The focus of this research study is glycemic control in the presence of multiple morbidities and polypharmacy in homebound individuals with Type 2 diabetes aged 65 years and older. The research method is a quantitative retrospective cohort study of discharged patients of a nonprofit community-based home health agency from January 1, 2010, to December 31, 2011, using OASIS data. Glycemic control is assessed using the hA1C laboratory test following the recommendation of the American Diabetes Association. The study documents a moderate significant association between glycemic control, polypharmacy and comorbid conditions, indicating that homebound individuals with Type 2 diabetes aged 65 years and older are less likely to have optimal glycemic control in the presence of multiple morbidities and polypharmacy. There continues to be a need for scientific research in this population cohort; and the dose-response association between antidiabetic therapy interventions designed to lower blood glucose levels in the presence of chronic disease and polypharmacy.

The purpose of this study was to identify factors that predict quality of life (QOL) for aging adults and to examine and compare Baby Boomers', Older Adults' and Younger Adults' responses to the 2010 National Health Interview Survey/QOL Functioning and Disability. Significant findings included several significant values based on the multivariate regression to estimate a model to predict QOL. In particular, being male, four ethnicities other than white, being older than Boomer, age in 10 years, the Functional Difficulty Index, the Functional Limitation Index scores, chronic heart disease, asthma, and arthritis all had significant p values. Adults with chronic heart disease, asthma, or arthritis scored lower on the QOL index, but cancer, stroke, or diabetes were not associated with the QOL index. Two hypotheses had strong support. Lower scores on both the Functional Difficulty Index and the Functional Limitation Index yielded lower QOL scores. Further research recommendations include establishing reliability and validity of the QOL index; running additional regressions for demographics (ethnicity, marital status, etc.) to predict possible combinations of variables predicting QOL or barriers to QOL; and investigating the viability of incorporating the QOL index into an electronic medical record (EMR) dashboard parameter to serve as a screening mechanism …

The transition from hospital to home or alternate care setting is a time of vulnerability for all patients and particularly for our elders. If not handled appropriately there is a risk to our elders for readmission to the hospital environment that may decrease their overall quality of life and further compromise their health status. in addition to the individual risks associated with patient readmissions, there are societal impacts that reach far beyond our current generation of elders 65 and older. This impact may have dire implications for the future fiscal health of the next generation. a review of the current and past literature shows that there are a limited number of resources available for hospitals to use in order to comply with the new Value Based Purchasing initiatives that are being implemented by CMS regarding the reduction in readmission rates. the problem of hospital readmissions is confounded by the many processes that are available for study, from pre-hospitalization conditions and care through hospitalization, discharge, and finally to post discharge processes. While most research and literature reviews have focused on individual disease causes, there is a need to provide hospitals with a resource that outlines the available options and interventions that …

This research study examines the decreased agitation level utilizing nonpharmacological therapeutic interventions in dementia patients, age 65 and older. The study examined the following question: Will a therapeutic art program diminish agitated behaviors in persons diagnosed with dementia, aged 65 and older? In this quasi-experimental research design, the sample consisted of 19 participants in 3 groups, selected using these criteria: must be receiving services from a long term care facility, be diagnosed with dementia, display agitated behaviors, and be age 65 and older. This research measures the reduction of agitated behaviors in demented patients with the use of a therapeutic art program. The therapeutic art group pretest, midtest and posttest means were separated into Factor 1: aggressive behavior, Factor 2: physically nonaggressive behaviors, and Factor 3: verbally aggressive behavior. A multivariate analysis of covariance (ANCOVA) was conducted on the data for Factor 1, Factor 2, and Factor 3. The ANCOVA was not statistically significant for Factor 1. The ANCOVA indicated statistically significant findings when using a one tailed test for Factor 2 and Factor 3. The ANCOVA indicated statistically significant findings using a two tailed test for overall agitation. These findings inform professionals about the efficacy of therapeutic art programs …

HIV/AIDS can affect individuals of any age. Efforts to educate those considered to be most at-risk, based on the age at which the most individuals are infected, are ongoing and public. Less work and mainstream education outreach, however, is being directed at an older population, who can be more likely to contract HIV, is more susceptible to the effects of HIV, and more likely to develop AIDS, than younger persons. Guided by the Health Belief Model theory, research was conducted to determine what, if any, relationship existed between age of an individual and the possibility that an HIV test will be sought. Factors of gender, education, ethnicity and marital status were included in analyses. the research indicated that as age increased, likelihood for getting an HIV test decreased. Overall, most individuals had not been tested for HIV. the implications of an aged and aging population with HIV include a need for coordinated service delivery, increased education and outreach.

The purpose of this exploratory study was to operationalize the responses from a sample of the community dwelling older population from Denton County, Texas on disaster preparedness education given by Denton County Health Department (DCHD) personnel. The goals and objectives were drawn from the Texas Public Health and Medical Emergency Management 5-Year Strategic Plan 2012-2016. It was hypothesized that after the disaster preparedness education was received, then comprehension, retention, and application of the information would increase and the goals set forth by the DCHD would be reached. Thirteen sites were used to educate the 224 participants between August 2011 and April 2012. The data were received using a pre-test survey before the training, a post-test immediately after the training, and a follow-up survey call approximately 30 days later. Using Cronbach's alpha, logistic regression and regression analysis through SAS, the data revealed that all DCHD goals were met by this training method and outcome which include the sample population increasing comprehension, retention, and action on the information learned.

The dissertation examined family caregivers’ perceptions of wandering behavior after their loved one has been diagnosed with ADRD (Alzheimer’s disease and related dementias). Semi-structured in-depth face-to-face interviews of a convenience sample of 22 caregivers in the Dallas metropolitan area were conducted. Responses were analyzed using a grounded theory approach. The use of qualitative methods facilitated the study of how caregivers of a loved one with ADRD understood and explained in their own voice the wandering behavior associated with the disease and how their views of the behavior informed the caregiving process. In particular, this research examined why some caregivers tend to recognize wandering behavior as significant early on while the ADRD patient is still living in the home (and community) and modifications can be made to keep him or her there despite the behavior, and why some caregivers do not. Findings indicated that caregivers were concerned about the general safety of their loved one. Precautions were taken within the home for conditions related to frailty, but were much less likely to be taken to address wandering behavior and its negative consequences. Three groups of caregivers emerged: (a) those who primarily reacted to their loved one’s problem behaviors including wandering, and …

This study was exploratory in nature, with the purpose of examining the relationships between working Baby Boomers’ knowledge of retirement health benefits and health costs and actions they have taken to prepare for retirement. An online survey was completed by 209 Baby Boomers who are employed by three city governments in the Dallas-Fort Worth Metroplex. The research showed that health benefits knowledge does not predict retirement preparation but that Baby Boomers who demonstrate higher levels of knowledge-seeking behavior are more likely to undertake retirement preparation, specifically by purchasing an annuity. Among public sector working Baby Boomers, retirement preparation activities are found to be minimal. Age was found to predict knowledge-seeking behavior, in that older vs. younger Baby Boomers are more likely to engage in knowledge-seeking behavior related to retirement preparation. Current knowledge about health benefits does not predict retirement preparation.