliness. In addition, 5 residents participated in one-on-one interviews. Compared to nonresidents, facility residents reported significantly greater happiness and perceived social support and significantly less loneliness. Furthermore, loneliness was found to mediate the relationship between ALF residence and happiness. Interviews with the residents revealed four themes related to the ALF that contribute to the residents' well-being. Although this study is limited by its small sample size, it indicates that tribally owned and/or managed ALFs may be a good long-term care option for many American Indian elders. Further investigation of long-term care options for American Indian elders is needed.